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Aims <p>To evaluate the structural and microvascular characteristics of eyes with coexisting macular telangiectasia type 2 (MacTel) and non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography (OCT) and OCT angiography (OCTA), and to explore how MacTel may influence retinal architecture and vascular integrity in diabetic eyes.</p> Methods <p>This retrospective cross-sectional study included 40 eyes with both MacTel and NPDR, 40 eyes with NPDR only, and 35 eyes from an age- and sex-matched control group. All participants underwent spectral-domain OCT and OCTA. Quantitative measurements of retinal layer thickness and vessel density in the superficial (SCP) and deep capillary plexuses (DCP) were compared between groups. Eye-level analyses were performed using linear mixed-effects models to account for inter-eye correlation.</p> Results <p>Groups were matched for age, diabetes duration, glycated hemoglobin, and NPDR stage (all <i>p</i> &gt; 0.05). Mean BCVA was significantly worse in eyes with MacTel and NPDR compared with NPDR-only eyes (0.79 ± 0.64 vs. 0.34 ± 0.32 logMAR; <i>p</i> &lt; 0.001). Retinal layer thicknesses within the inner temporal parafoveal region and central retinal thickness were significantly reduced in eyes with MacTel and NPDR (<i>p</i> &lt; 0.05). Vessel density in both the SCP and DCP was significantly higher in the MacTel and NPDR group compared with NPDR-only eyes (<i>p</i> &lt; 0.05). None of the eyes with MacTel showed proliferative diabetic retinopathy or diabetic macular edema.</p> Conclusions <p>This study provides the first quantitative evidence that MacTel modifies diabetic retinal pathology by attenuating microvascular injury while amplifying neurodegenerative thinning. The preservation of vessel density alongside pronounced retinal thinning and poorer vision suggests that MacTel alters the neurovascular balance of diabetic retinopathy.</p>

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Does macular telangiectasia type 2 influence the retinal microvasculature in diabetic retinopathy?

  • 期刊论文

  • 发表日期：

    2026年8月1日

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  • Merve Ozbek,
  • Metehan Simsek,
  • Ali Burak Onaran,
  • Ozgur Artunay

摘要

Aims

To evaluate the structural and microvascular characteristics of eyes with coexisting macular telangiectasia type 2 (MacTel) and non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography (OCT) and OCT angiography (OCTA), and to explore how MacTel may influence retinal architecture and vascular integrity in diabetic eyes.

Methods

This retrospective cross-sectional study included 40 eyes with both MacTel and NPDR, 40 eyes with NPDR only, and 35 eyes from an age- and sex-matched control group. All participants underwent spectral-domain OCT and OCTA. Quantitative measurements of retinal layer thickness and vessel density in the superficial (SCP) and deep capillary plexuses (DCP) were compared between groups. Eye-level analyses were performed using linear mixed-effects models to account for inter-eye correlation.

Results

Groups were matched for age, diabetes duration, glycated hemoglobin, and NPDR stage (all p > 0.05). Mean BCVA was significantly worse in eyes with MacTel and NPDR compared with NPDR-only eyes (0.79 ± 0.64 vs. 0.34 ± 0.32 logMAR; p < 0.001). Retinal layer thicknesses within the inner temporal parafoveal region and central retinal thickness were significantly reduced in eyes with MacTel and NPDR (p < 0.05). Vessel density in both the SCP and DCP was significantly higher in the MacTel and NPDR group compared with NPDR-only eyes (p < 0.05). None of the eyes with MacTel showed proliferative diabetic retinopathy or diabetic macular edema.

Conclusions

This study provides the first quantitative evidence that MacTel modifies diabetic retinal pathology by attenuating microvascular injury while amplifying neurodegenerative thinning. The preservation of vessel density alongside pronounced retinal thinning and poorer vision suggests that MacTel alters the neurovascular balance of diabetic retinopathy.