-Original-

Variations in the Formation of Lamellar Macular Hole through Epiretinal Membrane, Macular Pseudohole, and ERM-Foveoschisis

Noriko Kubota¹, Yosai Mori², Kazunori Miyata², Yuji Nakano¹, Hitoshi Goto³, Tomoyuki Kunishige¹ and Fumiki Okamoto¹

¹Department of Ophthalmology, Nippon Medical School, Tokyo, Japan
²Miyata Eye Hospital, Miyazaki, Japan
³Department of Ophthalmology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan

Purpose: To investigate morphological changes associated with lamellar macular hole (LMH).
Methods: We retrospectively reviewed data for all eyes with LMH, as determined by spectral-domain optical coherence tomography (OCT), from patients who had undergone vitrectomy and had at least 12 months of preoperative and 6 months of postoperative follow-up data. Eyes were classified as those with morphological changes in the epiretinal membrane (ERM), macular pseudohole (MPH), or ERM-foveoschisis (ERM-FS) that were observed before LMH formation (group A), and those in which LMH was present at the first visit and remained unchanged until surgery (group B). Follow-up time (from first visit to surgery), time from detection of diseases associated with LMH, and morphological changes were analyzed.
Results: Of 14 eyes of 14 patients, 9 were in group A and 5 were in group B, and mean follow-up time was 49.2 ± 23.5 months and 44.4 ± 25.4 months in groups A and B, respectively. In group A, LMH formed through ERM in 1 eye, MPH in 2 eyes, and ERM-FS in 6 eyes; 5 eyes maintained LMH morphology for longer than 12 months. The mean time from associated disease to LMH was 11.2 ± 13.8 months, and 30.3 ± 25.5 months from LMH to surgery. BCVA significantly improved in group A (p<0.05) but not in group B (p=0.0579). Neither time to surgery in group A nor follow-up time correlated with postoperative BCVA.
Conclusion: LMH likely forms through progression of associated diseases, and time from LMH to surgery was not significantly associated with visual outcomes.

J Nippon Med Sch 2026; 93: 218-224

Keywords
epiretinal membrane, lamellar macular hole, macular pseudohole, optical coherence tomography, vitrectomy

Correspondence to
Noriko Kubota
oishinoriko@nms.ac.jp

Received, October 22, 2025
Accepted, December 17, 2025