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Atypical epiretinal tissue in full-thickness macular holes: pathogenic and prognostic significance
  1. Kunho Bae1,2,
  2. Soo Min Lee1,
  3. Se Woong Kang1,
  4. Eung Suk Kim2,
  5. Seung-Young Yu2,
  6. Kyung Tae Kim1
  1. 1 Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  2. 2 Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea
  1. Correspondence to Dr Se Woong Kang, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; kangsewoong{at}


Background To elucidate the clinical characteristics of a full-thickness macular hole (FTMH) with atypical epiretinal tissue (AET), and expand the spectrum of pathogenesis of MH.

Methods This study involved 225 consecutive eyes of 211 patients who underwent surgery for an idiopathic FTMH. Eyes were divided into two groups according to the presence of AET. Tomographic features at baseline, closure rate of the MH and visual outcomes were compared between the two groups.

Results AET was detected in 26 (11.6%) among 225 eyes. Overall closure of the MH was noted in 92.3% of eyes with AET and 99.5% of eyes without AET at 12 months postoperatively (p=0.003). At 12 months postoperatively, the mean logarithm of the minimum angle of resolution visual acuity in eyes with and without AET was 0.38 and 0.21, respectively (p=0.046). At baseline, eyes with AET more frequently had splitting of the inner retina but fewer intact photoreceptors compared with eyes without AET (19.2% vs 2.5%, and 57.7% vs 89.9%, p<0.001, respectively).

Conclusions The presence of AET in an FTMH was related to poorer anatomical success and less visual recovery after surgery, suggesting that AET reflects a chronic pathogenic process involving more severe damage to the foveal tissue.

  • atypical tissue
  • epiretinal membrane
  • macular hole
  • lamellar hole

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  • Presented at This paper was presented at the Korean Retina Society Meeting 2017, Seoul, Republic of Korea.

  • Contributors KB designed the study, input the data into the spreadsheet, conducted the statistical analysis and wrote the initial draft of the paper. SML and KTK also contributed to the acquisition of data. ESK and S-YY provided contributions during the revision of the initial draft. SWK designed the study, revised the paper and gave final approval of the version to be published.

  • Funding This work was supported by a grant from the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1D1A1B03034695).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study protocol (2017-07-061) was approved by the institutional review board and ethics committees of Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

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

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