title: Surgical outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation.
abstract: OBJECTIVE
  To report the clinical findings and surgical outcomes of lamellar macular holes (LMHs) with and without lamellar hole-associated epiretinal proliferation (LHEP).
  
  
  METHODS
  A retrospective review was performed of 73 eyes of 73 patients who underwent vitrectomy for LMH. Patients were grouped according to the presence of LHEP on preoperative spectral-domain optical coherence tomography (SD-OCT). Postoperative best-corrected visual acuity (BCVA) and OCT features were compared between LMH patients with and without LHEP.
  
  
  RESULTS
  Lamellar hole-associated epiretinal proliferation (LHEP) was found in 15 of 73 eyes with LMHs (20.5%). The mean age was 65.0 years. The mean follow-up duration was 21.5 months. Preoperatively, eyes with LHEP were characterized by a greater hole diameter (p = 0.007), thinner fovea (p = 0.002) and greater incidence of outer retinal disruption (p < 0.001). Best-corrected visual acuity (BCVA) significantly improved after surgery in eyes without LHEP (p < 0.001), but showed no change in eyes with LHEP (p = 0.185). Initial BCVA was not different between the two groups; however, final BCVA was better in eyes without LHEP (logarithm of the minimum angle of resolution (logMAR) BCVA, 0.10 ± 0.10 versus 0.33 ± 0.40, p = 0.003). OCT evaluations of postoperative foveal configurations showed no difference between the two groups (p = 0.171). No case developed a full-thickness macular hole after surgery.
  
  
  CONCLUSIONS
  There was no visual benefit after surgery in LMH patients with LHEP. Different surgical indications for LMHs may be warranted based on the presence of LHEP-associated pathology.
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.|Changnyeong-gun Public Health Center, Changnyeong, Gyeongnam, Korea.
authors.forename: Jaesang
authors.initials: J
authors.lastname: Ko
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Gyu Ah
authors.initials: GA
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jihwan
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyoung Jun
authors.initials: HJ
authors.lastname: Koh
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Suk Ho
authors.initials: SH
authors.lastname: Byeon
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Christopher Seungkyu
authors.initials: CS
authors.lastname: Lee
mesh_terms: D000368:Aged; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
keywords: epiretinal membrane; epiretinal proliferation; lamellar hole-associated epiretinal proliferation; lamellar macular hole; vitrectomy