Diabetic retinopathy and type 2 macular telangiectasia

Abstract

AbstractPurpose To establish the severity and progression of diabetic retinopathy (DR) and maculopathy (DMac) in patients with both Type 2 macular telangiectasia (MacTel) and diabetes mellitus (DM) and relate these to characteristics of MacTel.Methods MacTel is a bilateral retinal disease affecting central vision. The MacTel Project enrols from 27 sites around the world; those in the study have multiple imaging performed yearly. Colour fundus, fluorescein angiographic, OCT and autofluorescence images were graded at the Reading Centre of Moorfields Eye Hospital, UK for characteristics of MacTel, DR and DMac; diabetes status and clinical data were obtained from the co‐ordinating centre (EMMES). Grading for DR and DMac was on 7‐field stereo images for baseline, and 3‐fields for follow‐ups using ETDRS standards.Results The mean age of MacTel patients at diagnosis was 57±9 years. Diabetes was diagnosed in 188 out of 555 MacTel patients enrolled. MacTel patients with DM had an average HbA1c of 6.9±1.4%. Over 70% of patients had no DR at baseline. Only one patient developed mild and one moderate non‐proliferative DR during the over 3 years follow‐up. Only one patient developed DMac requiring laser treatment. MacTel patients with DM had significantly lower visual acuity at baseline (No DM 70.3±0.7 letters, DM 65.±1.6; p=0.02). MacTel patients with DM progressed significantly more on NEI‐VFQ and on OCT characteristics at the fovea, such as foveal empty cavities and neuroretinal changes (all p<0.05). Progression of the severity of MacTel was significantly modified by DM (p<0.05).Conclusion DM has a clinically meaningful impact on visual functioning and progression of MacTel. Further study is required to understand the relationship between the two diseases.