Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy.
Eye Clinic, Hospital "S. G. MOSCATI," ASL TA, Statte, Italy.
Eur J Ophthalmol. 2021 Mar;31(2):NP81-NP85. doi: 10.1177/1120672119886177. Epub 2019 Nov 6.
BACKGROUND/PURPOSE: Full-thickness macular hole is a complication of idiopathic macular telangiectasia type 2 with a low surgical closure rate and a poor functional recovery. We analyze morphologic and functional outcomes after an inverted internal limiting membrane-flap technique for full-thickness macular hole complicating idiopathic macular telangiectasia type 2 using optical coherence tomography and microperimetry.
A 77-year-old man presented us complaining visual impairment in the left eye (20/40) due to a full-thickness macular hole complicating idiopathic macular telangiectasia type 2. The patient underwent vitrectomy with an inverted internal limiting membrane-flap technique and injection of 22% SF6 gas. Optical coherence tomography and functional analysis, including visual acuity test and microperimetry, were performed before surgery and over 3 months. Optical coherence tomography scans revealed macular hole closure at 1-month follow-up. Visual acuity and retinal sensitivity improved from 20/40 to 20/20 and from 13.1 to 14.9 dB, respectively. Fixation stability (bivariate contour ellipse area) improved from 2.02 to 1.58 deg, from 5.44 to 4.24 deg and from 9.72 to 7.58 deg, at 68%, 95%, and 99% of fixation points, respectively.
Inverted internal limiting membrane-flap technique may be an alternative approach in patients with full-thickness macular hole complicating diopathic macular telangiectasia type 2, and microperimetry may be a useful tool to analyze related functional changes.
背景/目的：特发性黄斑毛细血管扩张症 2 型可引起全层黄斑裂孔，其手术闭合率低，功能恢复效果差。我们使用光学相干断层扫描和微视野计分析了特发性黄斑毛细血管扩张症 2 型全层黄斑裂孔患者采用内界膜翻转瓣技术后的形态和功能结果。
一名 77 岁男性因特发性黄斑毛细血管扩张症 2 型全层黄斑裂孔导致左眼视力下降（20/40）而就诊。患者接受了玻璃体切除术，术中采用内界膜翻转瓣技术并注射 22%SF6 气体。在术前和术后 3 个月内进行了光学相干断层扫描和功能分析，包括视力测试和微视野计检查。光学相干断层扫描显示黄斑裂孔在术后 1 个月时闭合。视力和视网膜敏感度分别从 20/40 提高至 20/20 和从 13.1dB 提高至 14.9dB。在 68%、95%和 99%的注视点，固视稳定性（双变量轮廓椭圆面积）分别从 2.02 度改善至 1.58 度、从 5.44 度改善至 4.24 度和从 9.72 度改善至 7.58 度。
内界膜翻转瓣技术可能是治疗特发性黄斑毛细血管扩张症 2 型全层黄斑裂孔的一种替代方法，微视野计可能是分析相关功能变化的有用工具。
