Autofluorescence patterns and visual acuity in macular telangiectasia type 2

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Abstract

Purpose

An analysis was performed with a view of determining potential associations between typical patterns seen on autofluorescence (AF) imaging in patients with Macular Telangiectesia (MacTel) type 2 and distance visual acuity at presentation as well as visual change over a 2-year follow-up period, thus ascribing predictive value to AF patterns in MacTel.

Methods

A subgroup of 135 patients (229 eyes) enrolled in the MacTel study underwent AF imaging. Images were graded at the Moorfields Eye Hospital Reading Centre. Recorded AF patterns at baseline and at two years included the typical pattern of increased central AF due to loss of foveal masking, localized decreased AF at the end of a retinal vessel and a large area of decreased AF. Best-corrected visual acuity (BCVA) was measured by means of the Early Treatment for Diabetic Retinopathy Study charts at baseline and after two years. Statistical associations were derived by means of a generalized linear model.

Results

Presence of increased macular AF (p=0.004), a large area of decreased AF (p<0.001) or decreased AF at the end of a retinal vessel (p<0.001) at baseline were significantly associated with worse BCVA. Presence of increased macular AF (p<0.001) or of localized decreased AF at the end of a retinal vessel (p<0.001) and the absence of a large area of decreased AF (p<0.001) were predictive of a subtle, but statistically significant drop in BCVA at 2 years.

Conclusion

The typical pattern of increased central AF at baseline is encountered in patients with worse BCVA in MacTel type 2 and is also predictive of further subtle visual loss in a period of two years. Decreased AF is found in patients with worse baseline BCVA though no further visual loss at two years is observed.

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