Lamellar macular hole in diabetic retinopathy

Eur J Ophthalmol. 2021 Jan;31(1):166-172. doi: 10.1177/1120672119879665. Epub 2019 Oct 9.

Abstract

Purpose: To describe the clinical features and surgical outcomes of diabetic retinopathy-associated lamellar macular hole and compare them with those of idiopathic lamellar macular hole.

Methods: A total of 17 eyes with diabetic retinopathy-associated lamellar macular hole and 30 eyes with idiopathic lamellar macular hole undergoing surgery were retrospectively enrolled. Baseline best-corrected visual acuity, preoperative optical coherence tomography characteristics, and final best-corrected visual acuity were compared between two groups.

Results: Both the baseline and the final best-corrected visual acuity in the diabetic retinopathy group were significantly worse than those in the idiopathic group (p = 0.029 for baseline, p = 0.002 for final). Lamellar macular hole in diabetic retinopathy tended to have a wider opening (p < 0.001) and a thinner residual base (p = 0.023). The width and height of parafoveal schisis in diabetic retinopathy-associated lamellar macular hole were both larger than those in idiopathic lamellar macular hole (p < 0.001 for both). After operation, both groups achieved significant improvement in best-corrected visual acuity (p < 0.01 for both).

Conclusion: Compared with idiopathic group, diabetic retinopathy-associated lamellar macular hole had worse baseline best-corrected visual acuity, wider defect, and more pronounced parafoveal schisis. However, significant visual improvement could be obtained after operation. All cases in both groups achieved good anatomical outcomes with normalization of foveal contour and reduction of parafoveal schisis.

Keywords: Lamellar macular hole; diabetic retinopathy; internal limiting membrane peeling; lamellar hole-associated epiretinal proliferation.

MeSH terms

  • Aged
  • Diabetic Retinopathy / complications*
  • Diabetic Retinopathy / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Retinal Perforations / diagnostic imaging
  • Retinal Perforations / etiology*
  • Retinal Perforations / physiopathology
  • Retinal Perforations / surgery
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • Visual Acuity / physiology
  • Vitrectomy / methods