August 2021
Volume 62, Issue 11
Open Access
ARVO Imaging in the Eye Conference Abstract  |   August 2021
Retinal Vascular Changes in Macular Telangiectasia Type 2 (MacTel2) using Wide-Field Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA)
Author Affiliations & Notes
  • Itika Garg
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Raviv Katz
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Ying Cui
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
  • Rongrong Le
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Wenzhou Medical University Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  • Ying Zhu
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
  • Jade Y. Moon
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Chibuike Uwakwe
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Edward S. Lu
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Dimitrios Ntentakis
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • David M. Wu
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Leo A. Kim
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Dean Eliott
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Deeba Husain
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Demetrios G. Vavvas
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Joan W. Miller
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • John B. Miller
    Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Harvard Retinal Imaging Lab, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Itika Garg, None; Raviv Katz, None; Ying Cui, None; Rongrong Le, None; Ying Zhu, None; Jade Moon, None; Chibuike Uwakwe, None; Edward Lu, None; Dimitrios Ntentakis, None; David Wu, Massachusetts Eye and Ear Infirmary (P); Leo Kim, CureVac AG (F), National Eye Institute (F), Pykus Therapeutics (I), Pykus Therapeutics (S); Dean Eliott, Alcon (C), Aldeyra Therapeutics (I), Allergan (C), Dutch Ophthalmics (C), Glaukos (C), Neurotech Pharmaceuticals (F), Pykus Therapeutics (I); Deeba Husain, Allergan (C), Commonwealth Grant (F), Genetech (C), Lions Vision Gift (F), Macular Society (F), OMEICOS Ophthalmics, Inc. (C); Demetrios Vavvas, Alcon Research Institute (F), Loefflers Family Foundation (F), National Eye Institute (F), Olix Pharmaceuticals, Inc. (C), Research to Prevent Blindness (F), Valitor, Inc (C), Yeatts Family Foundation (F); Joan Miller, Druslov Therapeutics (S), Genentech/Roche (C), Genentech/Roche (R), Heidelberg Engineering (C), Heidelberg Engineering (R), KalVista Pharmaceuticals (C), KalVista Pharmaceuticals (R), Lowy Medical Research Institute (F), ONL Therapeutics (C), ONL Therapeutics (P), ONL Therapeutics (R), Sunovion (C), Sunovion (R), Valeant Pharmaceuticals/Mass. Eye and Ear (P), Valeant Pharmaceuticals/Mass. Eye and Ear (R); John Miller, Alcon (C), Allergan (C), Genentech (C), Sunovion (C), Zeiss (C)
  • Footnotes
    Support  Lions International Fund (Grant 530125 and 530869).
Investigative Ophthalmology & Visual Science August 2021, Vol.62, 10. doi:
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      Itika Garg, Raviv Katz, Ying Cui, Rongrong Le, Ying Zhu, Jade Y. Moon, Chibuike Uwakwe, Edward S. Lu, Dimitrios Ntentakis, David M. Wu, Leo A. Kim, Dean Eliott, Deeba Husain, Demetrios G. Vavvas, Joan W. Miller, John B. Miller; Retinal Vascular Changes in Macular Telangiectasia Type 2 (MacTel2) using Wide-Field Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA). Invest. Ophthalmol. Vis. Sci. 2021;62(11):10.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : MacTel2 is a primary retinal neurodegenerative disease with an unclear pathogenesis. Numerous imaging modalities have been used to characterize its unique findings, primarily focusing on the parafoveal region. We aim to describe more peripheral retinal vascular changes in MacTel2 using WF SS-OCTA.

Methods : We conducted a single center cross-sectional observational study (March 2019-January 2021), using WF SS-OCTA to obtain 12x12 mm scans centered on fovea. The ARI Network (Zeiss Portal v5.4) was used to quantify vascular metrics like vessel density (VD), vessel skeletonized density (VSD) in superficial capillary plexus (SCP), deep capillary plexus (DCP) and whole retina; and foveal avascular zone (FAZ) area, circularity and perimeter. Mixed-effects multiple regression models adjusting for age were used for statistical analysis.

Results : We included 38 MacTel2 eyes of 19 patients and 54 eyes of 35 patients as controls. The groups were matched based on age (median 58 vs 59 years, p=0.23), gender (p=0.31) and race (p=0.30). Thirteen MacTel2 patients (68.4%) had diabetes mellitus and/or hypertension, with no evidence of associated retinopathy. The central subsector of MacTel2 eyes showed a significant increase in the DCP VD (β=0.08, p<0.001) and VSD (β=2.86, p<0.001); and whole retina VD (β=0.06, p=0.02) and VSD (β=1.70, p=0.04). Conversely, when assessing beyond the parafoveal region, the outer nasal subsector had a significant decrease in SCP VD (β=-0.03, p=0.01) and VSD (β=-1.05, p=0.01); and the whole retina VD (β=-0.03, p=0.01) and VSD (β=-1.01, p=0.01). Additionally, the extended C1 nasal inferior subsector had a significant decrease in whole retina VSD (β=-0.52, p=0.048) only. There was no difference in the other subsectors vessel metrics or the FAZ parameters (p>0.05).

Conclusions : Herein, we present the first study to look at potential WF vascular changes in MacTel2 using WF OCTA. Our results demonstrate that the nasal region between the fovea and optic disc exhibit decreased vessel densities. Future studies correlating histology with WF OCTA may help to glean insights on its pathophysiology.

This is a 2021 Imaging in the Eye Conference abstract.

 

WF SS-OCTA of a MacTel2 eye

WF SS-OCTA of a MacTel2 eye

 

ETDRS grids overlaying the WF SS-OCTA heat map (C=Central disk, 1mm diameter; S=Superior; I=Inferior; T=Temporal; N=Nasal; I=Inner Ring, radius 0.5-1.5mm; O=Outer Ring, 1.5-3mm; Extended rings: C1, 3–4.5mm and C2, 4.5-6mm)

ETDRS grids overlaying the WF SS-OCTA heat map (C=Central disk, 1mm diameter; S=Superior; I=Inferior; T=Temporal; N=Nasal; I=Inner Ring, radius 0.5-1.5mm; O=Outer Ring, 1.5-3mm; Extended rings: C1, 3–4.5mm and C2, 4.5-6mm)

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