Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California.
Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California.
Retina. 2018 Feb;38(2):220-230. doi: 10.1097/IAE.0000000000001628.
To study the qualitative and quantitative features of choroidal neovascular (NV) membranes in age-related macular degeneration using optical coherence tomography angiography in patients with active and quiescent NV lesions before and after treatment with anti-vascular endothelial growth factor.
Macular optical coherence tomography angiography images were obtained using RTVue XR Avanti with AngioVue. Morphologic features and quantitative measurements of the NV lesion were analyzed using en face projection images. The NV lesion was subdivided into inner segment and outer fringe for further fractal dimension analysis.
In a series of 31 eyes, 11 eyes with active NV lesions at baseline and after consecutive follow-up after treatment with anti-vascular endothelial growth factor therapy and 20 eyes with quiescent NV lesions were included in this study. Morphologically, all the quiescent NV lesions versus 63.6% of the active NV lesions demonstrated a prominent central vessel and active leasions demonstrated a greater rate of small vessels branching (82%) and peripheral arcades (82%) than quiescent lesions (30% and 40% respectively) and this was statistically significant. The lesion area and vessel density was not statistically significantly different after treatment or versus quiescent lesions although the latter lesions were reduced in area. Lesion pattern complexity measured by the fractal dimension was statistically significantly lower in the inner part of the lesion after treatment and statistically significantly lower in the total lesion of the quiescent NV compared with the active NV.
Optical coherence tomography angiography is a new, noninvasive imaging modality that can be used to perform qualitative and quantitative analyses of NV lesions. In the future, OCT angiography may provide biomarkers of activity and guide the evaluation and treatment and monitoring of neovascularization in age-related macular degeneration.
使用光学相干断层扫描血管造影术（OCTA）研究抗血管内皮生长因子治疗前后活动性和静止性脉络膜新生血管（NV）病变患者的年龄相关性黄斑变性脉络膜 NV 膜的定性和定量特征。
使用 RTVue XR Avanti 结合 AngioVue 获得黄斑 OCTA 图像。使用平面投影图像分析 NV 病变的形态特征和定量测量。将 NV 病变分为内节段和外 fringe 进行进一步分形维数分析。
在一系列 31 只眼中，本研究包括 11 只基线时存在活动性 NV 病变且在抗血管内皮生长因子治疗后连续随访的眼，以及 20 只静止性 NV 病变的眼。从形态上看，所有静止性 NV 病变均表现出明显的中央血管，而活动性病变则表现出更多的小血管分支（82%）和周边弓状血管（82%），而静止性病变则分别为 30%和 40%，这具有统计学意义。尽管病变面积减小，但治疗后病变面积和血管密度与静止性病变相比无统计学差异。尽管病变面积减小，但通过分形维数测量的病变模式复杂性在内病灶和总病灶中均显著低于静止性 NV。
OCTA 是一种新的非侵入性成像方式，可用于对 NV 病变进行定性和定量分析。将来，OCTA 可能提供活动性的生物标志物，并指导年龄相关性黄斑变性中新生血管的评估、治疗和监测。
