Kim Yong-Kyu, Park Sang Jun, Woo Se Joon, Park Kyu Hyung
*Department of Ophthalmology, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, South Korea; and †Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
Retina. 2016 Aug;36(8):1516-26. doi: 10.1097/IAE.0000000000000952.
To investigate choroidal thickness changes after anti-vascular endothelial growth factor (VEGF) treatment in retinal angiomatous proliferation (RAP) and correlate choroidal thickness with disease recurrence.
Twenty-six eyes from 21 patients with RAP were treated with 3 monthly intravitreal anti-VEGF injections and additional injections as needed. RAP was divided according to the component of pigment epithelial detachment. The subfoveal choroidal thickness and choroidal thickness under the RAP lesion were measured using spectral-domain optical coherence tomography and compared between recurrence and nonrecurrence groups during the first year.
The subfoveal choroidal thickness and choroidal thickness under the RAP lesion showed a significant decrease during the first 3 months; however, this was not maintained for the first year. The recurrence group showed a significantly thicker subfoveal choroidal thickness (P = 0.021) and choroidal thickness under the RAP lesion (P = 0.020) during the first year in those with only drusen or drusenoid pigment epithelial detachment without serous component. A significant increase and decrease in choroidal thickness was observed during the recurrence and remission period.
Increased choroidal thickness was associated with a higher rate of recurrence after anti-VEGF treatment in RAP with only drusen or drusenoid pigment epithelial detachment. Choroidal thickness could also reflect disease activity, even before manifestation of retinal disease activity.
研究视网膜血管瘤样增生(RAP)患者抗血管内皮生长因子(VEGF)治疗后脉络膜厚度变化,并将脉络膜厚度与疾病复发相关联。
对21例RAP患者的26只眼进行每月1次、共3次的玻璃体内抗VEGF注射治疗,并根据需要进行额外注射。RAP根据色素上皮脱离的成分进行分类。使用光谱域光学相干断层扫描测量黄斑中心凹下脉络膜厚度和RAP病变下方的脉络膜厚度,并在第一年对复发组和未复发组进行比较。
黄斑中心凹下脉络膜厚度和RAP病变下方的脉络膜厚度在最初3个月内显著下降;然而,这种情况在第一年并未持续。在仅伴有玻璃膜疣或类玻璃膜疣色素上皮脱离而无浆液成分的患者中,复发组在第一年的黄斑中心凹下脉络膜厚度(P = 0.021)和RAP病变下方的脉络膜厚度(P = 0.020)显著更厚。在复发期和缓解期观察到脉络膜厚度有显著的增加和减少。
在仅伴有玻璃膜疣或类玻璃膜疣色素上皮脱离的RAP患者中,抗VEGF治疗后脉络膜厚度增加与更高的复发率相关。脉络膜厚度甚至在视网膜疾病活动表现出来之前也能反映疾病活动情况。