Anti-Vascular Endothelial Growth Factor Treatment Outcomes in Macular Telangiectasia: A Systematic Review.

IF 2.1 4区 医学 Q2 OPHTHALMOLOGY
Ophthalmologica Pub Date : 2025-02-17 DOI:10.1159/000543771
Aswen Sriranganathan, Justin Grad, Andrew Mihalache, Marko M Popovic, Peter J Kertes, Radha Kohly, Rajeev H Muni
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引用次数: 0

Abstract

Introduction: Macular telangiectasia (MacTel) is a rare retinal condition that can cause vision loss, and anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as a potential treatment. This study aimed to evaluate the clinical outcomes of anti-VEGF therapy in patients with MacTel.

Methods: A systematic literature search on Ovid MEDLINE, Embase, and Cochrane Library was performed from inception to June 2024 for comparative studies on anti-VEGF agents in MacTel. The primary outcome was the change in best-corrected visual acuity (BCVA). Secondary outcomes were central macular thickness (CMT), central choroidal thickness (CCT), and fluorescein angiography (FA) leakage.

Results: Ten studies on 377 eyes of 239 patients followed up over 23.4 ± 8.3 months were included. Mean (SD) BCVA changed from 0.42 (0.39) to 0.35 (0.18) over 23.4 (8.3) months of follow-up in non-proliferative MacTel. Mean BCVA changed from 0.66 (0.43) to 0.52 (0.34) at final follow-up in eyes with choroidal neovascularization (CNV). Five studies reported improved visual acuity, one showed improved FA leakage without visual acuity benefit, and four found no functional benefit. In non-proliferative MacTel, four studies showed no functional improvement, two reported significant functional and morphological improvements, and one suggested potential benefits in improving BCVA. In proliferative MacTel, two studies demonstrated improvement in both anatomical and functional outcomes, while one indicated that anti-VEGF treatment might produce improved results. In non-proliferative MacTel, mean CMT changed from 201 (32) µm to 199 (29) µm. CMT in patients with CNV decreased from an initial value of 328.23 (161.16) µm to 267.44 (118.56) µm at the final follow-up. CCT in proliferative MacTel eyes decreased from 272.37 (52.65) µm and 247.40 (48.80) µm on anti-VEGF therapy. Overall, FA leakage outcomes were improved on ranibizumab therapy. No study documented any significant adverse effects with treatment.

Conclusion: Anti-VEGF agents may be associated with favorable anatomical and functional outcomes, particularly in proliferative MacTel; however, future large-scale clinical trials are warranted.

抗血管内皮生长因子治疗黄斑毛细血管扩张的疗效:一项系统综述。
目的:评价抗血管内皮生长因子(anti-VEGF)治疗黄斑毛细血管扩张症(MacTel)的临床效果。方法:系统检索Ovid MEDLINE、Embase和Cochrane图书馆自成立至2024年6月的文献,比较抗vegf药物在MacTel中的应用。主要结果为最佳矫正视力(BCVA)的变化。次要结果是中央黄斑厚度(CMT)、中央脉络膜厚度(CCT)和荧光素血管造影(FA)渗漏。结果:纳入10项研究,239例患者377只眼,随访23.4±8.3个月。在23.4(8.3)个月的非增殖性MacTel随访期间,平均(SD) BCVA从0.42(0.39)变化到0.35(0.18)。脉络膜新生血管(CNV)眼最终随访时的平均BCVA从0.66(0.43)变为0.52(0.34)。五项研究报告了视力的改善,一项研究显示了FA渗漏的改善,但没有视力的改善,四项研究没有发现功能上的改善。在非增殖性MacTel中,4项研究未显示功能改善,2项研究报告了显著的功能和形态学改善,1项研究表明改善BCVA有潜在的益处。在增殖性MacTel中,两项研究表明解剖和功能结果均有改善,而一项研究表明抗vegf治疗可能会改善结果。在非增生性MacTel中,平均CMT从201(32)µm变化到199(29)µm。CNV患者的CMT从最初的328.23(161.16)µm下降到最终随访时的267.44(118.56)µm。抗vegf治疗后,增殖性MacTel眼的CCT分别从272.37µm(52.65)和247.40µm(48.80)µm下降。总的来说,雷尼单抗治疗改善了FA渗漏的结果。没有研究证明治疗有任何显著的不良反应。结论:抗vegf药物可能与良好的解剖和功能结果相关,特别是在增殖性MacTel中,然而,未来的大规模临床试验是必要的。
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
Ophthalmologica 医学-眼科学
CiteScore
5.10
自引率
3.80%
发文量
39
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.
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