抗 VEGF 治疗前后年龄相关性黄斑变性继发典型脉络膜新生血管的荧光素眼底血管造影和频域光相干断层扫描成像。

Combined fluorescein angiography and spectral-domain optical coherence tomography imaging of classic choroidal neovascularization secondary to age-related macular degeneration before and after intravitreal ranibizumab injections.

机构信息

Department of Ophthalmology, Creteil Eye Clinic, University Paris Est Creteil, Creteil, France.

出版信息

Retina. 2012 Jun;32(6):1069-76. doi: 10.1097/IAE.0b013e318240a529.

DOI:10.1097/IAE.0b013e318240a529

PMID:22466476

Abstract

PURPOSE

To evaluate the combined fluorescein angiography and spectral-domain optical coherence tomography features in a consecutive series of exudative age-related macular degeneration eyes with classic choroidal neovascularization before and after anti-vascular endothelial growth factor treatment.

METHODS

Retrospective interventional study. All consecutive patients with exudative age-related macular degeneration because of newly diagnosed classic choroidal neovascularization visited during 3 months and treated by intravitreal ranibizumab injection on "as-needed" basis were analyzed. Combined fluorescein angiography and spectral-domain optical coherence tomography examination (Spectralis Heidelberg Retina Angiograph OCT) was performed at baseline and at the 12-month follow-up visit.

RESULTS

Twenty-nine treatment-naive eyes (29 patients, 10 men and 19 women, mean age 76.28 ± 10.86 years) were included. A mean of 5.3 ± 3.5 injections was administered during 12 months. At Month 12 visit, patients showed an improved best-corrected visual acuity (P = 0.01), a reduction of linear dimension of the entire lesion on fluorescein angiography (P = 0.02), and a reduction of the entire lesion width on spectral-domain optical coherence tomography (P < 0.001). At baseline, in all cases we distinguished on spectral-domain optical coherence tomography scan a highly reflective subretinal lesion, above and separate from the retinal pigment epithelium. The highly reflective subretinal lesion showed a significant reduction of width along the length of a single B-scan, at Month 12 follow-up visit (P < 0.001). It is notable that a small "discreet" pigment epithelial detachment associated with the highly reflective subretinal lesions was present in 28 of 29 eyes at baseline and after treatment (at Month 12 follow-up visit).

CONCLUSION

A discreet pigment epithelial detachment represents a common associated finding of classic choroidal neovascularization. Our study demonstrated that anti-vascular endothelial growth factor treatment may not only stop the growth of the highly reflective subretinal lesion that colocalize with the classic choroidal neovascularization but also determine its regression.

摘要

目的

评估一系列连续的湿性年龄相关性黄斑变性伴有典型脉络膜新生血管病变患者在接受抗血管内皮生长因子治疗前后的联合荧光素血管造影和频域光相干断层扫描特征。

方法

回顾性干预研究。所有因新诊断的典型脉络膜新生血管病变而就诊的连续渗出性年龄相关性黄斑变性患者，均接受玻璃体腔内雷珠单抗按需注射治疗。在基线和 12 个月随访时进行联合荧光素血管造影和频域光相干断层扫描检查（Spectralis Heidelberg Retina Angiograph OCT）。

结果

共纳入 29 只未经治疗的眼（29 例患者，10 男 19 女，平均年龄 76.28 ± 10.86 岁）。在 12 个月内平均注射 5.3 ± 3.5 次。在 12 个月随访时，患者最佳矫正视力提高（P = 0.01），荧光素血管造影上整个病变的线性尺寸缩小（P = 0.02），频域光相干断层扫描上整个病变的宽度缩小（P < 0.001）。在基线时，在所有病例的频域光相干断层扫描扫描中，我们均能分辨出一个位于视网膜色素上皮上方和分离的高反射性视网膜下病变。在 12 个月随访时，高反射性视网膜下病变的宽度在单一 B 扫描的长度上显著缩小（P < 0.001）。值得注意的是，在 29 只眼中，有 28 只在基线和治疗后（12 个月随访时）均存在与高反射性视网膜下病变相关的小的“离散”色素上皮脱离。