Purpose: To describe surgical outcomes of macular telangiectasia (MacTel) Type 2 associated full-thickness macular holes (FTMH) in 4 patients and to review the literature.
Methods: Retrospective interventional case series with a review of medical records, including optical coherence tomography.
Results: One eye of each patient underwent pars plana vitrectomy with internal limiting membrane peeling, gas tamponade, and prone positioning. In 2 patients, the holes did not close (final visual acuity: 20/70 and 20/200). In 1 patient, the hole reopened after 4 months (final visual acuity: 20/400). In the fourth patient, the hole remained closed (final visual acuity: 20/30). In contrast to the failed cases with large retinal cavitations seen on optical coherence tomography before FTMH formation, the successful case had small intraretinal cavitation before FTMH development, and the appearance of FTMH being similar to typical idiopathic FTMH. Adding these cases to the limited published reports resulted in closure rate of 30% for FTMH associated with MacTel.
Conclusion: Since surgical outcomes for FTMH in MacTel Type 2 may be less successful than typical idiopathic FTMH, it is important to recognize that FTMH may be associated with MacTel. Lower success rate may be because of the pathophysiology of MacTel. The degree of tissue atrophy and appearance of FTMH on optical coherence tomography may guide surgical prognosis.