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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.06.08 Microperimetric assessment of patients with type II macular telangiectasia Charbel Issa P., Scholl H. P. N., Helb H. M., Holz F. G., for the MacTel-Study Group
Department of Ophthalmology, University of Bonn Objective: Type 2 macular telangiectasia (MT) is a rare disease of the parafoveal capillaries with angiographically late hyperfluorescence temporal to the fovea without macular edema. To assess retinal light increment sensitivity (LIS) of both the angiographically hyperfluorescent and the adjacent areas at the posterior pole we performed fundus controlled static threshold microperimetry in patients with type 2 MT.
Methods: 35 eyes of 18 patients (mean age: 61 years; range: 48 - 73 years) MT were included. Patients were examined by means of funduscopy, best-corrected visual acuity (ETDRS), fluorescein angiography, and optical coherence tomography (OCT3). Fundus controlled static threshold perimetry was performed with the Nidek MP1 (Goldmann III stimuli, white background illumination, background illumination: 1,27 cd/m2, maximal stimulus intensity: 127 cd/m2, maximal attenuation: 20 dB).
Results: Visual acuity (VA) was reduced in all but two eyes (median 20/50; range: 20/200 - 20/20). LIS was reduced within the hyperfluorescent areas temporal to the fovea in all but four eyes. The areas with reduced LIS correlated well with the angiographically hyperfluorescent areas and showed a relatively sharp demarcation from areas with normal LIS. In 19 eyes there was no LIS detectable at least at some test locations temporal to the fovea. However, in early stages of the disease, a normal retinal sensitivity was found in some eyes. Overall, there was good correlation between LIS reduction and stage of disease. In eyes with additional hyperfluorecence of the nasal parafoveal region, LIS was considerably higher or within normal limits in the nasal compared to the temporal area. Retinal sensitivity of normal appearing areas on angiography at the posterior pole was within normal limits in all but two eyes.
Conclusions: These findings indicate that MT type 2 is associated with functional impairment of retinal light sensitivity. There is good topographic correspondence between angiographically visible alterations and parafoveal scotomas, which both are mainly located in the temporal parafoveal area. Abnormal retinal sensitivity represents a different feature from visual acuity loss. Therefore, testing for retinal light sensitivity should be included as an additional outcome measure for future interventional studies.
Support: DFG Heisenberg fellowship SCHO 734/2-1; EU FP6, Integrated Project "EVI-GENORET" (LSHG-CT-2005-512036); Forschungsförderung der Pro-Retina: Pro-Re/Seed/Issa.1
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