The Imaging Correlation between outer retina-associated hyperreflectivity and outer retinal and choroidal...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Biology

Background:

• Macular Telangiectasia type 2 (MacTel 2) is a degenerative retinal disease.
• Outer-retinal choroidal microvascular abnormalities (ORCMA) are associated with MacTel 2.
• Outer retina-associated hyperreflectivity (ORaH) is a key imaging finding in MacTel 2.

Purpose of the Study:

• To elucidate the specific patterns of ORCMA in MacTel 2.
• To investigate the association between ORCMA and ORaH.
• To characterize the stages of microvascular changes in MacTel 2.

Main Methods:

• Retrospective analysis of 60 eyes diagnosed with MacTel 2 and ORaH.
• Detailed review of Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) images.
• Identification and classification of ORCMA patterns.

Main Results:

• All 60 eyes showed hyperreflective foci (HRF).
• Observed ORCMA patterns included vascular invasion, retinochoroidal anastomosis (RCA), and macular neovascularization (MNV).
• Vascular invasion correlated with subsidence (P=0.009); RCA associated with pigment clumps, cystoids, and double-layer sign (DLS) (P<0.05); MNV correlated with subsidence (P=0.022).

Conclusions:

• Three distinct ORCMA patterns in MacTel 2: vascular invasion, RCA, and MNV.
• Vascular invasion may lead to outer retinal subsidence.
• RCA represents a pre-proliferative stage, while MNV is an advanced stage, suggesting a continuum of disease progression.