The British journal of ophthalmology · 2016
Natural history and effect of therapeutic interventions on subretinal fluid causing foveal detachment in macular telangiectasia type 2.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mehta Hemal, Müller Simone, Egan Catherine A, Degli Esposti Simona, Tufail Adnan, Sim Dawn A, Holz Frank G, Browning Andrew C, Amoaku Winfried M, Charbel Issa Peter, Gillies Mark C
Аннотация
AIM: To report the natural history of subretinal fluid (SRF) causing foveal detachment in macular telangiectasia type 2 (MacTel) and our experience of therapeutic intervention with intravitreal steroids or antivascular endothelial growth factor inhibitor (anti-VEGF) agents in some cases.
METHODS: Retrospective case series. Three of the MacTel study's largest registries were searched to identify eyes with foveal detachment.
RESULTS: We identified 7 eyes from 6 exclusively female patients. The prevalence of foveal detachment was low, present in 1.4% of the assessed MacTel population. Age at presentation ranged from 50 to 66 years. Follow-up ranged from 2 to 8 years. There was late-phase leakage on fluorescein angiography from what was presumed to be ectatic capillaries. The SRF fluctuated without a rapid decline in visual acuity in cases that were not treated. When they were, intravitreal anti-VEGF and steroid therapy in general reduced SRF, at least temporarily, but did not halt the gradual long-term decrease in visual acuity. In one case, optical coherence tomography angiography showed significant reduction in the extent of the predominantly deep intraretinal vascular complex 1 month after anti-VEGF therapy.
DISCUSSION AND CONCLUSIONS: As the natural history of this unusual MacTel phenotype is not characterised by rapid visual decline, intervention with intravitreal anti-VEGF or steroid therapy may not be necessary.
METHODS: Retrospective case series. Three of the MacTel study's largest registries were searched to identify eyes with foveal detachment.
RESULTS: We identified 7 eyes from 6 exclusively female patients. The prevalence of foveal detachment was low, present in 1.4% of the assessed MacTel population. Age at presentation ranged from 50 to 66 years. Follow-up ranged from 2 to 8 years. There was late-phase leakage on fluorescein angiography from what was presumed to be ectatic capillaries. The SRF fluctuated without a rapid decline in visual acuity in cases that were not treated. When they were, intravitreal anti-VEGF and steroid therapy in general reduced SRF, at least temporarily, but did not halt the gradual long-term decrease in visual acuity. In one case, optical coherence tomography angiography showed significant reduction in the extent of the predominantly deep intraretinal vascular complex 1 month after anti-VEGF therapy.
DISCUSSION AND CONCLUSIONS: As the natural history of this unusual MacTel phenotype is not characterised by rapid visual decline, intervention with intravitreal anti-VEGF or steroid therapy may not be necessary.
Предметные рубрики MeSH
AgedAngiogenesis InhibitorsBevacizumabFemaleFluorescein AngiographyFollow-Up StudiesFundus OculiHumansIntravitreal InjectionsMacula LuteaMaleMiddle AgedRanibizumabRetinal DiseasesRetrospective StudiesSubretinal FluidTelangiectasia, Hereditary HemorrhagicTime FactorsTomography, Optical CoherenceVisual Acuity