Inverted internal limiting membrane-flap technique to treat a full-thickness macular hole complicating idiopathic macular telangiectasia type 2

2019 ◽  
pp. 112067211988617
Author(s):  
Giancarlo Sborgia ◽  
Alfredo Niro ◽  
Marco Coassin ◽  
Luigi Sborgia ◽  
Francesco D’Oria ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Flap Technique ◽  
Macular Telangiectasia ◽  
Full Thickness Macular Hole ◽  
Macular Telangiectasia Type 2 ◽  
Idiopathic Macular Telangiectasia

Background/purpose: Full-thickness macular hole is a complication of idiopathic macular telangiectasia type 2 with a low surgical closure rate and a poor functional recovery. We analyze morphologic and functional outcomes after an inverted internal limiting membrane-flap technique for full-thickness macular hole complicating idiopathic macular telangiectasia type 2 using optical coherence tomography and microperimetry. Case report: A 77-year-old man presented us complaining visual impairment in the left eye (20/40) due to a full-thickness macular hole complicating idiopathic macular telangiectasia type 2. The patient underwent vitrectomy with an inverted internal limiting membrane-flap technique and injection of 22% SF6 gas. Optical coherence tomography and functional analysis, including visual acuity test and microperimetry, were performed before surgery and over 3 months. Optical coherence tomography scans revealed macular hole closure at 1-month follow-up. Visual acuity and retinal sensitivity improved from 20/40 to 20/20 and from 13.1 to 14.9 dB, respectively. Fixation stability (bivariate contour ellipse area) improved from 2.02 to 1.58 deg2, from 5.44 to 4.24 deg2 and from 9.72 to 7.58 deg2, at 68%, 95%, and 99% of fixation points, respectively. Conclusion: Inverted internal limiting membrane-flap technique may be an alternative approach in patients with full-thickness macular hole complicating diopathic macular telangiectasia type 2, and microperimetry may be a useful tool to analyze related functional changes.

Spontaneous Closure of a Macular Hole in Macular Telangiectasia Type 2

2020 ◽  
pp. 247412642095890
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
Mark Gillies
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Spontaneous Closure ◽  
Full Thickness ◽  
External Limiting Membrane ◽  
Macular Telangiectasia ◽  
History Of ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: Spontaneous closure of a macular hole in macular telangiectasia type 2 (MacTel) with vision improvement is described. Methods: A case report is presented. Results: A 71-year-old man presented with a 1-week history of distorted vision in his left eye. Left visual acuity (LVA) was 20/80. Optical coherence tomography showed an almost full-thickness left macular hole with an intact internal limiting membrane drape. Small inner retinal cavitations were present at the right macula; multimodal imaging confirmed MacTel. Managed conservatively, at 5 months the patient’s LVA had improved to 20/60, the defect was no longer full thickness, and the external limiting membrane had reconstituted. At the right macula, the inner cavitations grew and outer cavitations developed, but the external limiting membrane remained intact. At 32 months, right VA was 20/20 and LVA was 20/40. Conclusions: This case of MacTel with spontaneous closure of a macular hole was associated with an overlying internal limiting membrane drape.

Vitrectomy with the inverted internal limiting membrane flap technique in eyes with full-thickness macular hole and dry age-related macular degeneration

2020 ◽  
pp. 112067212092137
Author(s):  
Zofia Michalewska ◽  
Jerzy Nawrocki
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Age Related Macular Degeneration ◽  
Full Thickness ◽  
Flap Technique ◽  
Age Related ◽  
Macular Holes ◽  
Full Thickness Macular Hole

Purpose To present effects of the inverted internal limiting membrane flap technique in full-thickness macular holes coexisting with dry age-related macular degeneration. Methods Our database was retrospectively reviewed in order to spot patients with the simultaneous diagnosis of dry age-related macular degeneration and full-thickness macular hole. Vitrectomy with the inverted internal limiting membrane flap technique was performed. Inclusion criteria were full-thickness macular hole, drusen, vitrectomy performed, and spectral domain optical coherence tomography (Copernicus HR, Optopol, Poland) or swept source optical coherence tomography (Triton, Topcon, Japan) before surgery, then 1 week (±3 days), 1 month (±1 week), 3 months (±1 month), 6 months (±1 month), 12 months (±2 months), and 18 months to 12 years after surgery. Main outcome measures Closure of macular hole and visual acuity at the final control. Results A total of 18 eyes of 12 patients (mean age: 68 years) were included. Mean minimum macular hole diameter was 493 μm. Mean maximum macular hole diameter was 1072 μm. Macular hole was closed in 16 eyes after first surgery and in all eyes after second surgery. Improvement of visual acuity was statistically significant ( P = 0.05), but there was no statistical significant correlation observed between initial macular hole diameters and final visual acuity ( P > 0.1). Conclusion The inverted internal limiting membrane flap technique improves anatomical and functional results in eyes with coexisting dry age-related macular degeneration and full-thickness macular holes. Final development of choroidal neovascularization or geographic atrophy is possible in rare cases.

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

2020 ◽  
Vol 4 (5) ◽  
pp. 494-497
Author(s):  
Alexander G. Miller ◽  
Rohit Chandra ◽  
Charles Pophal ◽  
Jerome P. Schartman ◽  
Joan H. Hornik ◽  
...  
Keyword(s):  
Macular Hole ◽  
Macular Hole Surgery ◽  
Macular Telangiectasia ◽  
Macular Telangiectasia Type 2 ◽  
Idiopathic Macular Telangiectasia
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