Evolution of lamellar macular hole studied by optical coherence tomography

To study the natural course of lamellar macular hole (LMH) as examined by optical coherence tomography (OCT) in a noncomparative observational case series.

Forty-one eyes of 41 patients with LMH were included in this analysis. Baseline and final OCT findings related to LMH diameter, foveal thickness and visual acuity (VA) were collected and compared. Mean follow-up was 37.1 months. Main outcome measures were best-corrected visual acuity (BCVA), diameter of the LMH opening, foveal thickness, epiretinal membrane (ERM), posterior vitreous detachment (PVD) and vitreoretinal traction.

The diameter of the LMH increased by an average of 13.7%. A statistically significant association was found between the LMH diameter increase and the presence of ERM. The mean foveal thickness depicted a statistically significant decrease between the initial and the final examination. The decrease of the foveal thickness showed to correlate with visual acuity deterioration. BCVA was stable in 30 (78%) and deteriorated in 11 (22%) cases. In eight of the 11 cases, the visual acuity deterioration ranged from 2 to 15 letters.

We identified an increase of LMH diameter related to the presence of ERM and a decrease of the foveal thickness within a period of observation which ranged from 24 to 54 months (mean 37.1 months).