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Macular Telangiectasia Type 2 With Bidirectional Neovascular Network.

George J Manayath1, Shweta Jagdeesh2, Akhila Sridharan3

  • 1MS Ophthalmology from St. John's National Academy of Health Sciences, Bangalore; FRCS Glasgow, UK; FVRS from Aravind Eye Hospital, Coimbatore; Consultant- Department of Retina and Vitreous, Aravind Eye Hospital, Coimbatore-14, India.

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|April 7, 2026
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Summary
This summary is machine-generated.

This case report details a rare instance of Macular Telangiectasia type 2 (MacTel-2) exhibiting unusual bidirectional neovascularization alongside proliferative diabetic retinopathy (PDR). Multimodal imaging confirmed complex, multilayered neovascular growth, highlighting diagnostic challenges.

Keywords:
Epiretinal neovascularisationMacular telangiectasia type 2Proliferative Diabetic retinopathySubretinal neovascularisationchoroidal neovascularizationmacular neovascularization

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Area of Science:

  • Ophthalmology
  • Retinal Vascular Diseases
  • Diabetic Retinopathy

Background:

  • Macular Telangiectasia type 2 (MacTel-2) is a degenerative retinal disease.
  • Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes affecting retinal blood vessels.

Purpose of the Study:

  • To describe a unique case of MacTel-2 presenting with both epiretinal and subretinal neovascularization.
  • To document this presentation occurring within the context of proliferative diabetic retinopathy.

Main Methods:

  • A case report was utilized to investigate this rare clinical presentation.
  • Multimodal imaging, including Fluorescein angiography, Indocyanine green angiography, and OCT angiography (OCTA), was employed.

Main Results:

  • The patient presented with vision loss, bilateral MacTel-2 features, and PDR.
  • Imaging revealed bidirectional vascular networks, including epiretinal, intra-retinal, and subretinal neovascularization in the macula.
  • Neovascularization occurred despite previous treatments for diabetic macular edema and PDR.

Conclusions:

  • This case represents a novel presentation of MacTel-2 with multilayered neovascular proliferation coexisting with PDR.
  • Multimodal imaging, particularly OCTA, is crucial for diagnosing complex neovascular patterns in overlapping retinal conditions.