Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study.
PURPOSE: To report on macular hole repair in macular telangiectasia type 2 (MacTel).
DESIGN: Global, multicenter, retrospective case series.
PARTICIPANTS: Patients with surgery for MacTel-associated full thickness macular hole (MTMH).
METHODS: A standardized data collection sheet was distributed to all surgeons.
MAIN OUTCOME MEASURES: Anatomic closure and visual outcomes of MTMH RESULTS: Sixty-three surgeries in 47 patients with MTMH were included from 30 surgeons. Mean age was 68.1 years, with 62% females, 72% Caucasians, 21% East or South Asians, 2% African American, 2% Hispanic or Latino. Procedures included 34 internal limiting membrane (ILM) peeling alone, 22 ILM flaps, 5 autologous retinal transplantations (ARTs), 1 retinotomy, and 1 subretinal bleb. For ILM peels, preoperative best available visual acuity (VA) was logMAR 0.667 ± 0.423. Minimum hole diameter (MHD) was 305.5 ± 159.4 μm (range 34 - 573 μm). Sixteen of 34 ILM peels resulted in MTMH closure for a 47% success rate. At postoperative month 6 VA was stable at logMAR 0.608 ± 0.516 (P=0.65). VA improved at least 2 lines in 43% and at least 4 lines in 24%. For ILM flaps, preoperative VA was logMAR 0.878 ± 0.552. MHD was 440.8 ± 175.5 μm (range 97 - 697 μm), which was significantly larger than for ILM peels (P
CONCLUSIONS: Surgical closure of macular holes improved VA in 57% of MTMHs. ILM flaps achieved better anatomical and functional outcomes than ILM peeling alone. ART may be an option for refractory MTMHs.
Park JG, Adrean SD, Begaj T, Capone AJ, Charles S, Chen S, et al. [Faia LJ, Garretson BR, Ruby AJ, Runner MM, Wolfe JD, Mahmoud TH] Surgical management of full thickness macular holes in macular telangiectasia type 2.A Global Multicenter Study. Ophthalmology. 2023 Sep 1:S0161-6420(23)00624-3. doi: 10.1016/j.ophtha.2023.08.025. Epub ahead of print. PMID: 37661066.