From the Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Eye Center, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
Am J Ophthalmol. 2021 Aug;228:27-34. doi: 10.1016/j.ajo.2021.03.022. Epub 2021 Mar 26.
To investigate the role of fundus autofluorescence (FAF) imaging in the diagnosis of macular telangiectasia type 2 (MacTel) and to describe disease-associated FAF patterns and their origin.
Cross-sectional multicenter study METHODS: FAF images were collected from the multicenter MacTel Natural History Observation and Registry Study. In a first qualitative approach, common FAF phenotypes were defined and correlated with multimodal imaging. We then evaluated how many eyes showed FAF changes, and temporal vs nasal asymmetry of FAF changes was graded. Finally, 100 eyes of MacTel patients and 100 control eyes (50 normal eyes and 50 eyes with other macular diseases) were combined and 2 masked graders assessed the presence of MacTel based on FAF images alone.
The study included 807 eyes of 420 patients (33 eyes were excluded owing to poor image quality). Loss of macular pigment, cystoid spaces, pigment plaques, neovascular membranes, and ectatic vascular changes commonly caused characteristic changes on FAF images. All MacTel patients had macular FAF changes in at least 1 eye. In 95% of eyes, these changes were more pronounced temporally than nasally. Common FAF patterns were increased (60%) and mixed/decreased FAF (38%) and/or visibility of vascular changes such as blunted vessels or ectatic capillaries (79%). Based on those features, high diagnostic performance was achieved for detection of the disease based on FAF alone (Youden index up to 0.91).
The study demonstrates that MacTel is consistently associated with disease-specific changes on FAF imaging. Those changes are typically more pronounced in the temporal parafovea.
研究眼底自发荧光（FAF）成像在 2 型黄斑毛细血管扩张症（MacTel）诊断中的作用，并描述与疾病相关的 FAF 模式及其来源。
横断面多中心研究
从多中心 MacTel 自然史观察和注册研究中收集 FAF 图像。在最初的定性方法中，定义了常见的 FAF 表型，并将其与多模态成像相关联。然后，我们评估了有多少只眼睛出现了 FAF 变化，以及 FAF 变化的颞侧与鼻侧不对称程度。最后，将 100 只 MacTel 患者的眼睛和 100 只对照眼（50 只正常眼和 50 只其他黄斑疾病眼）组合在一起，由 2 名盲法评估者根据 FAF 图像单独评估 MacTel 的存在。
该研究共纳入 420 名患者的 807 只眼（因图像质量差排除 33 只眼）。黄斑色素丧失、囊样空间、色素斑块、新生血管膜和扩张性血管改变通常会导致 FAF 图像上出现特征性改变。所有 MacTel 患者至少有 1 只眼的黄斑 FAF 发生改变。在 95%的眼中，这些改变在颞侧比鼻侧更为明显。常见的 FAF 模式是增加（60%）、混合/减少 FAF（38%）和/或血管改变的可见性，如变钝的血管或扩张的毛细血管（79%）。基于这些特征，仅基于 FAF 检测疾病的诊断性能很高（Youden 指数高达 0.91）。
该研究表明，MacTel 始终与 FAF 成像上的特定疾病改变相关。这些改变在颞侧旁中心凹处更为明显。
