Characterizing right-angled vessel in macular telangiectasia type 2 with structural optical coherence tomography

Yoo-Ri Chung,Kihwang Lee,Boram Lee,Sungmin Jang,So Min Ahn,Cheolmin Yun,Christopher Seungkyu Lee,Eun Young Choi,Jaeryung Oh,Seong-Woo Kim,Young Ho Kim

doi:10.1038/s41598-021-96789-4

Abstract

We investigated the structural findings on spectral-domain optical coherence tomography (SD-OCT) related to the presence of right-angled vessels (RAV) in patients with macular telangiectasia (MacTel) type 2 with severity 3 in Korea. A retrospective multicenter cross-sectional study was conducted in six tertiary hospitals in Korea; the study included 116 MacTel type 2 eyes with severity 3. The SD-OCT findings were compared between eyes with RAV on fundus photography or fluorescein angiography and those without RAV. Logistic regression was performed to determine factors associated with the presence of RAV. Fifty eyes presented with RAV and 61 eyes without RAV. More eyes presented with only inner retinal (IR) cavities on SD-OCT among eyes without RAV than among those with RAV (P < 0.001). However, eyes with RAV presented with IR disorganization, outer retinal (OR) cavity, and ellipsoid zone (EZ) disruption more frequently than eyes without RAV did (all P < 0.001). These SD-OCT findings were significantly associated with the presence of RAV. The presence of RAV was closely related to IR disorganization, OR cavities, and EZ disruption on SD-OCT. These findings suggest an advanced phase of MacTel type 2.

Highlights

We investigated the structural findings on spectral-domain optical coherence tomography (SD-OCT) related to the presence of right-angled vessels (RAV) in patients with macular telangiectasia (MacTel) type 2 with severity 3 in Korea
We previously reported the SD-OCT findings of MacTel type 2 in Korean patients; these patients presented with hyporeflective cavities and disruption of the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IDZ) as common features[6]
We investigated further various structural findings on SD-OCT related to the presence of RAV in patients with MacTel type 2 with severity 3

Summary

Introduction

We investigated the structural findings on spectral-domain optical coherence tomography (SD-OCT) related to the presence of right-angled vessels (RAV) in patients with macular telangiectasia (MacTel) type 2 with severity 3 in Korea. Unlike Gass’s proposal, Spaide et al.[4] reported that the presence of right-angled veissels (RAV) was associated with retinal-choroidal anastomoses (RCA) without evidence of neovascularization, such as hemorrhage, exudation, and lipids on optical coherence tomography angiography (OCTA). These vascular connections between the retinal deep capillary plexus and choroid were not a late stage phenomenon, as proposed by Gass, but could be seen with RAV, which is considered a signature of stage 3 4. Disorganization of inner retina Inner retinal cavity Only inner retinal cavity Outer retinal cavity Temporal Center Nasal Above ELM Below ELM ELM disruption EZ disruption IDZ disruption ONL collapse

Methods

Results

Conclusion