Swept source optical coherence tomography and optical coherence tomography angiography for diagnosis and follow‐up of type 2 macular telangiectasia

Abstract

AbstractPurpose: To report the contribution of swept source optical coherence tomography (SS‐OCT) and OCT‐angiography (OCTA) imaging findings in the diagnosis and the follow‐up of type 2 macular telangiectasia (MacTel 2).Methods: A retrospective study of eight eyes (five patients) with various stages of MacTel2. Clinical staging of MacTel 2 was performed based on SS‐OCT and OCTA.Results: The average age was 63 years old. The mean follow up was 33.6 months. A very early non‐proliferative stage was found in three eyes, an early non‐proliferative stage in three eyes and a late proliferative stage in two eyes. The most common findings on SS‐OCT were disruption of the inner segment‐outer segment (IS/OS) layer in all eyes, parafoveal hyporeflective retinal cavities in four eyes and superficial retinal crystals in three eyes. Two eyes showed irregularity of foveal contour and internal limiting membrane draping associated with retinal vascular channels connecting the superficial and deep retinal layers and forming retinal‐choroidal anastomosis. OCTA findings included capillary telangiectatic changes and enlargement of intercapillary spaces predominantly in deep capillary plexus (DCP) in comparison with superficial capillary plexus (SCP) in all eyes. Irregularity of capillary size in the perifoveal region of the DCP and SCP, predominantly temporal to the fovea, was found in five eyes. Circumferential capillary distortions and subretinal neovascularization at the level of the outer retina and choriocapillaris were detectable in two eyes. At the mean period of follow‐up, lesions were stable in two eyes, an extension of IS/OS disruption was noted in four eyes, parafoveal cavities' appearance and/or extension was found in two eyes and neovascular proliferation appeared in one eye.Conclusions: SS‐OCT and OCTA imaging features facilitate the diagnosis, staging and long‐term follow‐ up of MacTel 2. Further prospective studies are need to characterize the progressive and sequential nature of structural changes in this disease.