PT - JOURNAL ARTICLE AU - Simone Tzaridis AU - Kristina Hess AU - Martin Friedlander AU - Frank G Holz TI - Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2 AID - 10.1136/bjophthalmol-2020-316021 DP - 2020 Jun 08 TA - British Journal of Ophthalmology PG - bjophthalmol-2020-316021 4099 - http://bjo.bmj.com/content/early/2020/06/08/bjophthalmol-2020-316021.short 4100 - http://bjo.bmj.com/content/early/2020/06/08/bjophthalmol-2020-316021.full AB - Purpose To evaluate the utility of optical coherence tomography-angiography (OCT-A) for monitoring activity, progression and response to therapy of neovascularisations (NVs) secondary to macular telangiectasia type 2 (MacTel).Methods In a retrospective analysis, eyes with NVs secondary to MacTel were reviewed over a period of ≥8 months. Examinations at monthly intervals included visual acuity testing, dilated funduscopy, spectral domain-OCT and OCT-A. Eyes were treated with intravitreal VEGF (vascular endothelial growth factor)-inhibitors following a pro-re-nata (PRN) regime, and treatment decisions were based on morphological signs of activity as determined by B-scan OCT and funduscopy. Signs of neovascular activity were defined as an increase in retinal thickness, presence/increase of intraretinal/subretinal fluid and haemorrhages.Results A total of 19 eyes from 17 patients were analysed. Patients were evaluated over a mean period of 13.4 months (range: 8.9 to 24.2). OCT-A permitted the monitoring of both treatment effects (regression) and progression (growth) of NVs, but not neovascular activity. The growth of neovascular vessels was detectable in OCT-A before signs of activity occurred on OCT. NVs showed a progressive growth over time despite PRN-treatment and preferentially grew and extended within areas characterised by a focal reduction of choriocapillaris perfusion.Conclusions The results indicate that OCT-A represents a useful imaging modality for monitoring NV-progression and treatment effects in MacTel. We demonstrate its advantages over conventional B-scan OCT imaging, including an earlier detection of NV-progression, and propose an adjustment of the current OCT-controlled PRN treatment regime in order to prevent NV-progression and subsequent functional loss in neovascular MacTel.