NATURAL HISTORY OF TRACTIONAL LAMELLAR MACULAR HOLE.

Abstract

To evaluate the long-term functional and anatomical outcomes in patients with tractional lamellar macular holes who were managed without surgical intervention. A total of 63 eyes previously diagnosed with tractional lamellar macular hole between July 1, 2009, and January 30, 2024, without any surgical interventions were enrolled. The change in best-corrected visual acuity, lamellar hole diameter, central retinal thickness (CRT) on optical coherence tomography (OCT), foveal avascular zone areas on OCT angiography, and M-chart scores between initial and final visits were assessed. The mean follow-up was 3.7 ± 3.0 years. Best-corrected visual acuity remained stable (0.07 ± 0.07-0.08 ± 0.09 logMAR; ≈20/23-20/24 Snellen equivalent; P = 0.464). Lamellar hole diameter increased significantly (1,586 ± 610-1786 ± 603 µ m, P < 0.001), while CRT remained unchanged (374 ± 60-372 ± 62 µ m, P = 0.567). Foveal avascular zone area in the deep capillary plexus significantly increased (1.01 ± 0.49-1.19 ± 0.62 mm 2 , P = 0.009), whereas foveal avascular zone in the superficial capillary plexus showed no significant change (0.48 ± 0.19-0.49 ± 0.18 mm 2 , P = 0.624). M-chart scores remained stable in both horizontal and vertical axes (0.12 ± 0.27-0.16 ± 0.33°, P = 0.534; 0.17 ± 0.31-0.15 ± 0.28°, P = 0.640, respectively). Patients with tractional lamellar macular holes maintained stable visual function over long-term follow-up without surgical intervention.