Purpose: To describe the progressive morphologic changes of macular hole (MH)-associated epiretinal proliferation over long-term follow-up and to explore potential pathologic mechanisms. Methods: A single case was retrospectively reviewed. Results: A patient with a history of open-angle glaucoma and proliferative diabetic retinopathy maintained stable visual acuity (VA) of 6/9 OD and 6/18 OS over 2 years. On examination, MH-associated epiretinal proliferation was noted in the left eye, demonstrating increased thickness and cystic changes compared with the previous visit, for which topical nepafenac eye drops were advised. A follow-up visit 1 year later showed a marked increase in the volume of epiretinal proliferation with associated intraretinal fluid, despite no change in VA. Conclusions: This report documents progressive structural changes in this infrequently encountered entity and explores the possible pathologic mechanisms through a review of relevant literature.
Cystic changes with epiretinal proliferation may represent a benign process attributable to chronicity and often may not require intervention.
PangCEMaberleyDAFreundKB, et al. Lamellar hole-associated epiretinal proliferation: a clinicopathologic correlation. Retina. 2016;36(7):1408-1412.
2.
ComperaDEntchevEHaritoglouC, et al. Lamellar hole-associated epiretinal proliferation in comparison to epiretinal membranes of macular pseudoholes. Am J Ophthalmol. 2015;160(2):373-384.e1.
3.
YangYSLeeJSSonGSohnJ.Epiretinal proliferation associated with lamellar hole or macular hole: origin and surgical prognosis. Korean J Ophthalmol. 2019;33(2):142-149.
BatiogluFYanıkÖDemirelSÖzmertE.Pseudophakic macular edema involving epiretinal proliferation associated with macular hole. Indian J Ophthalmol. 2020;68(11):2599-2601.
6.
SiedleckiJVounotrypidisEVogtDWolfAPriglingerSGSchumannRG.Lamellar hole-associated epiretinal proliferation presenting with perifoveal exudative vascular anomalous complex. Am J Ophthalmol Case Rep. 2019;14:112-116.
7.
MatetASavastanoMCRispoliM, et al. En face optical coherence tomography of foveal microstructure in full-thickness macular hole: a model to study perifoveal Müller cells. Am J Ophthalmol. 2015;159(6):1142-1151.e3. doi:10.1016/j.ajo.2015.02.013
8.
GovettoASarrafDHubschmanJP, et al. Distinctive mechanisms and patterns of exudative versus tractional intraretinal cystoid spaces as seen with multimodal imaging. Am J Ophthalmol. 2020;212:43-56. doi:10.1016/j.ajo.2019.12.010
9.
ShahlaeeARahimyEHsuJGuptaOPHoAC.Preoperative and postoperative features of macular holes on en face imaging and optical coherence tomography angiography. Am J Ophthalmol Case Rep. 2016;5:20-25. doi:10.1016/j.ajoc.2016.10.008
10.
TsuboiKGuoYWangJ, et al. Three-dimensional quantification of intraretinal cystoid spaces associated with full-thickness macular hole. Retina. 2022;42(12):2267-2275.
11.
DaruichAMatetAMoulinA, et al. Mechanisms of macular edema: beyond the surface. Prog Retin Eye Res. 2018;63:20-68.
12.
ChoiMYLeeWK.Treatment and characteristics of pachychoroid neovasculopathy accompanying recalcitrant intraretinal cysts. Cureus. 2024;16(8):e68174.
13.
ShiragaFTakasuIFukudaK, et al. Modified vitreous surgery for symptomatic lamellar macular hole with epiretinal membrane containing macular pigment. Retina. 2013;33:1263-1269.
