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Topographic distribution of vascular and neurodegenerative signs in type 2 idiopathic macular telangiectasia
Author(s) -
SALLO F,
LEUNG I,
BALASKAS K,
PAULEIKHOFF D,
BIRD AC,
PETO T
Publication year - 2013
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2013.f055.x
Subject(s) - macular telangiectasia , telangiectasia , medicine , ophthalmology , luteal phase , stage (stratigraphy) , pathology , macular degeneration , fluorescein angiography , retinal , biology , paleontology , hormone
Purpose Idiopathic macular telangiectasia type 2 (MacTel) is associated with characteristic vascular signs including leakage/staining on fluorescein angiography (FA) as well as neurodegenerative signs including a progressive loss of luteal pigment. The distribution of luteal pigment can be assessed by dual‐wavelength autofluorescence (DWAF) imaging. Our aim was to investigate the relationship of vascular and neurodegenerative signs of type 2 MacTel in FA and DWAF images. Methods FA and DWAF images were acquired using a Heidelberg Spectralis SLO and a HRA Classic SLO device respectively. Thirty eyes of 30 MacTel patients were examined. Images were aligned to attain exact correspondence. Staging of luteal pigment loss in DWAF images was performed according to the system developed by Zeimer et al. The extent of abnormalities in the two imaging modalities was compared. Results According to severity of luteal pigment loss, 6 eyes were at stage 1, 14 at stage 2 and 10 at stage 3. At stages 2 and 3, the area with early FA changes was always smaller and contained within the area of luteal pigment loss. This also held true for stage 1 except in very early cases with minimal pigment loss. In these, FA changes, especially late staining appeared more extensive. Dense pigment plaques appeared as masking dark areas in both FA and DWAF images with hyperfluorescent spots in DWAF. Subretinal neovascularization broke up the pattern in 3 eyes. Conclusion Our results indicate that in non‐neovascular type 2 MacTel, luteal pigment loss appears more extensive than vascular change. The relative time sequence of changes may provide clues to the primary underlying cause. Confirmation on a larger sample with follow‐up is indicated.