Marques João Pedro, Costa José Filipe, Marques Marco, Cachulo Maria Luz, Figueira João, Silva Rufino
Department of Ophthalmology, Centro Hospitalar e Universitx00E1;rio de Coimbra (CHUC), Coimbra, Portugal.
Ophthalmic Res. 2016;55(3):145-51. doi: 10.1159/000442671. Epub 2016 Jan 7.
To assess and describe sequential morphological changes in the choroidal neovascularization (CNV) net using optical coherence tomography angiography (OCTA) in patients undergoing treatment with intravitreal antivascular endothelial growth factor (VEGF).
Prospective cohort study. OCTA was performed sequentially: before (t0), 1 h (t1), 1 week (t2) and 1 month after the injection (t3), using Avanti RTVue XR equipped with the AngioVue® software (Optovue, Calif., USA). All images were classified by two independent graders.
Ten eyes of 10 patients, with a mean age of 72.4 ± 10.5 years, were included. CNV morphology was described as tree-like in 5 eyes, glomerular in 1 and fragmented in 4. A fibrovascular capsule surrounding the CNV net was found in 4 eyes and a feeder trunk was noticed in 6. No changes were observed at t1. Loss of peripheral capillaries, vessel fragmentation and decreased vessel density were evident in 8 eyes at t2. The CNV capillary density and the peripheral anastomosis increased in all of these at t3. Two eyes remained unchanged through the whole length of follow-up.
Significant changes in the CNV net can be observable in OCTA at least 1 week after intravitreal anti-VEGF. The safety of frequent examinations may provide a method of gauging treatment effects.
使用光学相干断层扫描血管造影（OCTA）评估和描述接受玻璃体内抗血管内皮生长因子（VEGF）治疗的患者脉络膜新生血管（CNV）网的连续形态变化。
前瞻性队列研究。使用配备AngioVue®软件（美国加利福尼亚州Optovue公司）的Avanti RTVue XR依次进行OCTA检查：注射前（t0）、注射后1小时（t1）、1周（t2）和1个月（t3）。所有图像由两名独立的分级人员进行分类。
纳入10例患者的10只眼，平均年龄72.4±10.5岁。5只眼的CNV形态描述为树状，1只为肾小球状，4只为碎片状。4只眼发现CNV网周围有纤维血管包膜，6只眼发现有供血主干。t1时未观察到变化。t2时8只眼出现周边毛细血管丢失、血管碎片化和血管密度降低。t3时所有这些眼中的CNV毛细血管密度和周边吻合增加。2只眼在整个随访期间保持不变。
玻璃体内抗VEGF治疗后至少1周，OCTA可观察到CNV网的显著变化。频繁检查的安全性可能提供一种评估治疗效果的方法。
