Characteristics of retinal pigment clumps in Type 2 macular telangiectasia (MacTel).

Objective: To assess the relationship of retinal pigment clump (RPC) size and its location with visual acuity and retinal neovascularisation in eyes with type 2 macular telangiectasia (MacTel).

Methods: In this cross-sectional study, eyes diagnosed with type 2 MacTel showing RPC were included. Area occupied by pigment was measured on the multicolour image using the area tool on the Spectralis, Heidelberg machine. Pigment location within retinal layers was noted with OCT. Analysis was performed to identify factors associated with poor vision and proliferative disease.

Results: Sixty-two eyes of 42 patients diagnosed with type 2 MacTel and RPC were included. The mean age was 64.31 ± 10.19 years. There were 13 (31%) males and 29 (69%) females in the study. 74% of patients were diabetics and the mean logMAR visual acuity of the participants was 0.619 ± 0.359. Univariate and multivariate binary logistic regression analysis identified female gender (p = 0.026), increasing RPC size (p = 0.008) and its presence above the outer plexiform layer (p = 0.006) to be associated with poor vision and proliferative disease in type 2 MacTel.

Conclusion: Our data identified female gender, larger pigment size and its location above the OPL to be associated with poor vision and proliferative disease. This data may be useful for further improving the current system for staging disease severity in type 2 MacTel.