Current Perspectives on Type 3 Macular Neovascularization due to Age-Related Macular Degeneration.

IF 2.1 4区医学 Q2 OPHTHALMOLOGY

Ophthalmologica Pub Date : 2024-01-01 Epub Date: 2024-01-24 DOI:10.1159/000536278

Christoph R Clemens, Nicole Eter, Florian Alten

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引用次数: 0

Abstract

Background: The aim of this review was to systematically summarize the current knowledge on type 3 macular neovascularization (MNV3) in age-related macular degeneration (AMD).

Summary: Recent histopathologic and multimodal imaging findings led to the consensus definition of the new term "type 3 macular neovascularization" in AMD. MNV3 originates in the deep vascular plexus as a neovascular process without connection with the retinal pigment epithelium in the initial stages. This type has numerous clinical and pathomorphologic features that separate it from the other two types of MNV in AMD. Besides, its frequency appears to be higher than previously thought. In optical coherence tomography (OCT), MNV3 can be classified into stages 1-3. Hyperreflective foci in the outer retina possibly represent a precursor lesion. In addition, MNV3 is characterized by a strong association with reticular pseudodrusen, a high rate of bilaterality, close associations with advanced age and arterial hypertension, decreased choroidal thickness, and decreased choriocapillaris flow signals. Data from latest anti-vascular endothelial growth factor studies in MNV3 suggest that the OCT biomarkers in intraretinal and subretinal fluids should be interpreted differently than in the other types. Additionally, data from MNV3 eyes should be analyzed separately, allowing optimal type-specific treatment strategies in the future.

Key messages: This review highlights the need for accurate characterization of neovascular AMD lesions and an MNV type-specific approach, particularly for MNV3.

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目前对老年性黄斑变性引起的 3 型黄斑新生血管的看法。

背景：本综述旨在系统总结目前关于老年性黄斑变性（AMD）中 "3型黄斑新生血管"（MNV3）的知识：最近的组织病理学和多模态成像发现促使人们一致定义了AMD的新术语 "3型黄斑新生血管"。MNV3起源于深层血管丛，是一种新生血管过程，初期与视网膜色素上皮细胞没有联系。这种类型具有许多临床和病理形态学特征，有别于 AMD 中的其他两种 MNV。此外，它的发病率似乎也比以前认为的要高。在光学相干断层扫描（OCT）中，MNV3 可分为 1-3 期。视网膜外层的高反射灶可能是前驱病变。此外，MNV3 的特点还包括与网状假皱纹密切相关、双侧发病率高、与高龄和动脉高血压密切相关、脉络膜厚度减少以及绒毛膜血流信号减少。最新的 MNV3 抗血管内皮生长因子（VEGF）研究数据表明，对 OCT 生物标志物视网膜内液和视网膜下液的解释应不同于其他类型。此外，应单独分析 MNV3 眼球的数据，以便将来制定针对特定类型的最佳治疗策略：这篇综述强调了准确描述 nAMD 病变特征和针对 MNV 类型（尤其是 MNV3）的方法的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmologica 医学-眼科学

CiteScore

5.10

自引率

3.80%

发文量

审稿时长

3 months

期刊介绍： Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.