Morphological, vascular, and functional changes in macular telangiectasia type 2 in Egyptian patients

TL;DR

This study examines eye changes in Egyptian patients with macular telangiectasia type 2 using OCT-A, revealing vascular and thickness changes linked to disease progression.

Contribution

The study provides one of the few Egyptian analyses of MacTel-2 staging and its correlation with visual acuity and retinal vessel density.

Findings

Significant decreases in superficial and deep parafoveal vessel density in MacTel-2 eyes compared to controls.

Foveal and parafoveal retinal thickness was significantly reduced in affected eyes.

Stage 4 MacTel-2 was identified in 25% of cases, with neovascular patterns including sea-fan and dead tree networks.

Abstract

Little documented studies regarding analysis of macular telangiectasia type 2 in Egyptian patients. This prospective study included 24 eyes with MacTel-2, and 24 control eyes. Spectral-domain optical coherence tomography Angiography (OCT-A) was performed. Staging of eyes with MacTel-2, quantification of Foveal and parafoveal vascular density and full retinal thickness were performed. In MacTel-2 eyes, the superficial capillary vessel density was significantly decreased in the temporal, superior and inferior para-foveal area (p-value = 0.004, < 0.001 and 0.002 respectively). Only temporal parafoveal deep vessel density showed significant decrease in the MacTel-2 group as compared with the normal control group (49.6% versus 54.01%, p value = 0.010). There was a statistically significant decrease in the foveal and all the para-foveal thickness as compared with normal control group (P < 0.001). One-fourth of cases were classified as stage 4 MacTel-2. The patterns of neovessels were sea-fan, tangled or dead tree network, equally distributed among the six affected eyes. A significant reduction in both foveal density and visual acuity was documented with disease progression. This study emphasizes the role of OCT-A in diagnosis, staging and identification of neovascular pattern of MacTel-2. Furethermore, this study is considered one of the few Egyptian studies in staging the disease providing correlation to visual acuity, macular thickness and vessel density affection.

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