Definition: Abnormal dilatation of retinal capillaries.
Type 1 (MacTel 1) – congenital unilateral – uncommon
Type 2 (MacTel 2) – acquired bilateral in middle aged – common
Type 3 – uncommon occlusive and rarely understood
Signs and symptoms:
Asymptomatic +/- gradual reduction in vision.
Foveal atrophy with CNV in severe cases.
Can present with LMH or FTMH.
Slit lamp – telangiectatic retinal capillaries with aneurysmal dilatations involving up to 2 DD temporal to fovea.
FAF – hyperautofluorescent spot on fovea (due to Muller cells degeneration)
FFA – CNV
OCTA – Abnormal capillaries temporal fovea with atrophy
OCT – cavitation lesions
Inflammatory / vaso-occlusive diseases
Most do not treatment
Ix for systemic conditions – DR, HTN.
CNV – no effective Rx – can consider macular laser, anti-VEGF.
FTMH – PPV + ILM peel + gas – poorer success rate.