Surgery outcomes of lamellar macular eyes with or without lamellar hole-associated epiretinal proliferation: a meta-anal
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RESEARCH ARTICLE
Open Access
Surgery outcomes of lamellar macular eyes with or without lamellar hole-associated epiretinal proliferation: a meta-analysis Hanyue Xu1, Ling Qin2, Yifan Zhang1, Yinan Xiao1 and Ming Zhang2*
Abstract Background: Given the two different kinds of epiretinal membranes, this study aimed to compare both the structural and functional outcomes of lamellar macular holes with and without lamellar hole-associated epiretinal proliferation (LHEP) after surgery. Method: Publications up to July 2020 that compared the surgical outcomes of lamellar macular hole with and without LHEP were included. Forest plots were created by using a weighted summary of proportion meta-analysis. Fixed or random effects models were used on the basis of I2 heterogeneity estimates. Meanwhile, to evaluate the stability of the meta-analysis, a sensitivity analysis was carried out. Results: Eight pertinent publications that contained a total of 176 eyes without LHEP and 173 eyes with LHEP were included. They were all retrospective studies and had a follow-up of at least 6 months. In all studies, the preoperative best corrected visual acuity showed no significant differences between the two groups, and the visual acuity improved in both groups after surgery. The pooled result for the improved best corrected visual acuity was 0.18 (95% confidence interval (CI), 0.10 to 0.26; P < 0.01) between the with and without LHEP groups. The restored ellipsoid zone odds ratio was 0.80 (95% CI, 0.26 to 2.44; P = 0.69) for the group with LHEP compared to the group without LHEP. Conclusion: Patients without LHEP had better postoperative visual acuity than patients with LHEP. No significant difference in restored ellipsoid zone was found between the two groups. Keywords: Lamellar macular hole, Lamellar hole-associated epiretinal proliferation, Surgery, Best corrected visual acuity, Ellipsoid zone
Background Lamellar macular holes (LMHs), first described in biomicroscopic and angiographic findings by Gass in a case report, is a partial-thickness loss of foveal tissue [1]. The formation of LMHs is attributable to cystoid macular oedema, contraction of the perifoveal epiretinal membrane and vitreous traction [2]. Later, Witkin et al. * Correspondence: [email protected] 2 Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu No. 37, Guoxue Alley, Chengdu 610041, People’s Republic of China Full list of author information is available at the end of the article
redefined the LMH diagnosis to include (1) an irregular foveal contour; (2) a break in the inner fovea; (3) an intraretinal split; and (4) intact foveal photoreceptors [2]. The development of ultrahigh-resolution optical coherence tomography (UHR-OCT) has contributed to revealing more microscopic structures of LMHs. UHROCT has allowed visualization of the trapped vitreous or posterior hyaloid, termed epiretinal membranes (ERMs), in most LMH cases. Two types of ERM, tractional ERM (T ERM) and lamellar hole-associated epiretinal proliferation (LHEP), are known as
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