Ahn Seong Joon, Park Kyu Hyung, Woo Se Joon
Department of Ophthalmology Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea 2Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, South Korea.
Department of Ophthalmology Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Invest Ophthalmol Vis Sci. 2015 Sep;56(10):5794-800. doi: 10.1167/iovs.14-16006.
To investigate subfoveal choroidal thickness (SFCT) changes following intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy and to identify clinical and choroidal parameters associated with visual outcome in eyes with myopic choroidal neovascularization (CNV).
In 60 eyes of 54 patients who were treated with anti-VEGF injections for myopic CNV, SFCT was measured using enhanced depth imaging optical coherence tomography at baseline, at 1, 3, and 6 months after initial anti-VEGF therapy, and at the final visit. Subfoveal choroidal thickness was compared between visits in subgroups separated based on anatomic outcome, recurrence, or resolution. Univariate and multivariate regression analyses were performed to identify factors associated with final best-corrected visual acuity (BCVA).
At baseline, the mean SFCT was 47.6 ± 24.7 μm, significantly lower than that of the contralateral eyes (59.8 ± 34.4 μm, P = 0.022). The thickness significantly decreased to 45.2 ± 24.0 μm (P = 0.027) 1 month after the anti-VEGF therapy. In the recurrent cases, the SFCT significantly increased from 46.1 ± 25.5 μm at month 1 to 52.4 ± 25.8 μm at the time of recurrence (P = 0.020); however, no significant change in the SFCT was noted in the nonrecurrent cases. In the regression analyses, the baseline BCVA (P < 0.001) and central macular thickness (CMT; P = 0.003) significantly correlated with the final BCVA, whereas SFCT or its change was not significantly associated with final BCVA.
Subfoveal choroidal thicknesss significantly decreased following anti-VEGF therapy in myopic CNV, but showed a subsequent increase in recurrence. Subfoveal choroidal thickness may reflect disease activity and aid decision making regarding retreatment in myopic CNV for recurrent cases.
研究玻璃体内注射抗血管内皮生长因子（抗VEGF）治疗后黄斑中心凹下脉络膜厚度（SFCT）的变化，并确定与近视性脉络膜新生血管（CNV）患眼视力预后相关的临床和脉络膜参数。
对54例接受抗VEGF注射治疗近视性CNV的患者的60只眼，使用增强深度成像光学相干断层扫描在基线、初始抗VEGF治疗后1、3和6个月以及末次随访时测量SFCT。根据解剖学结果、复发或消退情况将亚组中的各次随访的黄斑中心凹下脉络膜厚度进行比较。进行单因素和多因素回归分析以确定与最终最佳矫正视力（BCVA）相关的因素。
基线时，平均SFCT为47.6±24.7μm，显著低于对侧眼（59.8±34.4μm，P = 0.022）。抗VEGF治疗1个月后，厚度显著降至45.2±24.0μm（P = 0.027）。在复发病例中，SFCT从第1个月时的46.1±25.5μm显著增加至复发时的52.4±25.8μm（P = 0.020）；然而，在未复发病例中未观察到SFCT有显著变化。在回归分析中，基线BCVA（P < 0.001）和中心黄斑厚度（CMT；P = 0.003）与最终BCVA显著相关，而SFCT或其变化与最终BCVA无显著关联。
近视性CNV患者接受抗VEGF治疗后，黄斑中心凹下脉络膜厚度显著降低，但复发时随后增加。黄斑中心凹下脉络膜厚度可能反映疾病活动，并有助于对复发的近视性CNV病例进行再次治疗的决策。
