Original article
Macular Telangiectasia Type 1: Capillary Density and Microvascular Abnormalities Assessed by Optical Coherence Tomography Angiography

https://doi.org/10.1016/j.ajo.2016.04.005Get rights and content

Purpose

To describe microvascular abnormalities and capillary density in macular telangiectasia type 1 (MT1) using optical coherence tomography angiography (OCTA), and correlate them with fluorescein angiography (FA).

Design

Observational case series.

Methods

Seven patients with MT1 and 12 age-matched controls were included. Focal microvascular dilations were identified on 3 × 3 mm OCTA and early-frame FA images. OCTA images were processed to determine the global capillary density after subtraction of larger vessels and cystoid edema cavities. Local capillary densities were calculated inside 100-μm circles around telangiectasias, projected over superficial (SCP) and deep capillary plexuses (DCP). They were compared to a random sample of 100-μm circles generated in each OCTA image. FA images were processed to measure mean perifoveal intercapillary areas (PIA), inversely reflecting capillary density.

Results

In MT1 eyes, fewer telangiectasias were identified with OCTA than with FA (P = .016), exclusively localized in the DCP (P = .016). Rarefaction of both capillary plexus and abnormal microvascular morphology were better identified by OCTA than by FA. The global capillary density on OCTA was significantly lower in MT1 eyes than in fellow and control eyes, respectively: SCP, 0.347 vs 0.513 (P = .004) and 0.560 (P = .0005); DCP, 0.357 vs 0.682 (P = .016) and 0.672 (P = .0005). Capillary density was significantly reduced around telangiectasias in both SCP (P = .021) and DCP (P = .042). Capillary density of the SCP correlated inversely with the mean PIA on FA (r = −0.94, P = .017). LogMAR visual acuity was inversely correlated with SCP (r = −0.88, P = .012) and DCP capillary densities (r = −0.79, P = .048).

Conclusions

OCTA confirmed that global and focal capillary depletion is associated with MT1.

Section snippets

Subjects

This observational case series adhered to the tenets of the Declaration of Helsinki and Swiss federal regulations and was approved by the local Ethics Committee of the Swiss Department of Health (CER-VD no. 19/15). The study was conducted from June 1 to October 1, 2015, at Jules-Gonin Eye Hospital, Lausanne, Switzerland.

Medical records, optical coherence tomography (OCT), OCTA, FA, and indocyanine green angiography (ICGA) images from 7 consecutive subjects presenting with MT type 1 were

Results

There was no difference between the 7 patients presenting MT type 1 and the 12 healthy controls in terms of age (57.1 ± 10.2 vs 57.8 ± 6.9 years, P >.99) and sex (all male subjects).

Discussion

With OCTA, telangiectasic microaneurysms typical of MT type 1 were identified as focal dilations of the microvasculature. Although OCTA detected fewer lesions than FA in each affected eye, OCTA showed that telangiectasias were exclusively located in the deep capillary plexus. Moreover, in MT type 1 eyes the density of the macular capillary network was reduced in both superficial and deep plexuses, as compared to fellow and healthy control eyes, and the capillary network density of both plexuses

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