Title : Navigating the complexity of MacTel: A case report
Abstract:
Aims/ Purpose: To report a patient with bilateral macular telangiectasia
Methods: Patient came to the eye OPD with complaints of diminution of vision of both eyes
Results: A 50 year old female came to the eye OPD with gradual, painless diminution of vision both eyes. She had no systemic illness. Her visual acuity was 6/60 both eyes not improving on BCVA. On ocular examination L/E exotropia of 45 degrees with restriction of medial rectus was present. She had early nuclear sclerosis of the lens B/E and rest of the anterior segment was within normal limits. Patient was pharmacologically dilated and both eyes greyish discoloration of the foveal area was seen with vessels diving at right angle into deeper retinal layers. Rest of the fundus was within normal limits.
OCT macula was done that showed disruption of foveal contour with foveal pit enlargement and ‘ILM drape’ over the affected area. R/E showed partial thickness macular hole and L/E showed full thickness macular hole. FFA was done to look for leaky vessels and it was within normal limits.Patient was investigated to rule out diabetes, hypertension and kept on close follow up to rule out development of CNVM.
Coclusion: High level of suspicion is necessary to pick up subtle signs on fundus examination and it must correlated with investigative findings. According to the Beaver Dam Eye Study which graded only colour fundus images, Mac Tel has a prevalence of 0.1% with an average age of 63 years. Although not ini)ally described by Gass, Yannuzzi found a slight female preponderance of 58%.
