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The preproliferative stage in type 2 macular telangiectasia (MacTel type 2)

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To study clinical and imaging features of various stages of macular telangiectasia (MacTel type 2).

Methods

In this retrospective study, cases of MacTel type 2 with fluorescein angiography (FA), optical coherence tomography (OCT) and OCT-angiography (OCTA) imaging were included. Based on angiographic perifoveal fluorescence, two groups were formed: group 1: diffuse hyperfluoroscence and group 2: diffuse + focal hyperfluoroscence. Later, based on OCT features, group 2 was subdivided into group 2A: without SRNVM and group 2B: with SRNVM. Clinical, FA, OCT and OCTA features were analysed. Eyes showing conversion to the proliferative stage at final visit were noted.

Results

Ninety-four eyes of 48 patients were included. Group 1 (n = 28) showed diffuse perifoveal hyperfluoroscence, hyperreflective middle retinal layers, absent SRNVM (p = 0.006) on OCT and dilated perifoveal capillaries in deep capillary plexus (DCP) on OCTA. Group 2A (n = 40) showed diffuse + focal perifoveal hyperfluoroscence, hyperreflective middle retinal layers (p = 0.001), hyporeflective outer retina cavities (p = 0.021), absent SRNVM with dilated and bunching perifoveal capillaries (p = 0.004) in DCP. Group 2B (n = 26) showed late diffuse + focal perifoveal hyperfluoroscence, foveal contour irregularity (p = 0.002), retinal pigment clumps (p = 0.015) and SRNVM on OCT with bunching of capillaries in DCP and vessels in outer retina (p = 0.002). Five eyes showed conversion to group 2B at final visit.

Conclusion

There exists a distinct disease stage called “preproliferative” MacTel type 2 showing clinical features of non-proliferative disease, diffuse + focal perifoveal hyperfluoroscence on FA, absent SRNVM on OCT and bunching perifoveal capillaries in DCP on OCTA. Its identification is important for suspecting proliferative disease, planning management and follow-up visit accordingly.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India

    Ramesh Venkatesh, Nikitha Gurram Reddy, Pranjal Mishra, Deepashri Mutalik, Sameeksha Agrawal, Abhishek Bhatt & Naresh Kumar Yadav

  2. Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, LL22 8DP, UK

    Arpitha Pereira

  3. Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA

    Jay Chhablani

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  1. Ramesh Venkatesh
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Contributions

RV, JC, NKY—conceptualising the study; data acquisition; analysing the data, statistics and results; interpreting the findings; writing and reviewing the manuscript. NR, PRM, SAM, DSM, AB—data acquisition and analysing the data. AP—critically reviewing the manuscript.

Corresponding author

Correspondence to Ramesh Venkatesh.

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Approval was obtained from Narayana Nethralaya Institutional Review Board and Ethics committee (C-2021–03-003).

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Obtained from the patients.

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The authors declare no competing interests.

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Venkatesh, R., Reddy, N.G., Mishra, P. et al. The preproliferative stage in type 2 macular telangiectasia (MacTel type 2). Graefes Arch Clin Exp Ophthalmol 260, 121–132 (2022). https://doi.org/10.1007/s00417-021-05371-1

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  • DOI: https://doi.org/10.1007/s00417-021-05371-1

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