Purpose:

To describe the characteristics of perifoveal capillaries, the plexuses involved and changes of the neurosensory retina in idiopathic macular telangiectasia using optical coherence tomography angiography (OCT-A) and correlate these findings with visual acuity.

Method:

Descriptive and analytical study. Heidelberg OCT-A was performed in patients diagnosed with Type 2 macular telangiectasia.

Results:

A total of 43 eyes of 24 adult patients were studied. Average age was of 60 years, and 80% of the cases were bilateral. Diabetic patients had significantly worse visual acuity (p < 0.05). Regarding vascular changes, we found 21% in Stage 1, 38% in Stage 2, 32% in Stage 3 and 9% in Stage 4. The most frequent location of vascular changes by OCT-A with respect to the fovea was temporal (63%), followed by superior (19%). There was no relationship between the affected quadrant and visual acuity (p = 0.25). The deep capillary plexus was affected in 94%. We found discrete thickening, dilated vessels and aneurysmal lesions. Twenty-one percent had neovascularization, 55% of these were subclinical and only detected by OCT-A. No relationship was observed between macular thickness and visual acuity (p = 0.29).

Conclusions:

We found patients in different stages of the disease; 21% had advanced disease with neovascularization and 55% had subclinical neovascularization, not detectable by fluorescein angiography and regular OCT. OCT-A is the ideal study to diagnose this disorder without the need for further studies.

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