Trends in MacTel treatment: A vascular or neurological disease?

Idiopathic macular telangiectasia type 2 (MacTel) is known with temporal juxtafoveal retinal capillaries dilation and telangiectasia. The disease is most common in the fi fth and sixth decades [1]. Patients often report a progressive bilateral visual loss. Macular transparency, retinal crystalline deposits, distribution of brown pigmented cells adjacent abnormal blood vessels, redistribution of macular pigment and retinal atrophy in the end stages are the fi ndings that can be seen [1]. Subretinal neovascularization may occur in some patients and worsens the symptoms. Yannuzzi et al. classifi ed MacTel disease based on clinical, therapeutic, and prognostic aspects: the non-proliferative phase (stage1 to 4) and the proliferative phase (stage 5) associated with development of subretinal neovascularization, however, it does not necessarily have a step-by-step pattern and CNV may appear at any stage [2]. In the primary stages, MacTel can have an intangible course with subtle signs which makes it diffi cult to diagnose in the classic examinations.

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