Objective: The purpose of the study was to quantify the optical coherence tomography angiography (OCTA) features of non-proliferative and proliferative macular telangiectasia type 2 (MacTel2). The retinal vessel density (RVD) of the superficial and deep layers of the retina were studied.

Methods: This cross-sectional and observational study was carried out at İstanbul Beyoğlu Eye Training and Research Hospital. Patients clinically diagnosed with MacTel2 underwent fundus photography, fluorescein angiography, spectral domain OCT, and OCTA imaging. Superficial and deep RVD in the foveal and parafoveal regions were calculated using device automated software.

Results: Thirteen eyes of 8 patients (4 male, 4 female) with a mean age of 64.6±3.8 years were included. The mean RVD of the superficial fovea and parafovea were 30.3%±9.3% and 49.5%±6.4% in non-proliferative MacTel2, compared with 39.4%±3.3% and 43.8%±2.9% in the proliferative MacTel2, respectively. No statistically significant difference was found between non-proliferative and proliferative MacTel2 (p=0.31, p=0.41; respectively). The mean deep foveal and parafoveal RVD was 30.4%±7.8% and 50.7%±3.8% in non-proliferative MacTel2 versus 47.5%±0.2% and 55.3%±8.4% in proliferative MacTel2, respectively. There was a significant difference in deep foveal RVD between proliferative and non-proliferative MacTel2 patients, whereas no difference was found in deep parafoveal RVD (p=0.02 and p=0.23, respectively).

Conclusion: The mean deep foveal RVD was significantly higher in proliferative MacTel2 than in non-proliferative MacTel2. Measurement of RVD in the deep retinal layers by OCTA may have diagnostic value in patients with proliferative MacTel2.