Visualization of microaneurysms in macular telangiectasia type 1 on optical coherence tomography angiography before and
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Visualization of microaneurysms in macular telangiectasia type 1 on optical coherence tomography angiography before and after photocoagulation Mitsuko Nakai 1 & Hisashi Iwami 1 & Hisashi Fukuyama 1 & Fumi Gomi 1 Received: 2 June 2020 / Revised: 9 September 2020 / Accepted: 21 September 2020 # The Author(s) 2020
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. Keywords Macular telangiectasia . Optical coherence tomography angiography . Microaneurysms . Photocoagulation
Introduction Macular telangiectasia (Mac Tel) is the name for a group of rare diseases that cause spontaneous capillary dilatation within the macula. This condition was first described by Gass and Oyakawa in 1982 as idiopathic juxtafoveal retinal telangiectasia [1]. Yannuzzi et al. later referred to it as idiopathic macular telangiectasia and classified into three types on the basis of optical coherence tomography (OCT) findings [2]. In Japan, Mac Tel type 1, which is characterized by aneurysmal telangiectasia, has a higher prevalence than Mac Tel type 2 [3]. Mac Tel type 1 is more often found in men, is usually unilateral, and is characterized by exudative lesions due to telangiectasia on the temporal side of the macula. * Fumi Gomi [email protected] 1
Department of Ophthalmology, Hyogo College of Medicine, 1-1, Mukogawa, Nishinomiya 663-8501, Japan
Mac Tel type 1 is often encountered in clinical practice, because cystoid macular edema (CME) associated with focal capillary dilatation and microaneurysms (MAs) causes visual deterioration [1, 2]. Currently, fluorescein angiography (FA) is necessary to assess the location of lesions in telangiectasia and the severity of leakage. Indocyanine green angiography (ICGA) is also useful in depictin
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