Abstract
Purpose :
To identify imaging abnormalities that predict disease progression in patients with early macular telangiectasia type 2 (MacTel) using OCT angiography (OCTA).
Methods :
Retrospective analysis of OCTA in eyes with early MacTel (grades 0-2) at baseline that developed outer retinal hyper-reflectivity, pigment or exudative neovascularization (grades 3-6) during follow-up. Images were processed using an interactive ImageJ macro. Using the en face and B-scan OCTA images, we measured the area of telangiectasia in the intermediate (ICP) and deep capillary plexus (DCP), ellipsoid zone (EZ) break, interdigitation zone (IZ) break, and photoreceptor disruption, defined as hyporeflective and less distinct EZ or IZ bands. We used baseline measurements of these abnormalities and their growth rate in the first year to predict progression of MacTel, defined as advancing to higher MacTel grade during follow-up. For statistical tests, we grouped eyes by their MacTel grade at baseline.
Results :
We included 41 eyes of 26 patients with early MacTel with an average of 3.7±1.7 years follow-up, totaling 131 follow-up visits. Twenty-three eyes (56%) had progression of MacTel during follow-up. Larger IZ and EZ break areas at baseline as well as telangiectasia in the SCP were significantly associated with MacTel progression (all P < 0.05; Figure). First year growth rates of ICP and DCP telangiectasia, EZ break, and IZ break were significantly greater in eyes with MacTel progression (all P < 0.05; Table).
Conclusions :
Baseline telangiectasia and photoreceptor derangement as well as the early rate of change in these abnormalities may be useful in predicting disease progression in MacTel.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.