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Judy E. Kim, Peter A. Karth; Full Thickness Macular Holes in Idiopathic Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3778.
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Idiopathic macular telangiectasia (IMT) Type 2 is an uncommon retinal condition that may be rarely complicated by development of full thickness macular hole (FTMH). There are only few reports in the literature regarding management and outcome of these patients. We describe two patients with type 2 IMT and FTMH who underwent vitreoretinal surgery for closure of macular holes.
Retrospective chart review was conducted. These patients were evaluated by means of optical coherence tomography (OCT), fundoscopy, and fluorescein angiography (FA) throughout their pre- and post-operative course.
Both patients showed findings typical for type 2 IMT bilaterally, including large lacunae and retinal thinning seen on OCT and telagiectatic vessels seen on FA. Three eyes exhibited FTMH and one eye had a lamellar hole. Pars plana vitrectomy was performed in the right eye of both patients using typical surgical methods for management of FTMH, including peeling of the internal limiting membrane, C3F8 gas tamponade, and face down positioning, without success.
Outcomes of vitreoretinal surgery for closure of FTMH in the setting of type 2 IMT may be less successful than typical macular hole surgery without associated IMT. This may be explained by recent findings that there is a depletion of Müller cells in the perifoveal region in type 2 IMT causing atrophy of retinal tissue versus otherwise intact retinal tissue as is seen in typical macular holes.
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