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Progression of functional loss in macular telangiectasia type 2

Session Details

Session Title: Miscellaneous

Session Date/Time: Saturday 13/09/2014 | 11:00-13:00

Paper Time: 11:40

Venue: Boulevard E

First Author: : E.H.Kr├╝ger GERMANY

Co Author(s): :    F.G. Holz   T.F.C. Heeren   T. Clemons   H.P.N. Scholl   A.C. Bird   P. Charbel Issa

Abstract Details

Purpose:

To investigate progressive functional loss in patients with macular telangiectasia (MacTel) type 2 and to compare the ability to detect functional decline between microperimetry and visual acuity testing

Setting:

Prospective longitudinal observational study

Methods:

Forty patients with MacTel type 2 underwent microperimetry (MP1, Nidek) testing to topographically map macular visual function. A uniform test grid with a one degree interval between test points was used within the central visual field. Distance best corrected visual acuity (BCVA) was determined for comparison. The main outcome measure was the change of cumulative defect size (number of test points with absolute scotoma) on microperimetry testing and change in distance BCVA

Results:

Mean review period was 55.3 months (SD = 17.3 months; range: 24-87 months). In 58% of all 71 eyes included for analysis, microperimetry revealed spread (n=31) or new development (n=10) of an absolute scotoma. At the same time, BCVA decreased >2 lines in only 17%. Twenty five (35%) eyes showed no change in visual function. Presence of an absolute scotoma at baseline, but not baseline BCVA, was predictive for functional decline on longitudinal microperimetry testing. Eyes with an absolute scotoma at baseline showed further growth of the scotoma in 94%. In contrast, only 26% of eyes without an absolute scotoma at baseline developed an absolute scotoma de novo.

Conclusions:

There is progressive visual field loss in MacTel type 2. Such loss of focal retinal sensitivity typically is more sensitive to detect functional decline and may precede significant loss of visual acuity. Therefore, microperimetry may provide considerably more power when being used as a functional outcome measure in future clinical trials that aim to halt or slow the progression of MacTel type 2

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