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Intraretinal Fibrosis in Macular Telangiectasia Type-2 (MacTel): Clinical and Multimodal Imaging Features
Kiran Chandran1,2, Anantharaman Giridhar1,2, Mahesh Gopalakrishnan1
1Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India.
Retinal Cases & Brief Reports
|April 25, 2025
Summary
Intraretinal Fibrosis (IRFib) in Macular Telangiectasia Type-2 (MacTel) presents as grayish-white lesions with characteristic OCT and OCTA findings. This condition is linked to advanced MacTel and potential Müller cell and glial cell dysfunction.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Vascular Biology
Background:
- Macular Telangiectasia Type-2 (MacTel) is a degenerative retinal disease.
- Intraretinal Fibrosis (IRFib) is a less understood complication within MacTel.
Purpose of the Study:
- To characterize the clinical and multimodal imaging features of Intraretinal Fibrosis (IRFib) in Macular Telangiectasia Type-2 (MacTel).
Main Methods:
- Retrospective analysis of 7 MacTel eyes with IRFib.
- Multimodal imaging including color fundus photography, multicolor imaging (MC), blue reflectance, spectral-domain optical coherence tomography (OCT), OCT-angiography (OCTA), and fluorescein angiography.
Main Results:
- IRFib appeared as grayish-white macular lesions, with vessel tortuosity noted on MC.
- OCT revealed intraretinal hyper-reflective distortion, collapse sign, epiretinal membrane, and pigmentary changes.
- OCTA showed vascular abnormalities like right-angled vessels, invasion, distortion of the foveal avascular zone (FAZ), and telangiectasia.
Conclusions:
- IRFib was observed in 1.75% of the MacTel cohort, with distinct OCT and OCTA signatures.
- IRFib is associated with advanced MacTel stages (3-5).
- The findings suggest a role for Müller cell dysfunction, glial activation, and vascular changes in IRFib pathogenesis.
