Park Yu Jeong, Lee Suhwan, Yoon Young Hee
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Hanvit Eye Center, 251, Yeongsan-ro, Mokpo-si, 58652, Jeollanam-do, Korea.
Graefes Arch Clin Exp Ophthalmol. 2022 Nov;260(11):3479-3488. doi: 10.1007/s00417-022-05695-6. Epub 2022 May 10.
To compare microstructural and microvascular changes in eyes with macular telangiectasia type 2 (MacTel2) and in those with tamoxifen retinopathy (TR) at baseline and at the 1-year follow-up using optical coherence tomography (OCT) and OCT angiography (OCTA).
We followed up patients diagnosed with MacTel2 or TR for at least 1 year. We included 17 patients with MacTel2 (31 eyes) and 15 with TR (25 eyes) who discontinued tamoxifen use after a TR diagnosis. We performed OCT and OCTA at baseline and after 1 year.
Patients with MacTel2 and TR showed intraretinal cavitation, ellipsoid zone (EZ) loss, and capillary telangiectasia in the superficial and deep plexuses. EZ disruption predominantly affected the temporal region in MacTel2 (32%) and was limited to the foveal center in TR (24%). Vascular density (VD) was significantly reduced within the deep temporal parafovea and superficial fovea in MacTel2 and TR eyes, respectively. After 1 year, the MacTel2 eyes showed enlarged EZ loss, proliferative vascular invasion, and increased VD (p = 0.021) in the temporal deep plexus compared with TR eyes.
After 1-year follow-up, the MacTel2 eyes showed proliferative vascular remodeling, particularly in the temporal parafovea of the deep plexus with EZ loss progression, whereas the TR eyes maintained their baseline capillary rarefaction.
使用光学相干断层扫描(OCT)和OCT血管造影(OCTA),比较2型黄斑毛细血管扩张症(MacTel2)患者和他莫昔芬视网膜病变(TR)患者在基线期和1年随访时的微观结构和微血管变化。
我们对诊断为MacTel2或TR的患者进行了至少1年的随访。我们纳入了17例MacTel2患者(31只眼)和15例TR患者(25只眼),这些患者在TR诊断后停用了他莫昔芬。我们在基线期和1年后进行了OCT和OCTA检查。
MacTel2和TR患者均表现出视网膜内空洞形成、椭圆体带(EZ)缺失以及浅层和深层血管丛中的毛细血管扩张。EZ破坏在MacTel2中主要影响颞侧区域(32%),而在TR中仅限于黄斑中心凹(24%)。MacTel2和TR患者的眼内,分别在颞侧黄斑旁中心凹深层和黄斑中心凹浅层的血管密度(VD)显著降低。1年后,与TR患者的眼相比,MacTel2患者的眼在颞侧深层血管丛中显示出EZ缺失扩大、增殖性血管侵入以及VD增加(p = 0.021)。
经过1年的随访,MacTel2患者的眼表现出增殖性血管重塑,特别是在深层血管丛的颞侧黄斑旁区域,伴有EZ缺失进展,而TR患者的眼则维持其基线期的毛细血管稀疏状态。