Definition: Abnormal dilatation of retinal capillaries.
Type 1 (MacTel 1) – congenital unilateral – uncommon
Type 2 (MacTel 2) – acquired bilateral in middle aged – common
Type 3 – uncommon occlusive and rarely understood
Signs and symptoms:
- Asymptomatic +/- gradual reduction in vision.
- Foveal atrophy with CNV in severe cases.
- Can present with LMH or FTMH.
- Slit lamp – telangiectatic retinal capillaries with aneurysmal dilatations involving up to 2 DD temporal to fovea.
- FAF – hyperautofluorescent spot on fovea (due to Muller cells degeneration)
- FFA – CNV
- OCTA – Abnormal capillaries temporal fovea with atrophy
- OCT – cavitation lesions
Reference: Multimodal Imaging of MacTel 2 using OCTA
- Inflammatory / vaso-occlusive diseases
- Most do not treatment
- Ix for systemic conditions – DR, HTN.
- CNV – no effective Rx – can consider macular laser, anti-VEGF.
- FTMH – PPV + ILM peel + gas – poorer success rate.