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Is indocyanine green angiography useful for the diagnosis of macular telangiectasia type 2?
  1. Maria Niskopoulou1,2,
  2. Konstantinos Balaskas1,3,
  3. Irene Leung3,
  4. Ferenc B Sallo3,4,
  5. Traci E Clemons5,
  6. Alan C Bird6,
  7. Tunde Peto7,
  8. MacTel Study group
  1. 1 Medical Retina Service, Moorfields Eye Hospital, London, UK
  2. 2 Department of Ophthalmology, Medical School of Athens University, Athens, Greece
  3. 3 Department of Research and Development, Moorfields Eye Hospital, London, UK
  4. 4 UCL Institute of Ophthalmology, London, UK
  5. 5 The EMMES Corporation, Rockville, Maryland, USA
  6. 6 Inherited Eye Disease, Moorfields Eye Hospital, London, UK
  7. 7 NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
  1. Correspondence to Dr Konstantinos Balaskas, The Reading Centre, Department of Research and Development, Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK; Konstantinos.Balaskas{at}moorfields.nhs.uk

http://dx.doi.org/10.1136/bjophthalmol-2013-303118

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    Macular telangiectasia (MacTel) type 2 is a bilateral disease of unknown origin exhibiting characteristic changes of the macular deep capillary network and neurosensory retina.1–3 Originally considered a predominantly vascular disorder, the introduction of novel imaging techniques has altered prevailing impressions of its underlying pathophysiology, suggesting a significant role of structural changes to the neurosensory retina. The MacTel study, a major multicenter observational study, attempts to shed light on the natural history of the disease and to identify optimal surrogates of disease progression that could be used as end points in interventional clinical trials. In view of the exploratory nature of the study, various imaging modalities were used at baseline and on annual follow-up visits to investigate their contribution to disease diagnosis and their role in offering clues on disease progression. These modalities included colour fundus imaging (CFI), fundus fluorescein angiography (FFA), autofluorescence imaging (AF), optical coherence tomography (OCT) and indocyanine green angiography (ICGA). All obtained images were sent to the Reading Centre at Moorfields Eye Hospital, UK, where the diagnosis was confirmed. During the MacTel study, it has been established that there are characteristic changes on CFI, AF, FFA and OCT that uniquely identify the disease.4 ,5

    The primary aim of this project is to determine whether ICGA is helpful in establishing the diagnosis of MacTel and, therefore, whether its inclusion in the MacTel imaging protocol was justified. The secondary aim was to identify any changes specific to MacTel on ICGA over the course of …

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    Footnotes

    • Collaborators Participating principal investigators and centers in the MacTel study: Jose-Alain Sahel, MD, PhD, Centre Hopitalier National D'Optalmologie des Quinze-Vingts, Paris, France; Robyn Guymer, MD, Centre for Eye Research, East Melbourne, Australia; Gisele Soubrane, MD, PhD, FEBO, Clinique Ophtalmolgie de Creteil, Creteil, France; Alain Gaudric, MD, Hopital Lariboisiere, Paris, France; Steven Schwartz, MD, Jules Stein Eye Institute, UCLA, Los Angeles, USA; Ian Constable, MD, Lions Eye Institute, Nedlands, Australia; Michael Cooney, MD, MBA, Manhattan Eye, Ear, and Throat Hospital, New York, USA; Catherine Egan, MD, Moorfields Eye Hospital, London, UK; Lawrence Singerman, MD, Retina Associates of Cleveland, Cleveland, USA; Mark C Gillies, MD, PhD, Save Sight Institute, Sydney, Australia; Martin Friedlander, MD, PhD, Scripps Research Institute, La Jolla, CA, USA; Daniel Pauleikhoff, Prof. Dr, St Franziskus Hospital, Muenster, Germany; Joseph Moisseiev, MD, The Goldschleger Eye Institute, Tel Hashomer, Israel; Richard Rosen, MD, The New York Eye and Ear Infirmary, New York, USA; Robert Murphy, MD, The Retina Group of Washington, Fairfax, VA, USA; Frank Holz, MD, University of Bonn, Bonn Germany; Grant Comer, MD, University of Michigan, Kellogg Eye Center, Ann Arbor, MI, USA; Barbara Blodi, MD, University of Wisconsin, Madison, WI, USA; Diana Do, MD, The Wilmer Eye Institute, Baltimore, MD, USA; Alexander Brucker, MD, Scheie Eye Institute, Philadelphia, PA, USA; Raja Narayanan, MD, LV Prasad Eye Institute, Hyderabad, India; Sebastian Wolf, MD, PhD, University of Bern, Bern, Switzerland; Philip Rosenfeld, MD, PhD, Bascom Palmer, Miami, FL, USA. Paul S Bernstein, MD, PhD, Moran Eye Center, University of Utah, Utah, USA. Joan W Miller, MD, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.

    • Contributors MN contributed to design, analysis and interpretation of data. KB contributed to analysis, interpretation of data and drafting the article. IL contributed to design, analysis and interpretation of data. FBS contributed to analysis, interpretation of data and critically revising for important intellectual content. TEC contributed to analysis and interpretation of data. ACB contributed to critically revising for important intellectual content and offered final approval of the version to be published. TP contributed to conception, design, analysis and interpretation of data critically revising for important intellectual content and offered final approval of the version to be published.

    • Funding The Lowy Medical Research Institute (LMRI) and the NIHR for providing support for funding this study.

    • Competing interests None.

    • Ethics approval Individual ethics committees of collaborating centers.

    • Provenance and peer review Not commissioned; externally peer reviewed.