Lamellar macular hole in high myopic eyes with posterior staphyloma: morphological and functional characteristics.

PURPOSE: To study morphological and functional characteristics of myopic lamellar macular hole (LMH) with posterior staphyloma.

METHODS: Retrospective observational longitudinal study. Forty myopic eyes affected by LMH and posterior staphyloma have been examined. Pathological myopia was defined as axial length equal or superior to 26.5 mm. LMH was defined on the basis of the following characteristics: irregular foveal contour, inner retinal defect with or without intraretinal splitting and absence of full thickness retinal defect. Demographic and functional parameters were: age, sex, status of lens and best corrected visual acuity (BCVA). Tomographic parameters were: type of LMH, macular retinoschisis (MRS), posterior vitreous detachment (PVD), type of epiretinal membrane (ERM), integrity of ellipsoid zone (EZ) and external limiting membrane (ELM), residual foveal thickness (RFT) and maximal diameter of intraretinal splitting (MDIRS).

RESULTS: The statistical analysis showed a significant prevalence of posterior vitreous adherence in the atypical ERM subgroup (P = 0.001). EZ (P = 0.006) and ELM (P = 0.007) damages were significantly associated with the atypical ERM subgroup. RFT was statistically lower in the atypical ERM subgroup compared to the conventional ERM subgroup (P = 0.015). During the follow-up, the statistical analysis showed a significant reduction of RFT in the atypical ERM subgroup (P = 0.041).

CONCLUSIONS: Myopic lamellar macular hole (LMH) associated with atypical ERM is a more severe clinical entity than myopic LMH associated with conventional ERM.