A consensus on a definition of LMH and similar conditions is needed. The panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and differentiate LMH from similar situations.

The panel reached a consensus on the definition of three clinical entities: LMH, ERM foveoschisis, and MPH. LMH definition is based on three mandatory criteria and three optional anatomical features. Optional anatomical features include epiretinal proliferation, the presence of a central foveal bump, and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria: ERM and the company of schisis at Henle’s fiber layer level. Three optional anatomical features can also be present: the presence of microcystin spaces in the INL, an increase of retinal thickness, and the presence of retinal wrinkling. Mandatory standards include the presence of a foveal sparing ERM, the company of a steepened foveal profile, and an increased central retinal thickness. Optional anatomical features are the presence of microcystin spaces in the INL and an average retinal thickness.

The study concluded that using the proposed definitions may provide uniform language for clinicians and future research.

References: https://bjo.bmj.com/content/104/12/1741