Review Article

The Management of Lamellar Macular Holes: A Review

Table 1

Observational studies.

AuthorNo. of eyesMean follow-up in months (range)Visual acuity evolution (logMAR)Anatomical evolutionComments

Theodossiadis et al. [23]4137.1 (25–54)73% of eyes: stable VA
27% of eyes: VA loss
(19.5% eyes lost 5–15 letters)
Diameter increased by 13.7%
Foveal thickness decreased by 10.3%
Metamorphopsia
75.6% eyes: initial
95% eyes: final
No cataract progression

Bottoni et al. [24]34
10 eyes with “thicker ERM”
18 (6–24)Mean VA stable
VA slightly worse at baseline
Diameter stable in 79% eyes
Decrease of foveal thickness: 3% at 24 months
Thinner foveas at baseline
30% IS/OS defects (vs 12.5% in “typical ERM”)
1/10 developed FTMH (compared with 1/24 in eyes with “typical ERM”)

Celik et al. [25]2121.6Initial VA 0.51
Final VA 0.55
3 had IS/OS defects at baseline ⟶ 2 developed defects

Pang et al. [15]145
42.7% with LHEP
57.3% ERM without LHEP
26Initial VA 0.51
5% of eyes lost 0.3 lines
Initial VA 0.33
4% of eyes lost 0.3 lines
18% anatomical progression
88% IS/OS disruption
13% anatomical progression
24% IS/OS disruption
No significant difference in the percentage of eyes that lost 0.3 logMAR lines

Zampedri et al. [26]189 eyes
Intact IS/OS line 66.1%
Intact ELM 78.3%
38% “atypical ERM”
68 eyes—12 months
35 eyes—24 months
VA has not changed significantly
VA slightly worse in “atypical ERM”
Mean diameter increased significantly in both groups
Foveal thickness decreased significantly in the “atypical ERM” group

Purtskhvanidze et al. [27]17111 (75–155)Initial VA 0.2
Final VA 0.3
Decrease of foveal thickness
Increased diameter
Increased IS/OS defects
2/3 of LMH and MPH remain stable after 8.3 years

Marques et al. [28]49
53% LHEP
32No differences in anatomical progression in patients with or without LHEP

Compera et al. [29]34 (100% with LHEP)40.5IS/OS defects:
65% at baseline
85% at final visit
Loss of VA correlates with maximal LMH diameter and IS/OS defects

Statistically significant difference; no significant difference.