Progression of CNF abnormalities in patients with MacTel

  • Research type

    Research Study

  • Full title

    Progression of corneal nerve fiber abnormalities in patients with macular telangiectasia type 2 (MacTel)

  • IRAS ID

    361122

  • Contact name

    Catherine Egan

  • Contact email

    cathy.egan@nhs.net

  • Sponsor organisation

    Lowy Medical Research Institute

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Macular telangiectasia type 2 (MacTel) is a slowly-progressive, neurodegenerative disease of the central retina. Recently, a common genetic background between MacTel and a rare form of peripheral neuropathy –hereditary sensory and autonomic neuropathy type 1 (HSAN1) – has been demonstrated. While only a very small fraction of MacTel patients have HSAN1, the broader MacTel population shares the same metabolic phenotype, elevated levels of neurotoxic lipids, deoxysphingolipids. Increased deoxysphingolipid levels have also been found in other diseases with peripheral neuropathy, including diabetic neuropathy. Corneal confocal microscopy is a non-invasive imaging technique that allows for examination of the density and structure of sub-basal corneal nerves in vivo. Alterations in corneal nerve fiber density and structure are very early signs of peripheral neuropathy and have been demonstrated in patients with diabetic and other peripheral neuropathies. In a previous study, we found a significant reduction in corneal nerve fibers, reflected by a decreased density, length and branch density of corneal nerve fibers in patients with MacTel. Whether these corneal nerve fiber abnormalities progress over time, and how this compares to retinal disease progression in MacTel, has not yet been evaluated.

  • REC name

    London - Dulwich Research Ethics Committee

  • REC reference

    25/LO/0663

  • Date of REC Opinion

    18 Sep 2025

  • REC opinion

    Unfavourable Opinion