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Case Reports
. 2020 Mar 7;18:100644.
doi: 10.1016/j.ajoc.2020.100644. eCollection 2020 Jun.

Autologous Neurosensory Retinal Flap for Closure of Refractory Macular Hole in a Patient With Macular Telangiectasia

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Free PMC article
Case Reports

Autologous Neurosensory Retinal Flap for Closure of Refractory Macular Hole in a Patient With Macular Telangiectasia

Andrew Hewson et al. Am J Ophthalmol Case Rep. .
Free PMC article

Abstract

Purpose: This study explores autologous neurosensory autograph for a patient with a chronic full-thickness macular hole (FTMH) and idiopathic macular telangiectasia type 2 (IMT2).

Observations: The patient had a chronic 1355 μm FTMH and best corrected visual acuity (BCVA) of 2 logMAR units after two unsuccessful attempts to close the macular hole. Following a 25-gauge vitrectomy, a 2-disc diameter neurosensory autograft from the supertemporal retina was mobilized and secured with perfluoro-N-octane (PFO) tamponade. After being postured supine for one week, the PFO was exchanged for silicone oil. Two months later, silicone oil was exchanged for 20% sulphur hexafluoride (SF6).

Conclusions and importance: The graft achieved anatomical and functional success with BCVA of 0.6 logMAR units. This case supports autologous neurosensory autograph as a technique for achieving closure of chronic macular holes refractory to conventional treatment.

Keywords: Macular hole; Macular telangiectasia; Neurosensory autograft.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
OCT of FTMH prior to his initial vitrectomy.
Fig. 2
Fig. 2
OCT of patient's FTMH, 3 years post unsuccessful repair.
Fig. 3
Fig. 3
Images of procedure: A. Endodiathermy to neurosensory donor site; B. Graft removed using grasping forceps; C. Free graft manipulated into correct position; D. PFO instilled over flap to secure it.
Fig. 4
Fig. 4
OCT post retinal autograft.
Fig. 5
Fig. 5
A. Automated pictometry using a 20-2 field study. B. Automated pictometry using a 10-2 field study.
Image 1

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