Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Right-angled vessel characteristics in different stages of type 2 macular telangiectasia (MacTel)

Eye volume 38, pages 1162–1167 (2024)Cite this article

Subjects

Abstract

Purpose

To study right-angled vessels (RAV) in disease progression and macular neovascularization in type 2 macular telangiectasia (MacTel) eyes.

Methods

This retrospective image analysis study examined type 2 MacTel patients’ multicolour® and OCT imaging records from January 2015 to March 2023. Age, gender, laterality, visual acuity, systemic disease, and follow-up duration were recorded. RAV characteristics were assessed using OCT and multicolour® images. This study examined RAV characteristics and type 2 MacTel disease stage.

Results

In total, 270 eyes of 146 patients (97 females, 66%) with a mean age of 60.77 ± 9.34 years were studied. 153 (57%) eyes showed RAV. The non-proliferative stage of type 2 MacTel had either no RAV or a normal-calibre right-angled vein, while the proliferative stage had a right-angled artery and a dilated or normal-calibre RAV [p < 0.001]. RAV characteristics differed at the final follow-up (p < 0.001). 11 eyes transitioned from non-proliferative to proliferative after a median period of 26 months (range: 5–96 months). RAV characteristics changed from a normal calibre right-angled vein at presentation to a normal calibre vein and artery in 6 (55%) eyes and to a dilated vein and artery in 5 (45%) eyes respectively.

Conclusion

RAV characteristics may indicate type 2 MacTel stages. A right-angled artery in type 2 MacTel may indicate proliferative disease.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Different characteristic features of right-angled vessel (RAV) in type 2 macular telangiectasia (MacTel).
Fig. 2: Changes in the characteristics of right-angled vessel (RAV) over transition from a non-proliferative to a proliferative type 2 macular telangiectasia (MacTel) disease stage.

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Charbel Issa P, Gillies MC, Chew EY, Bird AC, Heeren TFC, Peto T, et al. Macular telangiectasia type 2. Prog Retin Eye Res 2013;34:49–77.

    Article  CAS  PubMed  Google Scholar 

  2. Gass JD, Blodi BA. Idiopathic juxtafoveolar retinal telangiectasis. Update classification follow- study. Ophthalmol. 1993;100:1536–46.

    Article  CAS  Google Scholar 

  3. Yannuzzi LA, Bardal AMC, Freund KB, Chen K-J, Eandi CM, Blodi B. Idiopathic macular telangiectasia. Arch Ophthalmol Chic Ill 1960. 2006;124:450–60.

    Article  Google Scholar 

  4. Heeren TFC, Clemons T, Scholl HPN, Bird AC, Holz FG, Charbel Issa P. Progression of vision loss in macular telangiectasia type 2. Investig Opthalmol Vis Sci 2015;56:3905.

    Article  CAS  Google Scholar 

  5. Heeren TFC, Chew EY, Clemons T, Fruttiger M, Balaskas K, Schwartz R, et al. Macular telangiectasia type 2: visual acuity, disease end stage, and the MacTel area: MacTel project report number 8. Ophthalmology. 2020;127:1539–48.

    Article  PubMed  Google Scholar 

  6. Tzaridis S, Heeren T, Mai C, Thiele S, Holz FG, Charbel Issa P, et al. Right-angled vessels in macular telangiectasia type 2. Br J Ophthalmol. 2019: bjophthalmol-2018-313364.

  7. Charbel Issa P, Berendschot TTJM, Staurenghi G, Holz FG, Scholl HPN. Confocal blue reflectance imaging in type 2 idiopathic macular telangiectasia. Invest Ophthalmol Vis Sci 2008;49:1172–7.

    Article  PubMed  Google Scholar 

  8. Charbel Issa P, Finger RP, Helb H-M, Holz FG, Scholl HPN. A new diagnostic approach in patients with type 2 macular telangiectasia: confocal reflectance imaging. Acta Ophthalmol. 2008;86:464–5.

    Article  PubMed  Google Scholar 

  9. Venkatesh R, Pereira A, Bavaharan B, Jain K, Aseem A, Sangai S, et al. Relevance of multicolor imaging in type 2 macular telangiectasia. J Curr Ophthalmol 2020;32:375–80.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Garg AK, Knight D, Lando L, Chao DL. Advances in retinal oximetry. Transl Vis Sci Technol. 2021;10:5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Crane NJ, Schultz ZD, Levin IW. Contrast enhancement for in vivo visible reflectance imaging of tissue oxygenation. Appl Spectrosc. 2007;61:797–803.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Nitzan M, Nitzan I, Arieli Y. The various oximetric techniques used for the evaluation of blood oxygenation. Sensors. 2020;20:4844.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Huang Y, Gangaputra S, Lee KE, Narkar AR, Klein R, Klein BEK, et al. Signal quality assessment of retinal optical coherence tomography images. Invest Ophthalmol Vis Sci. 2012;53:2133–41.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Toto L, Di Antonio L, Mastropasqua R, Mattei PA, Carpineto P, Borrelli E, et al. Multimodal imaging of macular telangiectasia type 2: focus on vascular changes using optical coherence tomography angiography. Investig Opthalmology Vis Sci. 2016;57:OCT268.

    Article  Google Scholar 

  15. Govindahari V, Fraser-Bell S, Ayachit AG, Invernizzi A, Nair U, Nair DV, et al. Multicolor imaging in macular telangiectasia—a comparison with fundus autofluorescence. Graefes Arch Clin Exp Ophthalmol. 2020;258:2379–87.

    Article  CAS  PubMed  Google Scholar 

  16. Wu L. Multimodality imaging in macular telangiectasia 2: a clue to its pathogenesis. Indian J Ophthalmol. 2015;63:394.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Powner MB, Gillies MC, Zhu M, Vevis K, Hunyor AP, Fruttiger M. Loss of Müller’s cells and photoreceptors in macular telangiectasia type 2. Ophthalmology. 2013;120:2344–52.

    Article  PubMed  Google Scholar 

  18. Srinivasan R, Teussink MM, Sloan KR, Bharat RPK, Narayanan R, Raman R. Distribution of macular pigments in macular telangiectasia type 2 and correlation with optical coherence tomography characteristics and visual acuity. BMC Ophthalmol. 2022;22:264.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Venkatesh R, Reddy NG, Mishra P, Agrawal S, Mutalik D, Yadav NK, et al. Spectral domain OCT features in type 2 macular telangiectasia (type 2 MacTel): its relevance with clinical staging and visual acuity. Int J Retin Vitr. 2022;8:26.

    Article  Google Scholar 

  20. Reddy NG, Venkatesh R, Jayadev C, Agrawal S, Yadav NK, Chhablani J. Direct laser photocoagulation to the dilated right-angled vessel in the management of proliferative type 2 macular telangiectasia. Retin Cases Brief Rep. 2023;17:620–4.

Download references

Author information

Authors and Affiliations

  1. Dept. of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India

    Ramesh Venkatesh, Ashit Handa, Sai Prashanti Chitturi, Ayushi Choudhary, Vishma Prabhu, Isha Acharya, Rubble Mangla & Naresh Kumar Yadav

  2. University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA

    Jay Chhablani

Authors
  1. Ramesh Venkatesh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashit Handa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sai Prashanti Chitturi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayushi Choudhary
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Vishma Prabhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Isha Acharya
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rubble Mangla
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Naresh Kumar Yadav
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jay Chhablani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RV, JC, VP—conceptualising the study, data acquisition, analysing the data, statistics and results, interpreting the findings, writing & reviewing the manuscript. AC, AH, SPC, ISA, RB—Data acquisition and analysing the data. NKY—critically reviewing the manuscript.

Corresponding author

Correspondence to Ramesh Venkatesh.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Venkatesh, R., Handa, A., Chitturi, S.P. et al. Right-angled vessel characteristics in different stages of type 2 macular telangiectasia (MacTel). Eye 38, 1162–1167 (2024). https://doi.org/10.1038/s41433-023-02853-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-023-02853-w

Search

Advanced search

Quick links