Rush Ryan B, Rush Sloan W
From the *Southwest Retina Specialists; †Panhandle Eye Group; and ‡Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX.
Asia Pac J Ophthalmol (Phila). 2015 Jul-Aug;4(4):187-90. doi: 10.1097/APO.0000000000000111.
This study aimed to evaluate the utility of indocyanine green (ICG) angiography in predicting recalcitrance in neovascular age-related macular degeneration (nAMD).
A retrospective case series.
The charts of treatment-naive subjects with nAMD undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy during a 6-month period were retrospectively reviewed. The study group consisted of subjects with persistent retinal edema on optical coherence tomography (OCT) despite 6 consecutive monthly anti-VEGF injections. The control group was age-matched to the study group and consisted of subjects who demonstrated complete resolution of retinal edema on OCT after 3 or fewer monthly anti-VEGF injections.
There were 42 study cases and 42 controls included in the analysis. The baseline visual acuity, central macular thickness on OCT, and choroidal neovascularization (CNV) surface area on ICG angiography were statistically similar between the study and control groups. The CNV surface area on ICG angiography 2 months after starting consecutive monthly anti-VEGF injections increased from a baseline of 1.78 ± 0.86 to 2.66 ± 0.92 mm2 in the study group (P = 0.008) and decreased from a baseline of 1.94 ± 0.97 to 1.12 ± 0.05 mm2 in the control group (P = 0.04); this change in CNV size on ICG angiography from baseline to 2-month follow-up was statistically significant between the study and control groups (P < 0.0001).
Change in CNV surface area on ICG angiography can predict which subjects with nAMD are likely to have persistent retinal edema on OCT after 6 or more consecutive monthly anti-VEGF injections.
本研究旨在评估吲哚菁绿（ICG）血管造影在预测新生血管性年龄相关性黄斑变性（nAMD）治疗抵抗性方面的效用。
一项回顾性病例系列研究。
回顾性分析6个月期间接受抗血管内皮生长因子（抗VEGF）治疗的初治nAMD患者的病历。研究组包括尽管连续每月注射抗VEGF 6次，但光学相干断层扫描（OCT）显示视网膜持续水肿的患者。对照组与研究组年龄匹配，包括每月注射抗VEGF 3次或更少次后OCT显示视网膜水肿完全消退的患者。
分析纳入42例研究病例和42例对照。研究组和对照组在基线视力、OCT上的中心黄斑厚度以及ICG血管造影上的脉络膜新生血管（CNV）表面积方面在统计学上相似。在连续每月注射抗VEGF开始后2个月，研究组ICG血管造影上的CNV表面积从基线的1.78±0.86增加至2.66±0.92mm²（P = 0.008），而对照组从基线的1.94±0.97降至1.12±0.05mm²（P = 0.04）；从基线到2个月随访时ICG血管造影上CNV大小的这种变化在研究组和对照组之间具有统计学显著性（P < 0.0001）。
ICG血管造影上CNV表面积的变化可以预测哪些nAMD患者在连续每月注射抗VEGF 6次或更多次后OCT上可能出现持续的视网膜水肿。
