TY - JOUR
T1 - Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2
T2 - A Global Multicenter Study
AU - Park, Jong G.
AU - Adrean, Sean D.
AU - Begaj, Tedi
AU - Capone, Antonio
AU - Charles, Steve
AU - Chen, San Ni
AU - Chou, Hung Da
AU - Cohen, Michael N.
AU - Corona, Stephanie Trejo
AU - Faia, Lisa J.
AU - Garg, Sunir J.
AU - Garretson, Bruce R.
AU - Gregori, Ninel Z.
AU - Haller, Julia A.
AU - Houghton, Odette Margit
AU - Hsu, Jason
AU - Jo, Jaehyuck
AU - Kaiser, Richard S.
AU - Lai, Chi Chun
AU - Mahgoub, Mohamed Moghazy
AU - Mansoor, Mahsaw
AU - Matoba, Ryo
AU - Morizane, Yuki
AU - Nehemy, Marcio B.
AU - Raphaelian, Paul V.
AU - Regillo, Carl D.
AU - Ruby, Alan J.
AU - Runner, Margaret M.
AU - Sneed, Scott R.
AU - Sohn, Elliott H.
AU - Spirn, Marc J.
AU - Vander, James F.
AU - Wakabayashi, Taku
AU - Wolfe, Jeremy D.
AU - Wykoff, Charles C.
AU - Yonekawa, Yoshihiro
AU - Yoon, Young Hee
AU - Mahmoud, Tamer H.
N1 - Publisher Copyright:
© 2023 American Academy of Ophthalmology
PY - 2024/1
Y1 - 2024/1
N2 - 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.
AB - 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.
KW - Autologous retinal transplantation
KW - Full-thickness macular hole
KW - Internal limiting membrane flap
KW - Internal limiting membrane peeling
KW - Macular telangiectasia type 2
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U2 - 10.1016/j.ophtha.2023.08.025
DO - 10.1016/j.ophtha.2023.08.025
M3 - Article
C2 - 37661066
AN - SCOPUS:85173237076
SN - 0161-6420
VL - 131
SP - 66
EP - 77
JO - Ophthalmology
JF - Ophthalmology
IS - 1
ER -