Abstract
Objective: To examine the clinical features and outcomes of pars plana vitrectomy for full-thickness macular hole (MH) in patients with type 2 macular telangiectasia (MacTel).
Methods: Retrospective, interventional case series of consecutive patients with MacTel type 2 who underwent surgical repair of full thickness macular holes from January 2015 to January 2021 at a busy vitreoretinal surgery practice. The rate of macular hole closure, and visual outcome following repair were evaluated.
Results: Eight eyes of MacTel patients with full thickness macular holes were identified; however, 4 of these eyes did not meet inclusion criteria (i.e. no surgical intervention, or inadequate follow up after surgical intervention). Macular hole closure was achieved in 100% of eyes, with one eye requiring multiple surgeries to obtain closure. The mean preoperative visual acuity was 0.775 logMAR units (20/119 Snellen Equivalent) and improved to 0.725 logMAR units (20/106 Snellen Equivalent, Wilcoxon test, p=0.854), at the last known follow-up after macular hole repair. Overall, 50% patients had improvement in visual acuity at the final postoperative visit. There were no cases of postoperative retinal tears, breaks, or endophthalmitis.
Conclusions: Macular hole formation in patients with Macular telangiectasia type 2 is rare. Macular hole closure was eventually achieved in 100% of eyes. Although favorable anatomic results can be obtained with vitrectomy surgery, the postoperative visual gains are variable.