Lamellar macular hole formation in chronic cystoid macular edema associated with retinal vein occlusion

To report the formation of a lamellar macular hole (LMH) in four eyes with chronic cystoid macular edema (CME) associated with retinal vein occlusion (RVO).

We reviewed retrospectively the medical records of four patients with chronic CME associated with RVO, in whom LMH formation was observed by a series of examinations with optical coherence tomography.

All eyes showed a large chronic cystoid space in the fovea. Three eyes showed an epiretinal membrane, and one eye showed traction of a posterior hyaloid membrane to the fovea. The chronic cystoid space changed into an LMH by rupture of its inner wall due to traction. After formation of the LMH, the mean total foveal thickness decreased from 590 ± 131 to 95 ± 22 μm, equal to the thickness of the foveal photoreceptor layer before the formation of the LMH (mean 100 ± 23 μm). Visual acuity did not change substantially from before to after the formation of the LMH.

Chronic CME associated with RVO can transform into an LMH through the rupture of the inner wall of the foveal cystoid space. While this transformation is accompanied by a substantial reduction in macular thickness, it does not lead to changes in visual function.