Department of Ophthalmology, University of Bonn, Bonn, Germany.
Ophthalmology. 2010 Nov;117(11):2162-8. doi: 10.1016/j.ophtha.2010.02.014. Epub 2010 Jun 16.
To analyze focal hyperreflective morphologic alterations in outer retinal layers in patients with type 2 idiopathic macular telangiectasia (MacTel type 2) using spectral-domain optical coherence tomography (SD OCT).
Cross-sectional case-control study.
Forty-one patients with MacTel type 2.
Anatomic layers were evaluated and compared with those of controls of similar age. Simultaneous SD OCT scans were obtained with a combined confocal scanning laser ophthalmoscope for simultaneous tomographic and topographic in vivo imaging (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany).
Morphologic alterations in the retinal layers secondary to MacTel type 2.
Hyperreflective spots in the outer retina of MacTel type 2 patients were detected in all stages of disease using the SD OCT. Their presence was confined to the foveolar and parafoveolar region. The phenomenon also was detected in a monozygotic twin in an eye with no typical angiographic sign of the disease. A hyperreflective haze was detected in the vicinity of a disruption of the hyperreflective OCT line that is assumed to represent the line between the photoreceptor inner and outer segments and interdigitation of the outer segments and the retinal pigment epithelium. No corresponding pathologic features could be identified by biomicroscopy, time-domain OCT, or confocal scanning laser ophthalmoscope imaging. Crystalline deposits and intraretinal migration of pigmented cells were distinguishable because of differences in shape, reflectivity, and location.
Hyperreflective spots were identified in outer retinal layers of patients with MacTel type 2 in all disease stages. It is suggested that this phenomenon represents an early sign of a neurodegenerative process. Secondary assumptions include extravasated deposits or vascular abnormalities. The pathologic features are indicative of an active disease process before the disease manifests by typical fluorescein angiographic signs.
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使用谱域光相干断层扫描（SD-OCT）分析 2 型特发性黄斑毛细血管扩张症（MacTel 2 型）患者的外视网膜层局灶性高反射形态改变。
横断面病例对照研究。
41 例 MacTel 2 型患者。
评估解剖层并与年龄相似的对照组进行比较。使用同时具有共焦扫描激光检眼镜的 SD-OCT 进行同时进行层析和活体成像（Spectralis HRA+OCT；Heidelberg Engineering，Heidelberg，德国）。
MacTel 2 型患者视网膜层继发的形态改变。
使用 SD-OCT 在疾病的所有阶段均检测到 MacTel 2 型患者外视网膜的高反射斑点。它们局限于黄斑和旁黄斑区域。在疾病无典型血管造影征象的单卵双胞胎的一只眼中也发现了这种现象。在外层 OCT 线中断附近检测到高反射雾，假设该线代表光感受器内外节之间的线以及外节和视网膜色素上皮的交织。生物显微镜检查、时域 OCT 或共焦扫描激光检眼镜成像均无法识别相应的病理特征。由于形状、反射率和位置的差异，可区分结晶沉积物和色素细胞的内视网膜迁移。
在 MacTel 2 型患者的外视网膜层中，在所有疾病阶段均发现高反射斑点。这表明这种现象代表神经退行性过程的早期迹象。次要假设包括漏出的沉积物或血管异常。在疾病表现出典型荧光血管造影征象之前，病理特征表明疾病过程是活跃的。
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