Ophthalmologica最新文献

{"title":"Geographic atrophy and peripheral atrophy: quantitative analysis with ultra-widefield autofluorescence.","authors":"Daniele De Geronimo, Mariacristina Parravano, Riccardo Sacconi, Eliana Costanzo, Monica Varano, Giuseppe Querques","doi":"10.1159/000544958","DOIUrl":"https://doi.org/10.1159/000544958","url":null,"abstract":"<p><strong>Objective: </strong>To analyze and correlate the topographic distribution of atrophic areas at the posterior pole and peripheral retina in subjects with geographic atrophy (GA) using ultra-widefield fundus autofluorescence (FAF) imaging.</p><p><strong>Methods: </strong>This multicenter observational study included 15 patients (9 males, 19 eyes) with coexisting GA and peripheral atrophy. All eyes were imaged with Ultra-widefield Optos California (Optos, PLC, Dunfermline, Scotland) to acquire ultra-widefield (200°) color and FAF images centered on the fovea, superior, inferior, nasal, and temporal sectors. The extent of GA in the central FAF image and the peripheral atrophic areas in the peripheral FAF images were measured by manually defining the boundaries of the atrophic regions using the \"ROI free\" function integrated into the device software. The values obtained were then analyzed and correlated.</p><p><strong>Results: </strong>The mean ± SD GA size was 13.9 ± 15.0 mm2 [range: 1.8 -71.3 mm2] and the total peripheral atrophy was 51.0 ± 68.3 mm2 [range: 1.4 - 292.1 mm2]. The topographic analysis showed that the mean ± SD of superior peripheral atrophy was 9.0 ± 20.6 mm2, temporal atrophy was 30.5 ± 55.9 mm2, inferior atrophy was 9.3 ± 16.3 mm2, and nasal atrophy was 1.8 ± 3.9 mm2. GA size was significantly correlated with total peripheral atrophy (Rho=.463, p=.046) and temporal peripheral atrophy (Rho=.474, p=.040), whereas no correlations were found with peripheral atrophy in the remaining sectors.</p><p><strong>Conclusions: </strong>Ultra-widefield autofluorescence is a valuable technique for visualizing and assessing the extent of macular and peripheral atrophy. Macular atrophy correlates significantly with total and temporal peripheral atrophy but demonstrates no significant correlation with atrophy in the remaining sectors.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OCT-derived biomarkers in optic disc pit maculopathy are associated with age, visual function and natural history.","authors":"Edward Bloch, Blanca C Flores-Sánchez, Odysseas Georgiadis, Conor M Ramsden, Lyndon da Cruz","doi":"10.1159/000545664","DOIUrl":"https://doi.org/10.1159/000545664","url":null,"abstract":"<p><p>Introduction Optic disc pit maculopathy (ODP-M) describes the variable intra- and/or subretinal fluid accumulation complicating a congenital optic disc anomaly that is primarily observed in young adults. This study aims to explore the morphological variance in ODP-M, in order to measure associations between demographic and functional characteristics and investigate the natural course of the disease. Methods A single-centre, retrospective, observational study was performed. Subjects with ODP-M were identified through electronic notes review. Demographic characteristics, visual acuity and anatomical features were analysed with respect to a predefined OCT-based sub-categorisation: type 1a: intraretinal fluid (IRF) only; type 1b: IRF + outer lamellar hole (OLH) +/- subretinal fluid (SRF); type 2: SRF +/- IRF (no OLH). Results 50 eyes (50 subjects) were sub-categorised according to fluid distribution into type 1a (34%), type 1b (28%) and type 2 ODP-M (38%). Those with type 2 were found to be significantly younger than those with types 1a/b ODP-M (p<0.001), and accounted for 93% of cases occurring in subjects ≤20-years-old. The presence of OLH (i.e. type 1b) was noted to be independently associated with worse final VA (p=0.013) and higher likelihood of proceeding to surgery (p=0.002). Discussion There appears to be an age-related variation in ODP-M morphology, indicating the possibility of separate pathoanatomical processes, with distinct clinical courses and potentially different optimal management strategies. Sub-categorisation of ODP-M according to the reported structural features may help guide management of this rare condition.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autosomal dominant RP1 c.2613dupA (p.Arg872Thrfs*2) variant retinitis pigmentosa shows linear loss of the ellipsoid zone over time with highly variable phenotype.","authors":"Nastasia Foa, Maximilian Pfau, Georg Ansari, Giuseppe Cancian, Gabriela Grimaldi, Samuel Koller, Wolfgang Berger, Pascal Escher, Lucas Janeschitz-Kriegl, Carlo Rivolta, Hendrik P N Scholl, Moreno Menghini","doi":"10.1159/000545606","DOIUrl":"https://doi.org/10.1159/000545606","url":null,"abstract":"<p><strong>Introduction: </strong>To report the phenotype and progression pattern of RP1 retinitis pigmentosa carrying the variant c.2613dupA (p.Arg872Thrfs*2).</p><p><strong>Methods: </strong>Retrospective chart review and prospective cohort study from 13 families with confirmed RP1 c.2613dupA (p.Arg872Thrfs*2) variant. Analysis was performed on clinical data including multimodal imaging and visual function tests. Progression rate was defined as the length of ellipsoid zone lost per year and was calculated for all patients. Linear mixed model to predict the diameter of EZ loss as a function of age was applied.</p><p><strong>Results: </strong>21 patients were included in the study. EZ loss in all patients ranged from 3.8 to 576.0 µm/year (median PR 76.5, IQR 97.6) in right eyes, and from 26.6 to 340.7 µm/year (median PR 96.6, IQR 70.3), in left eyes, respectively with a linear slope of progression for both eyes. The linear mixed model using age as an explanatory variable explained 25% of the variability in PR, and showed that male patients had on average a statistically significant smaller EZ diameter at baseline.</p><p><strong>Discussion: </strong>The rate of progression of RP1 as measured by loss of EZ appears to be linear, independent of the age of onset. Furthermore, it appears that male subjects may present with earlier onset of disease as they showed a statistically significant smaller EZ diameter at baseline. Monitoring of EZ loss could be a valid clinical surrogate marker for clinical trials, but possibly sex differences and high variability of phenotypes need to be considered.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-16"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eyes on the Text: Assessing Readability of AI & Ophthalmologist Responses to Patient Surgery Queries.","authors":"Sai S Kurapati, Derek J Barnett, Antonio Yaghy, Cameron J Sabet, David N Younessi, Dang Nguyen, John C Lin, Ingrid U Scott","doi":"10.1159/000544917","DOIUrl":"https://doi.org/10.1159/000544917","url":null,"abstract":"<p><strong>Introduction: </strong>Generative artificial intelligence (AI) technologies like GPT-4 can instantaneously provide health information to patients; however, the readability of these outputs compared to ophthalmologist-written responses is unknown. This study aims to evaluate the readability of GPT-4-generated and ophthalmologist-written responses to patient queries about ophthalmic surgery.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used 200 randomly selected patient questions about ophthalmic surgery extracted from the American Academy of Ophthalmology's EyeSmart platform. The questions were inputted into GPT-4, and the generated responses were recorded. Ophthalmologist-written replies to the same questions were compiled for comparison. Readability of GPT-4 and ophthalmologist responses was assessed using six validated metrics: Flesch Kincaid Reading Ease (FK-RE), Flesch Kincaid Grade Level (FK-GL), Gunning Fog Score (GFS), SMOG Index (SI), Coleman Liau Index (CLI), and Automated Readability Index (ARI). Descriptive statistics, one-way ANOVA, Shapiro-Wilk, and Levene's tests (α=0.05) were used to compare readability between the two groups.</p><p><strong>Results: </strong>GPT-4 used a higher percentage of complex words (24.42%) compared to ophthalmologists (17.76%), although mean [SD] word count per sentence was similar (18.43 [2.95] and 18.01 [6.09]). Across all metrics (FK-RE; FK-GL; GFS; SI; CLI; and ARI), GPT-4 responses were at a higher grade level (34.39 [8.51]; 13.19 [2.63]; 16.37 [2.04]; 12.18 [1.43]; 15.72 [1.40]; 12.99 [1.86]) than ophthalmologists' responses (50.61 [15.53]; 10.71 [2.99]; 14.13 [3.55]; 10.07 [2.46]; 12.64 [2.93]; 10.40 [3.61]), with both sources necessitating a 12th-grade education for comprehension. ANOVA tests showed significance (p<0.05) for all comparisons except word count (p=0.438).</p><p><strong>Conclusions: </strong>The National Institutes of Health advises health information to be written at a sixth-seventh grade level. Both GPT-4- and ophthalmologist-written answers exceeded this recommendation, with GPT-4 showing a greater gap. Information accessibility is vital when designing patient resources, particularly with the rise of AI as an educational tool.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious causes of retinal vasculitis: Causes, presentation, differentiation and therapy.","authors":"Ariel Schlaen, Juliana Montoya, Milagros Heredia, Sebastián Inchauspe, Emilio M Dodds","doi":"10.1159/000545044","DOIUrl":"https://doi.org/10.1159/000545044","url":null,"abstract":"<p><strong>Background: </strong>Retinal vasculitis is a common manifestation of infections affecting the posterior segment. The purpose of this review is to describe the main characteristics of infectious retinal vasculitis, with an emphasis on its associated specific clinical manifestations.</p><p><strong>Summary: </strong>Retinal vasculitis is usually associated with retinal or choroidal involvement when infectious etiology is present. It may be caused by bacterial, viral, fungal or parasitic infection. Its prevalence and the spectrum of etiologies show geographical variations. Infectious vasculitis tends to exhibit ischemic areas, arterial or venous sheathing or occlusion, while non-infectious retinal vasculitis is predominantly associated with capillary vasculitis.</p><p><strong>Key messages: </strong>Recognizing the features of infectious retinal vasculitis, along with associated ocular and systemic signs, patient habits, and origin, enables the physician to suspect the potential causative etiology of the condition, facilitating more effective management of affected patients.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-46"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Outcomes of Vitrectomy with Gas or Silicone Oil Tamponade for Giant Retinal Tears.","authors":"Arielle Benchimol, Paul Denys, Raphaël Lejoyeux, Sébastien Bruneau, Sophie Bonnin, Aude Couturier","doi":"10.1159/000545042","DOIUrl":"10.1159/000545042","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to assess the long-term anatomic and functional outcomes in giant retinal tear (GRT)-associated retinal detachment (GRT-RD) and identify factors associated with recurrence.</p><p><strong>Methods: </strong>This is a retrospective monocentric study of the patients treated for GRT-RD between 2017 and 2022 at Rothschild Foundation Hospital, Paris, France.</p><p><strong>Results: </strong>A total of 65 eyes from 64 patients were analyzed with a mean follow-up of 21.5 months. The mean age was 52.7 years and 89.2% of them were men. 69.3% of eyes were phakic, the mean axial length was 25.4 mm, and 15 eyes had high myopia. The mean size of the GRT was 147.7°. Macula was attached in 33 cases. All the patients underwent pars plana vitrectomy. Perfluorocarbon liquids were used in almost all cases. Retinopexy was then performed. Silicone oil tamponade was used in 47 eyes and gas tamponade was used in 18 eyes (27.7%). Recurrence of RD occurred in 15 eyes. Factors associated with a recurrence of the RD were macula-off detachment and the presence of another retinal tear. No significant differences were made between silicone oil or gas tamponade in terms of recurrence. No significant difference was shown in postoperative outcomes between the two groups of tamponades.</p><p><strong>Conclusion: </strong>GRT-RD remains serious with a recurrence rate of 23% in this series. Whereas gas tamponade is less frequently used, its use showed no significant difference compared to silicone oil in terms of postoperative outcomes, and no difference in risk of recurrence of RD in this study.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Networking of Eye Hospitals on a National Level for Promoting and Advancing Conduct of Clinical Trials.","authors":"Barbara J Wilhelm, Frank G Holz, Katrin Lorenz","doi":"10.1159/000543727","DOIUrl":"10.1159/000543727","url":null,"abstract":"<p><strong>Purpose: </strong>The complexity of clinical trials is increasing for both sponsors and study sites. This impacts planning, preparation, implementation, and conduct of all studies. The exchange of experience and cooperation helps centers to better master the various challenges facing ophthalmological study centers. This serves the efficiency of multicenter studies, including timely patient recruitment.</p><p><strong>Methods: </strong>The DOG (German Society of Ophthalmology) Clinical Study Centers Working Group (WG) was founded in 2011. Since then, regular meetings have been held including the annual during the DOG and meeting. There is also a continuous exchange in between these meetings. Symposia are regularly held at the DOG conferences together with industry and regulatory authorities. A range of courses on the conduct clinical trials has been established, and joint publications and DOG recommendations are regularly generated.</p><p><strong>Results: </strong>Since its foundation, the WG has tremendously gained visibility and popularity. Its members have increased from 40 (2011) to 80 (2024). Study-specific recommendations were produced early on, which were published by the DOG in German and English language. The topics of the publications and symposia range from study design, budget negotiations, special challenges, publication regulations, and legislation to the attractiveness of Germany as a study location. Since 2023, a patient video of the WG has been available to support and foster recruitment of study patients.</p><p><strong>Conclusion: </strong>The DOG Working Group Clinical Study Centers has become a platform for cooperation and representation of the interests of German ophthalmological study centers. It also represents an important link to industry and is engaged in a lively dialogue to promote Germany as a study location in ophthalmology. The group and its activities may serve as a model for other medical societies and countries.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recalcitrant Macular Edema after Pseudophakic Rhegmatogenous Retinal Detachment Repair: Risk Factors and Response to Intravitreal Dexamethasone Implant.","authors":"Francesco Pignatelli, Alfredo Niro, Pasquale Viggiano, Giacomo Boscia, Gianluca Besozzi, Cristiana Iaculli, Giuseppe Addabbo, Francesco Boscia, Ermete Giancipoli","doi":"10.1159/000543749","DOIUrl":"10.1159/000543749","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate risk factors for recalcitrance to topical therapy of post-surgical macular edema (PSME) after rhegmatogenous retinal detachment (RRD) repair and its response to intravitreal dexamethasone implant (DEX-I).</p><p><strong>Methods: </strong>This two-center retrospective study reviewed the charts of pseudophakic patients who had undergone vitrectomy for RRD and experienced PSME within 6 months of surgery. A regression model analyzed the relationship between the recalcitrance of PSME to topical therapy and independent variables, including clinical data, surgical steps, and OCT parameters recorded at 1 month after surgery. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of eyes with responsive and recalcitrant PSME to topical therapy, the latest treated with DEX-I, were compared over follow-up.</p><p><strong>Results: </strong>Of the 361 eyes screened, 42 (11.7%) experienced PSME. Among those, all the eyes with recalcitrant PSME (21/42) received at least one DEX-I (1.38 ± 0.49 implant). The mean follow-up was 11.9 ± 0.3 months. Disrupted retinal outer layers (p = 0.02) and hyperreflective foci (HRF) (p = 0.01) were linked to recalcitrant PSME. An increased risk for recalcitrance was observed in the presence of HRF (OR: 7.69; IC: 1.31-44.9; p = 0.02). Over follow-up, BCVA and CMT were significantly (p < 0.01) worse in implanted eyes that experienced the more significant fluctuation of CMT (189.2 ± 104.7 µm (range: 58-409 µm); p < 0.01) with a reimplant rate of 42.8%. No one of the implanted eyes experienced ocular hypertension requiring intervention or other complications.</p><p><strong>Conclusion: </strong>HRF were found to be a risk factor for recalcitrance to topical therapy of PSME. Limited response to DEX-I was observed in such cases.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical Coherence Tomography imaging of perforating scleral vessels and dilated choroidal veins as potential image markers in myopic choroidal neovascularization using optical coherence tomography angiography.","authors":"Jorge Ruiz-Medrano, Elena Almazán-Alonso, Mariluz Puertas, Ignacio Flores-Moreno, María García-Zamora, Bachar Kudsieh, José M Ruiz-Moreno","doi":"10.1159/000544750","DOIUrl":"https://doi.org/10.1159/000544750","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze the role of perforating scleral vessel (PSV) and dilated choroidal veins (DCV) underneath macular myopic choroidal neovascularization (mCNV).</p><p><strong>Methods: </strong>This retrospective case-control study analyzed 78 eyes from 78 highly myopic patients defined by an axial length (AL) of ≥26 mm, assessed by optical coherence tomography (OCT) and OCT-angiography (OCTA) imaging. Patients with clinical diagnosis of mCNV and good-quality OCTA images were selected. Swept source (SS)-OCT and SS-OCTA images (TRITON; Topcon Corporation, Tokyo, Japan) were reviewed to detect image markers in the mCNV area. Highly myopic eyes without mCNV, matched by age and AL, were used as control group. The presence of PSV and DCV were recorded. Myopic maculopathy was graded using the ATN (Atrophic, Traction and Neovacularization) classification.</p><p><strong>Results: </strong>78 eyes from 78 patients (39 with mCNV and 39 without mCNV) were included, out of the total 775 eyes screened. Fifty-nine (75.6%) of them were women. The mean ATN grading of myopic-maculopathy was compared between eyes with mCNV and those without mCNV: Atrophy scores were 2.71±0.97 vs. 2.30±0.89, respectively (p=0.04); Traction scores were 0.64±0.66 vs. 0.84±0.98, respectively (p=0.54); and Neovascularization scores were 2.00±0.00 vs. 0.33±0.73, respectively (p<0.001). The presence of OCT-imaging markers did not significantly differ between groups; i.e., PSV was found in 34/39 vs. 32/39 (p=0.53) eyes and DCV was found in 11/39 vs. 7/39 eyes, mCNV vs. control group respectively (p=0.28).</p><p><strong>Conclusions: </strong>PSV and DCV are image markers present in a high number of highly myopic eyes, which are not specific to mCNV.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Vascular Endothelial Growth Factor Treatment Outcomes in Macular Telangiectasia: A Systematic Review.","authors":"Aswen Sriranganathan, Justin Grad, Andrew Mihalache, Marko M Popovic, Peter J Kertes, Radha Kohly, Rajeev H Muni","doi":"10.1159/000543771","DOIUrl":"10.1159/000543771","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Anti-VEGF agents may be associated with favorable anatomical and functional outcomes, particularly in proliferative MacTel; however, future large-scale clinical trials are warranted.</p>","PeriodicalId":19595,"journal":{"name":"Ophthalmologica","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}