Varied optical coherence tomography angiography patterns at different stages of macular telangiectasia type 2 – analysis of 15 cases

Purpose
The aim of the study was to assess vascular patterns in patients with different stages of macular telangiectasia (MacTel) type 2 using optical coherence tomography angiography (OCT-A) and compare these findings with standard fluorescein angiography (FA).

Material and methods
We retrospectively analysed medical records of 15 patients with macular telangiectasia type 2. All patients underwent a comprehensive ocular assessment, including best corrected visual acuity (BVCA), slit-lamp biomicroscopy, dilated fundus examination and colour fundus photography. Fluorescein angiography and optical coherence tomography angiography were performed. The pattern of vascular abnormalities in optical coherence tomography angiography was compared to fluorescein angiography findings.

Results
15 patients with MacTel 2 were enrolled in the study. The mean age was 62.7 years (range: 46–92). The mean visual acuity was 20/45 (range: 20/20 to 20/150). Hypertension coexists with MacTel 2 in 73.3% cases. The optical coherence tomography angiography findings included a reduction in density of superficial and deep capillaries, dilated capillaries, and neovascularization in the outer retinal layers. The features seen in optical coherence tomography angiography corresponded well with changes observable in fluorescein angiography. The vascular alterations were asymmetrical in 7 out of 15 patients, which was in keeping with fluorescein angiography findings.

Conclusion
Optical coherence tomography angiography is a valuable tool in the assessment of patients with different stages of MacTel 2, even in asymptomatic cases. In this study, the optical coherence tomography angiography showed a high correlation with fluorescein angiography images. More importantly, it revealed subtle vascular changes in 2 eyes, which appeared normal in fluorescein angiography. The optical coherence tomography angiography findings confirm the asymmetrical course of the MacTel 2, which hinders the diagnosis.