Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Foveal microstructure and visual function in patients with lamellar macular hole, epiretinal membrane foveoschisis or macular pseudohole

Abstract

Purpose

To compare the foveal microstructures, such as the prevalence of epiretinal proliferation (EP) and residual ellipsoid zone (EZ), in eyes with lamellar macular hole (LMH), epiretinal retinal membrane (ERM) foveoschisis and macular pseudohole (MPH), and to investigate the association of the foveal microstructure with visual functions.

Method

In addition to the prevalence of EP, we calculated the residual EZ index within 1mm and 3 mm (rEZ1 and rEZ3) in all examined eyes. Comparisons were conducted to baseline characteristics (logMAR visual acuity [logMAR VA], metamorphopsia score [Mave], central retinal thickness [CRT], the prevalence of EP, rEZ1 and rEZ3) between MPH, ERM foveoschisis and LMH subgroups. The relationships (1) between logMAR VA and each of age, type (MPH, ERM foveoschisis and LMH), the prevalence of EP, rEZ1, rEZ3, spherical equivalent (SE) and CRT and (2) between Mave and each of variables were investigated.

Results

Fifty-one eyes of 48 patients were enroled. The mean age was 65.2 ± 11.1 years. Ten eyes were diagnosed as LMH, 22 eyes as ERM foveoschisis and 19 eyes as MPH, respectively. There was a significant difference in CRT only between LMH and ERM foveoschisis (p = 0.023). There was a tendency toward significance in rEZ1 between LMH and ERM foveoschisis (p = 0.057), but not in rEZ3. The optimal model for logMAR VA included age, rEZ1, SE and CRT. On the other hand, the optimal model for Mave included the prevalence of EP, rEZ1 and SE.

Conclusion

Microstructural observations are useful to predict visual functions in LMH, ERM foveoshisis and MPH.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Representative OCT images of eyes with LMH, ERM foveoschisis or MPH.
Fig. 2: Measurement of residual EZ index.
Fig. 3: Visual functions in eyes with LMH, ERM foveoschisis or MPH.

References

  1. Gass JD. Lamellar macular hole: a complication of cystoid macular edema after cataract extraction. Arch Ophthalmol. 1976;94:793–800.

    Article  CAS  PubMed  Google Scholar 

  2. Witkin AJ, Ko TH, Fujimoto JG, Schuman JS, Baumal CR, Rogers AH, et al. Redefining lamellar holes and the vitreomacular interface: an ultrahigh-resolution optical coherence tomography study. Ophthalmology. 2006;113:388–97.

    Article  PubMed  Google Scholar 

  3. Hubschman JP, Govetto A, Spaide RF, Schumann R, Steel D, Figueroa MS, et al. Optical coherence tomography-based consensus definition for lamellar macular hole. Br J Ophthalmol. 2020;104:1741–7.

    Article  PubMed  Google Scholar 

  4. Lam M, Philippakis E, Gaudric A, Tadayoni R, Couturier A. Postoperative outcomes of idiopathic epiretinal membrane associated with foveoschisis. Br J Ophthalmol. 2021. https://doi.org/10.1136/bjophthalmol-2020-317982.

    Article  PubMed  Google Scholar 

  5. Omoto T, Asahina Y, Zhou HP, Fujino R, Takao M, Obata R, et al. Visual outcomes and prognostic factors of vitrectomy for lamellar macular holes and epiretinal membrane foveoschisis. PLoS ONE. 2021;16:e0247509. https://doi.org/10.1371/journal.pone.0247509.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Fujita A, Aoyama Y, Tsuneyoshi S, Sugiura A, Azuma K, Asano-Shimizu K, et al. Association between visual function and the integrity of residual ellipsoid zone in resolved central serous chorioretinopathy. Sci Rep. 2019;9:12433. https://doi.org/10.1038/s41598-019-48825-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hara T, Zhou HP, Kitano M, Kure K, Asaoka R, Inoue T, et al. Quantification of residual ellipsoid zone and its correlation with visual functions in patients with cone-rod dystrophy. Eur J Ophthalmol. 2021;26:1120672121990561. https://doi.org/10.1177/1120672121990561.

    Article  Google Scholar 

  8. Ota M, Tsujikawa A, Murakami T, Yamaike N, Sakamoto A, Kotera Y, et al. Foveal photoreceptor layer in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion. Am J Ophthalmol. 2008;145:273–80.

    Article  PubMed  Google Scholar 

  9. Inoue M, Morita S, Watanabe Y, Kaneko T, Yamane S, Kobayashi S, et al. Inner segment/outer segment junction assessed by spectral-domain optical coherence tomography in patients with idiopathic epiretinal membrane. Am J Ophthalmol. 2010;150:834–9.

    Article  PubMed  Google Scholar 

  10. Aizawa S, Mitamura Y, Baba T, Hagiwara A, Ogata K, Yamamoto S. Correlation between visual function and photoreceptor inner/outer segment junction in patients with retinitis pigmentosa. Eye. 2009;23:304–8.

    Article  CAS  PubMed  Google Scholar 

  11. Schumann RG, Hagenau F, Guenther SR, Wolf A, Priglinger SG, Vogt D. Premacular cell proliferation profiles in tangential traction vitreo-maculopathies suggest a key role for hyalocytes. Ophthalmologica. 2019;242:106–12.

    Article  PubMed  Google Scholar 

  12. Chehaibou I, Pettenkofer M, Govetto A, Rabina G, Sadda SR, Hubschman JP. Identification of epiretinal proliferation in various retinal diseases and vitreoretinal interface disorders. Int J Retin Vitreous. 2020;6:31. https://doi.org/10.1186/s40942-020-00233-0.

    Article  Google Scholar 

  13. dell’Omo R, Virgili G, Bottoni F, Parolini B, De Turris S, Di Salvatore A, et al. Lamellar macular holes in the eyes with pathological myopia. Graefes Arch Clin Exp Ophthalmol. 2018;256:1281–90. https://doi.org/10.1007/s00417-018-3995-8.

    Article  PubMed  Google Scholar 

  14. Lai TT, Yang CM. Lamellar hole-associated epiretinal proliferation in lamellar macular hole and full-thickness macular hole in high myopia. Retina. 2018;38:1316–23. https://doi.org/10.1097/IAE.0000000000001708.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

TI, YY, KeN and RyoA were responsible for writing the report, conducting the search, extracting and analysing data, interpreting results, updating reference lists. KoN, YT and ReiA contributed to extracting data. KK and MI provided feedback on the report.

Corresponding author

Correspondence to Tatsuya Inoue.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nakamura, K., Inoue, T., Nagura, K. et al. Foveal microstructure and visual function in patients with lamellar macular hole, epiretinal membrane foveoschisis or macular pseudohole. Eye 36, 2247–2252 (2022). https://doi.org/10.1038/s41433-021-01818-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-021-01818-1

This article is cited by

Search

Quick links