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IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-27 DOI:10.1016/j.xops.2025.100754

Paolo Forte MD , Jennifer Cattaneo MD , Vincenzo Fontana BSc , Bénédicte Dupas MD , Giovanni Forte MD , Daniela Castro-Farías MD , Giuseppe Querques MD, PhD , Michel Paques MD, PhD , Chiara Maria Eandi MD, PhD

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引用次数: 0

摘要

目的研究接受抗血管内皮生长因子单药治疗的视网膜静脉闭塞（RVO）患者毛细血管扩张（Telangiectatic capillaries，TelCaps）的发生率、时间、尺寸特征和空间特性。方法使用多模态成像技术，包括吲哚青绿血管造影术（ICGA）、OCT 和彩色眼底照相术，识别远端毛细血管。静脉闭塞事件复发的定义是新出现视网膜出血并伴有黄斑水肿恶化。结果在 4.4 ± 2.6 年的随访中，有 15/138 只眼睛（10.9%）在 26 ± 16 个月后出现了 TelCap。半球和中央 RVO 中的远端毛细血管与分支 RVO 相比直径更大（277 ± 44 μm vs. 196 ± 43 μm，P = 0.005），且更倾向于沿颞水平剑突定位（y 轴坐标：0.4 ± 0.6 mm vs. 0.9 ± 0.7 mm，P = 0.017）。随访期间，RVO 的复发与 TelCap 的发展显著相关（危险比 = 8.74，95% 置信限 = 2.92-26.2，P <0.001）。结论在接受玻璃体内抗 VEGF 单药治疗的 RVO 病例中，约有 10% 的病例会出现远端毛细血管扩张，并且根据 RVO 亚型的不同而具有不同的特征。这种现象与疾病复发密切相关，表明静脉阻塞的加剧是导致泰勒帽形成的原因之一。建议延长随访时间并提高筛查的警惕性；当怀疑有TelCap时，ICGA可以确诊并指导辅助性靶向治疗。

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Telangiectatic Capillaries in Retinal Vein Occlusion: Incidence, Topography, and Risk Factors

Purpose

To investigate the incidence, timing, dimensional features, and spatial characteristics of telangiectatic capillaries (TelCaps) in retinal vein occlusion (RVO) patients treated with anti-VEGF monotherapy.

Design

Prospective nonconcurrent cohort study.

Participants

One hundred thirty-eight eyes of 138 patients with treatment-naive RVO treated with anti-VEGF monotherapy for a minimum of 24 months.

Methods

Telangiectatic capillaries were identified using multimodal imaging, including indocyanine green angiography (ICGA), OCT, and color fundus photography. Recurrence of venous occlusive events was defined by new onset of retinal hemorrhages accompanied by worsening of macular edema. Cox regression modeling was used to assess risk factors for TelCap development.

Main Outcome Measures

Telangiectatic capillaries' incidence, dimensional features, spatial distribution, and association with RVO recurrence events.

Results

Over 4.4 ± 2.6 years of follow-up, TelCaps developed in 15/138 eyes (10.9%) after 26 ± 16 months. Telangiectatic capillaries in hemispheric and central RVO showed larger diameters compared with branch RVO (277 ± 44 μm vs. 196 ± 43 μm, P = 0.005) and preferential localization along the temporal horizontal raphe (y-axis coordinates: 0.4 ± 0.6 mm vs. 0.9 ± 0.7 mm, P = 0.017). The recurrence of RVO during follow-up was significantly associated with TelCap development (hazard ratio = 8.74, 95% confidence limit = 2.92–26.2, P < 0.001). At 5-year follow-up, the risk of developing TelCaps was ∼9% in patients without recurrence and ∼55% in those patients with recurrence.

Conclusions

Telangiectatic capillaries occur in approximately 10% of RVO cases undergoing intravitreal anti-VEGF monotherapy, with distinct characteristics based on RVO subtype. The strong association with disease recurrence suggests episodes of increased venous obstruction contribute to TelCap formation. Extended follow-up and vigilant screening are recommended; when TelCaps are suspected, ICGA can confirm the diagnosis and guide adjunctive targeted treatment.