[Features of the course of lamellar macular holes with epiretinal proliferation]. / Osobennosti techeniya lamellyarnykh makulyarnykh razryvov, soprovozhdayushchikhsya razvitiem epiretinal'noi proliferatsii.

The question of the course of lamellar macular holes (LMH) - favorable or progressive - remains controversial to this day. It is important to study the features of the course of this pathology in patients with epiretinal proliferation (EP). PURPOSE: To establish the features of the course of lamellar macular holes with the presence of epiretinal proliferation. MATERIAL AND METHODS: Clinical and instrumental monitoring was carried out in 48 patients with LMH divided into two groups: with the presence of EP (n=27) and its absence (n=21). The follow-up period lasted 15.9±2.3 months. The following parameters were assessed: changes in best corrected visual acuity (BCVA), mean retinal sensitivity (MRS) of the retina in 2- and 4-degree zones, subjective complaints; the main morphometric and morphostructural parameters of the retina were evaluated using optical coherence tomography (OCT). RESULTS: Patients with LMH and EP had lower initial BCVA, as well as, according to OCT, disruption of the ellipsoid zone and the presence of a foveal bump (37% and 22.2% of patients, respectively). During the follow-up, patients with EP showed an increase in subjective complaints, a statistically significant decrease in MRS in the 2-degree zone, and a decrease of the minimal retinal thickness. CONCLUSION: LMH with EP are characterized by an unfavorable course, which is confirmed by a decrease in functional and anatomical parameters.

[Rate of visual recovery after macular hole surgery with intraoperative optical coherence tomography and visualization of the internal limiting membrane]. / Tempy vosstanovleniia ostroty zreniia posle khirurgicheskogo lecheniia makuliarnykh razryvov s intraoperatsionnym primeneniem opticheskoi kogerentnoi tomografii i razlichnykh metodov vizualizatsii vnutrennei pogranichnoi membrany.

Currently, multiple techniques exist to repair a macular hole, but the functional result may be largely affected by the use of dyes during surgery. With our original visualization methods, one is able to remove the internal limiting membrane (ILM) without staining, and thus to avoid the toxic effect of dyes. AIM: to compare anatomical and functional results of surgical closure of large macular holes with or without ILM staining. MATERIAL AND METHODS: A total of 160 patients (190 eyes) were divided into 2 groups. Patients from group 1 (60 eyes) were subjected to surgery that involved the use of a dye, while in group 2 (130 eyes) ILM was not performed. Anatomical and functional results of the two groups were then compared. RESULTS: The next day after surgery, a large improvement in the best corrected visual acuity - of 3 lines or more - was found in 28 controls (46.6%) and 98 patients from the main group (75.4%). There was no significant change in 24 and 27 patients, respectively (40.0% and 20.7%). The remaining 8 and 5 patients (13.4% and 3.9%) deteriorated by 3 lines or more. CONCLUSION: Stain-free removal of the ILM under green-yellow light favours rapid recovery of visual acuity in patients with macular holes. Anatomical reconstruction of the foveola, including complete approximation of the hole margins and keeping the defect closed until the end of the operation, is controlled through a built-in optical coherence tomograph ensuring high anatomical and functional results.