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Metamorphopsia in patients with macular telangiectasia type 2

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Abstract

Purpose To assess metamorphopsia in patients with macular telangiectasia (MacTel) type 2. Methods In a prospective observational cohort study, 40 eyes of 20 patients with MacTel type 2 were investigated by funduscopy, fluorescein angiography, optical coherence tomography and microperimetry. Metamorphopsia was assessed using Amsler grids following a standard protocol and standardized questionnaire. Results Metamorphopsia was present in 30 (83%) out of 36 nonproliferative eyes and in all four eyes with neovascular membranes. In the 30 nonproliferative eyes with distortions, metamorphopsia was always present in the nasal quadrant of the central visual field. Distortions were most pronounced in the nasal and lower quadrant in 70 and 30%, respectively. Three nonproliferative eyes with a very early and three eyes with a late disease stage did not perceive metamorphopsia. The degree of distortions was often but not necessarily correlated with the degree of leakage. Metamorphopsia was present in five out of eight eyes with normal sensitivity in microperimetry testing. Detection of scotoma by Amsler grid testing was poor. Conclusion Metamorphopsia is a frequent clinical symptom in MacTel type 2 even in the absence of neovascularization. Since macular thickness was within normal limits in such eyes, extensive swelling or distortion of the neurosensory retina would not account for metamorphopsia in contrast to other macular diseases such as age-related macular degeneration or idiopathic epiretinal membranes.

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References

  1. Gass JD, Blodi BA (1993) Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study. Ophthalmology 100(10):1536–1546

    PubMed  CAS  Google Scholar 

  2. Charbel Issa P, Scholl HPN, Helb HM, Holz FG (2007) Idiopathic macular telangiectasia. In: Holz FG, Spaide RF (eds) Medical retina. Springer, Berlin, pp 183–197

    Chapter  Google Scholar 

  3. Charbel Issa P, Scholl HP, Gaudric A, Massin P, Kreiger AE, Schwartz S, Holz FG (2008) Macular full-thickness and lamellar holes in association with type 2 idiopathic macular telangiectasia. Eye 23:435–441

    Article  PubMed  Google Scholar 

  4. Charbel Issa P, Helb HM, Rohrschneider K, Holz FG, Scholl HPN (2007) Microperimetric assessment of patients with type II macular telangiectasia. Invest Ophthalmol Vis Sci 48(8):3788–3795

    Article  PubMed  Google Scholar 

  5. Charbel Issa P, Helb HM, Holz FG, Scholl HPN (2008) On behalf of the MacTel study group: correlation of macular function with retinal thickness in nonproliferative type 2 idiopathic macular telangiectasia. Am J Ophthalmol 245:169–175

    Article  Google Scholar 

  6. Schmitz-Valckenberg S, Fan K, Nugent A, Rubin GS, Peto T, Tufail A, Egan C, Bird AC, Fitzke FW (2008) Correlation of functional impairment and morphological alterations in patients with group 2A idiopathic juxtafoveal retinal telangiectasia. Arch Ophthalmol 126(3):330–335

    Article  PubMed  Google Scholar 

  7. Finger RP, Charbel Issa P, Fimmers R, Holz FG, Rubin GS, Scholl HPN (2009) Reading performance is reduced due to parafoveal scotomas in patients with macular telangiectasia type 2. Invest Ophthalmol Vis Sci 50(3):1366–1370

    Article  PubMed  Google Scholar 

  8. Abujamra S, Bonanomi MT, Cresta FB, Machado CG, Pimentel SL (2000) Caramelli CB: idiopathic juxtafoveolar retinal telangiectasis: clinical pattern in 19 cases. Ophthalmologica 214(6):406–411

    Article  PubMed  CAS  Google Scholar 

  9. Gass JD (1982) Oyakawa RT: idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 100(5):769–780

    PubMed  CAS  Google Scholar 

  10. Amsler M (1947) L’examen qualitatif de la fonction maculaire. Ophthalmologica 114:248–261

    Article  Google Scholar 

  11. Amsler M (1953) Earliest symptoms of diseases of the macula. Br J Ophthalmol 37(9):521–537

    Article  PubMed  CAS  Google Scholar 

  12. Fujii GY, de Juan E Jr, Sunness J, Humayun MS, Pieramici DJ, Chang TS (2002) Patient selection for macular translocation surgery using the scanning laser ophthalmoscope. Ophthalmology 109(9):1737–1744

    Article  PubMed  Google Scholar 

  13. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  PubMed  CAS  Google Scholar 

  14. Gaudric A, Ducos de LG, Cohen SY, Massin P, Haouchine B (2006) Optical coherence tomography in group 2A idiopathic juxtafoveolar retinal telangiectasis. Arch Ophthalmol 124(10):1410–1419

    Article  PubMed  Google Scholar 

  15. Gass JDM (1997) Retinal capillary diseases. In: Stereoscopic atlas of macular diseases, vol 1, 4th edn. Mosby, St. Louis, pp 476–515

  16. Paunescu LA, Ko TH, Duker JS, Chan A, Drexler W, Schuman JS, Fujimoto JG (2006) Idiopathic juxtafoveal retinal telangiectasis: new findings by ultrahigh-resolution optical coherence tomography. Ophthalmology 113(1):48–57

    Article  PubMed  Google Scholar 

  17. Achard OA, Safran AB, Duret FC, Ragama E (1995) Role of the completion phenomenon in the evaluation of Amsler grid results. Am J Ophthalmol 120(3):322–329

    PubMed  CAS  Google Scholar 

  18. Schuchard RA (1993) Validity and interpretation of Amsler grid reports. Arch Ophthalmol 111(6):776–780

    PubMed  CAS  Google Scholar 

  19. Ramachandran VS, Gregory RL (1991) Perceptual filling in of artificially induced scotomas in human vision. Nature 350(6320):699–702

    Article  PubMed  CAS  Google Scholar 

  20. Gerrits HJ, Timmerman GJ (1969) The filling-in process in patients with retinal scotomata. Vision Res 9(3):439–442

    Article  PubMed  CAS  Google Scholar 

  21. Hazel CA, Petre KL, Armstrong RA, Benson MT, Frost NA (2000) Visual function and subjective quality of life compared in subjects with acquired macular disease. Invest Ophthalmol Vis Sci 41(6):1309–1315

    PubMed  CAS  Google Scholar 

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Acknowledgments

Funding/Support BONFOR Program, grant O-137.0011 (Faculty of Medicine, University of Bonn); Marie Curie Intra European Fellowship (237238) within the 7th European Community Framework Programme; The Lowy Medical Research Institute; The Macular Telangiectasia Project; EU FP6, Integrated Project “EVI-GENORET” (LSHG-CT-2005-512036). Financial Disclosure No conflicting relationship exists for any author.

Conflict of interest

None of the authors has a financial relationship with the organization that sponsored the research. The funding organizations had no role in the design or conduct of this research. The authors had full control of all primary data and agree to allow the journal to review their data if requested. The contents of this publication reflect only the author’s views and not the views of the funding organizations.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany

    Peter Charbel Issa, Frank G. Holz & Hendrik P. N. Scholl

  2. Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, UK

    Peter Charbel Issa

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  1. Peter Charbel Issa
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  2. Frank G. Holz
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  3. Hendrik P. N. Scholl
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Correspondence to Hendrik P. N. Scholl.

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Charbel Issa, P., Holz, F.G. & Scholl, H.P.N. Metamorphopsia in patients with macular telangiectasia type 2. Doc Ophthalmol 119, 133–140 (2009). https://doi.org/10.1007/s10633-009-9190-9

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  • DOI: https://doi.org/10.1007/s10633-009-9190-9

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