OCTA in Mac Tel 2 – New and Complimentary Multi-Modal Imaging Findings

Ethan Priel, FOPS

MOR Ophthalmology Dept., MOR Institute, Bnei Brak, Israel

Purpose: To assess the contribution of Optical Coherent Topography Angiography (OCTA) when evaluating microvasculature morphology surrounding the central macula in eyes with idiopathic macular telangiectasis type 2 (MacTel 2). Results were compared to findings from fluorescein angiography (FA), fundus autofluorescence (FAF), confocal blue reflectance (CBR) and spectral-domain OCT (SDOCT).

Results: OCTA displayed microvascular and layer-associated vascular abnormalities found in eyes with MacTel 2. Findings included truncated and irregular small vessels in all eyes, while anastomotic connections between the inner and outer retinal layers appeared in 12 eyes. Neo-vascularization was noted in 5 eyes. FA demonstrated various degrees of leakage from peri-foveal vessels in all MacTel 2 eyes, while areas of non-perfusion and cystoid macular edema (CME) were noted in 12 eyes. SDOCT showed cystic formations and outer-segment atrophy with retinal thinning in 20 eyes with MacTel 2, while in eyes with clear media CBR was able to demonstrate a white-grey halo surrounding the macula seen in 22 of eyes with MacTel 2.

Conclusion: OCTA is unique in its ability to outline macular vasculature non-invasively, while additionally presenting layer-specific localization of abnormal vascular formations, present in select stages of MacTel 2. In addition, in certain cases it can prove the presence of intra-retinal neovascularization. Leakage was noted only in FA, while SDOCT alone was able to offer retinal-thickness measurement comparisons.

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ICOP 2023
Maaike van Zuilen

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