scholarly journals Bilateral Type 1 Idiopathic Macular Telangiectasia in a Female Patient: Multimodal Imaging of a Rare Presentation

2021 ◽  
pp. 373-379
Author(s):  
Mohamad Reza Niyousha ◽  
Narges Hassanpoor ◽  
Sasan Jafari
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Female Patient ◽  
Multimodal Imaging ◽  
Rare Presentation ◽  
Macular Telangiectasia ◽  
Healthy Female ◽  
Capillary Plexus ◽  
Idiopathic Macular Telangiectasia

We report a bilateral case of type 1 idiopathic macular telangiectasia (IMT) in a female patient. A 40-year-old otherwise healthy female with gradual vision loss since 2 years ago with best-corrected visual acuity of 20/400 in both eyes was referred. Her past medical history was negative for any systemic disease including diabetes and systemic hypertension. Color fundus photography showed bilateral loss of normal foveal reflex with macular edema. Fluorescein angiography demonstrated symmetric perifoveal telangiectasia mainly in the superior and nasal macula in both eyes with late staining and leakage. Spectral-domain optical coherence tomography revealed significant intraretinal fluid bilaterally and subretinal fluid in the left eye. Optical coherence tomography angiography (OCTA) revealed obvious saccular parafoveal capillary telangiectasia and capillary dropout as well as decreased vascular density in both superficial and deep capillary plexus. Deep capillary plexus involvement in OCTA was more evident than superficial plexus. Based on the patient’s medical history and multimodal imaging, the diagnosis of bilateral IMT type 1 was made. The patient underwent 5 intravitreal monthly injection of bevacizumab in both eyes, which resulted in macular edema resolution. However, after 3 months of discontinuation of intravitreal bevacizumab, macular edema relapsed. In conclusion, type 1 IMT can occur bilaterally in an otherwise healthy female patient as a very rare presentation. To the best of our knowledge, this case is the 4th case of bilateral type 1 IMT reported in a female.

scholarly journals Multimodal Imaging Findings and Treatment with Dexamethasone Implant in Three Cases of Idiopathic Macular Telangiectasia Type 1

2021 ◽  
pp. 92-97
Author(s):  
Paola Cirafici ◽  
Maria Musolino ◽  
Michela Saccheggiani ◽  
Carlo Enrico Traverso ◽  
Massimo Nicolò
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Multimodal Imaging ◽  
Diagnostic Errors ◽  
Wide Field ◽  
Vascular Changes ◽  
Macular Telangiectasia ◽  
First Choice ◽  
Idiopathic Macular Telangiectasia

This is a report of 3 patients diagnosed with idiopathic macular telangiectasia type 1 (MacTel 1) at Medical Retina Center of the University of Eye Clinic of Genova and then prospectically followed for a mean time of 26 months between 2016 and 2019. It is the first report of patients affected by MacTel 1 treated with dexamethasone (DEX) implant as a first choice of treatment. Aim of our study is to better characterize the disease using a multimodal wide-field imaging and to determine efficacy of DEX implant on MacTel 1 in terms of central macular thickness (CMT) and best-corrected visual acuity (BCVA). MacTel 1 is a rare unilateral disease, characterized by telangiectatic retinal capillaries, cystoid macular edema, and lipid deposition occurring temporal to the fovea. Patients underwent a comprehensive ophthalmic examination, BCVA, swept-source optical coherence tomography (SS-OCT), SS-OCT angiography (SS-OCTA), ultra-widefield (UWF) color, and fluorescein angiography (FA) fundus photograph. All the patients presented monolateral reduced BCVA and macular edema with increased CMT evaluated by SS-OCT. With SS-OCTA, we showed that the telangiectasia-associated vascular changes originate in the deep retinal vascular plexus and as a consequence macular edema and exudation develop causing vision loss. Furthermore, UWF imaging helped us to highlight vascular changes typical of Coats Disease at the far retinal periphery. All the patients were treated with DEX intravitreal implant, showing a decrease in CMT and a stabilization of visual acuity. Due to the recurrent nature of macular edema, patients underwent a mean of 4 DEX implants during the follow-up period. In order to address the clinical features of this uncommon disease avoiding diagnostic errors, it might be important to use a multimodal imaging approach. The anatomical and functional beneficial effects of DEX implant were well evident although transient.

scholarly journals Efficacy of Laser Photocoagulation for Type 1 Idiopathic Macular Telangiectasia: A Retrospective Study

2021 ◽  
pp. 9-16
Author(s):  
Hirofumi Kono ◽  
Katsuhiko Yokoyama ◽  
Daiji Kishi ◽  
Kenichi Kimoto ◽  
Toshiaki Kubota
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Photocoagulation ◽  
Macular Thickness ◽  
University Hospital ◽  
Type I ◽  
Central Macular Thickness ◽  
Macular Telangiectasia ◽  
Idiopathic Macular Telangiectasia

Aims: The aim of this study was to evaluate the efficacy of laser photocoagulation for type 1 idiopathic macular telangiectasia (MacTel). Study Design: Retrospective case series Place and Duration of Study: Department of Ophthalmology, Oita University Hospital during the period from 2004 to 2013. Patients and Methods: Six eyes of 6 patients with type 1 MacTel diagnosed consecutively in the Oita University Hospital during the period from 2004 to 2013 were studied. They showed macular edema and their visual acuity were deteriorated due to leakage from the aneurysms. Four patients were male and two were female with an average age of 64 years (range: 41 to 74 years). Informed consent was obtained from each patient and the laser photocoagulation was applied to leaky aneurysms in all eyes. The central macular thickness (CMT) was measured by optical coherence tomography (OCT). Mean follow up period was 44 months (range: 24 - 63 months).  Results: Mean visual acuity significantly increased from logMAR 0.25±0.27 at baseline to logMAR 0.11±0.14 (P<0.05) at the last visit. Visual acuity improved more than 0.2 logMAR in five eyes and was stable (gain or loss of < 0.3 logMAR) in one eye. Mean central macular thickness significantly decreased from 454±181 μm at baseline to 231±67 μm (P<0.05) at the last visit. Macular edema was not detected by OCT inany patients at the last visit. Conclusion: In type I MacTel, laser photocoagulation may achieve a visual improvement and normalize the central macular thickness.

scholarly journals Visualization of microaneurysms in macular telangiectasia type 1 on optical coherence tomography angiography before and after photocoagulation

2020 ◽  
Author(s):  
Mitsuko Nakai ◽  
Hisashi Iwami ◽  
Hisashi Fukuyama ◽  
Fumi Gomi
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Thickness ◽  
Optical Coherence ◽  
Macular Telangiectasia ◽  
Corrected Visual Acuity ◽  
Before And After

Abstract Purpose To evaluate changes in the visualization of microaneurysms (MAs) in cases of macular telangiectasia (Mac Tel) type 1 on optical coherence tomography angiography (OCTA) before and after treatment with direct photocoagulation and to evaluate their relationship with treatment efficacy. Methods The study included 12 eyes from 12 patients (8 men, 4 women; mean age 72.1 years) with Mac Tel type 1 accompanied by cystoid macular edema. OCTA for the evaluation of MAs was performed before and 15 min and 6, 12, and 24 weeks after photocoagulation. The best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were also evaluated. Results A total of 73 MAs were detected within the areas of macular edema on OCTA, and 39 of these underwent photocoagulation. At 15 min after treatment, 17 MAs were no longer visible on OCTA. At 6 weeks, two MAs had reappeared, whereas five additional MAs were no longer visible. The CRT in eyes with resolved MA was significantly less than that in eyes with persistent MAs (p = 0.016). At 24 weeks, seven eyes had no visible MAs, and the BCVA was not significantly different from baseline. Conclusion OCTA can monitor changes in the visualization of MAs associated with Mac Tel type 1 after direct photocoagulation. Eyes in which MAs disappeared after treatment could recover from cystoid macular edema.

MULTIMODAL IMAGING IN TYPE 2 IDIOPATHIC MACULAR TELANGIECTASIA

Retina ◽  
2015 ◽  
Vol 35 (4) ◽  
pp. 742-749 ◽  
Author(s):  
Ferenc B. Sallo ◽  
Irene Leung ◽  
Traci E. Clemons ◽  
Tunde Peto ◽  
Alan C. Bird ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Macular Telangiectasia ◽  
Idiopathic Macular Telangiectasia

scholarly journals Pars Plana Vitrectomy Combined with Focal Endolaser Photocoagulation for Idiopathic Macular Telangiectasia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gaku Terauchi ◽  
Celso Soiti Matsumoto ◽  
Kei Shinoda ◽  
Harue Matsumoto ◽  
Yutaka Imamura ◽  
...  
Keyword(s):  
Fluorescein Angiography ◽  
Pars Plana Vitrectomy ◽  
Late Phase ◽  
Macular Telangiectasia ◽  
Before And After ◽  
Antiangiogenic Drugs ◽  
Pars Plana ◽  
Idiopathic Macular Telangiectasia ◽  
Sd Oct

Background. To report the outcome of pars plana vitrectomy (PPV) combined with intraoperative endolaser focal photocoagulation (PC) on eyes with idiopathic macular telangiectasis (MacTel) type 1.Methods. This was a retrospective study of two female patients with MacTel type 1 who were resistant to focal photocoagulation, sub-Tenon triamcinolone injection, and/or antiangiogenic drugs. The best-corrected visual acuity (BCVA) was determined, and fluorescein angiography (FA) and spectral domain optical coherence tomography (SD-OCT) were performed before and after surgery for up to 19 months.Results. After surgery, the BCVA gradually improved from 20/100 to 20/20 at 19 months in Case 1 and from 20/50 to 20/13 at 13 months in Case 2. Fluorescein angiography (FA) showed leakage at the late phase, and OCT showed that the cystoid macular edema was resolved and the fovea was considerably thinner postoperatively.Conclusion. Patients with MacTel type 1 who are refractory to the other types of treatments can benefit from PPV combined with intraoperative endolaser focal PC with functional and morphological improvements.

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