光学相干断层扫描血管成像在2型黄斑毛细血管扩张症中的应用进展

doi:10.6040/j.issn.1673-3770.0.2021.450

摘要/Abstract

摘要： 2型黄斑毛细血管扩张症(MacTel 2)是一种双侧、进展缓慢的视网膜神经退行性疾病,血管病变是其主要特征。光学相干断层扫描血管成像(OCTA)是检测MacTel 2的理想工具。OCTA显示,MacTel 2的毛细血管扩张最早出现在旁中心凹颞侧的深层毛细血管丛,与椭圆体带丢失密切相关。随后出现的旁中心凹血管密度降低最先累及小静脉相邻的毛细血管。而直角小静脉的发展可促进视网膜-脉络膜吻合形成。一部分晚期MacTel 2患者可进展为新生血管,而使用血管内皮生长因子(VEGF)抑制剂对未经治疗的新生血管效果显著。现就OCTA近期在MacTel 2中的应用进行综述。

关键词: 2型黄斑毛细血管扩张症, 光学相干断层扫描血管成像, 深层毛细血管丛, 直角小静脉, 视网膜下新生血管

Abstract: Macular telangiectasia type 2(MacTel 2)is a bilateral, slowly-progressive neurodegenerative disease of the retina mainly characterized by vascular changes. Optical coherence tomography angiography(OCTA)is the ideal tool for detecting MacTel 2. In the early stage of MacTel 2, the telangiectasia shown by OCTA first appeared in the deep capillary plexus on the temporal side of the parafovea, which was closely related to the loss of the ellipsoid zone. Subsequently, the vascular density in the parafovea decreased, primarily involving the capillaries adjacent to the venules. The development of right-angle venules can promote the formation of retinal-choroidal anastomoses. The telangiectasia of some patients with advanced MacTel 2 can progress to neovascularization, and the use of vascular endothelial growth factor inhibitors has a significant effect on untreated neovascularization. This paper reviews the application of OCTA in MacTel 2.

Key words: Macular telangiectasia type 2, Optical coherence tomography angiography, Deep capillary plexus, Right-angle venules, Subretinal neovascularization

中图分类号:

R774.6

李鹏伟,苏光明,刘江川,穆雅林. 光学相干断层扫描血管成像在2型黄斑毛细血管扩张症中的应用进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 140-144.

LI Pengwei, SU Guangming, LIU Jiangchuan, MU Yalin. Application of optical coherence tomography angiography in macular telangiectasia type 2[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 140-144.

参考文献

[1] Heeren TFC, Chew EY, Clemons T, et al. Macular telangiectasia type 2: visual acuity, disease end stage, and the MacTel area: MacTel project report number 8[J]. Ophthalmology, 2020, 127(11): 1539-1548. doi:10.1016/j.ophtha.2020.03.040
[2] Charbel Issa P, Gillies MC, Chew EY, et al. Macular telangiectasia type 2[J]. Prog Retin Eye Res, 2013, 34: 49-77. doi:10.1016/j.preteyeres.2012.11.002
[3] Gass JD, Blodi BA. Idiopathic juxtafoveolar retinal telangiectasis. Update of classification and follow-up study[J]. Ophthalmology, 1993, 100(10): 1536-1546.
[4] Yannuzzi LA, Bardal AM, Freund KB, et al.Idiopathic macular telangiectasia[J]. Arch Ophthalmol, 2006, 124(4): 450-460.
[5] Shinkai A, Saito W, Hashimoto Y, et al. Morphological features of macular telangiectasia type 2 in Japanese patients[J]. Graefes Arch Clin Exp Ophthalmol, 2021, 259(5): 1179-1189. doi:10.1007/s00417-020-04989-x
[6] Gonzalez MA, Shechtman D, Haynie JM, et al. Unveiling idiopathic macular telangiectasia: clinical applications of optical coherence tomography angiography[J]. Eur J Ophthalmol, 2017, 27(4): e129-e133. doi:10.5301/ejo.5000984
[7] Bonnin S, Mané V, Couturier A, et al. New insight into the macular deep vascular plexus imaged by optical coherence tomography angiography[J]. Retina, 2015, 35(11): 2347-2352. doi:10.1097/IAE.0000000000000839
[8] Dogan B, Erol MK, Akidan M, et al. Retinal vascular density evaluated by optical coherence tomography angiography in macular telangiectasia type 2[J]. Int Ophthalmol, 2019, 39(10): 2245-2256. doi:10.1007/s10792-018-01060-x
[9] Pauleikhoff D, Pauleikhoff L, Chew EY. Imaging endpoints for clinical trials in MacTel type 2[J]. Eye(Lond), 2022, 36(2): 284-293. doi:10.1038/s41433-021-01723-7
[10] Thorell MR, Zhang QQ, Huang YP, et al. Swept-source OCT angiography of macular telangiectasia type 2[J]. Ophthalmic Surg Lasers Imaging Retina, 2014, 45(5): 369-380. doi:10.3928/23258160-20140909-06
[11] Micevych PS, Lee HE, Fawzi AA. Overlap between telangiectasia and photoreceptor loss increases with progression of macular telangiectasia type 2[J]. PLoS One, 2019, 14(10): e0224393. doi:10.1371/journal.pone.0224393
[12] Litts KM, Okada M, Heeren TFC, et al. Longitudinal assessment of remnant foveal cone structure in a case series of early macular telangiectasia type 2[J]. Transl Vis Sci Technol, 2020, 9(4): 27. doi:10.1167/tvst.9.4.27
[13] Zandi R, Song J, Micevych PS, et al. Topographic relationship between telangiectasia and cone mosaic disruption in macular telangiectasia type 2[J]. J Clin Med, 2020, 9(10): E3149. doi:10.3390/jcm9103149
[14] Powner MB, Gillies MC, Zhu MD, et al. Loss of Müller's cells and photoreceptors in macular telangiectasia type 2[J]. Ophthalmology, 2013, 120(11): 2344-2352. doi:10.1016/j.ophtha.2013.04.013
[15] Gantner ML, Eade K, Wallace M, et al. Serine and lipid metabolism in macular disease and peripheral neuropathy[J]. N Engl J Med, 2019, 381(15): 1422-1433. doi:10.1056/NEJMoa1815111
[16] Chidambara L, Gadde SGK, Yadav NK, et al. Characteristics and quantification of vascular changes in macular telangiectasia type 2 on optical coherence tomography angiography[J]. Br J Ophthalmol, 2016, 100(11): 1482-1488. doi:10.1136/bjophthalmol-2015-307941
[17] Ishibazawa A, de Pretto LR, Alibhai AY, et al. Retinal nonperfusion relationship to arteries or veins observed on widefield optical coherence tomography angiography in diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2019, 60(13): 4310-4318. doi:10.1167/iovs.19-26653
[18] Micevych PS, Soetikno BT, Fawzi AA. Perivenular capillary loss: an early, quantifiable change in macular telangiectasia type 2[J]. Transl Vis Sci Technol, 2020, 9(4): 5. doi:10.1167/tvst.9.4.5
[19] Tzaridis S, Heeren T, Mai C, et al. Right-angled vessels in macular telangiectasia type 2[J]. Br J Ophthalmol, 2021, 105(9): 1289-1296. doi:10.1136/bjophthalmol-2018-313364
[20] Breazzano MP, Yannuzzi LA, Spaide RF. Genesis of retinal-choroidal anastomosis in macular telangiectasia type 2: a longitudinal analysis[J]. Retina, 2021, 41(3): 464-470. doi:10.1097/IAE.0000000000002986
[21] Spaide RF, Marco RD, Yannuzzi LA. Vascular distortion and dragging related to apparent tissue contraction in macular telangiectasis type 2[J]. Retina, 2018, 38(Suppl 1): S51-S60. doi:10.1097/IAE.0000000000001694
[22] Zhang QQ, Wang RK, Chen CL, et al. Swept source optical coherence tomography angiography of neovascular macular telangiectasia type 2[J]. Retina, 2015, 35(11): 2285-2299. doi:10.1097/IAE.0000000000000840
[23] Spaide RF, Yannuzzi LA, Maloca PM. Retinal-choroidal anastomosis in macular telangiectasia type 2[J]. Retina, 2018, 38(10): 1920-1929. doi:10.1097/IAE.0000000000002289
[24] Chung YR, Kim YH, Oh J, et al. Characterizing right-angled vessel in macular telangiectasia type 2 with structural optical coherence tomography[J]. Sci Rep, 2021, 11: 17198. doi:10.1038/s41598-021-96789-4
[25] Simone Tzaridis, Kristina Hess, Martin Friedlander, et al. Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2[J]. Br J Ophthalmol, 2020, 105(5): bjophthalmol-2020. doi:10.1136/bjophthalmol-2020-316021
[26] Spaide RF, Klancnik JM Jr, Cooney MJ, et al. Volume-rendering optical coherence tomography angiography of macular telangiectasia type 2[J]. Ophthalmology, 2015, 122(11): 2261-2269. doi:10.1016/j.ophtha.2015.07.025
[27] Singh SR, Fraser-Bell S, Dogra A, et al. Optical coherence tomography angiography findings of fellow eye of proliferative macular telangiectasia type 2: long term study[J]. Eur J Ophthalmol, 2021, 31(4): 1933-1939. doi:10.1177/1120672120939505
[28] Reichenbach A, Bringmann A. Glia of the human Retina[J]. Glia, 2020, 68(4): 768-796. doi:10.1002/glia.23727
[29] Wangsa-Wirawan ND, Linsenmeier RA. Retinal oxygen: fundamental and clinical aspects[J]. Arch Ophthalmol, 2003, 121(4): 547-557. doi:10.1001/archopht.121.4.547
[30] Jorge R, Costa RA, Calucci D, et al. Intravitreal bevacizumab(Avastin)associated with the regression of subretinal neovascularization in idiopathic juxtafoveolar retinal telangiectasis[J]. Graefes Arch Clin Exp Ophthalmol, 2007, 245(7): 1045-1048. doi:10.1007/s00417-006-0468-2
[31] Thorell MR, Zhang QQ, Huang YP, et al. Swept-source OCT angiography of macular telangiectasia type 2[J]. Ophthalmic Surg Lasers Imaging Retina, 2014, 45(5): 369-380. doi:10.3928/23258160-20140909-06
[32] Charbel Issa P, Kupitz EH, Heeren TFC, et al. Treatment for macular telangiectasia type 2[J]. Dev Ophthalmol, 2016, 55: 189-195. doi:10.1159/000431263
[33] Tzaridis S, Wintergerst MWM, Mai C, et al. Quantification of retinal and choriocapillaris perfusion in different stages of macular telangiectasia type 2[J]. Invest Ophthalmol Vis Sci, 2019, 60(10): 3556-3562. doi:10.1167/iovs.19-27055
[34] 张昕雨, 雷春燕, 张美霞. 运用OCT及OCTA观察硅油对视网膜脉络膜的影响[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 132-136. doi: 10.6040/j.issn.1673-3770.0.2020.539 ZHANG Xinyu, LEI Chunyan, ZHANG Meixia. Retinochoriodal changes associated with silicone oil tamponade detected by optical coherence tomography and optical coherence tomography angiography[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 132-136. doi: 10.6040/j.issn.1673-3770.0.2020.539

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed