title: Staging of macular telangiectasia: power-Doppler optical coherence tomography and macular pigment optical density.
abstract: OBJECTIVE
  Two methods were used to study the stages of macular telangiectasia (MACTEL): Power-Doppler optical coherence tomography (PD-OCT), which allows imaging of the retinal circulation in three dimensions, and macular pigment optical density (MPOD), which quantifies the distribution of macular carotenoids.
  
  
  METHODS
  Among 49 patients with MacTel identified, 12 eyes (6 patients) with MacTel and 7 age-matched control eyes (7 patients) were imaged with a custom-built Fourier-domain OCT instrument to acquire PD-OCT images. MPOD was measured using heterochromatic flicker photometry in 10 eyes (5 patients) with MacTel and compared with 44 age-matched control eyes (44 patients). Clinical staging of MacTel was based on best-corrected visual acuity, fundus biomicroscopy, fluorescein angiography, and OCT.
  
  
  RESULTS
  Stage 1 eyes (n = 2) had subtle punctate vascular signal confined to the inner portion of the outer plexiform layer (OPL) on PD-OCT. Stage 2 (n = 2) showed larger oblique vascular signal extending into deeper OPL. Stage 3 (n = 5) had disruption of outer retinal layers with abnormal vasculature extending into the outer nuclear layer. Stage 4 (n = 3) showed diffuse blurring of the retinal layers with vascular channels extending the full thickness of the retina. MPOD values in four eyes with stage 1 or 2 MacTel correlated well with age-matched controls. Six eyes with stage 3 or 4 MacTel had loss of MPOD especially at the fovea.
  
  
  CONCLUSIONS
  PD-OCT shows penetration of the retinal capillaries into the deeper retinal layers in early stages of MacTel, with full thickness vascular proliferation in advanced disease. MPOD is commonly depleted but may appear normal in early stage MacTel.
authors.affiliation: Department of Ophthalmology and Vision Science, University of California-Davis Eye Center, Sacramento, California, USA.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Chin
authors.forename: Dae Yu
authors.initials: DY
authors.lastname: Kim
authors.forename: Allan A
authors.initials: AA
authors.lastname: Hunter
authors.forename: Suman
authors.initials: S
authors.lastname: Pilli
authors.forename: Machelle
authors.initials: M
authors.lastname: Wilson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Zawadzki
authors.forename: John S
authors.initials: JS
authors.lastname: Werner
authors.forename: Susanna S
authors.initials: SS
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003720:Densitometry; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012168:Retinal Pigments / Q000378:metabolism*; D058456:Retinal Telangiectasis / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D012168:Retinal Pigments
keywords: Power-Doppler; heterochromatic flicker photometry; idiopathic macular telangiectasia; macular pigment; optical coherence tomography; retinal telangiectasia