Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA.
Graefes Arch Clin Exp Ophthalmol. 2024 May;262(5):1455-1463. doi: 10.1007/s00417-023-06330-8. Epub 2023 Dec 18.
To describe the different types of vitreomacular interface abnormalities (VMIA) seen on optical coherence tomography (OCT) in type 2 macular telangiectasia (MacTel) and explain the possible reasons for its development.
In this retrospective cross-sectional study, type 2 MacTel eyes with macular volumetric OCT imaging protocol were included to identify different types of VMIA such as abnormal PVD, vitreomacular traction (VMT), ERM, and lamellar and full-thickness macular hole. The VMIA findings were then correlated with different MacTel disease stages and visual acuity.
One thousand forty-three OCTs of 332 type 2 MacTel eyes from 169 patients at different visits were examined. VMIA was detected in 709 (68%) of those OCT scans in 216 (65%) eyes. There were 273 (39%), 31 (4%), 89 (13%), 7 (1%), and 381 (54%) OCT scans with vitreomacular adhesion, VMT, ERM, and inner and outer lamellar macular holes discovered respectively. VMIA eyes had a high frequency of abnormal PVD (p = 0.001) and retinal pigment clumps (RPCs) [p = 0.032]. Eyes with abnormal PVD (p = 0.034) and RPC (p = 0.000) had a higher rate of ERM development. RPC was linked to an increased risk of developing ERM (odd ratio 2.472; 95% CI 1.488-4.052). RPC and ERM contributed significantly to poor visual acuity (0.661 ± 0.416, 20/92).
OCT reveals a high frequency of VMIA in advanced type 2 MacTel eyes. RPC could be responsible for the development of anomalous PVD, as well as subsequent VMIAs and ERM. Additional work is required to examine the long-term changes and surgical outcomes of these eyes.
描述 2 型黄斑毛细血管扩张症（MacTel）中光学相干断层扫描（OCT）所见的不同类型玻璃体黄斑界面异常（VMIA），并解释其发生的可能原因。
在这项回顾性的横断面研究中，纳入了接受黄斑容积 OCT 成像方案的 2 型 MacTel 眼，以识别不同类型的 VMIA，如异常玻璃体后脱离（PVD）、玻璃体黄斑牵引（VMT）、ERM、板层和全层黄斑裂孔。然后将 VMIA 发现与不同的 MacTel 疾病阶段和视力相关联。
在不同访视时，对 169 名患者的 332 只 2 型 MacTel 眼的 1043 个 OCT 进行了检查。在 216 只（65%）眼中的 709 个（68%）OCT 扫描中发现了 VMIA。分别发现 273 个（39%）、31 个（4%）、89 个（13%）、7 个（1%）和 381 个（54%）OCT 扫描有玻璃体黄斑粘连、VMT、ERM、内和外板层黄斑裂孔。VMIA 眼异常 PVD 的发生率较高（p=0.001）和视网膜色素团块（RPC）[p=0.032]。有异常 PVD（p=0.034）和 RPC（p=0.000）的眼发生 ERM 的几率更高。RPC 与发生 ERM 的风险增加相关（优势比 2.472；95%CI 1.488-4.052）。RPC 和 ERM 显著影响视力（0.661±0.416，20/92）。
OCT 显示在晚期 2 型 MacTel 眼中 VMIA 的发生率很高。RPC 可能导致异常 PVD 的发生，以及随后的 VMIAs 和 ERM。需要进一步的研究来检查这些眼睛的长期变化和手术结果。
