J Korean Ophthalmol Soc.  2013 Sep;54(9):1458-1462.

A Case of Bilateral Macular Hole in a Patient with Bilateral Macular Telangiectasia

• Kim SJ
• Kim KS

Abstract

PURPOSE
To report a case of bilateral macular holes in a patient with bilateral macular telangiectasia (Mac Tel).
CASE SUMMARY
A 61-year-old male presented with decreased central vision in both eyes. His best corrected visual acuity (BCVA) was 0.8 in the right eye and 0.6 in the left eye. On fundoscopy, fluorescein angiography (FAG), and optical coherence tomography (OCT), he was diagnosed with Mac Tel type 2 combined with stage 1A of the right eye and stage 1B impending macular hole in the left eye. Two years and 8 months later, the BCVA of both eyes was unchanged. On fundoscopy, FAG and OCT, there were no definitive changes in both eyes. The patient was observed without treatment.
CONCLUSIONS
Patients with Mac Tel type 2 may be predisposed to the development of a macular hole.

Keyword

Idiopathic juxtafoveal telangiectasis; Macular hole; Macular telangiectasia; Parafoveal telangiectasis

MeSH Terms

Eye
Fluorescein Angiography
Humans
Male
Middle Aged
Retinal Perforations
Telangiectasis
Tomography, Optical Coherence
Vision, Ocular
Visual Acuity

Figure

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  Figure 1. (A, B, C, D) Fundus photographs and red free photographs of both eyes showed mild grayish discoloration of the temporal to foveal area at the initial visit. Also, the corresponding area presents loss of retinal transparency of both eyes.

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  Figure 2. (A, B) Early fluorescein angiography (FAG) of the right eye shows mild fluorescein stain of the capillary in the super-otemporal to the macula and FAG of the left eye shows telangiectatic changes in the superotemporal macula area at the initial visit. (C, D) Late FAG of both eyes show late leakage from the telangiectatic vessels at the initial visit. (E, F) Optical coherence tomo-graph (OCT) of the right eye reveals 1A impending macular hole and OCT of the left eye reveals stage 1B impending macular hole at initial visit. OCT horizontal scan through the fovea of the right eye shows that stage 1A macular hole was in fact characterized by an inner foveal cyst. The foveal floor is flat and the posterior hyaloid is still attached to the foveal center. The photoreceptor IS/OS (inner segment/outer segment) line may be intact but slightly depressed at the foveal center. OCT horizontal scan through the fovea of the left eye shows that stage 1B macular hole characterized by an foveal cyst is extending in the outer retina. There is a dis-ruption of the photoreceptor layer. The posterior hyaloid is still attached to the center of the fovea.

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  Figure 3. (A, B) Two year 8 months later, fundus photographs of both eyes show no aggravation. (C, D) On OCT horizontal scan through the fovea, there are no definitive changes in both eyes.

Reference

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