Efficacy of Macular Hole Surgery in Patients with Idiopathic Macular Telangiectasia Type 2

Miller, Alexander; Chandra, Rohit; Pophal, Charles; Schartman, Jerome; Hornik, Joan H; Miller, David

doi:10.1016/j.oret.2019.11.017

Cited by 9 publications

(15 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The hole in the other 2 patients remained closed for at least 2 years after the surgery. Thus, our rate of closure of the FTMH in our 3 cases suggests that this technique is as good as that of earlier studies, [ 6 – 11 ] although the number of patients was low.…”

Section: Discussionsupporting

confidence: 81%

“…[ 6 – 11 ] The surgical outcomes in those reports were not good, with a lack of closure or a reopening of the FTMH, compared to those with an idiopathic FTMH. [ 6 – 11 ]…”

Section: Introductionmentioning

confidence: 99%

“…MacTel type 2 is not associated frequently with an FTMH, and thus, reports evaluating the outcomes of PPV for its treatment were few [6–11] . The surgical outcomes in those reports were not good, with a lack of closure or a reopening of the FTMH, compared to those with an idiopathic FTMH [6–11] …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique

Nishiyama

Iwase

2021

Medicine

View full text Add to dashboard Cite

Rational: Macular telangiectasia (MacTel) is an uncommon ocular disorder that can lead to legal blindness. MacTel type 2 is characterized by a bilateral loss of macular transparency, the presence of white crystals on the retina, aberrant blood vessel growth, and neurodegeneration of the macula. Full-thickness macular holes (FTMHs) are a prominent cause of vision reduction in MacTel type 2, and the standard care for an FTMH is pars plana vitrectomy (PPV) to restore the FTMH and best-corrected visual acuity (BCVA). However, surgical outcomes in previous reports were not good, with a lack of closure or a reopening of the FTMH, compared with those with an idiopathic FTMH. Thus, this study aimed to determine the surgical outcomes of PPV with the inverted ILM flap technique for the treatment of FTMHs with a 2-year postoperative follow-up in three patients with MacTel type 2. Patient concerns: This study involved 3 patients who had been diagnosed with MacTel type 2 at a local eye clinic and who was subsequently referred to our department for a more detailed examination. Diagnoses: Three patients were diagnosed with MacTel type 2 using dilated ophthalmoscopy, fluorescein angiography, and optical coherence tomography (OCT) in both eyes. A FTMH was developed and visual acuity decreased during follow-up period in all of the patients. Interventions: Each patient underwent PPV in 1 eye using the inverted ILM-flap technique, gas tamponade, and prone positioning. Outcomes: The FTMH was successfully closed in the 3 cases after the surgery. OCT showed that the FTMH remained closed at the last follow-up examination in 2 patients and vision improved to 20/20 and 20/25. In the other patient, the hole was closed temporarily after surgery, but was reopened at 6 months. The vision had improved to 20/60 until the hole was reopened, and it was 20/100 at the final follow-up examination. Lessons: Although only 3 patients were examined, the inverted ILM-flap technique may be an effective and safe method to close an FTMH in patients with MacTel type 2. However, the surgery cannot prevent the reopening of the hole when the retinal atrophy progresses.

show abstract

Section: Discussionsupporting

confidence: 81%

“…[ 6 – 11 ] The surgical outcomes in those reports were not good, with a lack of closure or a reopening of the FTMH, compared to those with an idiopathic FTMH. [ 6 – 11 ]…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique

Nishiyama

Iwase

2021

Medicine

View full text Add to dashboard Cite

show abstract

“…This surgical intervention requires several days of face-down positioning post-operatively. The few studies that have evaluated the effectiveness of PPV have noted no significant differences in visual acuity between MacTel eyes with macular holes treated surgically compared to those that were medically managed without surgery [ 25 ], lower rates of macular hole closure with PPV in MacTel eyes compared to idiopathic macular holes without MacTel also treated surgically [ 26 ], and overall limited reports of successful macular hole closure in a number of eyes with MacTel [ 27 , 28 ]. Hence, surgical intervention of concomitant macular holes with MacTel may not be the preferred treatment for all patients.…”

Section: Discussionmentioning

confidence: 99%

Use of OCT Angiography to Diagnose and Manage Atypical Presentations of Macular Telangiectasia Type 2

Moir

Amin

Khanna

et al. 2022

IJMS

View full text Add to dashboard Cite

Macular telangiectasia Type 2 (MacTel) is a bilateral acquired retinal disease characterized by both vascular changes and atrophy of the retina. The purpose of this case series is to highlight the use of optical coherence tomography angiography (OCTA) as a non-invasive imaging modality to distinguish atypical MacTel from other macular conditions with similar presentations. We performed a retrospective review of patients referred to our academic retinal practice with unconfirmed or misdiagnosed MacTel between July 2017 and July 2021. Patients’ OCTA imaging findings were reviewed to guide the appropriate diagnosis and management of atypical MacTel. Fifteen eyes from eight patients were included in this study. Six patients were referred with previous diagnoses of either full-thickness macular hole, lamellar hole, vitreomacular traction (VMT), postoperative cystoid macular edema (CME), or diabetic macular edema (DME). Two patients were referred to us to confirm the diagnosis of MacTel. OCTA revealed telangiectatic vessels in the temporal parafovea of all 15 eyes. OCTA also highlighted previously undiagnosed subretinal neovascularization (SRNV) in seven eyes. OCTA imaging is a valuable imaging modality to distinguish MacTel from other macular conditions, whose treatment courses vary substantially. Due to its ease of use, it holds immense potential in the future as treatments for non-proliferative MacTel emerge.

show abstract

“…In 2014, Karth et al [ 42 ] conducted postoperative follow-up in four patients, and only one patient's MH remained closed. Recently, Miller et al [ 43 ] reported that 4 of 12 eyes had a closure of the MH associated with MacTel type 2. Koizumi et al [ 44 ] suggested that Müller cells provide the main structural support to the fovea.…”

Section: Preoperative Factorsmentioning

confidence: 99%

Factors Associated with Anatomic Failure and Hole Reopening after Macular Hole Surgery

Jin

Shi

et al. 2021

Journal of Ophthalmology

View full text Add to dashboard Cite

A macular hole (MH), particularly an idiopathic macular hole (IMH), is a common cause of central vision loss. Risk factors for nonidiopathic MH include high myopia, cystoid macular edema, inflammation, and trauma. MH is primarily diagnosed using slit-lamp microscopy and optical coherence tomography (OCT). Half of the patients with stage I MHs are treated conservatively and may show spontaneous resolution. The main treatment methods for MHs currently include vitrectomy and stripping of the internal limiting membrane (ILM). However, in some patients, surgery does not lead to anatomical closure. In this review, we summarize the factors influencing the anatomical closure of MHs and analyze the potential underlying mechanisms.

show abstract

Efficacy of Macular Hole Surgery in Patients with Idiopathic Macular Telangiectasia Type 2

Cited by 9 publications

References 12 publications

Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique

Two years outcomes of treating full-thickness macula hole associated with idiopathic macular telangiectasia type 2 by internal limiting membrane inverted flap technique

Use of OCT Angiography to Diagnose and Manage Atypical Presentations of Macular Telangiectasia Type 2

Factors Associated with Anatomic Failure and Hole Reopening after Macular Hole Surgery

Contact Info

Product

Resources

About