A 54-year-old woman presents with difficulty reading. What is her diagnosis?
Analysis
Centrally, there is a hyporeflective area which is bordered anteriorly by the inner limiting membrane (ILM). This anterior ILM border is called an “ILM drape” (A). Temporal to this area are 2 areas of hyperreflectivity consistent with intraretinal RPE migration (superficial one) and a vascular lesion (deeper one). The patient was noted to have temporal dilated capillaries in the deep capillary plexus on OCTA (video).
The patient was diagnosed with MacTel and macular edema.
In this tip's accompanying 20 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:
- The key features of MacTel on both the OCT and OCTA
- How MacTel is believed to be related to dysfunction of Muller cells
OCT Tip
Central cavities associated with adjacent hyperreflectivity in the parafoveal area represents MacTel until proven otherwise.
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