표층황반원공에서 수술적 치료의 결과 = Visual and Surgical Outcomes of Lamellar Macular Hole

다국어 초록 (Multilingual Abstract)

Purpose: To investigate the visual and anatomical results of surgical treatment for symptomatic lamellar macular hole. Methods: Ten eyes of ten patients with decreased visual acuity and lamellar macular hole were diagnosed using optical coherence tomography (OCT). Pars plana vitrectomy, epiretinal membrane removal, internal limiting membrane peeling, and gas tamponade (5 eyes) were performed for the treatment of lamellar hole. The resolution of the lamellar hole was assessed in relation to each OCT image at baseline. Results: The mean postoperative follow-up duration was 7.5 months, and best corrected visual acuity improved from log MAR 0.67 ± 0.38 to log MAR 0.30 ± 0.28. Central foveal thickness decreased from 441 ± 184 μm to 291 ± 64 μm. The OCT of all eyes demonstrated improvement in macular contour. However, retinal detachment in one eye occurred at two months after the operation and was reattached with gas tamponade and photocoagulation. Conclusions: Vitrectomy, epiretinal membrane removal and internal limiting membrane peeling showed benefit in the treatment of symptomatic lamellar macular hole. However, large and prospective studies are necessary regarding the surgical indication, time and procedure for lamella macular hole. J Korean Ophthalmol Soc 2012;53(9):1291-1295

참고문헌 (Reference)

1 조원빈, "증상이 있는 표층황반원공 환자에서 시행한 유리체절제술 4예" 대한안과학회 50 (50): 1427-1431, 2009

2 Kelly NE, "Vitreous surgery for idiopathic macular holes. Results of a pilot study" 109 : 654-659, 1991

3 Garretson BR, "Vitrectomy for a symptomatic lamellar macular hole" 115 : 884-886, 2008

4 Michalewska Z, "Surgical treatment of lamellar macular holes" 248 : 1395-1400, 2010

5 Witkin AJ, "Redefining lamellar holes and the vitreomacular interface: an ultrahigh-resolution optical coherence tomography study" 113 : 388-397, 2006

6 Tanner V, "Optical coherence tomography of the vitreoretinal interface in macular hole formation" 85 : 1092-1097, 2001

7 Altaweel M, "Macular hole: improved understanding of pathogenesis, staging, and management based on optical coherence tomography" 18 : 58-66, 2003

8 Androudi S, "Lamellar macular holes: tomographic features and surgical outcome" 148 : 420-426, 2009

9 Gass JD, "Lamellar macular hole: a complication of cystoid macular edema after cataract extraction: a clinicopathologic case report" 73 : 231-250, 1975

10 Haouchine B, "Foveal pseudocyst as the first step in macular hole formation: a prospective study by optical coherence tomography" 108 : 15-22, 2001

11 Haouchine B, "Diagnosis of macular pseudoholes and lamellar macular holes by optical coherence tomography" 138 : 732-739, 2004

12 Leung CK, "Comparison of macular thickness measurements between time domain and spectral domain optical coherence tomography" 49 : 4893-4897, 2008

13 Kakinoki M, "Comparison of macular thickness between Cirrus HD-OCT and Stratus OCT" 40 : 135-140, 2009

14 Chen JC, "Clinical spectrum of lamellar macular defects including pseudoholes and pseudocysts defined by optical coherence tomography" 92 : 1342-1346, 2008

15 Chen J, "Clinical applications and new developments of optical coherence tomography: an evidence-based review" 90 : 317-335, 2007

16 Witkin AJ, "Anatomic and visual outcomes of vitrectomy for lamellar macular holes" 41 : 418-424, 2010