OCT Angiography and Ellipsoid Zone Mapping of Macular Telangiectasia Type 2 From the AVATAR Study

Abstract

PurposeTo evaluate alterations on optical coherence tomography angiography (OCT-A) and quantitatively assess alterations in the ellipsoid zone (EZ) in eyes with macular telangiectasia type 2 (MacTel type 2).MethodsThe Observational Assessment of Visualizing and Analyzing Vessels With Optical Coherence Tomography Angiography in Retinal Diseases study is an institutional review board-approved prospective, observational study investigating OCT-A in macular disease. Patients underwent spectral-domain (SD)-OCT and OCT-A imaging at a single visit. SD-OCT data were analyzed using a novel OCT EZ-mapping software to obtain linear, area, and volumetric measurements of the EZ-retinal pigment epithelium (RPE) complex across the macular cube. OCT-A retinal capillary density was measured using the Optovue Avanti split-spectrum amplitude-decorrelation angiography algorithm. EZ-RPE parameters were compared to age-matched, sex-matched controls.ResultsFourteen eyes of seven patients (mean age, 59 ± 6.5 years) were analyzed. Mean visual acuity was 20/45 (range, 20/20–20/150). EZ-RPE central foveal mean thickness was 27.8 ± 6.7 μm, EZ-RPE central foveal thickness was 22.1 ± 21.6 μm, EZ-RPE central foveal area was 0.17 ± 0.04 mm2, and EZ-RPE central subfield volume was 0.017 ± 0.012 mm3. Each of these measurements was significantly inversely correlated with visual acuity (P < 0.02). In addition, all of these measurements were significantly reduced compared to controls (all P ≤ 0.005). OCT-A showed a reduced parafoveal vessel density of 50.8% temporally compared to 53.8% nasally (P = 0.01) in the superficial vascular plexus. In the deep vascular plexus, similar findings were noted with a parafoveal vessel density of 56.7% temporally and 58.8% nasally (P = 0.01).ConclusionsAbnormalities in EZ-RPE thickness, area, and volume are correlated with visual acuity in MacTel type 2, and may provide quantitative markers to measure disease progression and treatment response. OCT-A was a useful adjunct for determining disease severity.

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

“…OCT-A revealed a rarefaction of capillaries in these cases, confirming that it is a powerful method in early detection of microvascular abnormalities. Furthermore, OCT-A provided valuable information so as to disease severity in other Varied optical coherence tomography angiography patterns at different stages of macular telangiectasia type 2 -analysis of 15 cases patients with MacTel 2 with its findings in keeping with other OCT-A studies (13)(14)(15). The study demonstrated strong correlations between OCT-A and early and late FA and confirmed the results reported by Toto et al (10).…”

“…OCT-A provides three-dimensional maps of macular perfusion and seems to be a promising method in the detection of early microcirculatory disorder (11). To date, there have been several studies focused on OCT-A findings in patients with Mac Tel 2 (10)(11)(12)(13). The aim of our study was to assess vascular patterns at different stages of Mac Tel 2 using OCT-A and determine the relationship between them and FA images.…”

Evaluation of 1-year follow-up results of macular telangiectasia type 2 cases by optical coherence tomography angiography

“…Optical coherence tomography angiography (OCTA) is a non-invasive imaging method for visualization of the retinal capillary network [2]. In recent years, OCTA has been examined as potential imaging modality to facilitate the diagnosis and characterization of MacTel2 [3].…”

The OCT Angiography Revolution: 5 Emerging Themes

“…10 Other conditions, such as macular telangiectasia type 2 (MacTel2) and paracentral acute middle maculopathy (PAMM) have very characteristic findings on OCTA suggesting its role as a mainstay in diagnosis of these conditions. 11, 12 In both of these conditions, the value of the depth-resolved nature of OCTA is particularly apparent. For PAMM, previous studies had strongly suggested the underlying pathophysiology was an infarct of the inner nuclear layer, but the depth-resolved vascular flow information provided through OCTA provides clear evidence of this hypothesis through hypoperfusion of the deep capillary retinal plexus.…”

“…12 For MacTel2, some of the earliest changes are subtle alterations in the temporal parafoveal deep capillary plexus. 11 OCTA easily visualizes these alterations and also functions as an excellent surveillance tool for underlying CNV.…”