Macular telangiectasia is an eye disorder that affects the central macula of the retina; the neurosensory tissue of the eye that transmits the optical images we see into the electrical images our brain understands.
Macular telangiectasia is also referred to as idiopathic juxta foveal macular telangiectasia, idiopathic juxta foveal telangiectasia; IJT, and may also be abbreviated as MacTel.
Macular telangiectasia occurs when capillaries in the macula dilate, or widen causing small macroaneurysms. These small macroaneurysms can leak fluid, blood, and lipid into the macula causing progressive distortion of central vision.
There are two types of macular telangiectasia, Type 1 and Type 2, both occurring in middle- aged male and females.
- Type 1 is less common and usually only affects one eye.
- Type 2 is more common and most often occurs in both eyes.
Sometimes new blood vessels may grow beneath the retina, causing loss of photoreceptor cells; thus, further obscuring central vision. These blood vessels are often called a secondary choroidal neovascular membrane and may be hidden and difficult to diagnose in most cases. At Retina Associates of Greater Philadelphia, we have the latest imaging capabilities to assist the physicians in the diagnosis and treatment of both types of macular telangiectasia. Our physicians utilize multiple imaging modalities, including our most advanced OCT-A scan allowing optimized clarity of all layers of the retina as well as the layer beneath the retina.
Color fundus photographs and OCT scans of the right and left eye showing the dilated capillaries in macular telangiectasia as well as a choroidal neovascular membrane in the right eye.
What are the symptoms of Macular telangiectasia?
Patients with macular telangiectasia may have the disorder for years with little or no symptoms. However, as the disease progresses the following symptoms may occur:
- Blurred or distorted central vision
- Missing letters or words when reading
- Loss of central vision
Who is at risk for Macular telangiectasia?
In most cases the cause for macular telangiectasia is unknown, or idiopathic, thus the name idiopathic juxta foveal macular telangiectasia.
Some researchers believe the cause is hereditary and may be linked to coats disease.
Other research shows patients with hypertension, high blood pressure, and diabetes may be more at risk to develop macular telangiectasia.
What can I expect during a visit to evaluate a Macular telangiectasia?
After a comprehensive, dilated eye examination is performed by your ophthalmologist, a series of diagnostic tests may be ordered to better evaluate the health of your retina. These tests include, but are not limited to: (all in yellow are tabs leading to info under diagnostic testing)
- Fundus Photography
- Optical coherence tomography (OCT)
- Optical coherence tomography angiography (OCT-A)
- Intravenous fluorescein angiography (IVFA)
Along with a comprehensive eye examination, diagnostic testing directly correlates in the assistance of each patient’s individual plan of care. Once diagnostic tests are performed, your physician can better map your retinal needs in order to best preserve your vision.
A multicolor image utilizes three wavelengths of light that penetrate to different depths within the retina capturing specific information from each layer of the retina in macular telangiectasia.
A state of the art OCT-A scan revealing a hidden neovascular membrane in the avascular zone.
A fluorescein angiogram image demonstrating an area of hyperfluorescent blood vessels.
How is Macular telangiectasia treated?
Some patients may not benefit from treatment. However, some patients may gain increased central vision when treatments are given such as-
- Laser therapy
- Oral steroid medication
- Anti-VEGF therapy
Your ophthalmologist will discuss with you which course of treatment is best for you.