Spontaneous Evolution of Lamellar Macular Hole into Full Thickness Macular Hole, and Resolution of the Same, Followed by Optical Coherence Tomography

Aim: Aim of this study is to, with the aid of optical coherence tomography, follow and evaluate spontaneous evolution of lamellar macular hole into full thickness macular hole, and vice versa.

Methods: A 70-year-old female with metamorphopsia and decreased central vision was examined and followed both clinically and with the aid of high-resolution optical coherence tomography. Idiopathic lamellar macular hole on the right eye and epiretinal membrane on the left eye were noted. Both, evolution of lamellar macular hole and epiretinal membrane were followed over a 2 year period.

Results: Over a period of 6 months lamellar macular hole had progressed into full thickness macular hole only to later ‘close’ and resolve into lamellar macular hole. High-definition optical coherence tomography confirmed that one of the mechanisms responsible for lamellar macular hole was opening of cystic spaces on the edges of lamellar macular hole. Loss of IS/OS juncture, or in other words, defects in the photoreceptor layer could be responsible for poor visual outcome. During the course of follow-up examinations of the left eye, there was partial separation of the epiretinal membrane without subsequent development of macular hole.

Conclusion: Lamellar macular hole slowly progresses and rarely evolves into a full thickness macular hole, and vice versa.