Functional and morphological outcomes after surgery in lamellar macular holes versus epiretinal membrane foveoschisis

Abstract

Purpose: To compare the clinical findings and outcomes of vitrectomy for lamellar macular holes (LMH) versus epiretinal membrane foveoschisis (ERMF). Materials and methods: This retrospective study enrolled 36 eyes of 35 patients with a minimum follow-up of 6 months. Spectral domain optical coherence tomography (SD-OCT) parameters and best-corrected visual acuity (BCVA) were analyzed preoperatively and postoperatively. Results: The 19 (52.8%) ERMF and 17 (47.2%) LMH were included. Preoperatively, eyes with LMH were characterized by a lower central foveal thickness (CFT) (102.18 ± 31.44 µm vs 159.37 ± 25.25 µm, p < 0.001) and a greater incidence of outer retinal disruption ( p < 0.001). Primary anatomical success was achieved in 34/36 eyes (94.4%). Preoperative BCVA was better in ERMF (0.16 – IQR 0.09 – logarithm of the minimal angle of resolution (LogMAR) – 20/28 Snellen) than LMH (0.40 – IQR 0.30 – LogMAR, 20/50 Snellen) ( p = 0.008). At 6 months after surgery, BCVA significantly improved in the ERMF group ( p < 0.001), but showed insignificant change in LMH ( p = 0.125). Two cases, both in the LMH group, developed full thickness macular hole after surgery. Conclusion: Eyes with LMH showed visual stabilization after surgery, whereas the eyes in the ERMF group were susceptible to functional improvement. These differences in BCVA outcomes may be the consequence of a higher damage in the outer retina in the LMH group; an accurate SD-OCT examination is a fundamental step when deciding to proceed or not to the surgery.