Clinical Ophthalmology (Jan 2019)
Lamellar macular hole surgery – current concepts, future prospects
Abstract
Christos Haritoglou,1 Ramin Tadayoni,2 Jean-Pierre Hubschman3 1Herzog Carl Theodor Eye Clinic, Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; 2Department of Ophthalmology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University Sorbonne Paris Cité, Paris, France; 3Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA Abstract: Lamellar macular holes present distinct morphological features including tractional or non-tractional epimacular membranes, foveal tissue alterations, defects of the outer retinal layers, or a separation of the retinal layers. At present, degenerative lamellar holes are differentiated from tractional holes based on the morphological characteristics seen in OCT. The current treatment approach is based on this gross differentiation. Considering the recent developments in high-resolution imaging, this classification needs to be revisited since morphological features may present simultaneously, making it difficult to separate these entities. In addition, a revisited classification may be of value to better standardize the indication for surgical treatment. Keywords: lamellar macular hole, degenerative lamellar hole, tractional lamellar hole, outer retina, lamellar macular hole-associated epimacular proliferation, LHEP
