Department of Ophthalmology. Bellvitge University Hospital, Barcelona, Spain.
Department of Ophthalmology. Sant Joan de Déu Hospital, Barcelona, Spain.
Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):1119-1124. doi: 10.1167/iovs.17-22144.
We evaluate changes in choroidal thickness after intravitreal injection (IVI) therapy for pachychoroid neovasculopathy (PNV).
An observational, retrospective, consecutive case series was studied of 18 patients (18 eyes) who underwent anti-vascular endothelial growth factor (VEGF) therapy for PNV. The 18 fellow eyes in these patients were used as controls. All eyes were evaluated with swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA).
Mean patient age was 68.3 ± 7.0 years. Mean follow-up was 16.4 ± 2.0 months. No differences in the best-corrected visual acuity (BCVA) of the affected eyes were observed between baseline and 12-month follow-up (median Early Treatment of Diabetic Retinopathy Study [ETDRS] score, 77.5 vs. 76 letters, P = 0.074; median logMAR, 0.22 vs. 0.22, P = 0.453). However, subfoveal choroidal thickness (SFCT) decreased significantly from a mean of 317.7 ± 39.9 μm at baseline to 266.9 ± 56.3 μm at 12 months (P ≤ 0.001). Median change in SFCT at 12 months was 44.0 μm (range, 17-133 μm). SFCT decreased by 16% from baseline to month 12. The change in SFCT at 12 months was highly correlated with the number of IVI (rs = 0.762, P ≤ 0.001). No significant changes in SFCT were observed in the fellow eyes over the 12-month study period (median, 267.5 vs. 267.0 μm; P = 0.930).
Choroidal thickness decreased significantly from baseline to month 12 in eyes with PNV treated with anti-VEGF injections. This reduction might be attributable to a reduction in choroidal vascular permeability and, thus, with a decrease in PNV activity. Prospective studies are needed to confirm these findings.
我们评估了脉络膜厚度在脉络膜新生血管病变（pachychoroid neovasculopathy，PNV）患者玻璃体腔内注射（IVI）治疗后的变化。
对 18 例（18 只眼）接受抗血管内皮生长因子（VEGF）治疗的 PNV 患者进行了一项观察性、回顾性、连续病例系列研究。这些患者的 18 只对侧眼作为对照。所有眼均行扫频源光学相干断层扫描（SS-OCT）和光相干断层扫描血管造影（OCTA）检查。
患者平均年龄为 68.3 ± 7.0 岁。平均随访时间为 16.4 ± 2.0 个月。受影响眼的最佳矫正视力（BCVA）在基线和 12 个月随访时无差异（中位早期糖尿病视网膜病变研究[ETDRS]评分，77.5 对 76 个字母，P = 0.074；中位 logMAR，0.22 对 0.22，P = 0.453）。然而，黄斑中心凹下脉络膜厚度（SFCT）从基线时的 317.7 ± 39.9μm 显著下降至 12 个月时的 266.9 ± 56.3μm（P ≤ 0.001）。12 个月时 SFCT 的中位变化为 44.0μm（范围，17-133μm）。SFCT 在 12 个月内下降了 16%。SFCT 在 12 个月时的变化与 IVI 的次数高度相关（rs = 0.762，P ≤ 0.001）。在 12 个月的研究期间，对侧眼的 SFCT 无明显变化（中位数，267.5 对 267.0μm；P = 0.930）。
接受抗 VEGF 注射治疗的 PNV 患者的脉络膜厚度从基线至 12 个月时显著下降。这种减少可能归因于脉络膜血管通透性的降低，从而导致 PNV 活性的降低。需要前瞻性研究来证实这些发现。
