Lamellar macular hole: causes, microstructural and functional changes during its development

Background. Lamellar hole of the macula is a serious lesion of the vitreomacular interface. Modern technological advances in optical coherence tomography of the posterior part of the eye reveal new aspects of the etiology and pathogenesis of this disease. The aim. To study microstructural and functional changes in the occurrence and development of lamellar ruptures of the macula, to identify criteria for the progression of this disease. Material and methods. A retrospective analysis of 47 eyes was performed in 47 patients aged 66.4 ± 8.6 years with idiopathic lamellar macular hole (LMH) at a time of 22.3 ± 11.2 months. Morphological features of LMH were studied; functional changes in visual acuity and microperimetry were evaluated. Results. As a result of monitoring, a traction trigger for the development of LMH was established in 38/47 (81 %) patients. The main morphological and functional criteria for the progression of this disease have been studied and described, which makes it possible to optimize the management tactics of these patients. Conclusion. The study showed that currently there are clear criteria for the diagnosis of LMH according to OCT. Long-term monitoring of patients has proven that the disease has a slowly progressive course. At the same time, the assessment of the progression of LMH should be comprehensive, based on the morphological and functional results of the examination, which will make it possible to correctly select and optimize the tactics of managing these patients.