Natural history and effect of therapeutic interventions on subretinal fluid causing foveal detachment in macular telangiectasia type 2

Mehta, Hemal; Müller, S. C.; Egan, Catherine; Esposti, Simona Degli; Tufail, Adnan; Sim, Dawn A; Holz, Frank G.; Browning, Andrew C.; Amoaku, Winfried; Issa, Peter Charbel; Gillies, Mark C

doi:10.1136/bjophthalmol-2016-309237

Cited by 13 publications

(8 citation statements)

References 17 publications

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“…Presently, there are no treatments for MacTel. Intravitreal steroid or anti-vascular endothelial growth factor injections have not been promising and seem to have no effect on improving visual outcome 31–33 . The effect of ciliary neurotrophic factor may be beneficial and is currently under investigation 34, 35…”

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confidence: 99%

Fluorescence Lifetime Imaging Ophthalmoscopy: A Novel Way to Assess Macular Telangiectasia Type 2

Sauer

Gensure

Hammer

et al. 2018

Ophthalmology Retina

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confidence: 99%

Fluorescence Lifetime Imaging Ophthalmoscopy: A Novel Way to Assess Macular Telangiectasia Type 2

Sauer

Gensure

Hammer

et al. 2018

Ophthalmology Retina

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“…Blue-light reflectance imaging as well as fluorescein angiography appeared helpful, but other imaging modalities also were discussed. 178,[182][183][184][185][186][187][188] FLIO images show very distinct changes at the area of the MacTel zone, as τ m prolongs in a crescent-shaped manner temporal to the fovea in early stages. In more advanced stages, FAF lifetimes of the entire MacTel area are shifted to longer means in an oval-shaped manner.…”

Section: Macular Telangiectasia Typementioning

confidence: 99%

“…They show very low levels and an accumulation in a ring-shaped manner around MacTel area. 77,102,[169][170][171][172][173][174][175] At this point, there is no treatment of MacTel available, and intravitreal injections of steroids or anti-VEGF have not been successful, [176][177][178] but ciliary neurotrophic factor may be beneficial and is currently being investigated. Therefore, the call for a reliable imaging modality to diagnose the disease at early stages is increasing.…”

Section: Macular Telangiectasia Typementioning

confidence: 99%

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

et al. 2018

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Autofluorescence-based imaging techniques have become very important in the ophthalmological field. Being noninvasive and very sensitive, they are broadly used in clinical routines. Conventional autofluorescence intensity imaging is largely influenced by the strong fluorescence of lipofuscin, a fluorophore that can be found at the level of the retinal pigment epithelium. However, different endogenous retinal fluorophores can be altered in various diseases. Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an imaging modality to investigate the autofluorescence of the human fundus in vivo. It expands the level of information, as an addition to investigating the fluorescence intensity, and autofluorescence lifetimes are captured. The Heidelberg Engineering Spectralis-based fluorescence lifetime imaging ophthalmoscope is used to investigate a 30-deg retinal field centered at the fovea. It detects FAF decays in short [498 to 560 nm, short spectral channel (SSC) and long (560 to 720 nm, long spectral channel (LSC)] spectral channels, the mean fluorescence lifetimes (τm) are calculated using bi- or triexponential approaches. These are meant to be relatively independent of the fluorophore's intensity; therefore, fluorophores with less intense fluorescence can be detected. As an example, FLIO detects the fluorescence of macular pigment, retinal carotenoids that help protect the human fundus from light damages. Furthermore, FLIO is able to detect changes related to various retinal diseases, such as age-related macular degeneration, albinism, Alzheimer's disease, diabetic retinopathy, macular telangiectasia type 2, retinitis pigmentosa, and Stargardt disease. Some of these changes can already be found in healthy eyes and may indicate a risk to developing such diseases. Other changes in already affected eyes seem to indicate disease progression. This review article focuses on providing detailed information on the clinical findings of FLIO. This technique detects not only structural changes at very early stages but also metabolic and disease-related alterations. Therefore, it is a very promising tool that might soon be used for early diagnostics.

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“…55 Recently, among 427 cases from 3 sites contributing to the international MacTel type 2 Project, 6 cases (1.4%) presented with subretinal fluid causing foveal detachment, a proportion similar to the rate of CSC observed among MacTel cases in the present study. 56 Four cases showed fluctuation in the amount of subretinal fluid, with spontaneous resolution in 3 cases, and partial resolution followed by recurrence in one case, that ultimately responded to intravitreal anti-VEGF. The last 2 cases responded to intravitreal anti-VEGF, and a neovascular lesion was suspected.…”

Section: Discussionmentioning

confidence: 95%

Concurrent Idiopathic Macular Telangiectasia Type 2 and Central Serous Chorioretinopathy

Matet

Yzer

Chew

et al. 2018

Retina

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Natural history and effect of therapeutic interventions on subretinal fluid causing foveal detachment in macular telangiectasia type 2

Abstract: As the natural history of this unusual MacTel phenotype is not characterised by rapid visual decline, intervention with intravitreal anti-VEGF or steroid therapy may not be necessary.

Cited by 13 publications

References 17 publications

Fluorescence Lifetime Imaging Ophthalmoscopy: A Novel Way to Assess Macular Telangiectasia Type 2

Fluorescence Lifetime Imaging Ophthalmoscopy: A Novel Way to Assess Macular Telangiectasia Type 2

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

Concurrent Idiopathic Macular Telangiectasia Type 2 and Central Serous Chorioretinopathy

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