Department of Ophthalmology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany,
Graefes Arch Clin Exp Ophthalmol. 2013 Nov;251(11):2513-20. doi: 10.1007/s00417-013-2346-z. Epub 2013 Apr 25.
To study the long-term course in patients with idiopathic macular telangiectasia and report the effect of anti VEGF and laser treatment.
A retrospective case series of 19 patients/38 eyes with symptomatic type 2 idiopathic macular telangiectasia was performed. Six eyes received intravitreal injections of bevacizumab (1-3 injections), four eyes received focal laser treatment. Follow up examinations comprised visual acuity, biomicroscopy, fluorescein angiography and assessment of macular morphology and thickness by time and spectral-domain optical coherence tomography (OCT).
Mean follow-up time was 81 months (range 15-188 months) - the median added up to 80 months. Visual outcome at final visit varied substantially (20/200-20/20). On average visual acuity decreased 1,2 lines (range -0,5 to 6) by 3 years, 2 lines (range -0,5 to 7) by 5 years and 4,1 lines (range 0 to 12) by 10 years. Development of choroidal neovascularisation was observed in only one eye. There was no significant difference in visual acuity between eyes receiving no treatment, intravitreal bevacizumab or laser treatment after 3 and 5 years. Morphological studies by OCT revealed typical changes with retinal atrophy and intraretinal cysts. Visual acuity correlated with the eccentricity of the main manifestation-visual preservation was associated with mainly extrafoveal disease manifestation.
Type 2 idiopathic macular telangiectasia is a chronic, often slowly progressing macular disease leading to retinal atrophy and visual impairment over decades. Thorough knowledge about the long term course of this disease is necessary to evaluate possible therapeutic options in the long run.
研究特发性黄斑毛细血管扩张症患者的长期病程，并报告抗 VEGF 和激光治疗的效果。
对 19 例（38 只眼）有症状的 2 型特发性黄斑毛细血管扩张症患者进行回顾性病例系列研究。6 只眼接受贝伐单抗玻璃体内注射（1-3 次），4 只眼接受局部激光治疗。随访检查包括视力、生物显微镜检查、荧光素血管造影以及通过时间和谱域光相干断层扫描（OCT）评估黄斑形态和厚度。
平均随访时间为 81 个月（范围 15-188 个月）-中位数为 80 个月。最终随访时的视力结果差异很大（20/200-20/20）。平均而言，视力在 3 年内下降 1.2 行（范围-0.5 至 6），5 年内下降 2 行（范围-0.5 至 7），10 年内下降 4.1 行（范围 0 至 12）。仅 1 只眼观察到脉络膜新生血管形成。3 年和 5 年后，未接受治疗、玻璃体内贝伐单抗或激光治疗的眼之间视力无显著差异。OCT 的形态学研究显示出典型的变化，包括视网膜萎缩和视网膜内囊肿。视力与主要表现的偏心度相关-视力保存与主要位于中心凹外的疾病表现相关。
2 型特发性黄斑毛细血管扩张症是一种慢性、常缓慢进展的黄斑疾病，可导致数十年的视网膜萎缩和视力损害。彻底了解这种疾病的长期病程对于长期评估可能的治疗选择是必要的。
