Vujosevic Stela, Heeren Tjebo F C, Florea Daniela, Leung Irene, Pauleikhoff Daniel, Sallo Ferenc, Bird Alan, Peto Tunde
The International Microperimetry Reading Centre, Padova, Italy.
Department of Ophthalmology, University of Padova, Italy.
Retina. 2018 Jan;38 Suppl 1:S14-S19. doi: 10.1097/IAE.0000000000001693.
To characterize scotomas in macular telangiectasia Type 2 (MacTel).
Five of the 27 centers performed microperimetry as part of the MacTel Natural History Observation Study. Data were analyzed in the Moorfields Eye Hospital Reading Centre. The number of stimuli under a threshold of 12, 10, 8, and <0 dB were counted (thresholding) and compared with one another.
A total of 565 examinations were gradable, received from 632 eyes of 322 participants (age 61.1 ± 9.1 years, 62% females). The authors found absolute scotomas in 243 eyes (43%), 98% of these affected the temporal quadrant, and 99.5% were unifocal. Growth of absolute scotomas was limited to an extent of approximately 40 deg. Although transition from functionally unimpaired retina to absolute scotomas is generally steeply sloped, the larger a scotoma, the steeper it is.
Scotoma features were consistent throughout a large MacTel cohort. The temporal quadrant was confirmed as predominantly affected, which might result from vascular or metabolic asymmetry. Functional loss did not exceed an area of 5° × 8° however advanced the disorder. Different MacTel phenotypes seem likely and point toward different types of progression; identifying these would improve planning for clinical trials and might lead to better understanding patient outcome.
对2型黄斑毛细血管扩张症（MacTel）中的暗点进行特征描述。
27个中心中的5个进行了微视野检查，作为MacTel自然病史观察研究的一部分。数据在摩尔菲尔德眼科医院阅读中心进行分析。对阈值为12、10、8和<0 dB以下的刺激数量进行计数（阈值测定）并相互比较。
共获得565份可分级检查结果，来自322名参与者的632只眼睛（年龄61.1±9.1岁，62%为女性）。作者在243只眼睛（43%）中发现了绝对暗点，其中98%影响颞侧象限，99.5%为单灶性。绝对暗点的扩大限于约40度的范围。尽管从功能未受损的视网膜到绝对暗点的转变通常斜率很大，但暗点越大，斜率越陡。
在一个大型MacTel队列中，暗点特征是一致的。颞侧象限被证实为主要受累部位，这可能是由于血管或代谢不对称所致。无论疾病进展到何种程度，功能丧失面积均未超过5°×8°。不同的MacTel表型似乎存在，指向不同类型的进展；识别这些表型将改善临床试验规划，并可能有助于更好地理解患者预后。
