Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, India; and.
University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, Pittsburg, Pennsylvania.
Retin Cases Brief Rep. 2023 Sep 1;17(5):620-624. doi: 10.1097/ICB.0000000000001253.
To report a case of proliferative Type 2 macular telangiectasia treated successfully with direct laser photocoagulation to the right-angled vessel.
Descriptive case report.
A 61-year-old man, with no past medical history, was diagnosed and treated previously elsewhere for bilateral proliferative Type 2 macular telangiectasia. He complained of recent onset decrease in vision in his right eye for last 2 months. Right eye visual acuity was counting fingers at 3 m and left eye was 6/18. Fundus examination showed proliferative Type 2 macular telangiectasia in both eyes with active neovascular complex in the right eye. Direct thermal laser photocoagulation to the tips of the right-angled vessels with single-spot PASCAL Synthesis (Topcon Medical Laser System) at 532 nm wavelength was done. After laser, reduction in the hyporeflective space height was noted on optical coherence tomography. No additional intravitreal anti-vascular endothelial growth factor injections were required. At the last 6-months follow-up visit, visual acuity improved to 6/36, N18 in the right eye.
Direct laser photocoagulation to the right-angled vessel can be considered as possible treatment option for proliferative Type 2 macular telangiectasia, especially in patients nonresponsive to anti-vascular endothelial growth factor therapy. However, long-term follow-ups are required to see whether it is possible to maintain the efficacy.
报告一例成功接受直角血管直接激光光凝治疗的增生型 2 型黄斑毛细血管扩张症病例。
描述性病例报告。
一名 61 岁男性，无既往病史，曾在其他地方被诊断和治疗过双侧增生型 2 型黄斑毛细血管扩张症。他诉右眼视力下降 2 个月，左眼视力为 6/18。眼底检查显示双眼均有增生型 2 型黄斑毛细血管扩张症，右眼有活跃的新生血管复合物。右眼直角血管尖端采用 532nm 波长的单斑点 PASCAL Synthesis（Topcon 医疗激光系统）进行直接热激光光凝。激光治疗后，光学相干断层扫描显示低反射空间高度降低。不需要额外的玻璃体内抗血管内皮生长因子注射。在最后 6 个月的随访中，右眼视力提高至 6/36，N18。
直接激光光凝直角血管可作为增生型 2 型黄斑毛细血管扩张症的治疗选择，尤其是在对血管内皮生长因子治疗无反应的患者中。然而，需要长期随访以观察是否可以维持疗效。
