Department of Retina and Vitreous, Retina Foundation, Near Shahibag Underbridge, Shahibag, Ahmedabad, Gujarat, India.
Indian J Ophthalmol. 2018 Dec;66(12):1790-1795. doi: 10.4103/ijo.IJO_866_18.
To evaluate and correlate the functional treatment response using microperimetry (MP3) with the morphological findings on optical coherence tomography angiography (OCTA) in wet AMD pre- and post-treatment with anti-vascular endothelial growth factor (VEGF). This was a single-centre prospective, interventional study.
Patients with wet AMD were treated with 3 injections of intravitreal anti-VEGF at monthly intervals for 3 months and followed at 1, 2, 3, and 6 months postinjection. Using "overlay" features, morphologic characteristics of OCTA at the site of choroidal neovascular membrane (CNVM) lesion were analyzed and correlated functionally with MP3. Data were collected including visual acuity at presentation and follow-up with multimodal imaging features, treatment details, complications (if any), and treatment given for that complication. Descriptive observational analysis and paired t-test was used to compare the appearance of the neovascular network on OCTA imaging with retinal sensitivity on MP3.
OCTA in the pretreatment phase revealed CNVM as an abnormal vascular network arising from the choroid and invading the subretinal space. On MP3, decreased retinal sensitivity was observed corresponding to the area of CNVM. Post-treatment, OCTA revealed reduction in abnormal vascular network in 51 (91.07%) eyes that correlated with increased retinal sensitivity at the corresponding area on MP3. Statistical analysis showed baseline mean retinal sensitivity at the site of CNVM as 320.07 dB, which improved to 521.53 and 730.20 dB at 1 and 3 months postinjection follow-up, respectively.
Combining the findings of OCTA and MP3 using "overlay" features gives us precise information of structure-function correlation at presentation and also in response to treatment. It also helps to improve patient's compliance, confidence to treatment, and their understanding of the disease process as well.
评估和关联湿性年龄相关性黄斑变性(AMD)患者在接受抗血管内皮生长因子(VEGF)治疗前后,使用微视野计(MP3)的功能治疗反应与光相干断层扫描血管造影(OCTA)的形态学发现。这是一项单中心前瞻性干预研究。
对湿性 AMD 患者进行 3 次玻璃体腔抗 VEGF 注射,每月 1 次,共 3 个月,然后在注射后 1、2、3 和 6 个月进行随访。使用“叠加”功能,分析脉络膜新生血管膜(CNVM)病变部位的 OCTA 形态特征,并与 MP3 进行功能相关分析。收集的数据包括就诊时和随访时的视力,包括多模态成像特征、治疗细节、并发症(如有)以及针对该并发症的治疗。使用描述性观察分析和配对 t 检验比较 OCTA 成像上新生血管网络与 MP3 上视网膜敏感性的外观。
预处理阶段的 OCTA 显示 CNVM 为异常血管网络,起源于脉络膜并侵入视网膜下间隙。在 MP3 上,观察到与 CNVM 区域相对应的视网膜敏感性降低。治疗后,51 只(91.07%)眼的 OCTA 显示异常血管网络减少,与 MP3 相应区域的视网膜敏感性增加相关。统计分析显示 CNVM 部位的基线平均视网膜敏感性为 320.07dB,分别在注射后 1 个月和 3 个月随访时提高至 521.53dB 和 730.20dB。
使用“叠加”功能结合 OCTA 和 MP3 的发现,为我们提供了在就诊时以及对治疗的反应中结构-功能相关性的精确信息。它还有助于提高患者的依从性、对治疗的信心,以及他们对疾病过程的理解。