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Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

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EXUDATIVE MACULAR NEOVASCULARIZATION BEFORE VISIBLE PIGMENTATION IN MACULAR TELANGIECTASIA TYPE-2 (MacTel).

Kiran Chandran1,2, Anantharaman Giridhar1,2, Jyoti Prakash Vyas1

  • 1Department of Vitreoretinal Services, Giridhar Eye Institute, Cochin, Kerala, India.

Retina (Philadelphia, Pa.)
|November 6, 2025
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Summary

Early Macular Telangiectasia Type-2 (MacTel) can progress directly to exudative macular neovascularization (ExMNV) without pigmentation. Identifying pre-ExMNV signs aids early intervention to prevent vision loss.

Keywords:
declensionexudationexudative macular neovascularizationmacular telangiectasia Type-2 (MacTel)pigmentationright-angled vesselstelangiectasia

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Area of Science:

  • Ophthalmology
  • Retinal Imaging
  • Neovascularization

Background:

  • Macular Telangiectasia Type-2 (MacTel) is a retinal disease.
  • Exudative macular neovascularization (ExMNV) is a common complication.
  • The role of pigmentation in MacTel progression to ExMNV is not fully understood.

Purpose of the Study:

  • To investigate multimodal imaging findings in MacTel eyes before and after ExMNV onset.
  • To characterize ExMNV development that bypasses the typical pigmentation stage.

Main Methods:

  • Retrospective evaluation of 16 MacTel eyes (from 798 patients) with ExMNV and no focal hyperpigmentation.
  • Analysis of color fundus photography, fundus autofluorescence, and spectral-domain optical coherence tomography (OCT).

Main Results:

  • 16 eyes (2%) showed ExMNV without prior pigmentation.
  • 5 eyes developed ExMNV over a mean of 27.6 months.
  • Pre-ExMNV signs included right-angled vessels, telangiectatic leaks, parafoveal thickening, intraretinal fluid, and subretinal fluid.
  • Progression led to ellipsoid zone loss, outer retinal hyper-reflectivity, and visual acuity decline.

Conclusions:

  • MacTel can progress directly to ExMNV without pigmentation.
  • Early identification of pre-ExMNV signs is crucial.
  • Closer follow-up and earlier treatment can prevent irreversible visual loss.