The Lowy Medical Research Institute, La Jolla, California, United States.
The Scripps Research Institute, Department of Molecular Medicine, La Jolla, California, United States.
Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):6. doi: 10.1167/iovs.62.3.6.
The purpose of this study was to quantify hyper-reflective lesions on en face optical coherence tomography (OCT) and study its functional relevance in macular telangiectasia type 2 (MacTel).
This was a retrospective, cross-sectional cohort study.
Baseline image and functional data from participants of a phase II clinical trial (NCT01949324) that studied the effect of Ciliary Neurotrophic Factor in patients with MacTel were analyzed. The projection of hyper-reflectivity within different layers on OCT was used to generate an en face view and measure the en face size of hyper-reflectivity. Ellipsoid zone (EZ)-loss was additionally evaluated, and en face images were superimposed onto microperimetry sensitivity maps, allowing to estimate mean retinal sensitivity within areas displaying hyper-reflectivity and EZ-loss, respectively. Best-corrected visual acuity (BCVA) and reading speed were also analyzed.
Fifty-two eyes from 52 patients were analyzed. Hyper-reflectivity was present in 32 eyes (62%), and EZ-loss in 50 (96%) eyes. Mean lesion size was 0.11 mm² (range = 0.01-0.26) for hyper-reflectivity and 0.51 mm² (range = 0.02-1.34) for EZ-loss, and lesion sizes correlated strongly (Spearman r = 0.79, P < 0.001). Although both hyper-reflectivity and EZ-loss were associated with a significant decrease in retinal sensitivity, mean sensitivity thresholds differed significantly between lesions (0.9 dB vs. 16.3 dB; P < 0.001), indicating an almost complete loss of sensitivity in hyper-reflective areas. No correlations were found between the size of hyper-reflectivity and BCVA (r = 0.09) or reading speed (r = -0.17).
En face OCT can be used to quantify the area of hyper-reflective lesions in MacTel. Hyper-reflectivity in MacTel is associated with severe functional impairment, leading to an almost complete loss of retinal sensitivity as observed on microperimetry.
本研究旨在定量分析 2 型黄斑毛细血管扩张症（MacTel）中光学相干断层扫描（OCT）的高反射病变，并研究其功能相关性。
这是一项回顾性、横断面队列研究。
分析参加一项 II 期临床试验（NCT01949324）的患者的基线图像和功能数据，该试验研究了睫状神经营养因子对 MacTel 患者的影响。通过 OCT 不同层内高反射性的投影生成一个共焦视图，并测量高反射性的共焦大小。还评估了椭圆体带（EZ）损失，并将共焦图像叠加到微视野灵敏度图上，分别估计显示高反射性和 EZ 损失区域的平均视网膜灵敏度。最佳矫正视力（BCVA）和阅读速度也进行了分析。
分析了 52 名患者的 52 只眼。32 只眼（62%）存在高反射性，50 只眼（96%）存在 EZ 损失。高反射性病变的平均大小为 0.11mm²（范围=0.01-0.26），EZ 损失的平均大小为 0.51mm²（范围=0.02-1.34），病变大小相关性较强（Spearman r=0.79，P<0.001）。虽然高反射性和 EZ 损失均与视网膜敏感性显著下降相关，但病变之间的平均敏感性阈值差异显著（0.9dB 与 16.3dB；P<0.001），表明高反射性区域的敏感性几乎完全丧失。高反射性病变大小与 BCVA（r=0.09）或阅读速度（r=-0.17）无相关性。
共焦 OCT 可用于定量分析 MacTel 中高反射病变的面积。MacTel 中的高反射性与严重的功能障碍相关，导致微视野检查观察到的视网膜敏感性几乎完全丧失。
