Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study

Jong G. Park; Sean D. Adrean; Tedi Begaj; Antonio Capone; Steve Charles; San-Ni Chen; Hung-Da Chou; Michael N. Cohen; Stephanie Trejo Corona; Lisa J. Faia; Sunir J. Garg; Bruce R. Garretson; Ninel Z. Gregori; Julia A. Haller; Odette Margit Houghton; Jason Hsu; Jaehyuck Jo; Richard S. Kaiser; Chi-Chun Lai; Mohamed Moghazy Mahgoub; Mahsaw Mansoor; Ryo Matoba; Yuki Morizane; Marcio B. Nehemy; Paul V. Raphaelian; Carl D. Regillo; Alan J. Ruby; Margaret M. Runner; Scott R. Sneed; Elliott H. Sohn; Marc J. Spirn; James F. Vander; Taku Wakabayashi; Jeremy D. Wolfe; Charles C. Wykoff; Yoshihiro Yonekawa; Young Hee Yoon; Tamer H. Mahmoud

doi:10.1016/j.ophtha.2023.08.025

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Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study

Journal article

Peer reviewed

Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study

Jong G. Park, Sean D. Adrean, Tedi Begaj, Antonio Capone, Steve Charles, San-Ni Chen, Hung-Da Chou, Michael N. Cohen, Stephanie Trejo Corona, Lisa J. Faia, …

Ophthalmology (Rochester, Minn.), Vol.131(1), pp.66-77

01/2024

DOI: 10.1016/j.ophtha.2023.08.025

PMID: 37661066

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Abstract

To report on macular hole repair in macular telangiectasia type 2 (MacTel). Global, multicenter, retrospective case series. Patients with surgery for MacTel-associated full thickness macular hole (MTMH). A standardized data collection sheet was distributed to all surgeons. Anatomic closure and visual outcomes of MTMH 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<0.01). Twenty of 22 ILM flaps resulted in MTMH closure for a 90% success rate, which was significantly higher for ILM flaps than for ILM peels (P<0.01). At postoperative month 6 VA improved to logMAR 0.555 ± 0.405 (P<0.05). VA improved at least 2 lines in 56% and at least 4 lines in 28%. For ARTs, preoperative VA was logMAR 1.460 ± 0.391. MHD was 390.2 ± 203.7 μm (range 132 – 687 μm). All 5 ARTs resulted in MTMH closure for a 100% success rate. At postoperative month 6 VA was stable at logMAR 1.000 ± 0.246 (P=0.08). VA improved at least 2 lines in 25%. 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.

autologous retinal transplantation

full thickness macular hole

internal limiting membrane flap

internal limiting membrane peeling

Macular telangiectasia type 2

Details

Title: Subtitle: Surgical Management of Full Thickness Macular Holes in Macular Telangiectasia Type 2.A Global Multicenter Study
Creators: Jong G. Park - Oakland University
Sean D. Adrean - Retina Consultants of Orange County, Fullerton, CA, USA
Tedi Begaj - Oakland University
Antonio Capone - Oakland University
Steve Charles - University of Tennessee at Knoxville
San-Ni Chen - Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
Hung-Da Chou - Chang Gung University
Michael N. Cohen - Thomas Jefferson University
Stephanie Trejo Corona - Houston Methodist
Lisa J. Faia - Oakland University
Sunir J. Garg - Thomas Jefferson University
Bruce R. Garretson - Oakland University
Ninel Z. Gregori - Bascom Palmer Eye Institute, Miami, FL, USA
Julia A. Haller - Thomas Jefferson University
Odette Margit Houghton - Mayo Clinic Arizona, Scottsdale, AZ, USA
Jason Hsu - Thomas Jefferson University
Jaehyuck Jo - University of Ulsan
Richard S. Kaiser - Thomas Jefferson University
Chi-Chun Lai - Chang Gung University
Mohamed Moghazy Mahgoub - Ain Shams University
Mahsaw Mansoor - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, and Iowa Institute for Vision Research, University of Iowa, Iowa City, IA
Ryo Matoba - Okayama University
Yuki Morizane - Okayama University
Marcio B. Nehemy - Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, Brazil
Paul V. Raphaelian - Oakland University
Carl D. Regillo - Thomas Jefferson University
Alan J. Ruby - Oakland University
Margaret M. Runner - Oakland University
Scott R. Sneed - Oakland University
Elliott H. Sohn - University of Iowa
Marc J. Spirn - Thomas Jefferson University
James F. Vander - Thomas Jefferson University
Taku Wakabayashi - Thomas Jefferson University
Jeremy D. Wolfe - Oakland University
Charles C. Wykoff - Houston Methodist
Yoshihiro Yonekawa - Thomas Jefferson University
Young Hee Yoon - University of Ulsan
Tamer H. Mahmoud - Oakland University
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.131(1), pp.66-77
Publisher: Elsevier Inc
DOI: 10.1016/j.ophtha.2023.08.025
PMID: 37661066
ISSN: 0161-6420
eISSN: 1549-4713
Language: English
Electronic publication date: 09/01/2023
Date published: 01/2024
Academic Unit: Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
Record Identifier: 9984463159702771

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