131:
56:
2032:
2062:
2072:
248:(IVTA) which have proved to be beneficial in the treatment of macular edema by their anti-inflammatory effect, their downregulation of VEGF production, and stabilization of the blood retinal barrier, were reported anecdotally in the management of Macular telangiectasia type 1. In two case reports, IVTA of 4 mg allowed a transitory reduction of retinal edema, with variable or no increase in
422:, particularly in the early stages of Type 2 disease. Formerly, FA was essential in making a definitive diagnosis. However, the diagnosis can be established with less invasive imaging techniques such as Ocular Coherence Tomography (OCT) and fundus autofluorescence. Some clinicians argue that FA testing may be unnecessary when a diagnosis is apparent via less invasive means.
2052:
2042:
2098:
178:
233:(VEGF) agents. Photocoagulation was recommended by Gass and remains to date the mainstay of treatment. It seems to be successful in causing resolution of exudation and VA improvement or stabilization in selected patients. Photocoagulation should be used sparingly to reduce the chance of producing a symptomatic paracentral
241:. Small burns (100–200 μm) of moderate intensity in a grid-pattern and on multiple occasions, if necessary, are recommended. It is unnecessary to destroy every dilated capillary, and, particularly during the initial session of photocoagulation, those on the edge of the capillary-free zone should be avoided.
510:
that secrete ciliary neurotrophic factor". During Phase 2 testing, the implant device was "shown to slow the progression of retinal degeneration compared with participants who received the sham treatment. Based on the positive Phase 2 results, two parallel Phase 3 studies were initiated... enrolling
298:
Today, laser photocoagulation remains mostly effective, but the optimal treatment of
Macular telangiectasia type 1 is questioned, and larger series comparing different treatment modalities seem warranted. The rarity of the disease, however, makes it difficult to assess in a controlled randomized
142:
originally identified four types of idiopathic juxtafoveolar retinal telangiectasis in 1982, contemporary researchers describe three types collectively known as idiopathic juxtafoveal telangiectasia: macular telangiectasia type 1, macular telangiectasia type 2, and macular telangiectasia type 3.
453:
The most crucial aspect of treating macular telangiectasia is recognition of the clinical signs. This condition is relatively uncommon: hence, many practitioners may not be familiar with or experienced in diagnosing the disorder. MacTel must be part of the differential in any case of idiopathic
286:
isoforms, have shown improved visual outcome and reduced leakage in macular edema from diabetes and retinal venous occlusions. In one reported patient with
Macular telangiectasia type 1, a single intravitreal bevacizumab injection resulted in a marked increase in VA from 20/50 to 20/20, with
164:
The natural history of macular telangiectasia suggests a slowly progressive disorder. A retrospective series of 20 patients over 10 to 21 years showed deterioration of vision in more than 84% of eyes, either due to intra-retinal edema and serous retinal detachment (Type 1) or retinal pigment
433:. Recognition of this condition can save an affected patient from unnecessarily undergoing extensive medical testing and/or treatment. MacTel should be considered in cases of mild paramacular dot and blot hemorrhages and in cases of macular and paramacular retinal pigment epithelium (RPE)
735:
Copyright © Middle East
African Journal of Ophthalmology. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
262:
of triamcinolone acetonide has also been reported in a limited number of patients with
Macular telangiectasia type 1 with improvement or stabilization of vision after a mean follow-up of 10 months. Further studies are needed to assess the efficacy of this treatment modality.
295:(OCT) up to 12 months. It is likely that patients with Macular telangiectasia type 1 with pronounced macular edema from leaky telangiectasis may benefit functionally and morphologically from intravitreal anti-VEGF injections, but this warrants further studies.
252:(VA). As expected with all IVTA injections, the edema recurred within 3–6 months, and no permanent improvement could be shown. In general, the effect of IVTA is short-lived and complications, mainly increased intraocular pressure and cataract, limit its use.
32:
1037:
Charbel Issa, Peter; Finger, Robert P.; Kruse, Kathrin; Baumüller, Sönke; Scholl, Hendrik P.N.; Holz, Frank G. (2011). "Monthly
Ranibizumab for Nonproliferative Macular Telangiectasia Type 2: A 12-Month Prospective Study".
349:
Typical patients present with a mean age of 55–59 years, and a wide range of symptoms from totally asymptomatic to substantially impaired; in most cases however, patients retain functional acuity of 20/200 or better.
527:"Idiopathic macular telangiectasia type 3 is a rare, acquired, eye disease characterized by progressive visual loss, due to bilateral juxtafoveolar capillary occlusions, capillary telangiectasia, and minimal
977:
Gantner, Marin L.; Eade, Kevin; Wallace, Martina; Handzlik, Michal K.; Fallon, Regis; Trombley, Jennifer; Bonelli, Roberto; Giles, Sarah; Harkins-Perry, Sarah; Heeren, Tjebo F.C.; Sauer, Lydia (2019-10-10).
325:
Although MacTel has been previously regarded as a rare disease, it is in fact probably much more common than previously thought. The subtleness of early symptoms of MacTel may cause mis-diagnosis by
581:
408:
Areas of focal RPE hyperplasia (pigment plaques) often develop in the paramacular region as a response to these abnormal vessels. Other signs of macular telangiectasia type 2 include right angle
341:
MacTel may also be referred to by various names, including (idiopathic) juxtafoveolar telangiectasia, or parafoveal telangiectasis, depending on the source. All refer to the same disease.
299:
manner. A 2014 case study of a single type 1 macular telangiectasia patient concluded
Bevacizumab was not effective, but Aflibercept produced beneficial results.
112:
Type 3 is an extremely rare, poorly understood neurological disease of the retina. It is characterized by occlusion and telangiectasia of the capillaries of the
72:, the light-sensing tissue at the back of the eye that causes gradual deterioration of central vision, interfering with tasks such as reading and driving.
412:, representing an unusual alteration of the vasculature in the paramacular area, with vessels taking an abrupt turn toward the macula as if being dragged.
2128:
1561:
1902:
2123:
807:
Charbel Issa, Peter; Gillies, Mark C.; Chew, Emily Y.; Bird, Alan C.; Heeren, Tjebo F.C.; Peto, Tunde; Holz, Frank G.; Scholl, Hendrik P.N. (2013).
1501:
511:
patients in the United States, Australia, and Europe to determine the safety and efficacy... for the treatment of MacTel". In
February 2019, the
502:(CNTF) is believed to have neuroprotective properties and could thus be able to slow down the progression of MacTel type 2. According to the
1801:
856:
Heeren, Tjebo F. C.; Holz, Frank G.; Issa, Peter
Charbel (2014). "First Symptoms and Their Age of Onset in Macular Telangiectasia Type 2".
1937:
1279:
477:
230:
1099:"Neurotech Pharmaceuticals, Inc. Granted Fast Track Designation from the U.S. FDA for the Treatment of Macular Telangiectasia type 2"
503:
445:
In
September 2019, researchers announced, "a combination of genetics, metabolism and biochemistry drives a disease such as MacTel".
2055:
1927:
1361:
953:
255:
2088:
1907:
512:
395:
292:
1551:
499:
488:(Avastin) may reduce vascular leakage, but neural atrophy may still occur in treated eyes. In proliferative stages (
1531:
1251:
1128:
1960:
1177:"Idiopathic Macular Telangiectasia Type 3 disease: Malacards - Research Articles, Drugs, Genes, Clinical Trials"
1752:
1674:
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1074:
1732:
1706:
415:
380:
288:
245:
106:
1152:
556:
130:
1324:
1272:
1176:
750:"Macular Oedema in Idiopathic Macular Telangiectasia Type 1 Responsive to Aflibercept but Not Bevacizumab"
539:
Type 3 macular telangiectasia is also called "occlusive idiopathic juxtafoveolar retinal telangiectasis".
226:
2118:
1975:
1861:
1834:
1807:
1759:
1713:
1408:
1247:
Bonelli R (2019): Integration of multi-'omics data identifies genetic & metabolic causes of MacTel
157:
and loss of central vision. The two diseases may be distinguished by symptoms, clinical features, and
1995:
1955:
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1631:
1611:
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1398:
430:
426:
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55:
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2017:
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Macular telangiectasia type 2 is commonly under-diagnosed. The findings may appear very similar to
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Type 1 idiopathic macular telangiectasia patients are typically males, 40 years old or older.
631:"Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study"
2035:
1917:
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258:-guided laser photocoagulation directed at the leaky microaneurysms and vessels combined with
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in the retina, typically affects a single eye in male patients, and it may be associated with
44:
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506:, a novel CNTF implant "is a semipermeable fiber membrane filled with human retinal pigment
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2010:
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379:
Diagnosis of MacTel type 2 may be aided by the use of advanced imaging techniques such as
354:(visual distortions) may be a subjective complaint. Due to the development of paracentral
113:
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398:. These can help to identify the abnormal vessels, pigment plaques, retinal crystals,
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366:
Type 2 MacTel commonly occurs in both eyes, and occurs equally in males and females.
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519:" designation for approval of the device to treat macular telangiectasia type 2.
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358:(blind spots), impaired reading ability may be the first symptom of the disease.
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or focal pigment hypertrophy, especially in those patients without a history of
434:
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1932:
1075:"One Blockbuster Drug Explains A Lot About Our Out-Of-Control Healthcare Costs"
480:
inhibitors have not proven to be effective in non-proliferative MacTel type 2.
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905:"Perifoveal Müller Cell Depletion in a Case of Macular Telangiectasia Type 2"
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429:, and many cases have been incorrectly ascribed to diabetic retinopathy or
996:
980:"Serine and Lipid Metabolism in Macular Disease and Peripheral Neuropathy"
766:
662:
531:. It is associated with systemic or cerebral vascular occlusive disease."
1511:
1288:
469:
Treatment options are limited. Laser therapy may actually enhance vessel
319:
202:
201:
region, leading to vascular incompetence. Telangiectatic vessels develop
109:. It generally affects both eyes and usually affects both sexes equally.
102:
1990:
1450:
1418:
1311:
1129:"Novel implant for macular telangiectasia gains fast-track designation"
899:
Powner, Michael B.; Gillies, Mark C.; Tretiach, Marina; Scott, Andrew;
528:
470:
402:
355:
234:
194:
154:
117:
580:
Christakis, Panos G.; Fine, Howard F.; Wiley, Henry E. (2019-03-22).
409:
283:
69:
685:
Nowilaty, Sawsan R.; Al-Shamsi, Hanan N.; Al-Khars, Wajeeha (2010).
177:
748:
Shibeeb, O'Sam; Vaze, Anagha; Gillies, Mark; Gray, Timothy (2014).
687:"Idiopathic Juxtafoveolar Retinal Telangiectasis: A Current Review"
206:
176:
209:. Macular telangiectasia type 1 has been called as a variant of
1261:
282:, a FDA-approved monoclonal antibody fragment that targets all
266:
Recently, intravitreal injections of anti-VEGF agents, namely
94:. It is categorized as "macular perifoveal telangiectasia", a
1257:
405:
and intraretinal cavities associated with this disorder.
1206:"The Diagnosis and Management of Macular Telangiectasia"
582:"The Diagnosis and Management of Macular Telangiectasia"
473:
and promote intraretinal fibrosis in these individuals.
307:
Contemporary research has shown that MacTel is likely a
197:(a focal expansion or outpouching) and dilation in the
287:
significant and sustained decrease in both leakage on
2086:
954:"Study Uncovers Metabolic Cause for Rare Eye Disease"
1153:"Orphanet: Idiopathic macular telangiectasia type 3"
557:"Orphanet: Idiopathic macular telangiectasia type 3"
181:
Cystoid
Macular Oedema in patient with MacTel type 1
1948:
1886:
1647:
1575:
1530:
1439:
1310:
1295:
43:
24:
903:; Hageman, Gregory S.; Fruttiger, Marcus (2010).
134:Diagram of the human eye showing macula and fovea
1204:Christakis PG, Fine HF, Wiley HE (March 2019).
193:Type 1 may be defined as an acquired capillary
16:Disease of the retina affecting central vision
1273:
586:Ophthalmic Surgery, Lasers and Imaging Retina
418:(FA) is helpful in identifying the anomalous
8:
691:Middle East African Journal of Ophthalmology
221:Treatment options for Type 1 include laser
1562:Reproductive endocrinology and infertility
1307:
1280:
1266:
1258:
629:Gass, J. D.; Blodi, B. A. (October 1993).
205:that leak fluid, blood, and occasionally,
54:
30:
21:
1903:Bachelor of Medicine, Bachelor of Surgery
1221:
1013:
995:
928:
832:
783:
765:
754:Case Reports in Ophthalmological Medicine
720:
702:
597:
437:where no other cause can be identified.
376:markers in the clinically altered area.
129:
2093:
548:
75:Type 1, a very rare disease involving
1210:Ophthalmic Surg Lasers Imaging Retina
952:Labios, Liezel (September 11, 2019).
116:in one or both eyes, as well as some
7:
2041:
1802:Physical medicine and rehabilitation
813:Progress in Retinal and Eye Research
680:
678:
676:
674:
672:
2051:
314:disease. MacTel is correlated with
165:epithelium (RPE) scar formation or
1938:Medical Scientist Training Program
466:or contributory systemic disease.
291:(FA) and cystoid macular edema on
231:vascular endothelial growth factor
14:
2129:Visual disturbances and blindness
1133:American Academy of Ophthalmology
1040:American Journal of Ophthalmology
513:U.S. Food and Drug Administration
504:American Academy of Ophthalmology
2096:
2070:
2060:
2050:
2040:
2031:
2030:
825:10.1016/j.preteyeres.2012.11.002
431:age-related macular degeneration
383:(which may identify an abnormal
148:age-related macular degeneration
146:Both macular telangiectasia and
2124:Disorders of choroid and retina
2071:
984:New England Journal of Medicine
809:"Macular telangiectasia type 2"
1928:Doctor of Osteopathic Medicine
1362:Oral and maxillofacial surgery
1:
647:10.1016/S0161-6420(93)31447-8
372:studies have shown a loss of
260:sub-Tenon’s capsule injection
256:Indocyanine green angiography
90:) is the most common macular
1908:Bachelor of Medical Sciences
1675:Neurosurgical anesthesiology
1223:10.3928/23258160-20190301-02
1127:Lee, Keng Jin (2019-02-15).
921:10.1016/j.ophtha.2010.04.001
870:10.1097/IAE.0000000000000082
599:10.3928/23258160-20190301-02
293:optical coherence tomography
500:Ciliary neurotrophic factor
244:Intravitreal injections of
2145:
2026:
1052:10.1016/j.ajo.2010.11.019
38:
29:
1862:Transplantation medicine
1753:Clinical neurophysiology
1670:Obstetric anesthesiology
1590:Interventional radiology
1350:Digestive system surgery
454:paramacular hemorrhage,
278:, circulatory VEGF; and
1733:Intensive care medicine
1707:Mass gathering medicine
1552:Maternal–fetal medicine
704:10.4103/0974-9233.65501
416:Fluorescein angiography
381:fluorescein angiography
289:fluorescein angiography
246:triamcinolone acetonide
227:intravitreal injections
107:coronary artery disease
86:Type 2 (referred to as
1325:Cardiothoracic surgery
1254:(video, 58:08 minutes)
476:Monthly injections of
182:
135:
68:is a condition of the
66:Macular telangiectasia
39:Macular telangiectasia
25:Macular telangiectasia
1976:Personalized medicine
1835:Reproductive medicine
1760:Occupational medicine
1714:Evolutionary medicine
997:10.1056/NEJMoa1815111
274:targeted against pro-
229:of steroids, or anti-
180:
133:
1996:Traditional medicine
1956:Alternative medicine
1823:Addiction psychiatry
1637:Transfusion medicine
1632:Medical microbiology
1547:Gynecologic oncology
1399:Reproductive surgery
427:diabetic retinopathy
2018:History of medicine
2001:Veterinary medicine
1808:Preventive medicine
1660:Adolescent medicine
1502:Infectious diseases
1108:. February 12, 2019
767:10.1155/2014/219792
272:monoclonal antibody
1966:Molecular oncology
1923:Doctor of Medicine
1913:Master of Medicine
1830:Radiation oncology
1702:Emergency medicine
1655:Addiction medicine
1622:Clinical chemistry
1617:Clinical pathology
1409:Transplant surgery
1367:Orthopedic surgery
1345:Colorectal surgery
492:), treatment with
490:neovascularisation
345:Signs and symptoms
183:
167:neovascularization
136:
101:, correlated with
99:metabolic disorder
2084:
2083:
1918:Master of Surgery
1882:
1881:
1867:Tropical medicine
1813:Prison healthcare
1728:Hospital medicine
1692:Disaster medicine
1682:Aviation medicine
1497:Hospital medicine
1404:Surgical oncology
1389:Pediatric surgery
1383:
1330:Endocrine surgery
1181:www.malacards.org
1073:Jennings, Katie.
1046:(5): 876–886.e1.
990:(15): 1422–1433.
958:ucsdnews.ucsd.edu
641:(10): 1536–1546.
320:diabetes mellitus
309:neurodegenerative
96:neurodegenerative
63:
62:
19:Medical condition
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2100:
2099:
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1738:Medical genetics
1723:General practice
1600:Nuclear medicine
1475:Gastroenterology
1431:Vascular surgery
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1079:Business Insider
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901:Guymer, Robyn H.
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508:epithelium cells
496:can be helpful.
392:autofluorescence
331:ophthalmologists
223:photocoagulation
59:
58:
34:
22:
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2011:Chief physician
1944:
1889:
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1872:Travel medicine
1857:Sports medicine
1840:Sexual medicine
1780:Palliative care
1775:Pain management
1719:Family medicine
1697:Diving medicine
1643:
1571:
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1435:
1394:Plastic surgery
1340:General surgery
1320:Cardiac surgery
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1198:Further reading
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915:(12): 2407–16.
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303:Type 2 (MacTel)
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203:micro-aneurysms
191:
189:Pathophysiology
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1665:Anesthesiology
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1595:Neuroradiology
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1532:Obstetrics and
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1357:Neurosurgery
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1790:Neonatology
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1542:Gynaecology
1534:gynaecology
1517:Pulmonology
1335:Eye surgery
1297:Specialties
1112:January 14,
535:Terminology
486:bevacizumab
482:Ranibizumab
464:retinopathy
435:hyperplasia
420:vasculature
374:Müller glia
337:Terminology
280:ranibizumab
268:bevacizumab
2113:Categories
1818:Psychiatry
1804:(PM&R)
1797:Phlebology
1785:Pediatrics
1612:Anatomical
1577:Diagnostic
1557:Obstetrics
1507:Nephrology
1492:Hematology
1487:Geriatrics
1480:Hepatology
1465:Cardiology
1455:Immunology
1186:2021-01-06
1162:2021-01-06
1138:2021-01-14
1084:2021-01-12
963:2020-10-19
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543:References
517:Fast Track
387:pattern),
276:angiogenic
199:parafoveal
169:(Type 2).
140:J. D. Gass
2006:Physician
1890:education
1748:Neurology
1743:Narcology
1607:Pathology
1585:Radiology
1460:Angiology
1424:Andrology
1006:0028-4793
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449:Treatment
385:capillary
362:Diagnosis
312:metabolic
217:Treatment
138:Although
118:exudation
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