Espina Mark, Arcinue Cheryl A, Ma Feiyan, Camacho Natalia, Barteselli Giulio, Mendoza Nadia, Ferrara Napoleone, Freeman William R
Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, California, USA.
Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, California, USA Department of Ophthalmology, Genentech Inc., South San Francisco, California, USA.
Br J Ophthalmol. 2016 Jun;100(6):819-23. doi: 10.1136/bjophthalmol-2015-307141. Epub 2015 Sep 30.
To review the longitudinal changes of outer retinal tubulations (ORTs) in wet age-related macular degeneration (AMD) and their response to anti-vascular endothelial growth factor (VEGF) therapy by spectral-domain optical coherence tomography (SD-OCT), and to correlate these observations with disease activity, presence or absence of fluid, and patients' demographics.
Retrospective study of wet AMD eyes treated with anti-VEGF agents and showing ORTs on SD-OCT, and the patients' fellow eye with wet AMD but without ORTs.
Fifty-one wet AMD eyes from 31 patients diagnosed and treated for wet AMD were included in the review and analysis of data; 33 eyes showed ORTs at baseline, while 18 fellow eyes had no ORTs. During a median follow-up treatment period of 11 months, 23 eyes had stable ORTs and 10 eyes had ORT changes. Among the 10 eyes with ORTs changes, ORTs collapsed during anti-VEGF treatment in 5 eyes but then reappeared within 12 months after stopping treatment. In two eyes, ORTs increased in size during anti-VEGF treatment, while in two other eyes ORTs collapsed without any treatment. In a single eye, ORTs collapsed within 10 months of no treatment and did not reappear upon recurrence of fluid. Eyes with ORTs tended to have lower visual acuity than eyes with no ORTs due to greater disruption of the external limiting membrane in the fovea.
ORTs documented by SD-OCT may exhibit multiple types of longitudinal changes, such as collapse, recurrence or enlargement, which could be associated with anti-VEGF treatment or spontaneous. Some ORTs may have a vascular component or may be vascular in nature, considering their response to anti-VEGF treatment, while other ORTs are likely composed only of degenerating photoreceptor cells and may collapse independently from anti-VEGF treatments.
通过光谱域光学相干断层扫描（SD-OCT）评估湿性年龄相关性黄斑变性（AMD）中外层视网膜管状结构（ORTs）的纵向变化及其对抗血管内皮生长因子（VEGF）治疗的反应，并将这些观察结果与疾病活动、有无积液以及患者人口统计学特征相关联。
对接受抗VEGF药物治疗且SD-OCT显示有ORTs的湿性AMD患眼，以及患有湿性AMD但无ORTs的对侧眼进行回顾性研究。
纳入31例诊断并接受治疗的湿性AMD患者的51只患眼进行数据回顾与分析；33只眼在基线时显示有ORTs，而18只对侧眼无ORTs。在中位随访治疗期11个月期间，23只眼的ORTs稳定，10只眼的ORTs有变化。在10只ORTs有变化的眼中，5只眼在抗VEGF治疗期间ORTs塌陷，但在停药后12个月内又重新出现。2只眼中，ORTs在抗VEGF治疗期间增大，而另外2只眼中ORTs未经任何治疗即塌陷。1只眼中，ORTs在未治疗10个月内塌陷，在积液复发时未再出现。由于黄斑区外界膜的破坏更大，有ORTs的眼视力往往低于无ORTs的眼。
SD-OCT记录的ORTs可能表现出多种类型的纵向变化，如塌陷、复发或增大，这可能与抗VEGF治疗或自发因素有关。考虑到ORTs对抗VEGF治疗的反应，一些ORTs可能有血管成分或本质上是血管性的，而其他ORTs可能仅由退化的光感受器细胞组成，可能独立于抗VEGF治疗而塌陷。
