PUNE: In a seminal research, a team of eye surgeons at the Pune-based National Institute of Ophthalmology have found that measuring the dimensions of the abnormal network of tiny retinal blood vessels (capillaries) can be a more reliable way of tracking the vision loss in patients diagnosed with macular telangiectasia (MacTel), than their conventional grading.
Telangiectasia is a network of blood capillaries — a type of spider veins — that some people with underlying medical conditions may get caught up with. It develops when there are problems with the tiny blood vessels around the fovea, which is the centre of the macula that gives us our sharpest central vision.
MacTel is seen in one in 10,000 eye patients. It is primarily seen in women and people with diabetes. The Indian Journal of Ophthalmology, a peer-reviewed index journal, published the study in December 2021.
“Usually, stage one is interpreted as a mild disease and stage four a severe one. However, in MacTel, visual acuity is often seen not corealting with the conventional staging pattern. So there must be some other guiding parameter,” eye surgeon Dr Aditya Kelkar, the lead researcher, said.
The new approach makes clever use of non-invasive optical coherence tomography angiography (OCTA) to accurately track the vision loss in patients with MacTel. “Through the OCT angiography, we are able to clearly see the network of the retinal veins.The non-invasive angiography clearly define network of retinal blood veins called telangiectasia and makes it easier to track the vision loss by measuring the girth of the retinal spider veins or MacTel," said Dr Kelkar, medical director, NIO.
NIO eye surgeons studied 40 patients with MacTel for six months in 2019. “We will follow up with them for next five years to assess whether the vertical or horizontal diameter has increased further, affecting central vision,” Dr Jai Kelkar, another researcher said. Other researchers were Jai Kelkar, Sayali Tidke, Aanchal Agarwal, Mounika Bolisetty and Shreekant Kelkar.
Retina surgeon Muna Bhende of Chennai, in her commentary on the study said, “The dynamic changes that occur in the natural history of the disease especially with respect to retinal cavitations on OCT emphasize the need to select imaging techniques and parameters that are reliable, reproducible, and easily interpreted.”
