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Vishal Govindahari, Jay Chhablani, Samantha Fraser-Bell, Apoorva G Ayachit, Alessandro Invernizzi, Unnikrishnan Nair, Sumit Randhir Singh, Marco Lupidi, Dhanya V Nair, Anand Rajendran, Dinah Zur, Roberto Gallego-Pinazo, Rosa Dolz-Marco, Carlo Cagini; Multicolour imaging(MCI) in macular telangiectasia type 2A(MacTel) and comparative analysis with fundus autofluorescence(FAF). Invest. Ophthalmol. Vis. Sci. 2020;61(7):5324.
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© ARVO (1962-2015); The Authors (2016-present)
MCI uses three wavelengths of monochromatic light to capture reflectances from various levels of the retina and choroid. Lacuna exists in the characterization of various clinical features of MacTel on MCI and comparison of non-invasive imaging modalities in MacTel.We performed a retrospective, observational clinical study to understand how clinical findings at various anatomical levels in MacTel appear on MCI and to compare imaging findings (qualitative and quantitative) on MCI with FAF
Patients with a clinical diagnosis of MacTel, based on Gass and Blodi’s classification, underwent MCI, FAF and spectral-domain optical coherence tomography (SD-OCT).A comparison of imaging features of MacTel on MCI and FAF was performed with SD-OCT as the gold standard. Qualitatively the stage of the disease; the margins of involvement; hyperautofluorescence with corresponding retinal atrophy on MCI and presence of crystals were graded. Quantitatively area involved by MacTel; hypoautofluorescene and the corresponding lesions on MCI (intraretinal pigment hyperplasia and retinal pigment epithelium atrophy); the number of quadrants involved and the number of foci of right-angled venules were graded.
78 eyes of 45 patients were included in the study cohort. Both imaging modalities showed no difference with respect to Gass and Blodi’s staging. Retinal crystals were recognized on MCI in 65.3% of eyes while FAF failed to detect the same. MCI detected retinal atrophy and subretinal neovascular membrane with 92.3 and 80% sensitivity respectively. Intraretinal pigmented hyperplasia was more accurately detected (70.1 vs 58.4%, p < 0.001) compared to RPE atrophy on MCI. MCI showed larger area of involvement (6±3.1mm2 vs 5.2±3.0 mm2 signed-rank test- significant, alpha= 0.001), higher number of quadrants involved (p <0.001), better delineation of margins(49 vs 30 eyes,p=0.002) and higher mean number of vessel dipping foci (3.1 ± 2.1 vs 3.3 ± 2.2 signed-rank test, alpha= 0.001) compared to FAF.
Various parameters were more easily defined using MCI compared to FAF in MacTel and hence MCI can be considered as a non-invasive en-face depth-resolved imaging adjunct to conventional multimodal imaging in MacTel. The ability to detect imaging features such as area of retinal atrophy, retinal crystals and intraretinal pigment hyperplasia makes MCI a valuable tool in MacTel.
This is a 2020 ARVO Annual Meeting abstract.
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