SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF NEOVASCULAR MACULAR TELANGIECTASIA TYPE 2

Background/Purpose: To image subretinal neovascularization in proliferative macular telangiectasia Type 2 (MacTel2) using swept source optical coherence tomography based microangiography (OMAG). Methods: Patients with macular telangiectasia Type 2 were enrolled in a prospective, observational study known as the MacTel Project and evaluated using a high-speed 1,050 nm swept-source OCT prototype system. The OMAG algorithm generated en face flow images from three retinal layers, and the region bounded by the outer retina and Bruch membrane, the choriocapillaris, and the remaining choroidal vasculature. The en face OMAG images were compared with images from fluorescein angiography and indocyanine green angiography. Results: Three eyes with neovascular macular telangiectasia Type 2 were imaged. The neovascularization was best identified from the en face OMAG images that included a layer between the outer retinal boundary and Bruch membrane. Optical coherence tomography based microangiography images identified these abnormal vessels better than fluorescein angiography and were comparable to the images obtained using indocyanine green angiography. In all 3 cases, OMAG identified choroidal vessels communicating with the neovascularization, and these choroidal vessels were evident in the 2 cases with indocyanine green angiography imaging. In 1 case, monthly injections of bevacizumab reduced the microvascular complexity of the neovascularization, and the telangiectatic changes within the retinal microvasculature. In another case, less frequent bevacizumab therapy was associated with growth of the subretinal neovascular complex. Conclusion: Optical coherence tomography based microangiography imaging provided detailed, depth-resolved information about subretinal neovascularization in macular telangiectasia Type 2 eyes demonstrating superiority to fluorescein angiography imaging, and similarities to indocyanine green angiography imaging for documenting the retinal microvascular changes, the size and extent of the neovascular complex, the communications between the neovascular complex and the choroidal circulation, and the response to monthly bevacizumab therapy.

[1]  Ruikang K. Wang,et al.  Depth-resolved imaging of capillary networks in retina and choroid using ultrahigh sensitive optical microangiography. , 2010, Optics letters.

[2]  Michael D Abramoff,et al.  INTRAVITREAL BEVACIZUMAB FOR TREATMENT OF PROLIFERATIVE AND NONPROLIFERATIVE TYPE 2 IDIOPATHIC MACULAR TELANGIECTASIA , 2011, Retina.

[3]  Emily W. Gower,et al.  RANIBIZUMAB FOR MACULAR TELANGIECTASIA TYPE 2 IN THE ABSENCE OF SUBRETINAL NEOVASCULARIZATION , 2014, Retina.

[4]  V. Gabel,et al.  Optical coherence tomography findings in idiopathic juxtafoveal retinal telangiectasis , 2007, Graefe's Archive for Clinical and Experimental Ophthalmology.

[5]  Alain Gaudric,et al.  Optical coherence tomography in group 2A idiopathic juxtafoveolar retinal telangiectasis. , 2006, Archives of ophthalmology.

[6]  Catherine Egan,et al.  "En face" OCT imaging of the IS/OS junction line in type 2 idiopathic macular telangiectasia. , 2012, Investigative ophthalmology & visual science.

[7]  Philip J Rosenfeld,et al.  BEVACIZUMAB (AVASTIN) THERAPY FOR IDIOPATHIC MACULAR TELANGIECTASIA TYPE II , 2009, Retina.

[8]  J. F. Arevalo,et al.  Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A, Mac Tel 2). , 2013, Survey of ophthalmology.

[9]  Ruikang K. Wang,et al.  Swept-source OCT angiography of the retinal vasculature using intensity differentiation-based optical microangiography algorithms. , 2014, Ophthalmic surgery, lasers & imaging retina.

[10]  Ruikang K. Wang,et al.  User-guided segmentation for volumetric retinal optical coherence tomography images. , 2014, Journal of biomedical optics.

[11]  Ruikang K. Wang,et al.  Mapping of cerebro-vascular blood perfusion in mice with skin and skull intact by Optical Micro-AngioGraphy at 1.3 mum wavelength. , 2007, Optics express.

[12]  R. Lira,et al.  Intravitreous ranibizumab as treatment for macular telangiectasia type 2. , 2010, Archives of ophthalmology.

[13]  G. Rubin,et al.  STRUCTURAL AND FUNCTIONAL CHANGES OVER TIME IN MacTel PATIENTS , 2009, Retina.

[14]  Tunde Peto,et al.  Baseline Characteristics of Participants in the Natural History Study of Macular Telangiectasia (MacTel) MacTel Project Report No. 2 , 2010, Ophthalmic epidemiology.

[15]  F. Holz,et al.  Eighteen-month follow-up of intravitreal bevacizumab in type 2 idiopathic macular telangiectasia , 2008, British Journal of Ophthalmology.

[16]  R. Guymer,et al.  THE PREVALENCE ESTIMATES OF MACULAR TELANGIECTASIA TYPE 2: The Melbourne Collaborative Cohort Study , 2010, Retina.

[17]  S. Sivaprasad,et al.  Agreement between Time-Domain and Spectral-Domain Optical Coherence Tomography in the Assessment of Macular Thickness in Patients with Idiopathic Macular Telangiectasia Type 2 , 2013, Ophthalmologica.

[18]  Wolfgang Drexler,et al.  Idiopathic juxtafoveal retinal telangiectasis: new findings by ultrahigh-resolution optical coherence tomography. , 2006, Ophthalmology.

[19]  H. Sachs,et al.  Bevacizumab in the treatment of idiopathic macular telangiectasia , 2008, Graefe's Archive for Clinical and Experimental Ophthalmology.

[20]  Richard F Spaide,et al.  Retinal vascular layers in macular telangiectasia type 2 imaged by optical coherence tomographic angiography. , 2015, JAMA ophthalmology.

[21]  L. Yannuzzi,et al.  Idiopathic Macular Telangiectasia , 2006, Retina.

[22]  Ruikang K. Wang,et al.  Three dimensional optical angiography. , 2007, Optics express.

[23]  Ruikang K. Wang,et al.  High-resolution wide-field imaging of retinal and choroidal blood perfusion with optical microangiography. , 2010, Journal of biomedical optics.

[24]  Catherine Egan,et al.  The IS/OS junction layer in the natural history of type 2 idiopathic macular telangiectasia. , 2012, Investigative ophthalmology & visual science.

[25]  Ruikang K. Wang,et al.  In vivo volumetric imaging of vascular perfusion within human retina and choroids with optical micro-angiography. , 2008, Optics express.

[26]  Steffen Schmitz-Valckenberg,et al.  Outer retinal hyperreflective spots on spectral-domain optical coherence tomography in macular telangiectasia type 2. , 2010, Ophthalmology.

[27]  P. Charbel Issa,et al.  Findings in fluorescein angiography and optical coherence tomography after intravitreal bevacizumab in type 2 idiopathic macular telangiectasia. , 2007, Ophthalmology.

[28]  Brian C. Toy,et al.  TREATMENT OF NONNEOVASCULAR IDIOPATHIC MACULAR TELANGIECTASIA TYPE 2 WITH INTRAVITREAL RANIBIZUMAB: Results of a Phase II Clinical Trial , 2012, Retina.

[29]  David Williams,et al.  Retinal crystals in type 2 idiopathic macular telangiectasia. , 2010, Ophthalmology (Rochester, Minn.).

[30]  M. Gillies,et al.  THE RELATIONSHIP BETWEEN INNER RETINAL CAVITATION, PHOTORECEPTOR DISRUPTION, AND THE INTEGRITY OF THE OUTER LIMITING MEMBRANE IN MACULAR TELANGIECTASIA TYPE 2 , 2013, Retina.

[31]  Ruikang K. Wang,et al.  Swept-source OCT angiography of macular telangiectasia type 2. , 2014, Ophthalmic surgery, lasers & imaging retina.

[32]  H. Koizumi,et al.  Morphologic features of group 2A idiopathic juxtafoveolar retinal telangiectasis in three-dimensional optical coherence tomography. , 2006, American journal of ophthalmology.

[33]  P. Charbel Issa,et al.  Monthly ranibizumab for nonproliferative macular telangiectasia type 2: a 12-month prospective study. , 2011, American journal of ophthalmology.