Macular telangiectasia

Definition: Abnormal dilatation of retinal capillaries.


Classification:

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:

  1. Asymptomatic +/- gradual reduction in vision.
  2. Foveal atrophy with CNV in severe cases.
  3. Can present with LMH or FTMH.
  4. Slit lamp – telangiectatic retinal capillaries with aneurysmal dilatations involving up to 2 DD temporal to fovea.

Investigations:

  1. FAF – hyperautofluorescent spot on fovea (due to Muller cells degeneration)
  2. FFA – CNV
  3. OCTA – Abnormal capillaries temporal fovea with atrophy
  4. OCT – cavitation lesions

Reference: Multimodal Imaging of MacTel 2 using OCTA


Differential diagnosis:

  1. Inflammatory / vaso-occlusive diseases
  2. BRVO
  3. DR
  4. AMD

Management:

  1. Most do not treatment
  2. Ix for systemic conditions – DR, HTN.
  3. CNV – no effective Rx – can consider macular laser, anti-VEGF.
  4. FTMH – PPV + ILM peel + gas – poorer success rate.

Location Birmingham Midlands Eye Centre 76 Dudley Road Birmingham B18 7QH UK Phone 0121 554 3801 Hours Mr Ch'ng | Vitreoretinal Clinic Sessions: Monday: 8.30am - 12.30pm Wednesday (alternate): 8.30am - 5.00pm Thursday: 8.30am - 12.30pm Friday: 8.30am - 12.30pm | Vitreoretinal Theatre Sessions: Wednesday (alternate): 8.30am - 5.00pm & Friday (emergency cases): 1.30pm - 5.00pm | Eye Casualty Session: Monday 1.00pm - 4.30pm |
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