Study finds, Microvascular changes precedes visible neurodeg
The purpose of this study was to highlight that some eyes that shows microvascular changes which precedes any visible neuronal changes on spectral-domain optical coherence tomography (SD-OCT). Macular telangiectasia type 2 (MacTel) is bilateral disease with characteristic alterations of the macular capillary network along with decreased macular pigment in the parafoveal area.

From a registry of 630 patients with MacTel, 4 patients with typical MacTel characteristics in only one eye with no visible changes on colour photographs or SD-OCT in the fellow eye were identified. These 4 patients had findings of MacTel documented by colour fundus photograph, multicolour imaging (MCI), fundus autofluorescence (FAF), confocal blue reflectance (CBR), SD-OCT, and OCT-Angiography (OCT-A) in one eye.

OCT-A was performed in MacTel patients using the High-resolution Spectralis (Heidelberg Engineering) module with a full-spectrum probabilistic approach and we employed a 30°x15° scan pattern covering the macula. MCI was done at the end so as to avoid fading the confocal blue reflectance hyperreflectivity seen in MacTel.

-- On OCT-A, all 4 fellow eyes showed telangiectasia and foveal avascular zone changes in the superficial and deep capillary plexuses with no changes on SD-OCT.

--None of the eyes showed typically increased reflectance on CBR around the foveal area.

Finally, microvascular abnormalities on OCT-A may appear before obvious neurodegenerative changes on OCT, providing further information regarding the disease's development.