Fragiotta Serena, Parravano Mariacristina, Corradetti Giulia, Bousquet Elodie, Polito Maria Sole, Sacconi Riccardo, Capuano Vittorio, Costanzo Eliana, Tombolini Beatrice, Souied Eric H, Bandello Francesco, Sadda SriniVas R, Sarraf David, Querques Giuseppe
Ophthalmology Unit, "Sapienza" University of Rome, NESMOS Department, St. Andrea Hospital, Rome, Italy.
Retina Medica Unit, IRCCS-Fondazione Bietti, Rome, Italy.
Ophthalmol Retina. 2024 Dec;8(12):1151-1162. doi: 10.1016/j.oret.2024.07.003. Epub 2024 Jul 14.
To characterize clinical and prognostic implications of leptovitelliform maculopathy (LVM), a distinctive phenotype of vitelliform lesion characterized by the coexistence of subretinal drusenoid deposits (SDDs) and leptochoroid.
Retrospective, cohort study.
The study compared patients affected by LVM with cohorts displaying a similar phenotypic spectrum. This included patients with acquired vitelliform lesions (AVLs) and those with SDDs alone.
A total of 60 eyes of 60 patients were included, of which 20 eyes had LVM, 20 eyes had AVLs, and the remaining had SDDs. Patients >50 years of age with complete medical records and multimodal imaging for ≥6 months of follow-up, including color fundus photography or MultiColor imaging, OCT, fundus autofluorescence, and OCT angiography were included.
Choroidal vascularity index (CVI); proportion of late-stage complications (macular neovascularization, atrophy).
The AVL subgroup exhibited a significantly higher CVI compared with both LVM (P = 0.001) and SDD subgroups (P < 0.001). The proportion of late-stage complications significantly differed among subgroups (chi-square = 7.5, P = 0.02). Eyes with LVM presented the greatest proportion of complications (55%) after a mean of 29.3 months, whereas the remaining eyes presented a similar proportion of complications, including 20% in the AVL group after 27.6 months and 20% in the SDD group after 36.9 months. Kaplan-Meier estimates of survival demonstrated a significant difference in atrophy development between groups (P < 0.001), with a median survival of 3.9 years for the LVM group and 7.1 years for controls. The presence of LVM correlated with a fourfold increase in the likelihood of developing complications.
Leptovitelliform maculopathy, characterized by the association of vitelliform lesions with SDDs and leptochoroid, represents a distinct clinical phenotype in the broader spectrum of vitelliform lesions. The importance of a clinical distinction for these lesions is crucial due to their higher propensity for faster progression and elevated rate of complications, particularly atrophic conversion.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
描述薄卵黄样黄斑病变（LVM）的临床及预后意义，LVM是一种独特的卵黄样病变表型，其特征为视网膜下玻璃膜疣样沉积物（SDD）与薄脉络膜并存。
回顾性队列研究。
本研究将LVM患者与具有相似表型谱的队列进行比较。这包括获得性卵黄样病变（AVL）患者和仅患有SDD的患者。
共纳入60例患者的60只眼，其中20只眼患有LVM，20只眼患有AVL，其余患有SDD。纳入年龄>50岁、有完整病历且随访≥6个月的多模态影像检查的患者，包括彩色眼底照相或多色成像、光学相干断层扫描（OCT）、眼底自发荧光和OCT血管造影。
脉络膜血管指数（CVI）；晚期并发症（黄斑新生血管形成、萎缩）的比例。
与LVM组（P = 0.001）和SDD组（P < 0.001）相比，AVL亚组的CVI显著更高。晚期并发症的比例在亚组间有显著差异（卡方检验=7.5，P = 0.02）。LVM组的眼睛在平均29.3个月后出现并发症的比例最高（55%），而其余眼睛出现并发症的比例相似，包括AVL组在27.6个月后为20%，SDD组在36.9个月后为20%。Kaplan-Meier生存估计显示各组间萎缩发展存在显著差异（P < 0.001），LVM组的中位生存期为3.9年，对照组为7.1年。LVM的存在与发生并发症的可能性增加四倍相关。
薄卵黄样黄斑病变以卵黄样病变与SDD和薄脉络膜相关为特征，在更广泛的卵黄样病变谱中代表一种独特的临床表型。由于这些病变更易快速进展且并发症发生率较高，尤其是萎缩性转化，对这些病变进行临床区分非常重要。
本文末尾的脚注和披露中可能会有专有或商业披露信息。
