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. 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. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.