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Progression of lamellar hole-associated epiretinal proliferation and retinal changes during long-term follow-up
  1. Denise Compera1,
  2. Ricarda G Schumann1,
  3. Matteo G Cereda2,
  4. Alessandra Acquistapace2,
  5. Viviane Lita1,
  6. Siegfried G Priglinger1,
  7. Giovanni Staurenghi2,
  8. Ferdinando Bottoni2
  1. 1 Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  2. 2 Eye Clinic, Department of Biomedical and Clinical Science ‘Luigi Sacco’, Sacco Hospital, University of Milan, Via G.B. Grassi 74, Milan, Italy
  1. Correspondence to Dr Denise Compera, Ludwig-Maximilians-University, Department of Ophthalmology, Vitreoretinal Pathology Unit, Mathildenstrasse 8, 80336 Munich, Germany; denise.compera{at}


Purpose To report on progression of lamellar hole-associated epiretinal proliferation (LHEP) in eyes with lamellar macular holes (LMH) using spectral-domain optical coherence tomography (SD-OCT), and to correlate with intraretinal changes and visual function.

Methods From a retrospectively reviewed series of 167 eyes with non-full-thickness macular holes, we exclusively included a subgroup of 34 eyes with LMH and LHEP by SD-OCT evaluation. In these eyes, area of LHEP, intraretinal changes of defect diameter, central retinal thickness, defects of the ellipsoid zone and occurrence of a contractive epiretinal membrane were analysed. Additionally, clinical data were documented.

Results Area of LHEP significantly increased during a mean follow-up period of 40.5 months (median 52 months). Analysing intraretinal changes, a significant enlargement of minimum and maximum horizontal lamellar hole diameter was found that correlated with the area of LHEP. Defects of the ellipsoid zone were seen in 65% of the eyes at baseline and in 85% at the end of follow-up. Increase of maximum horizontal hole diameter and ellipsoid zone defects correlated with a decline of visual acuity. Fifty per cent of patients with LMH and LHEP also demonstrated extrafoveal typical contractive epiretinal membranes with retinal folds.

Conclusions Long-term follow-up revealed an increase of the area of LHEP in eyes with LMH that correlated with the enlargement of lamellar hole diameter and ellipsoid zone defects. Our data delineate the progression of intraretinal changes in association with a decline of visual function in this subgroup of LMH eyes.

  • lamellar macular hole
  • lamellar hole-associated epiretinal proliferation
  • epiretinal membrane
  • optical coherence tomography

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  • Contributors Substantial contributions to the conception or design of the work: DC, RGS, MGC and FB. Acquisition of data: DC, AA and VL. Analysis and interpretation of data: DC, RGS, MGC and FB. Drafting the work or revising it critically for important intellectual content: DC, RGS, SP, GS and FB. Final approval of the version published: all authors.

  • Competing interests None declared.

  • Patient consent Retrospective nature of the study.

  • Ethics approval Ethics committee of the medical faculty of the Ludwigs-Maximilians-University Munich.

  • Provenance and peer review Not commissioned; externally peer reviewed.