Retina-Vitreous Service, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
Retina. 2012 Feb;32(2):265-74. doi: 10.1097/IAE.0b013e31822091b0.
To describe the natural course of Type 2 idiopathic macular telangiectasia in terms of visual outcomes, causes of visual loss, and incidence of subretinal neovascular membranes (SRNV).
This retrospective observational case series consisted of chart review of 104 outpatients (203 eyes; 66 women, 38 men) who were diagnosed to have Type 2 idiopathic macular telangiectasia by clinical examination and fluorescein angiography between January 2000 and December 2008. Visual and anatomic outcomes were analyzed during a minimum follow-up of 1 year.
The mean age of the patients was 57 years (range, 40-74 years). Nineteen eyes (18 patients) presented with SRNV; the number increased to 29 eyes (14%; 23 patients) by the final visit (mean follow-up, 31 months). Diabetes was common (59%) though retinopathy was initially absent or mild to moderate in 99% patients. Mean logarithm of the minimum angle of resolution best-corrected visual acuity declined from 0.35 to 0.43 by the last visit (P < 0.0001) overall; final mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.61 (20/80) in the eyes with SRNV and 0.40 (20/50) in eyes without SRNV. The latter group started with better best-corrected visual acuity than SRNV group and remained better at 1-year, 2-year, and final follow-ups (P ≤ 0.0002). Overall, 30 eyes (15%; 24 patients) lost ≥ 2 Snellen lines, the main causes being SRNV and intraretinal pigment migration. Of 128 eyes (including SRNV) with best-corrected visual acuity ≥ 20/40 at baseline, 98 (77%) retained stable visual status; 74 (71%) patients retained best-corrected visual acuity of 20/40 or better at least in 1 eye.
Over a follow-up of approximately 3 years, most eyes with Type 2 idiopathic macular telangiectasia starting with good vision were found to retain status quo; sight-threatening complications developed in a minority of eyes; most patients retained good vision at least in 1 eye.
描述 2 型特发性黄斑毛细血管扩张症在视力结果、视力丧失原因和视网膜下新生血管膜（SRNV）发生率方面的自然病程。
本回顾性观察性病例系列研究纳入了 2000 年 1 月至 2008 年 12 月期间通过临床检查和荧光素血管造影诊断为 2 型特发性黄斑毛细血管扩张症的 104 名门诊患者（203 只眼；66 名女性，38 名男性）的图表回顾。在至少 1 年的随访期间分析了视力和解剖学结果。
患者的平均年龄为 57 岁（范围，40-74 岁）。19 只眼（18 名患者）出现 SRNV；在最后一次就诊时，这一数字增加到 29 只眼（14%；23 名患者）（平均随访 31 个月）。尽管 99%的患者最初没有或仅有轻度至中度视网膜病变，但糖尿病很常见（59%）。总的来说，最佳矫正视力的最小角度分辨率对数从最后一次就诊时的 0.35 下降到 0.43（P < 0.0001）；在有 SRNV 的眼中，最终的平均最小角度分辨率对数最佳矫正视力为 0.61（20/80），在没有 SRNV 的眼中为 0.40（20/50）。后一组在最佳矫正视力方面开始优于 SRNV 组，并在 1 年、2 年和最后随访时保持更好（P ≤ 0.0002）。总的来说，30 只眼（15%；24 名患者）视力丧失≥2 行，主要原因是 SRNV 和视网膜内色素迁移。在基线时最佳矫正视力≥20/40 的 128 只眼中（包括 SRNV），98 只（77%）保持稳定的视力状态；74 只（71%）患者至少在 1 只眼中保持 20/40 或更好的最佳矫正视力。
在大约 3 年的随访中，大多数开始视力良好的 2 型特发性黄斑毛细血管扩张症患者被发现保持现状；少数患者出现威胁视力的并发症；大多数患者至少在 1 只眼中保持良好的视力。
