The Imaging Correlation between outer retina-associated hyperreflectivity and outer retinal and choroidal microvascular changes in Macular Telangiectasia type 2.

IF 2.3 2区医学 Q2 OPHTHALMOLOGY

Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2025-03-10 DOI:10.1097/IAE.0000000000004466

Unnikrishnan Nair, Indu Nair, Jay Sheth, Manoj Soman

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引用次数: 0

Abstract

Purpose: To elucidate outer-retinal choroidal microvascular abnormalities (ORCMA) observed in Macular Telangiectasia type 2 (MacTel 2), particularly in association with outer retina-associated hyperreflectivity (ORaH).

Methods: Retrospective analysis of 60 eyes with MacTel 2 having ORaH was conducted. OCT and OCTA images were meticulously reviewed to identify ORCMA patterns.

Results: All 60 eyes exhibited hyperreflective foci (HRF), with varying incidences of subsidence, ellipsoid zone (EZ) loss, pigment clumps, cystoids, and double-layer sign (DLS). Vascular invasion, retinochoroidal anastomosis (RCA), and macular neovascularization (MNV) were observed, with all cases demonstrating ORaH. OCTA revealed microvascular changes. Subsidence correlated significantly with invasion (P=0.009), while pigment clumps, cystoids, and DLS were not significant. RCA was associated with pigment clumps, cystoids, and DLS (P<0.05), whereas MNV correlated with subsidence (P=0.022).

Conclusion: The study delineates ORCMA in MacTel 2, identifying three patterns: vascular invasion, RCA, and MNV. Vascular invasion affects the outer retina, potentially leading to subsidence. RCA, a pre-proliferative stage, involves anastomosis between retinal and choroidal microvasculature, associated with pigment clumps, cystoids, and DLS. MNV, an advanced stage, exhibits extensions below the RPE and exudation, suggesting a continuum from invasion to neovascularization. Recognizing these stages aids in diagnosis, prognosis, and intervention development for MacTel 2.

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目的：阐明在 2 型黄斑部远端血管扩张症（MacTel 2）中观察到的外视网膜脉络膜微血管异常（ORCMA），尤其是与外视网膜相关高反射（ORaH）有关的异常：方法：对60只患有MacTel 2并伴有ORaH的眼睛进行回顾性分析。方法：对 60 只患有 MacTel 2 并伴有 ORaH 的眼睛进行回顾性分析，仔细查看 OCT 和 OCTA 图像，以确定 ORCMA 模式：结果：所有 60 只眼睛都有高反射灶 (HRF)，并伴有不同程度的沉降、椭圆形区 (EZ) 消失、色素团块、囊肿和双层征 (DLS)。观察到血管侵犯、视网膜脉络膜吻合（RCA）和黄斑新生血管（MNV），所有病例均显示 ORaH。OCTA 显示微血管变化。沉降与浸润有显著相关性（P=0.009），而色素团块、囊状物和 DLS 则无显著相关性。RCA与色素团块、囊状物和DLS相关（PC结论：该研究对ORCMA进行了划分，并得出结论：ORCMA与色素团块、囊状物和DLS相关：该研究划分了 MacTel 2 中的 ORCMA，确定了三种模式：血管侵犯、RCA 和 MNV。血管入侵影响视网膜外层，可能导致视网膜下陷。RCA是增殖前阶段，涉及视网膜和脉络膜微血管之间的吻合，与色素团块、囊肿和DLS有关。MNV是晚期阶段，表现为向RPE下方延伸和渗出，表明从入侵到新生血管的连续性。识别这些阶段有助于 MacTel 2 的诊断、预后和干预措施的制定。

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

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.