Original article
Fundus Autofluorescence in Type 2 Idiopathic Macular Telangiectasia: Correlation with Optical Coherence Tomography and Microperimetry

https://doi.org/10.1016/j.ajo.2009.04.030Get rights and content

Purpose

To use multiple imaging methods to investigate patients with type 2 idiopathic macular telangiectasia (IMT) at different disease severity stages so as to characterize and categorize disease progression through the full spectrum of disease phenotypes.

Design

Observational case series.

Methods

Twelve patients with type 2 IMT (22 eyes) examined with fundus photography, angiography, optical coherence tomography imaging, fundus autofluorescence (FAF), and microperimetry testing in an institutional setting.

Results

Eyes examined by multiple imaging methods were classified into 5 proposed categories (0 through 4): category 0 (fellow) eyes had normal results on all imaging methods. Category 1 eyes had increased foveal autofluorescence on FAF imaging as the only imaging abnormality. Category 2 eyes had increased foveal autofluorescence together with funduscopic and angiographic features typical of type 2 IMT. Category 3 eyes had additional evidence of foveal atrophy on optical coherence tomography, and category 4 eyes had all the above features plus clinically evident pigment clumping. FAF signal increased in intensity in the foveal region from category 0 through category 3, whereas category 4 eyes demonstrated a mixed pattern of increased and decreased FAF signal.

Conclusions

The findings here outline a sequence of progressive changes seen with multiple imaging methods in advancing stages of disease. Increase in foveal autofluorescence is an early anatomic change in type 2 IMT that may precede typical clinical and angiographic changes. Loss of macular pigment density in the fovea and a changing composition of fluorophores in the retinal pigment epithelium may underlie these changes on FAF in the fundus.

Section snippets

Methods

The record of 12 patients with the diagnosis of type 2 IMT, seen at the National Eye Institute between 2003 and 2007, were reviewed retrospectively. The diagnosis in all cases was made based on typical fundus findings such as parafoveal graying or opacification of the retina, intraretinal crystalline deposits, and right-angled vessels, as well as the presence of parafoveal leakage on FA. Patients received complete ophthalmic examinations including best-corrected visual acuity (VA) testing using

Patient Population

Twelve patients (7 males and 5 females; mean age, 60 years) with findings of type 2 IMT in at least 1 eye were examined. One eye (Patient 8, right eye) was excluded from the series because of the presence of central maculopathy from central serous retinopathy as evidenced by the presence of pinpoint leakage on FA and subretinal fluid on OCT. Imaging data were unavailable for 1 eye (Patient 11, left eye) with advanced subretinal fibrosis resulting from neovascularization; this eye was not

Discussion

In this retrospective, cross-sectional case series, we used a multiple method approach to examine the ocular features of 12 patients with type 2 IMT. We observed on multiple modality examination that mild foveal increases in autofluorescence on FAF are detectable at a stage when other clinical or angiographic findings are not present (category 1). In eyes in which subtle and limited clinical and angiographic abnormalities first appear, this increase in central FAF signal becomes more prominent.

References (24)

  • T.A. Albini et al.

    Optical coherence tomography of idiopathic juxtafoveolar telangiectasia

    Ophthalmic Surg Lasers Imaging

    (2006)
  • V. Gupta et al.

    Optical coherence tomography in group 2A idiopathic juxtafoveolar telangiectasis

    Ophthalmic Surg Lasers Imaging

    (2005)
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