Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Am J Ophthalmol. 2012 Feb;153(2):314-9. doi: 10.1016/j.ajo.2011.06.026. Epub 2011 Oct 8.
To investigate near-infrared autofluorescence (IR-AF) patterns and related changes in patients with idiopathic choroidal neovascularization (CNV) treated with intravitreal bevacizumab (IVB).
Retrospective observational consecutive case series.
Bevacizumab was intravitreally injected into 12 eyes of 12 patients with idiopathic CNV as the primary treatment. Color fundus photographs, optical coherence tomography (OCT), fluorescein angiography and indocyanine green angiography (ICGA), and autofluorescence imaging short-wavelength and near-infrared autofluorescence (SW-AF and IR-AF) were performed at baseline. Changes in the autofluorescence patterns were evaluated after IVB.
All 12 eyes had classic CNV on fluorescein angiography at baseline. OCT showed CNV above the retinal pigment epithelium (RPE) in all eyes. After treatment, the final best-corrected visual acuity improved significantly (P < .001) compared with baseline. IR-AF showed ring-shaped hyperautofluorescence surrounding the CNV corresponding to the dark rim on ICGA in 6 of the 12 eyes on IR-AF at baseline. During the follow-up period after IVB, all 12 eyes had ring-shaped hyperautofluorescence. The intensity of the ring-shaped autofluorescence and its contrast increased as the CNV regressed. The contrast of the ring-shaped autofluorescence partially decreased in all 3 eyes with a recurrence.
Ring-shaped hyperautofluorescence on IR-AF in the eyes with idiopathic CNV may indicate an involutional process of CNV enveloped by the RPE because its area corresponded to the dark rim on ICGA that reflects regression of idiopathic CNV. IR-AF can be a useful noninvasive adjunctive examination to evaluate the involution of CNV.
研究特发性脉络膜新生血管(CNV)患者接受玻璃体内注射贝伐单抗(IVB)治疗后的近红外自发荧光(IR-AF)模式及相关变化。
回顾性连续病例系列研究。
对 12 例 12 只眼特发性 CNV 患者进行了玻璃体内注射贝伐单抗的治疗。所有患者均在基线时进行了眼底彩色照相、光学相干断层扫描(OCT)、荧光素血管造影和吲哚青绿血管造影(ICGA)以及自发荧光成像短波长和近红外自发荧光(SW-AF 和 IR-AF)检查。在 IVB 后评估自发荧光模式的变化。
所有 12 只眼在基线时的荧光素血管造影上均有典型的 CNV。OCT 显示所有眼的 CNV 均位于视网膜色素上皮(RPE)上方。治疗后,最终最佳矫正视力较基线显著提高(P<0.001)。在基线时的 IR-AF 上,6 只眼的 IR-AF 显示围绕 CNV 的环形高自发荧光,与 ICGA 上的暗环相对应。在 IVB 后的随访期间,所有 12 只眼均出现环形高自发荧光。随着 CNV 的消退,环形自发荧光的强度及其对比度增加。在 3 只复发的眼中,环形自发荧光的对比度部分降低。
特发性 CNV 眼中的 IR-AF 上的环形高自发荧光可能表明 CNV 被 RPE 包裹的退行性过程,因为其面积与反映特发性 CNV 消退的 ICGA 上的暗环相对应。IR-AF 可以作为一种有用的非侵入性辅助检查,用于评估 CNV 的退行性变化。