Forte Paolo, Cattaneo Jennifer, Fontana Vincenzo, Dupas Bénédicte, Forte Giovanni, Castro-Farías Daniela, Querques Giuseppe, Paques Michel, Eandi Chiara Maria
Department of Ophthalmology, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Lausanne, Switzerland.
Eye Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Ophthalmol Sci. 2025 Feb 27;5(4):100754. doi: 10.1016/j.xops.2025.100754. eCollection 2025 Jul-Aug.
To investigate the incidence, timing, dimensional features, and spatial characteristics of telangiectatic capillaries (TelCaps) in retinal vein occlusion (RVO) patients treated with anti-VEGF monotherapy.
Prospective nonconcurrent cohort study.
One hundred thirty-eight eyes of 138 patients with treatment-naive RVO treated with anti-VEGF monotherapy for a minimum of 24 months.
Telangiectatic capillaries were identified using multimodal imaging, including indocyanine green angiography (ICGA), OCT, and color fundus photography. Recurrence of venous occlusive events was defined by new onset of retinal hemorrhages accompanied by worsening of macular edema. Cox regression modeling was used to assess risk factors for TelCap development.
Telangiectatic capillaries' incidence, dimensional features, spatial distribution, and association with RVO recurrence events.
Over 4.4 ± 2.6 years of follow-up, TelCaps developed in 15/138 eyes (10.9%) after 26 ± 16 months. Telangiectatic capillaries in hemispheric and central RVO showed larger diameters compared with branch RVO (277 ± 44 μm vs. 196 ± 43 μm, = 0.005) and preferential localization along the temporal horizontal raphe (y-axis coordinates: 0.4 ± 0.6 mm vs. 0.9 ± 0.7 mm, = 0.017). The recurrence of RVO during follow-up was significantly associated with TelCap development (hazard ratio = 8.74, 95% confidence limit = 2.92-26.2, < 0.001). At 5-year follow-up, the risk of developing TelCaps was ∼9% in patients without recurrence and ∼55% in those patients with recurrence.
Telangiectatic capillaries occur in approximately 10% of RVO cases undergoing intravitreal anti-VEGF monotherapy, with distinct characteristics based on RVO subtype. The strong association with disease recurrence suggests episodes of increased venous obstruction contribute to TelCap formation. Extended follow-up and vigilant screening are recommended; when TelCaps are suspected, ICGA can confirm the diagnosis and guide adjunctive targeted treatment.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究接受抗VEGF单药治疗的视网膜静脉阻塞（RVO）患者中毛细血管扩张（TelCaps）的发生率、出现时间、尺寸特征和空间特征。
前瞻性非同期队列研究。
138例初治RVO患者的138只眼，接受抗VEGF单药治疗至少24个月。
使用多模态成像技术识别毛细血管扩张，包括吲哚菁绿血管造影（ICGA）、光学相干断层扫描（OCT）和彩色眼底照相。静脉阻塞事件的复发定义为视网膜出血新发并伴有黄斑水肿加重。采用Cox回归模型评估毛细血管扩张发生的危险因素。
毛细血管扩张的发生率、尺寸特征、空间分布以及与RVO复发事件的关联。
在4.4±2.6年的随访中，15/138只眼（10.9%）在26±16个月后出现了毛细血管扩张。半球形和中心性RVO中的毛细血管扩张直径比分支性RVO更大（277±44μm对196±43μm，P = 0.005），且更倾向于沿颞侧水平中纬线定位（y轴坐标：0.4±0.6mm对0.9±0.7mm，P = 0.017）。随访期间RVO的复发与毛细血管扩张的发生显著相关（风险比 = 8.74，95%置信区间 = 2.92 - 26.2，P < 0.001）。在5年随访时，无复发患者发生毛细血管扩张的风险约为9%，复发患者约为55%。
接受玻璃体内抗VEGF单药治疗的RVO病例中约10%会出现毛细血管扩张，根据RVO亚型具有不同特征。与疾病复发的强关联表明静脉阻塞增加的发作有助于毛细血管扩张的形成。建议延长随访并进行 vigilant筛查；当怀疑有毛细血管扩张时，ICGA可确诊并指导辅助靶向治疗。
在本文末尾的脚注和披露中可能会发现专有或商业披露。
