Session Title: Free Paper Session 21: Imaging III
Session Date/Time: Sunday 10/09/2017 | 08:00-09:30
Paper Time: 08:24
Venue: Room 113
First Author: : Y.Nozaki JAPAN
Co Author(s): : M. Nozaki N. Hasegawa A. Kato T. Yasukawa M. Yoshida Y. Ogura
In Japanese patients, the most frequent type of idiopathic macular telangiectasia (MacTel) has been reported as type 1, whereas the perifoveal type 2 is not common. Sometimes it is difficult to differentiate MacTel type 1from old macular branch retinal vein occlusion (BRVO) using fluorescein angiography (FA) due to dye leakage. The purpose of this study was to re-evaluate the patients who were previously diagnosed as MacTel by FA using optical coherence tomography angiography (OCTA) which can not detect dye leakage.
Retrospective review of the charts of consecutive patients who were diagnosed and followed as MacTel in Nagoya City University Hospital.
Previous diagnosis of MacTel were made based on the findings of fundus examination, FA/ Indocyanine green angiography (HRA2, Heidelberg) and SD-OCT (Cirrus HD-OCT, Zeiss). The OCTA images were obtained by using RTVue XR Avanti (Optovue, Inc.) at 3 x 3 mm. The differential diagnosis was performed using analysis of OCTA images, and the number of microaneurysms in the superficial capillary plexus and the deep capillary plexus were counted.
Twenty-two eyes from 21 patients were included in this study. Ten were men and 11 were women. The mean age ± SD was 74.1 ± 6.4 years (range, 59-86 years). Five of 21 eyes (24 %) were treatment-naïve, and 16 eyes were previously treated by anti-VEGF drug, focal laser photocoagulation and topical injection of triamcinolone acetonide. Two eyes were diagnosed as macular BRVO based on the OCTA images. Eighteen eyes (90 %) were diagnosed as MacTel type 1, and only 2 eyes (10 %) were diagnosed as MacTel type 2. In MacTel type 1, 75.6±8.4 % of microaneurysms were located in the deep capillary plexus.
In our study, OCTA could clearly detect the retinal vessel abnormalities in the eyes with MacTel, and was useful in differentiating from old macular BRVO. In MacTel type 2, it was reported that important retinal vascular changes occurred in the deep capillary plexus using OCTA. Our study demonstrated that the microaneurysms were also mainly located in the deep capillary plexus in MacTel type 1.