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PURPOSE: To investigate the progression characteristics of ellipsoid zone (EZ) loss in eyes with macular telangiectasia type 2 (MacTel) as reflected by area and linear measurements, and their relevance for visual acuity. METHODS: Participants were selected from the MacTel Study cohort. Linear and area measurements of EZ loss were performed in Spectral-Domain Optical Coherence Tomograph (SD-OCT) volume scans. Progression characteristics and correlations between linear and area measurements were analysed using linear mixed effects models. RESULTS: A total of 134 eyes of 70 patients were included (85 eyes with follow-up, mean 4.7 years, range: 1.4-8 years). Ellipsoid zone (EZ) loss significantly progressed at a mean annual increment of 0.057 mm2 (p = 0.005). The progression rate was non-linear and interacted significantly with initial EZ lesion size indicating an exponential growth before reaching a plateau. There was a strong heterogeneity in area sizes between fellow eyes. EZ break length had a significant linear effect on EZ break area (b = 1.06, p < 0.001) and could predict it. The location of the EZ break had a significant impact on visual acuity. CONCLUSION: Ellipsoid zone (EZ) loss in MacTel has a non-linear progression characteristic, and its rate depends on area size at baseline, which must be taken into account at sample selection in clinical trials. Our results show a good correlation of linear and area measures of EZ loss and a segregation of best-corrected visual acuity by EZ location, which may help routine clinical practice.

Original publication

DOI

10.1111/aos.14110

Type

Journal article

Journal

Acta Ophthalmol

Publication Date

11/2019

Volume

97

Pages

e998 - e1005

Keywords

OCT , MacTel, ellipsoid zone, en face image, macular telangiectasia type 2, Adult, Aged, Aged, 80 and over, Disease Progression, Female, Fluorescein Angiography, Follow-Up Studies, Fundus Oculi, Humans, Macula Lutea, Male, Middle Aged, Prognosis, Retinal Pigment Epithelium, Retinal Telangiectasis, Retinal Vessels, Time Factors, Tomography, Optical Coherence, Visual Acuity