Abstract
Purpose :
To assess longitudinal surgical outcomes of macular telangiectasia type 2 macular hole (MacTel MH) with idiopathic MH.
Methods :
A retrospective, single tertiary center study of patients who underwent macular hole surgery between 2015-2023. Patients with characteristic optical coherence tomography (OCT) findings of MacTel in boths eyes or who had undergone fluorescence angiography were classified as MacTel MH. Baseline and postoperative visual acuity (VA) and OCT parameters were reviewed.
Results :
A total of 27 eyes with MacTel MH and 243 eyes with idiopathic MH were included. The average time between surgery had no difference (46.26 ± 54.84 vs 31.42 ± 55.05, P = 0.185). Macular hole closure rate was better achieved in idiopathic MH group than MacTel MH group at postoperative 2 years (93.0 % vs 80.0 %). Temporal recovery of ellipsoid zone (EZ) and external limiting membrane (ELM) was more prominent with MacTel MH group (MacTel MH vs idiopathic MH; 53.3 % vs 25.3 %; 33.3 % vs 17.1 %, respectively). Final visual acuity showed no statistically significant difference between two groups, though with multiple regression analysis, MH pathology showed significant association with final visual outcome (p<0.001).
Conclusions :
This is the first report to analyze surgical outcomes of MacTel MH in long term and compared the postoperative change with idiopathic MH. Even though hole closure rate was lower with MacTel patients, EZ and ELM restoration rate was higher with MacTel group over time. It has been suggested that Muller cell dysfunction is related with pathogenesis of MacTel. We assume that post operative microglia change would have affected the restoration of outer retinal layer of patients, and further studies are needed for clarification.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.