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Tzaridis S, Aguilar E, Dorrell MI, Friedlander M, Eade KT. Retinal pigment epithelial cells reduce vascular leak and proliferation in retinal neovessels. Angiogenesis 2024; 28:1. [PMID: 39601967 PMCID: PMC11602807 DOI: 10.1007/s10456-024-09954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 10/27/2024] [Indexed: 11/29/2024]
Abstract
In multiple neurodegenerative diseases, including age-related macular degeneration, retinitis pigmentosa, and macular telangiectasia type 2 (MacTel), retinal pigment epithelial (RPE)-cells proliferate and migrate into the neuroretina, forming intraretinal pigment plaques. Though these pigmentary changes are hallmarks of disease progression, it is unknown if their presence is protective or detrimental.Here, we first evaluated the impact of pigment plaques on vascular changes and disease progression in MacTel. In a retrospective, longitudinal study, we analyzed multimodal retinal images of patients with MacTel and showed that pigment plaques were associated with decreased vascular leakage and stabilized neovascular growth. We then modeled the underlying pathomechanisms of pigment plaque formation in aberrant neovascular growth using the very-low-density lipoprotein receptor mutant (Vldlr-/-) mouse. Our data indicated that during RPE-proliferation, migration and accumulation along neovessels RPE-cells underwent epithelial-mesenchymal transition (EMT). Pharmacologic inhibition of EMT in Vldlr-/- mice decreased pigment coverage, and exacerbated neovascular growth and vascular leakage.Our findings indicate that the proliferation, migration and perivascular accumulation of RPE-cells stabilize vascular proliferation and exudation, thereby exerting a protective effect on the diseased retina. We conclude that interfering with this "natural repair mechanism" may have detrimental effects on the course of the disease and should thus be avoided.
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Affiliation(s)
- Simone Tzaridis
- The Lowy Medical Research Institute, La Jolla, CA, USA.
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA.
| | - Edith Aguilar
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Michael I Dorrell
- The Lowy Medical Research Institute, La Jolla, CA, USA
- Point Loma Nazarene University, San Diego, CA, USA
| | - Martin Friedlander
- The Lowy Medical Research Institute, La Jolla, CA, USA
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Kevin T Eade
- The Lowy Medical Research Institute, La Jolla, CA, USA
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
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Krivosic V, Zureik A, Tadayoni R, Gaudric A. FROM OUTER RETINAL NEOVACULARIZATION TO EXUDATIVE SUBRETINAL NEOVASCULARIZATION IN MACULAR TELANGIECTASIA TYPE 2. Retina 2024; 44:1217-1223. [PMID: 38900579 DOI: 10.1097/iae.0000000000004079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
PURPOSE To describe the progression from outer retinal neovascularization (ORNV) to exudative subretinal new vessels (SRNVs) in idiopathic macular telangiectasia type 2. METHODS A total of 135 patients (270 eyes) imaged with optical coherence tomography angiography were included. MAIN OUTCOME MEASURES Ellipsoid zone loss, outer retinal hyperreflectivity, ORNV, and SRNVs. Outer retinal neovascularization was defined as a flow signal passing through the outer plexiform layer, with or without vertical linear outer retinal hyperreflectivity on the optical coherence tomography B-scan. Subretinal new vessels were defined as an abnormal capillary network with a peripheral anastomotic arcade seen on en face optical coherence tomography angiography and a convex hyperreflectivity at the retinal pigment epithelium. RESULTS Subretinal new vessels were observed in 38/270 eyes (14%). Subretinal new vessels were at a fibrotic stage in 24/38 eyes and at an exudative stage in 6/38 eyes, and a progression from ORNV to SRNVs was documented in 8/38 eyes. All cases showed an ellipsoid zone loss. In seven eyes (2.5%), SRNVs were also associated with subepithelial neovascularization. No retinochoroidal anastomosis was detected. The visual acuity dropped when SRNVs were present. CONCLUSION In this case series, SRNVs were found in 14% of eyes. In all cases, they were associated with an ellipsoid zone loss and with outer retinal hyperreflectivity. A progression from ORNV to SRNVs was observed.
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Affiliation(s)
- Valérie Krivosic
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Cité, Paris, France; and
- Centre de Référence des maladies Vasculaires rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, APHP, Paris, France
| | - Abir Zureik
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Cité, Paris, France; and
- Centre de Référence des maladies Vasculaires rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, APHP, Paris, France
| | - Ramin Tadayoni
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Cité, Paris, France; and
- Centre de Référence des maladies Vasculaires rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, APHP, Paris, France
| | - Alain Gaudric
- Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Cité, Paris, France; and
- Centre de Référence des maladies Vasculaires rares du Cerveau et de l'Œil (CERVCO), Hôpital Lariboisière, APHP, Paris, France
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Gedik B, Erol MK, Bulut M, Dogan B, Bozdogan YC, Ekinci R, Ayan A. Proximal nailfold videocapillaroscopy findings of patients with idiopathic macular telangiectasia type 2. Indian J Ophthalmol 2024; 72:S148-S152. [PMID: 38131558 PMCID: PMC10833163 DOI: 10.4103/ijo.ijo_1731_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Idiopathic macular telangiectasia type 2 (IMT) is a neurodegenerative disease characterized by bilateral, idiopathic, and perifoveal retinal telangiectatic vessel formations. We aimed to compare proximal nailfold videocapillaroscopy (NV) findings between patients with IMT and healthy individuals and evaluate the optical coherence tomography angiography (OCTA) parameters of the patients with IMT according to their NV findings. METHODS The study included 43 patients with IMT and 92 healthy controls of similar age and gender without any additional diseases. The OCTA and NV findings of the patients and controls were examined. RESULTS The mean age was 59.76 ± 5.73 years in the IMT group and 58.23 ± 4.96 years in the control group. Of the 43 patients with IMT, 19 were found to have increased capillary tortuosity, six had microhemorrhage, and 18 had bizarre capillaries (P < 0.001). In the IMT group, the total vascular density value of the superficial capillary plexus was higher among the patients with capillary microhemorrhage (P = 0.001), and the subfoveal choroidal thickness was lower among those with increased capillary tortuosity and bizarre capillaries (P = 0.04 and P = 0.07, respectively). CONCLUSION This is the first study in which the NV findings of patients with IMT were compared with those of a control group. We found higher rates of increased capillary tortuosity, microhemorrhage, and bizarre capillaries in the IMT group compared to the controls. We consider that this situation is caused by microvascular damage. We also think that IMT is a systemic disease that affects both proximal nailfold capillaries and eye vessels.
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Affiliation(s)
- Birumut Gedik
- Department of Ophthalmology, Antalya Serik State Hospital, Antalya, Turkey
| | - Muhammet K Erol
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Mehmet Bulut
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Berna Dogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Yigit C Bozdogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Rojbin Ekinci
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Ayse Ayan
- Department of Internal Medicine, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
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Wu L. Unraveling the mysteries of macular telangiectasia 2: the intersection of philanthropy, multimodal imaging and molecular genetics. The 2022 founders lecture of the pan American vitreoretinal society. Int J Retina Vitreous 2023; 9:69. [PMID: 37968753 PMCID: PMC10652610 DOI: 10.1186/s40942-023-00505-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/24/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE Offer a personal perspective on the scientific advances on macular telangiectasia type 2 (MacTel2) since the launch of the MacTel Project in 2005. DESIGN Literature review and personal perspective. METHODS Critical review of the peer-reviewed literature and personal perspective. RESULTS Generous financial support from the Lowy Medical Research Institute laid the foundations of the MacTel Project. MacTel Project investigators used state of the art multimodal retinal imaging and advanced modern biological methods to unravel many of the mysteries surrounding MacTel2. Major accomplishments includes elucidation of the pathogenic role that low serine levels, elevated 1-deoxysphingolipids and other mechanisms induce mitochondrial dysfunction which lead to Müller cell and photoreceptor degeneration; the use of objective measures of retinal structures such as the area of ellipsoid zone disruption as an outcome measure in clinical trials; the demonstration that the ciliary neurotrophic factor slows down retinal degeneration and the development of a new severity scale classification based on multimodal imaging findings. CONCLUSIONS MacTel2 is a predominantly metabolic disease characterized by defects in energy metabolism. Despite relatively good visual acuities, MacTel2 patients experience significant visual disability. The Mac Tel Project has been instrumental in advancing MacTel2 knowledge in the past two decades.
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Affiliation(s)
- Lihteh Wu
- Asociados de Macula, Vitreo y Retina de Costa Rica, Primer Piso Torre Mercedes Paseo Colon, San Jose, Costa Rica.
- Illinois Eye and Ear Infirmary, University of Illinois School of Medicine, Chicago, IL, USA.
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Erol MK, Gedik B, Bozdogan YC, Ekinci R, Bulut M, Dogan B, Suren E, Akidan M. Evaluation of Optic Disc, Retinal Vascular Structures, and Acircularity Index in Patients with Idiopathic Macular Telangiectasia Type 2. Diagnostics (Basel) 2023; 13:3046. [PMID: 37835789 PMCID: PMC10572724 DOI: 10.3390/diagnostics13193046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND We aimed to compare the retinal, optic disc vascular density (ODVD) values, and acircularity index (AI) of patients with idiopathic macular telangiectasia type 2 (IMT) and healthy individuals using the optical coherence tomography angiography (OCTA) device. METHODS The study included 39 patients with IMT and 37 healthy controls. The OCTA findings of the patients and controls were examined. RESULTS The total, parafoveal and perifoveal vascular density of the superficial capillary plexus, choriocapillaris blood flow, inside-disc ODVD, retinal nerve fiber layer (RNFL), and retinal thicknesses were found to be statistically significantly lower, and the foveal avascular zone value was statistically significantly higher in the IMT group compared to the control group (p = 0.001, p = 0.01, p = 0.02, p = 0.01, p = 0.009, p = 0.002, p = 0.02, respectively). There was a statistically significant negative correlation between best-corrected visual acuity (BCVA) and AI (p = 0.02), and a statistically significant positive correlation between peripapillary vascular density and BCVA (p = 0.04). CONCLUSIONS We consider that the lower retinal, choriocapillaris, ODVD values, and retinal and RNFL thicknesses in the patients with IMT compared to the controls were due to vascular damage, remodeling, fibrosis, proliferation, and Müller cell damage. Ellipsoid zone defect, AI, and peripapillary vascular density are important indicators in the evaluation of visual acuity in these patients.
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Affiliation(s)
- Muhammet Kazim Erol
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Birumut Gedik
- Department of Ophthalmology, Serik State Hospital, 07500 Antalya, Turkey;
| | - Yigit Caglar Bozdogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Rojbin Ekinci
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Mehmet Bulut
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Berna Dogan
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Elcin Suren
- Department of Ophthalmology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey; (Y.C.B.); (R.E.); (M.B.); (B.D.); (E.S.)
| | - Melih Akidan
- Department of Ophthalmology, Kepez State Hospital, 07320 Antalya, Turkey;
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Zhang L, Van Dijk EHC, Borrelli E, Fragiotta S, Breazzano MP. OCT and OCT Angiography Update: Clinical Application to Age-Related Macular Degeneration, Central Serous Chorioretinopathy, Macular Telangiectasia, and Diabetic Retinopathy. Diagnostics (Basel) 2023; 13:diagnostics13020232. [PMID: 36673042 PMCID: PMC9858550 DOI: 10.3390/diagnostics13020232] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Similar to ultrasound adapting soundwaves to depict the inner structures and tissues, optical coherence tomography (OCT) utilizes low coherence light waves to assess characteristics in the eye. Compared to the previous gold standard diagnostic imaging fluorescein angiography, OCT is a noninvasive imaging modality that generates images of ocular tissues at a rapid speed. Two commonly used iterations of OCT include spectral-domain (SD) and swept-source (SS). Each comes with different wavelengths and tissue penetration capacities. OCT angiography (OCTA) is a functional extension of the OCT. It generates a large number of pixels to capture the tissue and underlying blood flow. This allows OCTA to measure ischemia and demarcation of the vasculature in a wide range of conditions. This review focused on the study of four commonly encountered diseases involving the retina including age-related macular degeneration (AMD), diabetic retinopathy (DR), central serous chorioretinopathy (CSC), and macular telangiectasia (MacTel). Modern imaging techniques including SD-OCT, TD-OCT, SS-OCT, and OCTA assist with understanding the disease pathogenesis and natural history of disease progression, in addition to routine diagnosis and management in the clinical setting. Finally, this review compares each imaging technique's limitations and potential refinements.
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Affiliation(s)
- Lyvia Zhang
- Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY 13210, USA
| | | | - Enrico Borrelli
- Ophthalmology Department, San Raffaele University Hospital, 20132 Milan, Italy
| | - Serena Fragiotta
- Ophthalmology Unit, Department NESMOS, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy
| | - Mark P. Breazzano
- Department of Ophthalmology & Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY 13210, USA
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY 13088, USA
- Correspondence: ; Tel.: +1-(315)-445-8166
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Macular Telangiectasia Type 2: A Classification System Using MultiModal Imaging MacTel Project Report Number 10. OPHTHALMOLOGY SCIENCE 2022; 3:100261. [PMID: 36846105 PMCID: PMC9944556 DOI: 10.1016/j.xops.2022.100261] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Purpose To develop a severity classification for macular telangiectasia type 2 (MacTel) disease using multimodal imaging. Design An algorithm was used on data from a prospective natural history study of MacTel for classification development. Subjects A total of 1733 participants enrolled in an international natural history study of MacTel. Methods The Classification and Regression Trees (CART), a predictive nonparametric algorithm used in machine learning, analyzed the features of the multimodal imaging important for the development of a classification, including reading center gradings of the following digital images: stereoscopic color and red-free fundus photographs, fluorescein angiographic images, fundus autofluorescence images, and spectral-domain (SD)-OCT images. Regression models that used least square method created a decision tree using features of the ocular images into different categories of disease severity. Main Outcome Measures The primary target of interest for the algorithm development by CART was the change in best-corrected visual acuity (BCVA) at baseline for the right and left eyes. These analyses using the algorithm were repeated for the BCVA obtained at the last study visit of the natural history study for the right and left eyes. Results The CART analyses demonstrated 3 important features from the multimodal imaging for the classification: OCT hyper-reflectivity, pigment, and ellipsoid zone loss. By combining these 3 features (as absent, present, noncentral involvement, and central involvement of the macula), a 7-step scale was created, ranging from excellent to poor visual acuity. At grade 0, 3 features are not present. At the most severe grade, pigment and exudative neovascularization are present. To further validate the classification, using the Generalized Estimating Equation regression models, analyses for the annual relative risk of progression over a period of 5 years for vision loss and for progression along the scale were performed. Conclusions This analysis using the data from current imaging modalities in participants followed in the MacTel natural history study informed a classification for MacTel disease severity featuring variables from SD-OCT. This classification is designed to provide better communications to other clinicians, researchers, and patients. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Key Words
- BCVA, best-corrected visual acuity
- BLR, blue light reflectance
- CART, Classification and Regression Trees
- CF, color fundus
- Classification
- Classification and Regression Trees (CART)
- EZ, ellipsoid zone
- FAF, fundus autoflorescence
- FLIO, fluorescence lifetime imaging ophthalmoscopy
- MacTel, macular telangiectasia type 2
- Machine learning
- Macular telangiectasia type 2
- NHOR, natural history observation registry
- NHOS, natural history observation study
- Neurovascular degeneration
- OCTA, OCT angiography
- SD-OCT, spectral domain-OCT
- VA, visual acuity
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Chun H, Suh H, Kim JY, Kwak JH, Kim RY, Kim M, Park YG, Park YH. Choroidal vascularity index change in macular telangiectasia type 2. PLoS One 2022; 17:e0262112. [PMID: 35389993 PMCID: PMC8989206 DOI: 10.1371/journal.pone.0262112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To analyze choroidal structure using subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) in Macular Telangiectasia (MacTel) type 2. Methods Medical records of 43 eyes with MacTel type 2 and 30 sex and age-matched healthy eyes were retrospectively reviewed. Their SFCT and CVI were measured using the SS-OCT scan passing through the central fovea and image binarization. The difference in baseline SFCT and CVI from each group and their yearly changes up to second year of follow up were analyzed. The baseline characteristics of the groups were also compared. Results The baseline characteristics, including CVI and SFCT, of the MacTel group and the control group were not significantly different, except for BCVA. The mean CVI of MacTel group were 64.59 ± 2.92%, 63.76 ± 2.67%, and 62.97 ± 2.74% (p < 0.001) whereas that of control group were 63.33 ± 2.45%, 63.04 ± 2.46%, and 63.43 ± 2.25% (p = 0.636) at baseline, 1 and 2 years, respectively. The mean SFCT of MacTel group were 324.65 ± 89.65μm, 326.14 ± 93.11μm, and 322.65 ± 91.77μm (p = 0.436), whereas that of control group were 304.30 ± 51.86 μm, 300.86 ± 52.64μm, and 298.55 ± 53.71μm (p = 0.275) at baseline, 1 and 2 years, respectively. Conclusion CVI decreases at a faster rate in MacTel type 2 in comparison with healthy subjects. This may suggest possible choroidal involvement in the progression of MacTel type 2.
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Affiliation(s)
- Heejeong Chun
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Suh
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joo Young Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyuck Kwak
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Rae Young Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mirinae Kim
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Gun Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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Zhang Q, Yang L, Xu X, Lan X, Wang Z, Sun Y, Fu S, Xiong Y. The Association of Axial Length with Macular Microvascular Changes in Chinese Diabetic Retinopathy Patients. Int J Gen Med 2022; 15:3895-3902. [PMID: 35431576 PMCID: PMC9005356 DOI: 10.2147/ijgm.s364790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 01/09/2023] Open
Abstract
Objective To use optical coherence tomography angiography (OCTA) to compare macular blood flow density, subfoveal choroidal thickness (SFCT) and outer retina thickness (ORT) in non-proliferative diabetic retinopathy (NPDR) patients with different axial length (AL). Methods Total 42 patients with NPDR with different eye axis were divided into three groups: group A: 22 mm≤AL<24 mm; group B: 24 mm≤AL<26 mm; group C: AL≥26 mm. Superficial capillary plexus (SCP) in the macular area, vascular length density (VLD) and vascular perfusion density (VPD) in the foveal region, the parafoveal region, the perifoveal region and whole macular region were analyzed. The correlations among axial length, macular microvascular density, SFCT and outer retinal thickness (ORT) were analyzed. Results Compared with group A and B, VLD and VPD in group C were significantly lower except the foveal region, and VLD and VPD were negatively correlated with AL. The difference in SFCT among group A, B and C was significant, and SFCT was negatively correlated with AL. Compared with group A, parafoveal ORT in group C was significantly lower than that in group A, and parafoveal ORT was negatively correlated with AL. Conclusion In NPDR patients with different AL, macular microvascular density, SFCT, and parafoveal ORT decreased with the increase of AL.
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Affiliation(s)
- Qian Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Liu Yang
- Department of Ophthalmology, The First People’s Hospital of Fuzhou City, Fuzhou, 344000, People’s Republic of China
| | - Xiaoling Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Xinmei Lan
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Ziwei Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Yali Sun
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Shuhua Fu
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
| | - Yu Xiong
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China
- Correspondence: Yu Xiong, Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China, Email
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10
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Tapia Quijada HE, Mantolan Sarmiento C, Gómez Perera S, Serrano García M, Betancor Caro N, Haro Álvarez B. OCT-angiography for diagnosis and response to treatment of subretinal neovascularization secondary to idiopathic macular telangiectasia type 2. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:224-229. [PMID: 35523469 DOI: 10.1016/j.oftale.2020.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/21/2020] [Indexed: 06/14/2023]
Abstract
Idiopathic macular telangiectasia type 2 (MacTel 2) is a slow and progressive bilateral condition that affects middle-aged and elderly individuals. Vision loss is generally mild and occurs over the course of many years. The development of sub-retinal neovascularisation (SRNV) can occur late in the disease process, and lead to more dramatic vision loss. A report is presented of 2 cases of MacTel 2 in which optical coherence tomography angiography (OCTA) was essential for the diagnosis of secondary SRNV. The commercially available OCTA Cirrus AngioPlex 5000 platform (Zeiss, Jena, Germany) was used. Subretinal neovascularization was detectable in both cases in OCTA at the level of the deep capillary plexus and the avascular layer. OCTA also allowed us to monitor disease progression and monitor response to anti-VEGF therapy.
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Affiliation(s)
- H E Tapia Quijada
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, Spain.
| | - C Mantolan Sarmiento
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, Spain
| | - S Gómez Perera
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, Spain
| | - M Serrano García
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, Spain; Centro de Enfermedades Oculares Serrano, Tenerife, Spain
| | - N Betancor Caro
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, Spain; Centro de Enfermedades Oculares Serrano, Tenerife, Spain
| | - B Haro Álvarez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Valladolid, Spain
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Pauleikhoff D, Pauleikhoff L, Chew EY. Imaging endpoints for clinical trials in MacTel type 2. Eye (Lond) 2022; 36:284-293. [PMID: 34389818 PMCID: PMC8807726 DOI: 10.1038/s41433-021-01723-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Macular Telangiectasia type 2 (MacTel) is a bilateral neurodegenerative disease associated with dysfunction in the serine and lipid metabolism resulting in loss of Muller cells and photoreceptors. Typical structural changes include vascular abnormalities, loss of retinal transparency, redistribution of macular pigment and thinning of the central retina with photoreceptor loss. The presence and extent of photoreceptor loss, as visible on Optical Coherence Tomography (OCT) ("disease severity scale"), correlate with functional loss and the limitation of photoreceptor loss appears to be the most promising therapeutic approach. Ongoing clinical trials of ciliary neurotrophic factor (CNTF) implants for the treatment of MacTel are using this outcome to evaluate efficacy. An ideal outcome measure provides the ability to quantify the extent of the disease progression with precision and reproducibility. METHODS This review describes the changes and findings on different imaging techniques including fluorescein- and OCT angiography, blue light reflectance, 1- and 2-wavelength autofluorescence and OCT. RESULTS The possibilities of objective quantification of the severity of MacTel and correlation with functional characteristics such as best-corrected visual acuity (BCVA) and microperimetry and their applications as quantitative imaging endpoints for clinical treatment trials are discussed. OCT and especially en face OCT could be demonstrated as precise and reproducible methods to quantify the area of photoreceptor loss, which correlated highly significantly with functional loss in microperimetry. CONCLUSION The analysis of the area of photoreceptor loss on en face OCT is the most reliable imaging endpoint for treatment trials in MacTel. This method is already being used in ongoing randomized trials.
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Affiliation(s)
- Daniel Pauleikhoff
- Department of Ophthalmology, St. Franziskus Hospital Muenster, Münster, Germany.
| | | | - Emily Y Chew
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
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Characterizing right-angled vessel in macular telangiectasia type 2 with structural optical coherence tomography. Sci Rep 2021; 11:17198. [PMID: 34433894 PMCID: PMC8387352 DOI: 10.1038/s41598-021-96789-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022] Open
Abstract
We investigated the structural findings on spectral-domain optical coherence tomography (SD-OCT) related to the presence of right-angled vessels (RAV) in patients with macular telangiectasia (MacTel) type 2 with severity 3 in Korea. A retrospective multicenter cross-sectional study was conducted in six tertiary hospitals in Korea; the study included 116 MacTel type 2 eyes with severity 3. The SD-OCT findings were compared between eyes with RAV on fundus photography or fluorescein angiography and those without RAV. Logistic regression was performed to determine factors associated with the presence of RAV. Fifty eyes presented with RAV and 61 eyes without RAV. More eyes presented with only inner retinal (IR) cavities on SD-OCT among eyes without RAV than among those with RAV (P < 0.001). However, eyes with RAV presented with IR disorganization, outer retinal (OR) cavity, and ellipsoid zone (EZ) disruption more frequently than eyes without RAV did (all P < 0.001). These SD-OCT findings were significantly associated with the presence of RAV. The presence of RAV was closely related to IR disorganization, OR cavities, and EZ disruption on SD-OCT. These findings suggest an advanced phase of MacTel type 2.
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Sánchez-Vicente JL, de Las Morenas-Iglesias J, González-Jáuregui-López B, Rueda-Rueda T, Espiñeira-Periñán Á, López-Herrero F. Idiopathic macular telangiectasia type 2, stage V or proliferative stage: Multimodal imaging. J Fr Ophtalmol 2021; 44:1447-1451. [PMID: 34420799 DOI: 10.1016/j.jfo.2021.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/31/2021] [Accepted: 02/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- J L Sánchez-Vicente
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain
| | - J de Las Morenas-Iglesias
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain
| | - B González-Jáuregui-López
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain.
| | - T Rueda-Rueda
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain
| | - Á Espiñeira-Periñán
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain
| | - F López-Herrero
- Department of Ophthalmology. Virgen-del-Rocío University Hospital, avenue Manuel-Siurot, 41013 Seville, Spain
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Hess K, Charbel Issa P, Holz FG, Tzaridis S. Morphological characteristics preceding exudative neovascularisation secondary to macular telangiectasia type 2. Br J Ophthalmol 2021; 106:1736-1741. [PMID: 34167944 DOI: 10.1136/bjophthalmol-2020-318470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/11/2021] [Indexed: 11/03/2022]
Abstract
AIMS To identify morphological characteristics preceding the development of exudative neovascularisation secondary to Macular Telangiectasia type 2 (MacTel) using multimodal retinal imaging. METHODS In this retrospective study, eyes with a minimum observation period of 6 months prior to the de novo diagnosis of an exudative neovascularisation secondary to MacTel were analysed. Morphological changes preceding the formation of neovascularisation were evaluated using colour fundus photography, infrared imaging, fluorescein angiography, macular pigment measurement and optical coherence tomography (OCT). OCT-angiography (OCT-A) images were additionally available in a subset of patients. RESULTS Twenty eyes from 20 patients were examined over a median period of 17 months (range: 6-100 months). Eyes were characterised by an accelerated progression of ellipsoid zone loss (median of 0.013 mm2/month), increased thickness of the temporal parafovea and hyper-reflective lesions on OCT. The latter underwent morphological changes preceding the development of exudative neovascularisation, including an increase in size and density, and expansion to outer retinal layers and the retinal pigment epithelium. All eyes showed a foveal depletion of macular pigment. On OCT-A, a focal increase in blood flow was observed at the level of the outer retina/choriocapillaris, and retinal-retinal and retinal-choroidal anastomoses preceded the formation of exudative neovascularisation. CONCLUSIONS Multimodal imaging allows the identification of prognostic morphological features preceding the formation of exudative neovascularisation in MacTel. Eyes exhibiting these characteristics should be monitored closely and patients should be alert for emergent symptoms in order to detect and treat neovascularisation early and, thereby, prevent irreversible visual loss.
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Affiliation(s)
- Kristina Hess
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Peter Charbel Issa
- Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Simone Tzaridis
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany .,Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA.,The Lowy Medical Research Institute, La Jolla, California, USA
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Tzaridis S, Friedlander M. Functional Relevance of Hyper-Reflectivity in Macular Telangiectasia Type 2. Invest Ophthalmol Vis Sci 2021; 62:6. [PMID: 33661283 PMCID: PMC7937992 DOI: 10.1167/iovs.62.3.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose The purpose of this study was to quantify hyper-reflective lesions on en face optical coherence tomography (OCT) and study its functional relevance in macular telangiectasia type 2 (MacTel). Design This was a retrospective, cross-sectional cohort study. Methods Baseline image and functional data from participants of a phase II clinical trial (NCT01949324) that studied the effect of Ciliary Neurotrophic Factor in patients with MacTel were analyzed. The projection of hyper-reflectivity within different layers on OCT was used to generate an en face view and measure the en face size of hyper-reflectivity. Ellipsoid zone (EZ)-loss was additionally evaluated, and en face images were superimposed onto microperimetry sensitivity maps, allowing to estimate mean retinal sensitivity within areas displaying hyper-reflectivity and EZ-loss, respectively. Best-corrected visual acuity (BCVA) and reading speed were also analyzed. Results Fifty-two eyes from 52 patients were analyzed. Hyper-reflectivity was present in 32 eyes (62%), and EZ-loss in 50 (96%) eyes. Mean lesion size was 0.11 mm² (range = 0.01-0.26) for hyper-reflectivity and 0.51 mm² (range = 0.02-1.34) for EZ-loss, and lesion sizes correlated strongly (Spearman r = 0.79, P < 0.001). Although both hyper-reflectivity and EZ-loss were associated with a significant decrease in retinal sensitivity, mean sensitivity thresholds differed significantly between lesions (0.9 dB vs. 16.3 dB; P < 0.001), indicating an almost complete loss of sensitivity in hyper-reflective areas. No correlations were found between the size of hyper-reflectivity and BCVA (r = 0.09) or reading speed (r = -0.17). Conclusions En face OCT can be used to quantify the area of hyper-reflective lesions in MacTel. Hyper-reflectivity in MacTel is associated with severe functional impairment, leading to an almost complete loss of retinal sensitivity as observed on microperimetry.
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Affiliation(s)
- Simone Tzaridis
- The Lowy Medical Research Institute, La Jolla, California, United States
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, California, United States
| | - Martin Friedlander
- The Lowy Medical Research Institute, La Jolla, California, United States
- The Scripps Research Institute, Department of Molecular Medicine, La Jolla, California, United States
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Tapia Quijada HE, Mantolan Sarmiento C, Gómez Perera S, Serrano García M, Betancor Caro N, Haro Álvarez B. OCT-angiography for diagnosis and response to treatment of subretinal neovascularization secondary to idiopathic macular telangiectasia type 2. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 97:S0365-6691(20)30490-1. [PMID: 33495053 DOI: 10.1016/j.oftal.2020.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/23/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
Idiopathic macular telangiectasia type 2 (MacTel 2) is a slow and progressive bilateral condition that affects middle-aged and elderly individuals. Vision loss is generally mild and occurs over the course of many years. The development of sub-retinal neovascularisation (SRNV) can occur late in the disease process, and lead to more dramatic vision loss. A report is presented of 2cases of MacTel 2 in which optical coherence tomography angiography (OCTA) was essential for the diagnosis of secondary SRNV. The commercially available OCTA Cirrus AngioPlex 5000 platform (Zeiss, Jena, Germany) was used. Subretinal neovascularization was detectable in both cases in OCTA at the level of the deep capillary plexus and the avascular layer. OCTA also allowed us to monitor disease progression and monitor response to anti-VEGF therapy.
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Affiliation(s)
- H E Tapia Quijada
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, España.
| | - C Mantolan Sarmiento
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, España
| | - S Gómez Perera
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, España
| | - M Serrano García
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, España; Centro de Enfermedades Oculares Serrano, Tenerife, España
| | - N Betancor Caro
- Servicio de Oftalmología, Sección de Retina, Hospital Universitario de Canarias, Tenerife, España; Centro de Enfermedades Oculares Serrano, Tenerife, España
| | - B Haro Álvarez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Valladolid, España
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Mueller S, Gunnemann F, Rothaus K, Book M, Faatz H, Bird A, Pauleikhoff D. Incidence and phenotypical variation of outer retina-associated hyperreflectivity in macular telangiectasia type 2. Br J Ophthalmol 2021; 105:573-576. [PMID: 33414243 DOI: 10.1136/bjophthalmol-2020-317997] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/23/2020] [Accepted: 12/16/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Macular telangiectasia type 2 (MacTel) is a neurodegenerative disease resulting in photoreceptor loss. Optical coherence tomography (OCT) reveals outer retina-associated hyperreflectivity (ORaH) as part of this process. The purpose of this study was to describe the incidence and phenotypical variation of ORaH. METHODS Different parameters of ORaH were analysed: OCT characteristics (Spectralis SD-OCT), correlation with vascular changes (OCT angiography; OCTA 3×3 mm Optovue) and correlation with hyperpigmentation (autofluorescence/fundus images). ORaH was also evaluated regarding the grade of severity of photoreceptor loss (Disease Severity Scale). RESULTS Of 220 eyes with MacTel type 2, 106 demonstrated ORaH. On OCT, the size, the extension into the inner retina and the contact with retinal pigment epithelium (RPE) of the ORaH were variable. On OCTA neovascularisation (NV) in the outer retina (OR) was present at the location of the ORaH in 97.6%. Increasing size of NV correlated with progressive photoreceptor loss. In 86.6% with NV, the flow signals were visible between the OR and the choriocapillaris. In 85.7%, the ORaH was associated with hyperpigmentation on autofluorescence and fundus colour images. CONCLUSIONS The presence of ORaH is associated with increasing photoreceptor loss and disease severity. In these more advanced cases of the present study, a variable presentation of ORaH in respect to size and form was seen, but in most cases, ORaH was in contact to the RPE. Additionally, ORaH was associated with hyperpigmentation and OR NV on OCTA. These results are consistent with the concept of ORaH representing fibrovascular OR-NV with RPE proliferation after contact with the RPE.
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Affiliation(s)
- Stefanie Mueller
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Frederic Gunnemann
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany.,Retinal Disorders and Ophthalmic Genetics, Jules Stein Eye Institute, Los Angeles, California, USA
| | - Kai Rothaus
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Marius Book
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Henrik Faatz
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany
| | - Alan Bird
- Genetics, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Daniel Pauleikhoff
- Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany .,Department of Ophthalmology, University of Duisburg-Essen Faculty of Medicine, Essen, Nordrhein-Westfalen, Germany
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Xin X, Zhu Y, Xi R, Hao Y. Establishing a mouse model of choroidal neovascularization to study the therapeutic effect of levotinib and its mechanism. Saudi J Biol Sci 2020; 27:2491-2497. [PMID: 32884431 PMCID: PMC7451724 DOI: 10.1016/j.sjbs.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/13/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Objective To study the therapeutic effect and mechanism of levotinib on choroidal neovascularization (CNV) in mice. Methods 45 healthy C57BL/6 mice were selected and randomly divided into three groups: control group (group A), model group (group B) and levotinib group (group C). The model of CNV in mice was established. The fluorescence leakage of choroidal lesions in mice was observed by fundus fluorescein angiography. The morphological changes of retinal vessels in mice were observed by retinal slice preparation, the pathological changes of eyeball tissues in mice were observed by hematoxylin-eosin (HE) staining, the expression of vascular endothelial growth factor (VEGF) in mice retina was detected by real-time quantitative fluorescence PCR, and the protein expression of VEGF in mice retina was detected by Western blotting. Result On the 7th, 14th and 21st day after modeling, compared with group B, the fluorescence leakage area of group C mice was significantly reduced, and the difference was statistically significant (P < 0.05). The morphology of retinal vessels in group A was normal. In group B, the retinal vessels showed large areas of ischemia without perfusion and abundant neovascularization clusters and capillaries. Compared with group B, the morphology of retinal vessels in group C was significantly improved. Group A mice had normal eyeball structure, group B mice had visible spindle-like damage to the inner and outer retina, while group C mice had significantly less spindle-like damage than group B. Compared with group A, group B mice had significantly higher expression of retinal VEGF and the difference was statistically significant (P < 0.05), but compared with group B mice, the expression of VEGF in the retina of mice in group C was significantly decreased, and the difference was statistically significant (P < 0.05). Compared with group A, the expression of VEGF in retina of group B mice was significantly increased, and the difference was statistically significant (P < 0.05). Compared with group B, the expression of VEGF in retina of group C mice was significantly decreased, and the difference was statistically significant (P < 0.05). Conclusion Levatinib has obvious therapeutic effect on CNV, which may be achieved by inhibiting the high expression of VEGF in CNV.
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Affiliation(s)
- Xiaonan Xin
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yueyu Zhu
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Ruijie Xi
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yuhua Hao
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
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