Matet Alexandre, Yzer Suzanne, Chew Emily Y, Daruich Alejandra, Behar-Cohen Francine, Spaide Richard F
Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Rotterdam Eye Hospital, Rotterdam, the Netherlands.
Retina. 2018 Jan;38 Suppl 1(Suppl 1):S67-S78. doi: 10.1097/IAE.0000000000001836.
To describe cases presenting with features of idiopathic macular telangiectasia (MacTel) Type 2 and central serous chorioretinopathy (CSC).
Databases from four tertiary retina centers were searched for cases copresenting CSC and MacTel Type 2.
Five cases were identified (4 men, 1 woman; mean age: 67.2 years). Four patients were referred for chronic or nonresolving CSC, and the diagnosis of MacTel Type 2 was made based on multimodal imaging findings. One patient had advanced MacTel Type 2, and developed acute CSC. Regarding the MacTel Type 2 findings, all subjects presented perifoveal telangiectasia on fluorescein angiography, and four subjects showed intraretinal cavitations typical of MacTel Type 2 on optical coherence tomography, in one or both eyes. Regarding the CSC findings, fluorescein angiography identified focal or extended retinal pigment epithelium alteration in all eyes, and an active leakage in two eyes. Indocyanine green angiography showed choroidal vascular hyperpermeability in four subjects. On optical coherence tomography, pigment epithelial detachments were detected in five eyes (four subjects), and foveal detachments were present in five eyes (three subjects), which spontaneously resolved (two eyes), responded to photodynamic therapy (two eyes), or persisted (one eye). Mean choroidal thickness was 402 ± 99 μm.
The codiagnosis of CSC and MacTel Type 2 should be considered in atypical presentations associating features from both disorders.
描述表现为特发性黄斑毛细血管扩张症2型(MacTel)和中心性浆液性脉络膜视网膜病变(CSC)特征的病例。
检索四个三级视网膜中心的数据库,以查找同时存在CSC和MacTel 2型的病例。
共识别出5例(4例男性,1例女性;平均年龄:67.2岁)。4例患者因慢性或不愈性CSC就诊,根据多模态影像学检查结果诊断为MacTel 2型。1例患者患有晚期MacTel 2型,并发生了急性CSC。关于MacTel 2型的检查结果,所有受试者在荧光素血管造影中均表现为黄斑周围毛细血管扩张,4例受试者在光学相干断层扫描中一只或两只眼睛出现了MacTel 2型典型的视网膜内空洞。关于CSC的检查结果,荧光素血管造影显示所有眼睛均有局灶性或广泛性视网膜色素上皮改变,2只眼睛有活动性渗漏。吲哚菁绿血管造影显示4例受试者脉络膜血管通透性增加。在光学相干断层扫描中,5只眼睛(4例受试者)检测到色素上皮脱离,5只眼睛(3例受试者)出现黄斑脱离,其中2只眼睛自发消退,2只眼睛对光动力疗法有反应,1只眼睛持续存在。平均脉络膜厚度为402±99μm。
对于具有两种疾病特征的非典型表现,应考虑CSC和MacTel 2型的联合诊断。