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Bish Pal, Celine Sys, Maria Gkika; Long term visual and anatomic outcomes of Type 1 Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2702.
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© ARVO (1962-2015); The Authors (2016-present)
To report visual and anatomic outcomes of different management options in eyes with Type 1 idiopathic Macular Telangiectasia (MacTel)
A retrospective review of patients with symptomatic MacTel Type 1 seen at Moorfields Eye Hospital was performed. Eyes with diabetic retinopathy, age-related macular degeneration, or any other macular pathology were excluded. Demographic data, medical and ocular history, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measured by optical coherence tomography (OCT) were recorded
12 eyes were included in this study. 6 eyes were treated with macular laser (Group1) and 4 eyes with a combination of treatment (macular laser±intravitreal antivascular endothelial growth factor±intravitreal steroids) (Group2). 2 patients were just observed (Group3). In all treated eyes treatment was initiated if BCVA was less than 6/9 Snellen. Mean age was 48.3±15.3 years. At the last follow-up, there was a mean±SD decrease in BCVA of 1±1.3 lines in Group1, 0.8±1.7 lines in Group2 and 0.5±0.7 lines in Group3. In 5 eyes BCVA was stable. These were eyes that either left untreated because BCVA was better than 6/9 Snellen or their treatment was initiated when BCVA was better than 6/18 Snellen. In 1 eye (Group2) there was an improvement of 1 line. However, BCVA changes are not at a statistically significant level (p=0.105, Wilcoxon Singed Rank Test). Also, CRT changes are not statistically significant (p=0.638, Wilcoxon Singed Rank Test). OCT revealed intraretinal cysts and exudates in all eyes, however their presence is not correlated to BCVA (p=0.777, Spearman Test). BCVA preservation is related to extrafoveal disease manifestation. Disruption of the photoreceptor layer is related to worse initial and final BCVA.
Macular laser alone or in combination with other treatments stabilised, but did not improve the BCVA or CRT significantly in eyes with Type 1 MacTel. The suboptimal outcomes may be related to the retrospective nature of the study with small sample size. If the treatment is initiated early in the disease the outcomes maybe better.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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