Rush Ryan B, Rush Sloan W, Aragon Antonio V, Ysasaga J Edward
Southwest Retina Specialists, Amarillo, Texas; Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas.
Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas.
Am J Ophthalmol. 2014 Aug;158(2):337-44. doi: 10.1016/j.ajo.2014.05.007. Epub 2014 May 17.
To report the clinical implications of interval changes in choroidal neovascularization (CNV) size measured by indocyanine green (ICG) angiography in neovascular age-related macular degeneration (AMD) patients undergoing intravitreal bevacizumab therapy.
Retrospective, consecutive chart review.
The charts of neovascular AMD patients who underwent intravitreal bevacizumab therapy using a treat-and-extend dosing schedule were reviewed. ICG angiographic CNV surface areas were measured at baseline, 2 months, 6 months, and 12 months in each subject. The primary outcome was change in CNV size. Secondary outcomes included the correlation of change in CNV surface area with change in best-corrected visual acuity (BCVA), change in central macular thickness on optical coherence tomography (OCT), and the number of injections delivered over the 12-month study interval.
A total of 123 subjects were included in the analysis. The baseline CNV size was 1.9 mm2±2.5 mm2. CNV size was 1.66 mm2±2.11 mm2 at 2 months, 1.60 mm2±2.23 mm2 at 6 months, and 1.50 mm2±2.12 mm2 at 12 months. The change in CNV size from baseline was not statistically significant at any of the follow-up intervals. A decrease in CNV size of 33% or more at 2 months was associated with a significant decrease in CNV size at 12 months (P=.0096), complete resolution of CNV at 12 months (P=.0013), and a decrease in the number of injections delivered over the study interval (P=.0165). Complete resolution of CNV at 12 months occurred in 7.3% of subjects. Subjects that had complete resolution of CNV at 12 months were significantly more likely to gain 3 more lines of BCVA at the end of the study interval (P=.0131). No significant correlation was found between CNV size and change in central macular thickness on OCT.
Our study suggests that change in CNV size on ICG angiography may help the clinician predict the clinical course of neovascular AMD subjects undergoing intravitreal bevacizumab therapy using a treat-and-extend dosing schedule.
报告在接受玻璃体内注射贝伐单抗治疗的新生血管性年龄相关性黄斑变性（AMD）患者中，通过吲哚菁绿（ICG）血管造影测量脉络膜新生血管（CNV）大小的间隔变化的临床意义。
回顾性、连续病例图表审查。
回顾使用治疗并延长给药方案接受玻璃体内注射贝伐单抗治疗的新生血管性AMD患者的病历。在每位受试者的基线、2个月、6个月和12个月时测量ICG血管造影的CNV表面积。主要结果是CNV大小的变化。次要结果包括CNV表面积变化与最佳矫正视力（BCVA）变化、光学相干断层扫描（OCT）上中心黄斑厚度变化的相关性，以及在12个月研究期间的注射次数。
共有123名受试者纳入分析。基线时CNV大小为1.9 mm²±2.5 mm²。2个月时CNV大小为1.66 mm²±2.11 mm²，6个月时为1.60 mm²±2.23 mm²，12个月时为1.50 mm²±2.12 mm²。在任何随访间隔中，CNV大小相对于基线的变化均无统计学意义。2个月时CNV大小减少33%或更多与12个月时CNV大小显著减少（P = 0.0096）、12个月时CNV完全消退（P = 0.0013）以及研究期间注射次数减少（P = 0.0165）相关。12个月时7.3%的受试者CNV完全消退。在研究间隔结束时，12个月时CNV完全消退的受试者更有可能获得3行以上的BCVA改善（P = 0.0131）。未发现CNV大小与OCT上中心黄斑厚度变化之间存在显著相关性。
我们的研究表明，ICG血管造影显示的CNV大小变化可能有助于临床医生预测使用治疗并延长给药方案接受玻璃体内注射贝伐单抗治疗的新生血管性AMD患者的临床病程。
