# Idiopathic macular telangiectasia type 1: Clinical, multimodal imaging features and response to treatment

## TL;DR

This study examines the eye condition idiopathic macular telangiectasia type 1, using imaging techniques and evaluating treatment responses.

## Contribution

The study identifies intravitreal dexamethasone implants as a more effective treatment than anti-VEGF therapy for idiopathic macular telangiectasia type 1.

## Key findings

- Idiopathic macular telangiectasia type 1 is characterized by vascular changes in the inferotemporal macular quadrant.
- Intravitreal dexamethasone implants showed better outcomes in reducing macular edema compared to anti-VEGF therapy.
- Multimodal imaging revealed distinctive vascular alterations such as telangiectasias and microaneurysms.

## Abstract

To describe the clinical characteristics, multimodal imaging findings, and treatment response in patients with idiopathic macular telangiectasia type 1 (MactTel Type 1).

This retrospective cohort study involved patients affected by idiopathic MactTel Type 1. Multimodal imaging with fundus photography, optical coherence tomography (OCT), and optical coherence tomography angiography (OCT-A) and fluorescein angiography were reviewed. Treatment response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) and dexamethasone (DEX) implants was evaluated.

A retrospective, observational study including 10 eyes from 10 patients diagnosed with MactTel Type 1. All eyes exhibited telangiectasias and microaneurysms in the foveal region. OCT showed intraretinal cysts and macular thickening. OCT-A demonstrated a mild reduction in superficial capillary density and numerous telangiectasias in the deep capillary plexus, correlating with macular edema. Fluorescein angiography revealed prominent parafoveal capillaries with late-phase leakage. Moreover, the presence of equatorial leakage was identified in 20% of cases and vascular hyperfluorescence in 60% of cases. Complete response to treatment was observed in 40% patients.

MactTel type 1 predominantly affects the temporal retinal quadrants. While anti-VEGF therapy is minimally effective, intravitreal DEX appears to be a promising alternative.

MacTel Type 1 predominantly affects the inferotemporal macular quadrant, presenting with characteristic vascular alterations such as telangiectasias and microaneurysms. Anti-VEGF therapy has shown limited efficacy, as MacTel Type 1 is a non-neovascular condition; conversely, intravitreal dexamethasone (DEX) implants have demonstrated better outcomes by reducing macular edema and preserving anatomical integrity.

MacTel Type 1 predominantly affects the inferotemporal macular quadrant, presenting with characteristic vascular alterations such as telangiectasias and microaneurysms.

Anti-VEGF therapy has shown limited efficacy, as MacTel Type 1 is a non-neovascular condition; conversely, intravitreal dexamethasone (DEX) implants have demonstrated better outcomes by reducing macular edema and preserving anatomical integrity.

This study provides a detailed characterization of idiopathic MacTel Type 1, highlighting distinctive vascular changes—particularly in the inferotemporal retina—through multimodal imaging. It is confirmed that intravitreal DEX implants are a more effective therapeutic option than anti-VEGF agents, offering anatomical and functional outcomes with a mean follow-up of 3 years.

This study provides a detailed characterization of idiopathic MacTel Type 1, highlighting distinctive vascular changes—particularly in the inferotemporal retina—through multimodal imaging.

It is confirmed that intravitreal DEX implants are a more effective therapeutic option than anti-VEGF agents, offering anatomical and functional outcomes with a mean follow-up of 3 years.