The natural history of lamellar macular holes: a spectral domain optical coherence tomography study
The natural history of lamellar macular holes: a spectral domain optical coherence tomography study
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DOI：
10.1007/s00417-012-2044-2
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发表时间：
2013-02-01
影响因子：
2.7
通讯作者：
Staurenghi, Giovanni
中科院分区：
文献类型：
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作者：
Bottoni, Ferdinando;Deiro, Antonio Peroglio;Staurenghi, Giovanni
使用谱域光学相干断层扫描 (SD-OCT) 研究板层黄斑裂孔 (LMH) 的演变。2008 年 10 月至 2011 年 1 月，萨科大学医院对 34 名连续诊断为 LMH 的患者进行了前瞻性随访。纳入标准为 SD-OCT 上的中央凹缺损，视网膜色素上皮上方有残留的中央凹组织，以及眼底自发荧光上相应的超自发荧光。成像。基线时通过 SD-OCT 将视网膜前膜 (ERM) 分为两种不同类型：正常和比正常更厚。在基线时以及此后每 6 个月收集并比较最佳矫正视力 (BCVA) 和 SD-OCT 结果。主动眼动追踪技术确保在后续访问中识别出相同的扫描位置。主要结果指标是视力变化（早期治疗糖尿病视网膜病变图表）和板层黄斑缺损的进展。还评估了ERM类型对疾病进展的影响。患者包括15名男性和19名女性，平均年龄73岁，平均屈光度为-0.25屈光度。平均随访期为 18 个月（范围 6 至 24 个月）。基线时的 BCVA（+/- 标准差）为 63 +/- 6 个字母，在随访期间没有显着变化 (P = 0.256)。基线时中心凹厚度为 180 +/- 29 μm，也稳定 (P = 0.592)。所有眼睛的基线都有 ERM。在随访过程中，较厚的 ERM 和正常的 ERM 均表现出相似的功能和形态演变，没有显着变化。两名 LMH（5.8%）分别在 6 个月和 15 个月的随访后出现全层黄斑裂孔。层状黄斑裂孔似乎是一种稳定的黄斑状况。仅当疾病随访期间出现中心凹厚度逐渐变薄和/或视力下降时才应考虑玻璃体切除术。
To study the evolution of lamellar macular holes (LMHs) using spectral domain-optical coherence tomography (SD-OCT).Thirty-four consecutive patients diagnosed with a LMH were followed prospectively at Sacco University Hospital from October 2008 to January 2011. Inclusion criteria were a foveal defect on SD-OCT with residual foveal tissue above the retinal pigment epithelium and corresponding hyperautofluorescence on fundus autofluorescence imaging. Epiretinal membranes (ERMs) were categorized by SD-OCT at baseline as two different types: normal and thicker than normal. Best corrected visual acuity (BCVA) and SD-OCT findings were collected and compared at baseline and every 6 months thereafter. Active eye tracking technology ensured that the same scanning location was identified on follow-up visits. Main outcome measures were visual acuity changes (Early Treatment Diabetic Retinopathy charts) and progression of the lamellar macular defect. The influence of ERM type on disease progression was also evaluated.The patients included 15 males and 19 females with a mean age of 73 years and mean refraction of -0.25 diopters. The mean follow-up period was 18 months (range 6 to 24 months). BCVA at baseline (+/- standard deviation) was 63 +/- 6 letters and did not change significantly during the follow-up period (P = 0.256). Foveal thickness at baseline, 180 +/- 29 mu m, was also stable (P = 0.592). All eyes had an ERM at baseline. Both thicker and normal ERMs showed similar functional and morphological evolution during follow-up with no significant changes. Two LMHs (5.8 %) developed a full thickness macular hole after 6 and 15 months follow-up respectively.Lamellar macular holes seem to be a stable macular condition. Vitrectomy should be considered only in the presence of progressive thinning of foveal thickness and/or decrease of visual acuity during the follow-up of the disease.