RESUMEN
BACKGROUND: Macular telangiectasia (MacTel), also known as idiopathic juxtafoveolar telangiectasis (IJFTs), involves telangiectatic changes in the macular capillary network. The most common variant, MacTel type 2, has distinct clinical features and management strategies. METHODS: This study offers a comprehensive review of MacTel and focuses on a series of three patients diagnosed with MacTel type 2 in our clinic. A meticulous ophthalmological evaluation, augmented by high-resolution imaging techniques like optical coherence tomography (OCT), OCT angiography (OCT-A), fundus autofluorescence (FAF), fluorescein angiography (FA), and adaptive optics (AOs) imaging, was conducted. RESULTS: The findings revealed normal anterior segment features and a grayish discoloration in the temporal perifoveal area on fundus examination. OCT exhibited hyporeflective cavities in the inner and outer neurosensory retina, along with other changes, while OCT-A identified retinal telangiectatic vessels in the deep capillary plexus. FAF demonstrated increased foveal autofluorescence, while FA initially detected telangiectatic capillaries followed by diffuse perilesional leakage in the later phase. Adaptive optics images showed the cone mosaic pattern. Notably, one patient developed a macular hole as a complication, which was successfully managed surgically. CONCLUSION: This study underscores the challenges in diagnosing and managing MacTel, emphasizing the importance of a multidisciplinary approach and regular follow-ups for optimal outcomes.
RESUMEN
The current research approaches the retinal microvasculature of healthy volunteers (17 subjects), patients with diabetes mellitus without retinopathy (19 subjects), and of diabetic patients with nonproliferative (17 subjects) and proliferative (21 subjects) diabetic retinopathy, by using adaptive optics ophthalmoscopy and optical coherence ophthalmoscopy angiography. For each imaging technique, several vascular parameters have been calculated in order to achieve a comparative analysis of these imaging biomarkers between the four studied groups. The results suggest that diabetic patients with or without diabetic retinopathy prove signs of retinal arteriole structural alterations, mainly showed by altered values of wall to lumen ratio, calculated for the superior or inferior temporal branch of the central retinal artery, near the optic nerve head, and significant changes of the vascular density in the retinal superficial capillary plexus. Both adaptive optics ophthalmoscopy and optical coherence ophthalmoscopy angiography are providing useful information about the retinal microvasculature from early onset of diabetic disease, having a promising diagnostic and prognostic role in the future.