Department of Ophthalmology, University of Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France.
Invest Ophthalmol Vis Sci. 2013 Oct 21;54(10):6886-92. doi: 10.1167/iovs.13-11665.
To investigate the multimodal morphological and functional characteristics of treatment-naïve "quiescent" choroidal neovascularization (CNV) secondary to AMD.
Eleven patients with treatment-naïve "quiescent" CNV that consecutively presented over a 6-month period, underwent multimodal morphological and functional assessment (including indocyanine green angiography [ICGA], spectral-domain optical coherence tomography [SD-OCT], microperimetry, and preferential hyperacuity perimeter [PHP]). For the purpose of this study, asymptomatic previously untreated CNVs showing absence of intraretinal/subretinal exudation in two consecutive visits (at least 6 months apart) were defined as treatment-naïve "quiescent" CNV.
Eleven eyes of 11 patients (9 females; mean age 76.5 ± 8.5 years) were included. On fluorescein angiography (FA), "quiescent" CNVs appeared as late speckled hyperfluorescent lesions lacking well-demarcated borders. Mid-late phase ICGA allowed visualizing the hyperfluorescent "quiescent" CNV network and delineating the plaque. Mean lesion area (mid-late phase ICGA) appeared larger compared with earliest previous examination performed 23.8 ± 16.0 months before (3.24 ± 2.51 mm(2) vs. 3.52 ± 2.46 mm(2), respectively; P = 0.01). SD-OCT revealed, at the site of "quiescent" CNV, an irregularly slightly elevated RPE, without hyporeflective intraretinal/subretinal fluid, showing a major axis in the horizontal plane, which was characterized by collections of moderately reflective material in the sub-RPE space and clear visualization of the hyperreflective Bruch's membrane. Hypergeometric distribution revealed a significant correlation between microperimetry and PHP with respect to locations of "affected areas" (P = 0.001).
"Quiescent" CNVs are sub-RPE CNVs secondary to AMD, showing absence of intraretinal/subretinal exudation on repeated OCT. "Quiescent" CNVs enlarge over time and may contribute to local reduced retinal sensitivity and metamorphopsia.
研究未经治疗的“静止”性年龄相关性黄斑变性（AMD）脉络膜新生血管（CNV）的多模态形态和功能特征。
在 6 个月的时间内，连续出现未经治疗的“静止”性 CNV 的 11 名患者接受了多模态形态和功能评估（包括吲哚青绿血管造影 [ICGA]、谱域光学相干断层扫描 [SD-OCT]、微视野和超敏偏好视野 [PHP]）。为了进行本研究，将两次连续就诊（至少相隔 6 个月）均显示无视网膜内/下渗出的无症状性未经治疗的 CNV 定义为未经治疗的“静止”性 CNV。
纳入 11 名患者的 11 只眼（9 名女性；平均年龄 76.5±8.5 岁）。在荧光素血管造影（FA）上，“静止”性 CNV 表现为晚期斑点状高荧光病变，边界不清。中晚期 ICGA 可使高荧光“静止”性 CNV 网络可视化，并勾勒出斑块。与 23.8±16.0 个月前进行的最早检查相比，平均病变面积（中晚期 ICGA）似乎更大（3.24±2.51mm2 vs. 3.52±2.46mm2；P=0.01）。SD-OCT 在“静止”性 CNV 部位显示出不规则的轻微抬高的 RPE，无低反射性视网膜内/下液，在水平方向上具有长轴，其特征是在 sub-RPE 空间中存在中等反射性物质的集合和清晰可见的高反射性 Bruch 膜。超几何分布显示，微视野和 PHP 与“受影响区域”的位置之间存在显著相关性（P=0.001）。
“静止”性 CNV 是 AMD 继发的 sub-RPE CNV，在重复的 OCT 上显示无视网膜内/下渗出。“静止”性 CNV 随时间而增大，可能导致局部视网膜敏感性降低和变形。
