Multimodal image in idiopathic macular telangiectasia type 1 atypic bilateral

Author: Maria Cristina Mantolan Sarmiento (Spain)

Co-authors: Hugo E. Tapia Quijada, Carla Arteaga Henriquez

Purpose

Idiopathic macular telangiectasia type 1 (MacTel-1) almost always presents unilaterally. We report the case of a 73-year-old man with no significant history diagnosed with MacTel -1 but with an atypical bilateral presentation, something very rare in this disease.

Setting/Venue

Section Retina. Hospital Universitario de Canarias. Tenerife-Spain

Methods

Case Report

Results

A 73-year-old man presented gradual loss of vision in both eyes (OU). His visual acuity was 0.16 in the right eye (RE) and 0.1 in the left eye (LE). Examination of the anterior segment was normal. The fundus revealed a dull looking macula, no capillary abnormalities or dilations were distinguished in OU. OCT showed cystoid macular edema (CME). Autofluorescence (FAF) showed in both eyes a faint homogeneous macular hypoautofluorescence, which would correspond to the CME present at the time of the examination. Fluorescein angiography (FA) in the early stages revealed telangiectasias and microaneurysms surrounding the perifoveal area with late leakage. The FA excluded retinal venous branch occlusion. OCTA showed good flow in the telangiectatic vessels and ruled out the presence of macular neovascularization in both eyes. Given that there was no medical history of diabetes, arterial hypertension and considering the absence of evidence of Irvine-Gass syndrome or venous branch occlusion, we reached the diagnosis of bilateral idiopathic macular telangiectasia. He was treated with aflibercept, maintaining anatomical and functional stability with a fixed bimonthly regimen.

Conlusions

MacTel -1 can rarely present bilaterally. Multimodal imaging is essential for correct diagnosis.

Financial Disclosure

NO FINANCIAL DISCLOSURES

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