Different types of macular telangiectasia in two eyes of a patient

To report a case of macular telangiectasia (MacTel) showing the features of type 3 disease in one eye and type 2 disease in the other eye.

Descriptive case report.

A 50-year-old well-controlled diabetic man presented with complaints of distorted vision in the right eye for the past 1 year. His best-corrected visual acuity in both eyes was 20/20, N6. His anterior segment findings were normal. The right eye fundus showed an irregular perifoveal greying and a localised dark patch temporally inside the perifoveal region. Few microaneurysms were seen on clinical examination. No hard exudates were noted. The left eye fundus showed a few microaneurysms with minimal perifoveal greying temporally. Imaging with confocal blue reflectance, fluorescein and optical coherence tomography angiography confirmed the diagnosis of MacTel type 3 in the right eye and type 2A stage 2 in the left eye with mild non-proliferative diabetic retinopathy in both eyes.

This case raises the possibility that type 3 disease could be a progressive non-proliferative form of a pre-existing type 2 MacTel disease.