Lucy V Cobbs, M.D. » Miscellaneous

Mar 29 2024 by Lucy V Cobbs, M.D.

Color fundus photograph of a right eye depicts fundus changes typically seen early in disease onset of MacTel type 2. The first clinical sign of disease is subtle retinal opacification parafoveally. RPE changes initially occur temporally along dilated capillaries and then later involve the rest of the parafoveal region as disease progresses.

Condition/keywords: Mac Tel type 2, retina

Mar 29 2024 by Lucy V Cobbs, M.D.

Color fundus photograph of the right eye of a 61-year-old Caucasian female shows that as disease progresses, parafoveal capillaries become dilated temporally and then circumferentially around the fovea. The vessels also appear to make “right angle” turns as they plunge into deep retina. Punctate crystals may form at the vitreoretinal interface in almost half of MacTel type 2 patients and do not correlate with disease progression. This patient had bilateral asymmetric disease involvement, which is typical for MacTel type 2.

Condition/keywords: fundus photograph

Mar 29 2024 by Lucy V Cobbs, M.D.

Fundus autofluorescence photograph of both eyes of a patient with MacTel type 2. Fundus autofluorescence can aid in early diagnosis of disease, showing development of foveal hyperautofluorescence corresponding to deterioration of macular pigment and possible damage to Muller cells. As the disease progresses, RPE hyperplasia may develop and manifests as hypoautofluorescent regions.

Condition/keywords: Mac Tel type 2, retina

Mar 29 2024 by Lucy V Cobbs, M.D.

Optical coherence tomography demonstrates a cavitation involving the inner retina with a thin ILM drape over the region of tissue loss. In addition, there is underlying focal disruption of the ellipsoid zone. These hyporreflective cavitations do not correlate with leakage on fluorescein angiography and are distinct from cysts in that they are not thought to be fluid filled.

Condition/keywords: Mac Tel type 2

Mar 29 2024 by Lucy V Cobbs, M.D.

Color fundus photograph of the left eye of a 70-year-old male with a disciform scar resulting from a neovascular membrane. A minority of MacTel type 2 patients develop neovascular disease, and the gold standard treatment is anti-VEGF intravitreal therapy. Without treatment, membranes may progress to severe central macular scarring. Late stages of proliferative MacTel type 2 may be confused with AMD, and a differentiating aspect is that MacTel type 2 typically lacks pigment epithelial detachments and drusen.

Condition/keywords: Mac Tel type 2

Mar 29 2024 by Lucy V Cobbs, M.D.

Fluorescein angiography of the left eye of a 45-year-old African American female with MacTel type 2 and Type 2 Diabetes. This angiogram demonstrates peripheral microaneurysms characteristic of mild non proliferative diabetic retinopathy and temporal foveal leakage with telangiectatic macular capillaries classic for MacTel type 2. There is a well-established association between the two conditions.

Condition/keywords: Mac Tel type 2

Mar 29 2024 by Lucy V Cobbs, M.D.

Optical coherence tomography angiography allows for 3-dimensional vessel imaging and may help detect abnormal vessels earlier than fluorescein angiography, which was historically used in diagnosis of MacTel type 2. This OCTA of the left eye of a 52-year-old male captures superficial telangiectatic macular vessels (top left) and follows them as they dive into deeper capillary layers (top right). The structural image of this OCTA (bottom right) shows the classic “right angles” of these abnormal vessels as they plunge. The outer retinal slab image (bottom left) shows a choroidal neovascular membrane, which is a rare complication of MacTel type 2.

Condition/keywords: Mac Tel type 2