Abstract
Purpose :
To describe the multimodal imaging (MMI) findings in Mac Tel2 of a Latin American cohort and to validate the new severity classification by the MacTel Project.
Methods :
A retrospective chart and MMI review of eyes diagnosed with Mac Tel2 in the past decade (2013-2023). MMI included blue fundus autofluorescence, SD-OCT, confocal blue reflectance imaging, OCT angiography, and fluorescein angiography. Eyes were classified according to the new severity classification by the MacTel Project.
Results :
A total of 208 eyes of 112 pts (88 females) with a mean of age 62 yrs (range 25-81) were included. Systemic comorbidities included 27 with HTN, 36 with DM and 6 with hypothyroidism. Of the patients with DM, there were 4 eyes with mild NPDR, 2 eyes with moderate NPDR and 3 eye with PDR. The mean presenting BCVA was 20/38 (20/20 -20/400). There were 16 (14.3%) unilateral Mac Tel2 eyes (7 OS and 9 OD).
Findings included hyper FAF (93.3%), cavitations in the inner (62.5%) and outer retina (40%), discontinuities in the EZ (85%), outer retinal hyperreflectivity (18%) in SD-OCT, macular neovascularization (3%), increased confocal blue reflectance (82%), crystals (17%), pigment (26%), FA abnormalities (92%) and OCTA abnormalities (55%).
In 25% of patients there was a ≥ 2 grade difference between eyes in the severity classification. Grade 0 eyes had a mean logMAR visual acuity of 0.205, Grade 1 had 0.308, Grade 2 had 0.366, Grade 3 had 0.464, Grade 4 had 0.467, Grade 5 had 0.689 and Grade 6 had 0.797.
Conclusions :
Mac Tel2 is mostly a bilateral but asymmetric entity. Up to 14% may present unilaterally. Earliest abnormality detected in MMI was hyper FAF. The severity classification correlated well with the presenting visual acuities.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.