High-Resolution Imaging in Macular Telangiectasia Type 2: Case Series and Literature Review

TL;DR

This study uses high-resolution imaging to examine three cases of Macular Telangiectasia Type 2, highlighting diagnostic and management challenges.

Contribution

The paper presents a detailed case series with advanced imaging techniques to better understand MacTel type 2.

Findings

OCT and OCT-A revealed retinal changes and telangiectatic vessels in the deep capillary plexus.

Adaptive optics imaging showed a disrupted cone mosaic pattern in affected patients.

One patient developed a macular hole, successfully treated with surgery.

Abstract

Background: Macular telangiectasia (MacTel), also known as idiopathic juxtafoveolar telangiectasis (IJFTs), involves telangiectatic changes in the macular capillary network. The most common variant, MacTel type 2, has distinct clinical features and management strategies. Methods: This study offers a comprehensive review of MacTel and focuses on a series of three patients diagnosed with MacTel type 2 in our clinic. A meticulous ophthalmological evaluation, augmented by high-resolution imaging techniques like optical coherence tomography (OCT), OCT angiography (OCT-A), fundus autofluorescence (FAF), fluorescein angiography (FA), and adaptive optics (AOs) imaging, was conducted. Results: The findings revealed normal anterior segment features and a grayish discoloration in the temporal perifoveal area on fundus examination. OCT exhibited hyporeflective cavities in the inner and outer neurosensory retina, along with other changes, while OCT-A identified retinal telangiectatic vessels in the deep capillary plexus. FAF demonstrated increased foveal autofluorescence, while FA initially detected telangiectatic capillaries followed by diffuse perilesional leakage in the later phase. Adaptive optics images showed the cone mosaic pattern. Notably, one patient developed a macular hole as a complication, which was successfully managed surgically. Conclusion: This study underscores the challenges in diagnosing and managing MacTel, emphasizing the importance of a multidisciplinary approach and regular follow-ups for optimal outcomes.

Figures