Shah Syed Nasir Ali, Kang Qian-Yan, Fan Xiao-Juan, Sun Yue-Ming
Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Int J Ophthalmol. 2016 Feb 18;9(2):271-4. doi: 10.18240/ijo.2016.02.17. eCollection 2016.
To investigate factors associated with responses to intravitreal bevacizumab (IVB) in naive idiopathic choroidal neovascularization (iCNV) by high domain optical coherence tomography (OCT).
We retrospectively reviewed clinical data of 40 eyes of iCNV patients who received a single or multiple IVB on an as-needed basis (1.25 mg/0.05 mL). One month after the first injection, subretinal fluid (SRF) volume was evaluated and the eyes were divided into 3 groups based on responses to IVB. Good, moderate, and poor responses were defined as 61%-99%, 30%-60%, and <30% resolution of SRF on OCT after IVB in iCNV, respectively. OCT findings were analyzed to find factors associated with difference in response levels. Comparisons were made using Wilcoxon's matched-pairs signed-rank test, the Mann-Whitney U test for means with continuous data and Fisher's exact test for categorical data.
The mean number of IVB was 1.28±1.50 and mean follow up time was 3.60±1.20mo. At postoperative 1mo, there were 8 (20%) eyes in good response, 20 (50%) in moderate response and 12 (30%) eyes in poor response group and at last visit there were 28 good responders (70%), 8 (20%) moderate responders and 4 (10%) poor responders. Statistically significant difference was detected between good responders and non good responders in choroidal neovessels thickness (P=0.029), SRF height (P=0.049) and SRF volume (P=0.031) at post treatment 1mo.
OCT is a valuable diagnostic tool. Decrease in choroidal neovessels thickness, SRF height and volume predicts favorable response of iCNV to IVB therapy.
通过高分辨率光学相干断层扫描(OCT)研究初发性特发性脉络膜新生血管(iCNV)患者玻璃体内注射贝伐单抗(IVB)疗效的相关因素。
回顾性分析40例iCNV患者(40只眼)的临床资料,这些患者根据需要接受单次或多次IVB注射(1.25mg/0.05mL)。首次注射后1个月,评估视网膜下液(SRF)体积,并根据IVB疗效将患眼分为3组。iCNV患者IVB治疗后,OCT显示SRF消退61%-99%、30%-60%和<30%分别定义为疗效好、疗效中等和疗效差。分析OCT检查结果,以找出与疗效水平差异相关的因素。采用Wilcoxon配对符号秩检验、Mann-Whitney U检验(用于连续数据的均值比较)和Fisher精确检验(用于分类数据)进行比较。
IVB平均注射次数为1.28±1.50次,平均随访时间为3.60±1.20个月。术后1个月,疗效好的患眼有8只(20%),疗效中等的有20只(50%),疗效差的有12只(30%);末次随访时,疗效好的有28只(70%),疗效中等的有8只(20%),疗效差的有4只(10%)。治疗后1个月,疗效好与疗效不好的患者在脉络膜新生血管厚度(P=0.029)、SRF高度(P=0.049)和SRF体积(P=0.031)方面存在统计学显著差异。
OCT是一种有价值的诊断工具。脉络膜新生血管厚度、SRF高度和体积的降低预示着iCNV对IVB治疗有良好反应。