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

Sborgia, Giancarlo; Niro, Alfredo; Coassin, Marco; Sborgia, Luigi; D’Oria, Francesco; Pastore, Valentina; Albano, Valeria; Tritto, Tiziana; Sborgia, Alessandra; Boscia, Francesco; Alessio, Giovanni

doi:10.1177/1120672119886177

Cited by 6 publications

(9 citation statements)

References 31 publications

(42 reference statements)

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“…The inverted ILM flap technique has demonstrated a higher or similar closure rate in large MHs than the conventional ILM peeling technique, although its superiority with respect to long-term functional outcome is inconclusive. 23 , 24 , 25 Some studies suggested that the inverted ILM flap technique is effective in MH complicated by other macular pathologies, such as type 2 idiopathic macular telangiectasia 26 and dry age-related macular degeneration. 27 The inverted ILM flap technique was selected in the current case because exudative changes due to nAMD might have hampered MH closure.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous development of full-thickness macular hole and neovascular age-related macular degeneration

Aoki

Imaizumi

2022

American Journal of Ophthalmology Case Reports

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Purpose To present a case of full-thickness macular hole (MH) with treatment-naïve neovascular age-related macular degeneration (nAMD). Observations A 74-year-old woman presented with sudden visual impairment and floaters in her left eye. Fundus examination revealed retinal hemorrhages and hemorrhagic pigment epithelial detachment at the fovea. Optical coherence tomography angiography revealed both type 1 nAMD and stage 4 MH obscured by blood. After the first intravitreal aflibercept injection, early pars plana vitrectomy in addition to the inverted internal limiting membrane flap technique was performed to close MH without complications. This improved the patient's visual acuity. Throughout the postoperative follow-up period of 18 months, recurrent exudates from nAMD required repetitive aflibercept injections; MH relapse was not observed. Conclusions MH can be complicated by acute, treatment-naïve nAMD. Early surgical closure of secondary MH combined with anti-vascular endothelial growth factor therapy for nAMD may yield a satisfactory visual outcome.

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Section: Discussionmentioning

confidence: 99%

Simultaneous development of full-thickness macular hole and neovascular age-related macular degeneration

Aoki

Imaizumi

2022

American Journal of Ophthalmology Case Reports

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“…They reported a successful closure of the FTMH and an improvement of vision to 20/20. [ 13 ] However, the follow-up period was relatively short at 3 months. Thus, the outcome after a long follow-up period has still not been determined.…”

Section: Discussionmentioning

confidence: 99%

“…Sborgia et al [13] reported a single case of MacTel type 2 with an FTMH that had been treated by PPV using the inverted ILM-flap technique. They reported a successful closure of the FTMH and an improvement of vision to 20/20 [13] . However, the follow-up period was relatively short at 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…They reported that this technique resulted in a successful closure of the FTMH, with an improvement of vision to 20/20. [ 13 ] However, their report had only 1 patient, with a short follow-up period of 3 months. The outcomes of this technique to treat an FTMH associated with MacTel after a long postoperative period have not been determined.…”

Section: Introductionmentioning

confidence: 99%

“…Sborgia et al [13] were the first to report on the effect of the inverted ILM-flap technique in treating an FTMH associated with MacTel type 2. They reported that this technique resulted in a successful closure of the FTMH, with an improvement of vision to 20/20 [13] . However, their report had only 1 patient, with a short follow-up period of 3 months.…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Macular hole as a complication of type 2 macular telangiectasia: Case report and surgical technique

de Oliveira Miranda,

Moreira-Neto,

Moreira

2024

Journal Français d'Ophtalmologie

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

Cited by 6 publications

References 31 publications

Simultaneous development of full-thickness macular hole and neovascular age-related macular degeneration

Simultaneous development of full-thickness macular hole and neovascular age-related macular degeneration

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

Macular hole as a complication of type 2 macular telangiectasia: Case report and surgical technique

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