Abstract
Purpose :
Macular telangiectasia type 2 (MacTel) is a retinal disease that leads to central visual distortions such as metamorphopsia and central scotomas in affected individuals. The clinical diagnosis of MacTel can be challenging, and the use of multimodal imaging approaches improves diagnostic potential. Fluorescence lifetime imaging ophthalmoscopy (FLIO) has proven to be a useful tool in diagnosing this condition. The aim of this study is to investigate all suspected MacTel patients that received FLIO imaging in order to determine sensitivity and specificity of FLIO in our clinical practice.
Methods :
From March 2018 until January 2022, 161 patients were referred for FLIO imaging at the Moran Eye Center to be evaluated for MacTel. A prototype Heidelberg Engineering FLIO was used to obtain autofluorescence lifetimes in short (SSC, 498-560 nm) and long (LSC, 560-720 nm) spectral channels. All patients received a comprehensive ophthalmologic exam and most patients received standard clinical imaging including optical coherence tomography (OCT).
Results :
119 patients had characteristic patterns of MacTel on FLIO imaging and the diagnosis of MacTel was clinically confirmed. Images of 5 patients were inconclusive on FLIO imaging, due to severe cataracts (3 cases) or poor image quality (2 cases). All of these 124 patients were clinically diagnosed with MacTel. The remaining 37 patients did not show characteristic signs of MacTel in FLIO imaging. None of these patients were diagnosed with MacTel, and further testing revealed the presence of other retinal diseases, such as cone dystrophy, tamoxifen retinopathy, hydroxychloroquine toxicity, or age-related macular degeneration.
Conclusions :
The ability of FLIO to detect disease related changes in patients with MacTel has proven to be diagnostically advantageous in clinical practice. In our cohort of 161 patients evaluated for MacTel, FLIO has a high sensitivity (96%) and specificity (100%) when determining if a patient has MacTel or not.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.