Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2: A Global Multicenter Study.
Publication/Presentation Date
1-1-2024
Abstract
PURPOSE: To report on macular hole repair in macular telangiectasia type 2 (MacTel2).
DESIGN: Global, multicenter, retrospective case series.
PARTICIPANTS: Patients undergoing surgery for MacTel2-associated full-thickness macular hole (MTMH).
METHODS: Standardized data collection sheet 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% female, 72% White, 21% East or South Asian, 2% African American, and 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 peeling, preoperative visual acuity (VA) was 0.667 ± 0.423 logarithm of the minimum angle of resolution (logMAR). Minimum hole diameter (MHD) was 305.5 ± 159.4 μm (range, 34-573 μm). Sixteen of 34 ILM peels (47%) resulted in MTMH closure. At postoperative month 6, VA was stable at 0.602 ± 0.516 logMAR (P = 0.65). VA improved by at least 2 lines in 43% and at least 4 lines in 24%. For ILM flaps, preoperative VA was 0.878 ± 0.552 logMAR. MHD was 440.8 ± 175.5 μm (range, 97-697 μm), which was significantly larger than for ILM peels (P < 0.01). Twenty of 22 ILM flaps (90%) resulted in MTMH closure, which was significantly higher than for ILM peels (P < 0.01). At postoperative month 6, VA improved to 0.555 ± 0.405 logMAR (P < 0.05). VA improved by at least 2 lines in 56% and at least 4 lines in 28%. For ARTs, preoperative VA was 1.460 ± 0.391 logMAR. MHD was 390.2 ± 203.7 μm (range, 132-687 μm). All 5 ARTs (100%) resulted in MTMH closure. At postoperative month 6, VA was stable at 1.000 ± 0.246 logMAR (P = 0.08). Visual acuity improved at least 2 lines in 25%.
CONCLUSIONS: Surgical closure of macular holes improved VA in 57% of MTMHs. Internal limiting membrane flaps achieved better anatomic and functional outcomes than ILM peeling alone. Autologous retinal transplantation may be an option for refractory MTMHs.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Volume
131
Issue
1
First Page
66
Last Page
77
ISSN
1549-4713
Published In/Presented At
Park, J. G., Adrean, S. D., Begaj, T., Capone, A., Jr, Charles, S., Chen, S. N., Chou, H. D., Cohen, M. N., Corona, S. T., Faia, L. J., Garg, S. J., Garretson, B. R., Gregori, N. Z., Haller, J. A., Houghton, O. M., Hsu, J., Jo, J., Kaiser, R. S., Lai, C. C., Mahgoub, M. M., … Mahmoud, T. H. (2024). Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2: A Global Multicenter Study. Ophthalmology, 131(1), 66–77. https://doi.org/10.1016/j.ophtha.2023.08.025
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37661066
Department(s)
Administration and Leadership
Document Type
Article