Stoffelns B M, Schoepfer K, Kramann C
Augenklinik der Johannes-Gutenberg-Universität, Mainz.
Klin Monbl Augenheilkd. 2010 Apr;227(4):252-6. doi: 10.1055/s-0029-1245187. Epub 2010 Apr 20.
The aim of this study was to evaluate the effectiveness of laser photocoagulation for idiopathic macular telangiectasia (IMT) by using the revised and simplified classification of Yannuzzi 2006.
The Yannuzzi classification was used for a retrospective analysis of the medical records of all patients with idiopathic macular telangiectasia as diagnosed consecutively in the University Eye Clinic of Mainz in the time period from 1 / 02 to 12 / 06. Laser treatment was indicated only in those eyes which presented with a visual acuity below 10 / 20 (follow-up interval in median 37 months, minimum 13 months).
12 patients with unilateral macular telangiectasia (IMT type I) and 30 patients with bilateral macular telangiectasia (IMT type II) were recruited. In type I disease 9 / 12 patients were male with an average age of 41 years (range: 28 to 47). 10 / 12 eyes showed macular oedema. After focal laser photocoagulation in 6 / 10 eyes the macular oedema decreased in 4 / 6 eyes and visual acuity improved in 3 / 6 eyes. In type II disease 17 / 30 patients were male and the average age was 56 years (range: 45 to 63). All 60 eyes showed macular oedema. In 40 eyes, which did not receive a laser photocoagulation, the ocular findings did not change during the follow-up examinations. In 16 / 20 eyes the macular oedema has successfully been reduced by laser photocoagulation, however without significant visual improvement. In 2 of these 16 treated eyes the development of a subfoveal choroidal neovascularisation with central loss of vision was noted.
In IMT type I laser photocoagulation was able to achieve a visual improvement. In IMT type II, however, a laser photocoagulation indication should be considered very carefully because in this group no visual improvement was reached and a secondary induction of subretinal neovascular membranes seems likely.
本研究旨在采用2006年修订简化的扬努齐分类法评估激光光凝治疗特发性黄斑毛细血管扩张症（IMT）的有效性。
采用扬努齐分类法对2002年1月至2006年12月期间在美因茨大学眼科诊所连续诊断的所有特发性黄斑毛细血管扩张症患者的病历进行回顾性分析。仅对视力低于10/20的眼进行激光治疗（中位随访间隔37个月，最短13个月）。
招募了12名单侧黄斑毛细血管扩张症患者（IMT I型）和30名双侧黄斑毛细血管扩张症患者（IMT II型）。在I型疾病中，9/12例患者为男性，平均年龄41岁（范围：28至47岁）。10/12只眼出现黄斑水肿。在10只眼中的6只眼进行局灶性激光光凝后，4/6只眼的黄斑水肿减轻，3/6只眼的视力提高。在II型疾病中，17/30例患者为男性，平均年龄56岁（范围：45至63岁）。所有60只眼均出现黄斑水肿。在40只未接受激光光凝的眼中，随访检查期间眼部情况未发生变化。在20只眼中的16只眼，激光光凝成功减轻了黄斑水肿，但视力无明显改善。在这16只接受治疗的眼中，有2只出现了黄斑下脉络膜新生血管形成并伴有中心视力丧失。
在IMT I型中，激光光凝能够改善视力。然而，在IMT II型中，应非常谨慎地考虑激光光凝指征，因为该组患者视力未得到改善，且似乎有可能继发视网膜下新生血管膜。
