Background/aims To quantify retinal cavitation size over time in macular telangiectasia type 2 (MacTel) and to correlate changes with visual acuity and area of ellipsoid zone loss.
Methods Optical coherence tomography (OCT) macula volume scans from sham eyes included in a prospective, phase II clinical trial of human ciliary neutrophic factor for MacTel at baseline, 1 year and 2 years of follow-up were analysed. Cavitations were segmented by two independent readers. Total cavitation volume was compared with area of ellipsoid zone loss and best-corrected visual acuity (BCVA).
Results Fifty-one eyes from 51 unique patients (mean age 62 years, range 45–79 years) were included. Intraclass correlation between readers for cavitation volume was excellent (>0.99). Average cavitation volume was 0.0109 mm3, 0.0113 mm3 and 0.0124 mm3 at baseline, 1 year and 2 years, respectively. The average rate of cavitation volume change was +0.0039 mm3/year. 10 eyes (20%) had a significant change in cavitation volume during the study (3 decreased, 7 increased). Eyes with increased cavitation volume had worse BCVA compared with eyes with no change/decreased cavitation volume (71.5 vs 76.1 ETDRS letters, respectively). Cavitation volume was negatively correlated to BCVA (r=−0.37) but not to area of ellipsoid zone loss. Cavitation volume was negatively predictive of BCVA in both univariate and multivariate mixed-effects modelling with ellipsoid zone loss.
Conclusions Retinal cavitations and their rate of change in MacTel can be reliably quantified using OCT. Cavitations are negatively correlated with visual acuity and may be a useful OCT-based biomarker for disease progression and visual function in MacTel.
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Contributors CC and GJ conceived the project. EC contributed to the design of the project. CC, JC, SF and SJC contributed to the analysis of the data. All authors discussed the results and contributed to the final manuscript.
Funding 2018 VitreoRetinal Surgery Foundation Research Award (CXC). Heed Ophthalmic Foundation (CXC). 2018 Unrestricted Grant from Research to Prevent Blindness to Duke Eye Center (all). Duke Eye Center P30 Core Grant from NIH/NEI (all).
Competing interests SF: Duke University (patent). SJC: Duke University (patent). GJ: Heidelberg Engineering, Inc. (consultant).
Patient consent for publication Not required.
Ethics approval This retrospective post hoc analysis was approved by the Institutional Review Board of the Duke Eye Center and adhered to the tenets of the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. NA.
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