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, 47 (5), 279-284

Optical Coherence Tomography Angiography Findings in Type-2 Macular Telangiectasia

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Optical Coherence Tomography Angiography Findings in Type-2 Macular Telangiectasia

Hilal Nalcı et al. Turk J Ophthalmol.

Erratum in

  • Correction.
    Turk J Ophthalmol. 2018 Feb;48(1):56. doi: 10.4274/tjo.e00001. Epub 2018 Feb 23. Turk J Ophthalmol. 2018. PMID: 29578543 Free PMC article.

Abstract

Objectives: To evaluate the vascular changes of idiopathic macular telangiectasia type 2 (MacTel 2) patients with optical coherence tomography angiography (OCTA) and correlate these changes with the findings of spectral domain optical coherence tomography (SD-OCT).

Materials and methods: Simultaneous SD-OCT and OCTA images of 10 eyes of 6 patients who were diagnosed as MacTel 2 in Ankara University Faculty of Medicine, Department of Ophthalmology were obtained and graded according to the OCTA grading system for MacTel 2.

Results: Ten eyes of 6 patients were included. Four (66%) patients were female and 2 (34%) were male. The disease was grade 0 in 2 eyes, grade 1 in 2 eyes, grade 2 in 3 eyes, grade 3 in 1 eye, grade 4 in 1 eye, and grade 5 in 1 eye. The most common findings in grade 1, 2, and 3 non-proliferative disease were thinning of the outer retinal layers, presence of intraretinal hyporeflective layers and inner limiting membrane draping. In cases with subretinal choroidal neovascularisation (CNV) in OCTA, CNV or CNV scar was present in the B-scan SD-OCT images. In a case in which OCT was within normal limits, vascular changes consistent with grade 1 disease were observed in OCTA. On the contrary, 2 patients with significant foveal atrophy and macular hole in B-scan showed changes of early disease in OCTA. In some of the eyes, OCTA revealed an intact superficial vascular layer despite visible changes in the deep layer and the presence of neovascularisation.

Conclusion: OCTA yields findings which are important for understanding the pathogenesis of the disease and providing better follow-up. Contrary to fundus fluorescein angiography, changes in the deep arterial plexus in the early disease and CNV can be clearly observed with OCTA. To achieve the best results in clinical practice, en face flow maps should be evaluated together with B-scan SD-OCT images.

Keywords: Macular telangiectasia type-2; optic coherence tomography angiography; spectral domain optic coherence tomography.

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1. Patient 6, right eye. a) Foveal avascular zone (FAZ) irregularity and reduced vascular density in the superficial vascular network; b) Optical coherence tomography angiography in the same eye shows stage 3 disease with irregularity and vascular invasion of the FAZ; c,d) B-scan imaging shows foveal atrophy accompanied by outer retinal atrophy, inner segment/outer segment band defect, and stage 2 macular hole without internal limiting membrane drape or traction
Figure 2
Figure 2. Patient 1, left eye, stage 2. a) Optical coherence tomography angiography shows minimal increase in space between vessels in the superficial vascular network; b) in the same eye, increased space between vessels and telangiectatic changes in the deep vascular network; c) B-scan imaging shows intraretinal hyperreflective cavitations
Figure 3
Figure 3. a) Patient 4, right eye, stage 4. Optical coherence tomography angiography shows neovascularization in the deep capillary network; b) B-scan optical coherence tomography in the same eye reveals classic choroidal neovascularization; c) Same patient’s left eye, stage 5. d) OCT shows pronounced atrophy of the outer retinal layers and a large, scarred fibrovascular membrane
Figure 4
Figure 4. Patient 1, right eye. a) Superficial capillary plexus appears normal on optical coherence tomography angiography imaging; b) Widened vessels and telangiectases are apparent in the deep vascular network; c) B-scan optical coherence tomography imaging is within normal limits
Figure 5
Figure 5. Patient 3, right eye. a) Capillary plexus appears within normal limits on optical coherence tomography angiography imaging; b) No findings other than minimal vessel thickening in the deep layer; c) B-scan OCT imaging shows pronounced internal limiting membrane drape, cavitation, and atrophy in the outer segments
Figure 6
Figure 6. Patient 2, right eye, stage 1. a) Optical coherence tomography angiography reveals no pronounced changes in the superficial capillary network; b) Mild telangiectatic changes in the deep capillary plexus; c) B-scan imaging shows marked intraretinal cavitation and stage 1 macular hole
Figure 7
Figure 7. Patient 4, right eye. a) No pronounced changes in the superficial vascular layer; b) Neovascularization in the normally avascular outer retinal area
Figure 8
Figure 8. Patient 1, right eye. A) Superficial capillary layer appears normal; B) Thickening and telangiectases in the vessels of the deep capillary network

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