Long-term follow-up of fellow eye in patients with lamellar macular hole

Ugo Nava; Matteo Giuseppe Cereda; Ferdinando Bottoni; Chiara Preziosa; Marco Pellegrini; Andrea Giani; Giovanni Staurenghi

doi:10.1007/s00417-017-3652-7

Long-term follow-up of fellow eye in patients with lamellar macular hole

Graefes Arch Clin Exp Ophthalmol. 2017 Aug;255(8):1485-1492. doi: 10.1007/s00417-017-3652-7. Epub 2017 Apr 13.

Authors

Ugo Nava¹, Matteo Giuseppe Cereda², Ferdinando Bottoni², Chiara Preziosa², Marco Pellegrini², Andrea Giani², Giovanni Staurenghi²

Affiliations

¹ Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy. ugonava89@gmail.com.
² Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milano, MI, Italy.

PMID: 28405744
DOI: 10.1007/s00417-017-3652-7

Abstract

Background: To evaluate macular changes in fellow eyes of patients diagnosed with lamellar macular hole (LMH) using spectral-domain optical coherence tomography (SD-OCT) and blue fundus autofluorescence (B-FAF).

Methods: Fellow eyes of patients diagnosed with a LMH were retrospectively evaluated on OCT. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were recorded. Corresponding B-FAF images, vitreo-macular relations, and type of epiretinal membranes (ERMs) were also examined.

Results: Thirty-five patients were included. At baseline, six fellow eyes (17%) showed a normal foveal profile, 26 (74%) had a tractional ERM, and three cases (9%) revealed a bilateral LMH, one of them with a lamellar hole-associated epiretinal proliferation (LHEP). A posterior vitreous detachment (PVD) was present in 29 patients (83%), four (11%) had only a vitreo-papillary adhesion (VPA), and two (6%) had both vitreo-macular adhesion (VMA) and VPA. After a mean follow-up of 4.6 ± 1.9 years, one eye (3%) developed a vitreous detachment from the macula with persistent VPA, and one developed a PVD from a VPA with subsequent ERM formation. BCVA and mean CFT remained stable in 35 eyes (100%). Likewise, no B-FAF signal variations were detected. One patient developed a LMH during the 3rd year of follow-up.

Conclusions: Our data suggest that the presence of a LMH in one eye does not increase significantly the risk of developing the same condition in the fellow eye after 4 years. Bilateral condition is uncommon, and an ERM is often detected in the fellow eye. LHEPs were not observed in fellow eyes with foveal integrity, and all LHEPs observed (in main and fellow eyes) were always associated with LMHs; this supports the hypothesis that LHEP is a consequence and not a causative factor for LMHs. The occurrence of a LMH in one fellow eye after 3 years follow-up may suggest that a higher incidence of bilateral disease could develop in a longer time span.

Keywords: Epiretinal membrane; Epiretinal proliferation; Lamellar macular hole; Lamellar macular hole fellow eye; Vitreoretinal interface.

MeSH terms

Aged
Disease Progression
Female
Follow-Up Studies
Fovea Centralis / pathology*
Humans
Male
Prognosis
Retinal Perforations / diagnosis*
Retinal Perforations / physiopathology
Retrospective Studies
Time Factors
Tomography, Optical Coherence / methods*
Visual Acuity*