Vitreomacular interface abnormalities in type 2 macular telangiectasia (MacTel)

• Published in: Graefe's archive for clinical and experimental ophthalmology 2024-05, Vol.262 (5), p.1455-1463
• Main Authors: Venkatesh, Ramesh, Mangla, Rubble, Handa, Ashit, Chitturi, Sai Prashanti, Parmar, Yash, Sangoram, Rohini, Yadav, Naresh Kumar, Chhablani, Jay
• Format: Article
• Language: English
• Subjects: Acuity; Cross-Sectional Studies; Diabetic Retinopathy; Eye; Humans; Macula Lutea; Medicine; Medicine & Public Health; Ophthalmology; Retinal Diseases - diagnosis; Retinal Diseases - etiology; Retinal Disorders; Retinal Perforations - diagnosis; Retinal Perforations - etiology; Retrospective Studies; Telangiectasis; Tomography, Optical Coherence - methods; Vision Disorders; Visual acuity
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-023-06330-8

Purpose To describe the different types of vitreomacular interface abnormalities (VMIA) seen on optical coherence tomography (OCT) in type 2 macular telangiectasia (MacTel) and explain the possible reasons for its development. Methods In this retrospective cross-sectional study, type 2 MacTel eyes with macular volumetric OCT imaging protocol were included to identify different types of VMIA such as abnormal PVD, vitreomacular traction (VMT), ERM, and lamellar and full-thickness macular hole. The VMIA findings were then correlated with different MacTel disease stages and visual acuity. Results One thousand forty-three OCTs of 332 type 2 MacTel eyes from 169 patients at different visits were examined. VMIA was detected in 709 (68%) of those OCT scans in 216 (65%) eyes. There were 273 (39%), 31 (4%), 89 (13%), 7 (1%), and 381 (54%) OCT scans with vitreomacular adhesion, VMT, ERM, and inner and outer lamellar macular holes discovered respectively. VMIA eyes had a high frequency of abnormal PVD ( p  = 0.001) and retinal pigment clumps (RPCs) [ p  = 0.032]. Eyes with abnormal PVD ( p  = 0.034) and RPC ( p  = 0.000) had a higher rate of ERM development. RPC was linked to an increased risk of developing ERM (odd ratio 2.472; 95% CI 1.488–4.052). RPC and ERM contributed significantly to poor visual acuity (0.661 ± 0.416, 20/92). Conclusion OCT reveals a high frequency of VMIA in advanced type 2 MacTel eyes. RPC could be responsible for the development of anomalous PVD, as well as subsequent VMIAs and ERM. Additional work is required to examine the long-term changes and surgical outcomes of these eyes.