Clinical and morphologic features of macular telangiectasia type 2: natural course of the disease
Abstract
Purpose: The purpose of this study is to report the clinical characteristics of macular telangiectasia type 2 (MacTel 2) in a natural disease course.
Materials and Methods: A retrospective analysis of patients diagnosed with MacTel 2 over a 4-year period. Best-corrected visual acuity (BCVA), fundus photography, and optical coherence tomography (OCT) images were reviewed. Differences in BCVA, fundoscopic findings, and OCT parameters were compared between the initial and final visits.
Results: The study included 28 eyes from 14 patients (11 women, 3 males), with a mean age of 65.5 ± 9.8 years. The mean follow-up period was 55.6 ± 32.9 months. The mean BCVA at baseline and final follow-up were 0.51 ± 0.6 and 0.7 ± 0.62 logMAR, respectively. At the first and last visits, the right-angle venules were the most common fundoscopic finding (78.6% for both). Subretinal neovascularization (NV) was initially present in two eyes and developed in one eye during follow-up. The mean temporal macular thickness decreased significantly during the follow-up period, while the central and nasal thickness did not show a significant change. At the last visit, focal ellipsoid zone (EZ) loss was found in 27 eyes (96.4%), compared to 24 eyes (85.7%) at baseline. External limiting membrane (ELM) loss was found in 23 eyes (82.1%) at the first visit and in 25 eyes (89.3%) at the final visit. The increase in mean length of the EZ and ELM loss during the follow-up was not statistically significant.
Conclusion: Despite the progressive effect of the disease on central visual acuity, it is very important to closely monitor these eyes for the development of secondary NV, which may develop due to degenerative and atrophic changes in the macula.
Keywords
ellipsoid zone, external limiting membrane, hyporeflective cavitation, macular telangiectasia type 2
Supporting Institution
Çukurova Üniversitesi
Thanks
Optik koherens tomografi çekimlerinde büyük emeği olan teknisyenimiz Pınar Çakır' a teşekkür ederiz.
References
- Gass JD, Oyakawa RT. Idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol. 1982;100:769-80.
- Marsonia K, Kiran Chandra K, Ali MH, Chhablani J, Narayanan R. Long term follow-up of visual acuity and incidence of subretinal neovascularization in Mactel Type 2 in 82 Eyes. Semin Ophthalmol. 2022;37:136-41.
- Powner MB, Gillies MC, Tretiach M, Scott A, Guymer RH, Hageman GS et al. Perifoveal müller cell depletion in a case of macular telangiectasia type 2. Ophthalmology. 2010;117:2407–16.
- Kedarisetti KC, Narayanan R, Stewart MW, Gurram NR, Khanani AM. Macular telangiectasia type 2: a comprehensive review. Clin Ophthalmol. 2022;10:16:3297-309.
- Wu L, Evans T, Arevalo JF. Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A, Mac Tel 2). Surv Ophthalmol. 2013;58:536-59.
- Clemons TE, Gillies MC, Chew EY, Bird AC, Peto T, Wang JJ et al. Medical characteristics of patients with macular telangiectasia type 2 (MacTel Type 2) MacTel project report no. 3. Ophthalmic Epidemiol. 2013;20:109-13.
- Charbel Issa, P, Gillies MC, Chew EY, Bird AC, Heeren TFC, Peto T et al. Macular telangiectasia type 2. Prog Retin Eye Res. 2013;34:49–77.
- Nalcı H, Şermet F, Demirel S, Özmert E. Optical coherence tomography angiography findings in type-2 macular telangiectasia. Turk J Ophthalmol. 2017;47:279-84.
- Gass JD, Blodi BA. Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study. Ophthalmology. 1993;100:1536-46.
- Cohen SM, Cohen ML, El-Jabali F, Pautler SE. Optical coherence tomography findings in nonproliferative group 2a idiopathic juxtafoveal retinal telangiectasis. Retina. 2007;27:59-66
