Department of Ophthalmology, Duke Medicine, Durham, North Carolina, USA.
Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.
Br J Ophthalmol. 2021 Jan;105(1):109-112. doi: 10.1136/bjophthalmol-2019-315416. Epub 2020 Mar 9.
BACKGROUND/AIMS: To quantify retinal cavitation size over time in macular telangiectasia type 2 (MacTel) and to correlate changes with visual acuity and area of ellipsoid zone loss.
Optical coherence tomography (OCT) macula volume scans from sham eyes included in a prospective, phase II clinical trial of human ciliary neutrophic factor for MacTel at baseline, 1 year and 2 years of follow-up were analysed. Cavitations were segmented by two independent readers. Total cavitation volume was compared with area of ellipsoid zone loss and best-corrected visual acuity (BCVA).
Fifty-one eyes from 51 unique patients (mean age 62 years, range 45-79 years) were included. Intraclass correlation between readers for cavitation volume was excellent (>0.99). Average cavitation volume was 0.0109 mm, 0.0113 mm and 0.0124 mm at baseline, 1 year and 2 years, respectively. The average rate of cavitation volume change was +0.0039 mm/year. 10 eyes (20%) had a significant change in cavitation volume during the study (3 decreased, 7 increased). Eyes with increased cavitation volume had worse BCVA compared with eyes with no change/decreased cavitation volume (71.5 vs 76.1 ETDRS letters, respectively). Cavitation volume was negatively correlated to BCVA (r=-0.37) but not to area of ellipsoid zone loss. Cavitation volume was negatively predictive of BCVA in both univariate and multivariate mixed-effects modelling with ellipsoid zone loss.
Retinal cavitations and their rate of change in MacTel can be reliably quantified using OCT. Cavitations are negatively correlated with visual acuity and may be a useful OCT-based biomarker for disease progression and visual function in MacTel.
背景/目的：定量分析 2 型黄斑毛细血管扩张症（MacTel）中视网膜空洞的大小随时间的变化，并将其变化与视力和椭圆体带丢失面积相关联。
分析纳入一项前瞻性、2 期人类睫状神经营养因子治疗 MacTel 的临床试验中 sham 眼的光学相干断层扫描（OCT）黄斑体积扫描。由两位独立的读者对空洞进行分割。将总空洞体积与椭圆体带丢失面积和最佳矫正视力（BCVA）进行比较。
51 只眼（51 名患者，平均年龄 62 岁，范围 45-79 岁）被纳入。读者之间对空洞体积的内类相关系数很高（>0.99）。基线、1 年和 2 年时平均空洞体积分别为 0.0109mm、0.0113mm 和 0.0124mm。空洞体积变化的平均速率为+0.0039mm/年。在研究期间，10 只眼（20%）的空洞体积发生了显著变化（3 只眼减少，7 只眼增加）。与空洞体积无变化/减少的眼相比，空洞体积增加的眼的 BCVA 更差（分别为 71.5 和 76.1 ETDRS 字母）。空洞体积与 BCVA 呈负相关（r=-0.37），但与椭圆体带丢失面积无关。在单变量和多变量混合效应模型中，空洞体积与椭圆体带丢失一起对 BCVA 具有负预测作用。
使用 OCT 可以可靠地定量分析 MacTel 中的视网膜空洞及其变化速度。空洞与视力呈负相关，可能是 MacTel 疾病进展和视力功能的有用的基于 OCT 的生物标志物。
