Epiretinal proliferations in lamellar holes: clinical and surgical implications

Session Details

Session Title: Free Paper Session 20: Vitreoretinal Surgery V

Session Date/Time: Sunday 10/09/2017 | 08:00-09:30

Paper Time: 09:12

Venue: Room 117

First Author: : M.Marques PORTUGAL

Co Author(s): :    S. Rodrigues   M. Raimundo   J. Costa   J. Marques   M. Alfaiate   J. Figueira              

Abstract Details

Purpose:

To describe the prevalence of epiretinal proliferations (ERP) in lamellar macular holes (LMH) and to correlate this feature with both the morphology of the LMH and its anatomical and functional prognosis after a conservative or surgical approach.

Setting:

Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra - CHUC, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light - AIBILI, Coimbra, Portugal

Methods:

Retrospective case-series. We included consecutive LMH patients with at least 6 months of follow-up. Clinical data was registered and all optical coherence tomography (OCT) exams were evaluated for the presence of EPR or epiretinal membrane (ERM), thickness of LMH bed, biggest LMH diameter and biggest internal diameter. When surgical approached, patients were via pars plana vitrectomized. Dye-assisted ERM and internal limiting membrane peeling and internal tamponade with SF6 was performed in all cases.

Results:

Sixty-two eyes from 57 patients were included. Mean follow-up time was 27.1±19.8 months. ERP was noticed in 53.2% (n=33) of the eyes. The presence of an ERP was associated with a bigger LMH diameter (p=0,001) and a lower LMH bed thickness (p=0,018). Twenty-seven (81,8%) ERP eyes presented a tent-like configuration, with an approach of its inner limits, comparing to 23,3% of the LMH without ERP. Inner segment – outer segment (IS-OS) disruption was significantly more prevalent in LMH with ERP (p=0,001). No differences were noticed between visual performance (p=0,687) or closure rate (p=0,569) in the subgroup of patients undergoing surgical approach.

Conclusions:

ERP are recently described entities, which in our series seem to induce larger footings and reduced bed thickness in LMH architecture, as well as IS-OS disruption. We found no prognostic value related to ERP in what concerns visual prognosis or LMH closure rate.

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