Outcome of Inverted Internal Limiting Membrane Flap Technique in Full-Thickness Macular Hole Secondary to Macular Telangiectasia Type 2

Abstract

Purpose: To report the long-term anatomic and functional outcomes of a full-thickness macular hole (FTMH) secondary to macular telangiectasia type 2 treated with a 360-degree inverted internal limiting membrane (ILM) flap technique. Methods: A single postoperative case was reviewed. Results: A 40-year-old woman presented with a 1-year history of central scotoma in the right eye. Comprehensive ophthalmic evaluation revealed a visual acuity (VA) of 20/300, and optical coherence tomography (OCT) demonstrated an FTMH secondary to macular telangiectasia type 2. The patient underwent pars plana vitrectomy with a 360-degree inverted ILM flap and gas tamponade. During the postoperative follow-up period of 24 months, OCT showed near-complete anatomic closure of the macular hole; however, persistent disruption of the outer retina remained. The VA improved to 20/200. Conclusions: FTMH is a rare complication of macular telangiectasia type 2, and surgical outcomes may be limited by underlying neurodegenerative retinal changes. While the inverted ILM flap technique has demonstrated efficacy in achieving satisfactory closure of these macular holes, the visual outcomes are often worse compared with the outcomes for idiopathic macular holes. Further studies with larger cohorts and longer follow-ups are needed to evaluate the long-term surgical outcomes and efficacy of this technique in macular holes associated with macular telangiectasia type 2.