Sasaki Mariko, Kato Yu, Fujinami Kaoru, Hirakata Toshiaki, Tsunoda Kazushige, Watanabe Ken, Akiyama Kunihiko, Noda Toru
Department of Ophthalmology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan.
Department of Ophthalmology, Tachikawa Hospital, Tokyo, Japan.
PLoS One. 2017 Nov 2;12(11):e0186955. doi: 10.1371/journal.pone.0186955. eCollection 2017.
To quantitatively evaluate changes in the sub-retinal pigment epithelial (RPE) space and determine the association with recurrent neovascular age-related macular degeneration (AMD). Twenty-two eyes treated with intravitreal aflibercept for treatment-naïve neovascular AMD were studied retrospectively. The sub-RPE area, volume, and central retinal thickness (CRT) were evaluated 1 and 2 months after the loading phase using spectral-domain optical coherence tomography. Recurrence was defined as newly detected neovascular activity during the 6 months after the loading phase. In eyes with recurrent AMD, the sub-RPE area increased significantly (P = 0.036) from 1 to 2 months after the loading phase and the sub-RPE volume increased marginally (P = 0.06). Subgroup analysis showed significant (P = 0.008 and P = 0.016, respectively) increases in the sub-RPE area and volume in typical AMD. In eyes with no recurrence, no significant changes occurred in the two parameters. No significant CRT changes occurred in eyes with or without a recurrence. A quantitative analysis demonstrated an increased likelihood of the sub-RPE space shortly after the loading phase in eyes with recurrent AMD; no changes occurred in eyes without a recurrence. These early changes in the sub-RPE space could indicate disease activity and are valuable for predicting recurrences of neovascular AMD.
为了定量评估视网膜色素上皮（RPE）下间隙的变化，并确定其与复发性新生血管性年龄相关性黄斑变性（AMD）的关联。对22只初治新生血管性AMD患者接受玻璃体内阿柏西普治疗的眼睛进行回顾性研究。在负荷期后1个月和2个月，使用光谱域光学相干断层扫描评估RPE下面积、体积和中央视网膜厚度（CRT）。复发定义为负荷期后6个月内新检测到的新生血管活动。在复发性AMD患者的眼睛中，负荷期后1至2个月RPE下面积显著增加（P = 0.036），RPE下体积略有增加（P = 0.06）。亚组分析显示，典型AMD患者的RPE下面积和体积显著增加（分别为P = 0.008和P = 0.016）。在无复发的眼睛中，这两个参数无显著变化。有或无复发的眼睛中CRT均无显著变化。定量分析表明，复发性AMD患者的眼睛在负荷期后不久RPE下间隙增加的可能性增大；无复发的眼睛无变化。RPE下间隙的这些早期变化可能表明疾病活动，对预测新生血管性AMD的复发具有重要价值。
