CHARACTERIZING RETINAL-CHOROIDAL ANASTOMOSIS IN MACULAR TELANGIECTASIA TYPE 2 WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

Abstract

PURPOSE:

To characterize structural and angiographic findings in macular telangiectasia Type 2 (MacTel 2) and examine associations with visual acuity.

METHODS:

MacTel 2 patients with complete ophthalmologic examination, including fundus photography, autofluorescence, spectral-domain optical coherence tomography, and projection-resolved optical coherence tomography angiography, were retrospectively evaluated.

RESULTS:

There were 43 eyes of 22 patients with a mean age 63.9 (±10.3) years. Six patients had diabetes. Twenty-one eyes (48.8%) had retinal-choroidal anastomoses (RCAs) without any evidence of neovascularization extending laterally in a plane above or below the retinal pigment epithelium. None of the eyes had hemorrhage, lipid, or signs of subretinal exudation. When present, an average of 55 (±33.7) individual RCAs were clustered primarily in temporal juxtafoveal region of involved eyes. Right-angle veins were seen in all 21 eyes with RCAs, and hyperpigmentation was present in 18 (P < 0.001 for both). A conical collection of hyperreflective material spanning from Bruch membrane past external limiting membrane of ≥200-μm basal diameter was found in 21 eyes and labeled outer retinal hyperreflective lesion. Retinal-choroidal anastomoses occurred in clusters, often within the outer retinal hyperreflective lesion. This lesion colocalized with focal thinning of the outer nuclear layer and was surrounded by a larger defect in the ellipsoid zone. The presence of diabetes (P = 0.015), outer retinal hyperreflective lesion (P = 0.006), RCA (P = 0.005), and ellipsoid zone defect extent (P < 0.001) were associated with decreased visual acuity.

CONCLUSION:

Retinal-choroidal anastomoses occur in eyes with MacTel 2 without signs of exudation. Retinal-choroidal anastomoses occur in numerous clusters particularly in the temporal juxtafoveal macula. Diabetes, ellipsoid zone defect extent, RCAs, and the outer retinal hyperreflective lesion predict poorer vision in MacTel 2.

• Authors: Mark P Breazzano, Lawrence A Yannuzzi, Richard F Spaide
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 40 Issue 1 Pg. 92-98 (Jan 2020) ISSN: 1539-2864 [Electronic] United States
• PMID: 31246676 (Publication Type: Journal Article)

Topics

• Aged
• Arteriovenous Fistula (diagnosis)
• Choroid (blood supply)
• Female
• Fluorescein Angiography
• Humans
• Male
• Middle Aged
• Multimodal Imaging
• Retinal Telangiectasis (diagnosis)
• Retinal Vessels (abnormalities, pathology)
• Retrospective Studies
• Tomography, Optical Coherence
• Visual Acuity (physiology)