Abstract
Purpose :
To study the demographics and multimodal imaging features of macular telangiectasia type 2 (MacTel type 2) in Korea and investigate the relationship with various signs of each modalities, visual acuity and clinical stages of MacTel type 2.
Methods :
Retrospective multicenter cross-sectional study were conducted in 6 tertiary hospital in Korea. Demographic and imaging data of fundus photographs (FP), fundus autofluorescence (FAF) images, confocal blue-light reflectance (CBR) images, fluorescein angiography (FAG), and optical coherence tomography (OCT) images of MacTel type 2 patients were collected from January 2009 to May 2019 in dataset of each hospital. We evaluate various imaging findings and lateral extents of their involvement and investigate their association with visual acuity. We also have tried to classify OCT findings according to pathophysiology and the stages of MacTel type 2.
Results :
A total of 166 eyes of 84 patients were included in the study. The mean age was 66.2 ± 10.3 years and female were predominant (75%). Mean LogMAR visual acuity was 0.282 ± 0.243 (approximately 20/40 Snellen equivalents). The typical imaging features of MacTel type 2 were found in 84.5%, 83.6%, 95.8% and 93.4% in FP, FAF, FAG and OCT, respectively. According to Gass and Blodi staging system, stage 1-5 was 3.6%, 29.5%, 31.3%, 11.4%, and 8.4%, respectively. Among various abnormal imaging features, increased AF at foveal center in FAF and inner retinal hyporeflective cavity without outer retinal abnormalities and clustered hyperreflective foci in OCT were relative early disease findings arising from Müller cell cone (MCC) degeneration. In advanced stage, there are 2 types of morphologic patterns in OCT image according to dominant pathophysiologic mechanism of neurodegeneration or vasculopathy after typical Müller cells as well as MCC degeneration.
Conclusions :
The demographics and multimodal imaging features of MacTel type 2 in Koreans were similar to previous Caucasian dominant study. MacTel type 2 was diagnosed earlier phase of disease with widespread use of newer imaging modality and better understanding of the disease. There was some limitation of currently used staging system. Our imaging findings according to disease progression might be helpful for a better classification of the disease stage and treatment decision in the clinical trials as well as in daily clinical practice.
This is a 2020 ARVO Annual Meeting abstract.