Macular Telangiectasia Type 2 With Bidirectional Neovascular Network

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.