Cohen Salomon Y, Tabary Sandrine, El Ameen Ala, Mrejen Sarah, Quentel Gabriel, Giocanti-Auregan Audrey
Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France.
Department of Ophthalmology, Paris Est University, Creteil, France.
Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):485-493. doi: 10.1007/s00417-018-04205-x. Epub 2018 Dec 7.
To investigate morphological changes in myopic choroidal neovascularization (mCNV) using optical coherence tomography-angiography (OCT-A) after treatment with ranibizumab.
Retrospective analysis of consecutive patients over a 24-month period. All treatment-naïve mCNV were imaged at baseline with color pictures, spectral-domain OCT and OCT-A, and fluorescein angiography in selected cases. CNV morphology was classified at baseline and at 6 months. The CNV lesion surface was also compared.
Twenty-nine patients with a mean age of 70.3 ± 10.1 years were included. They received a mean number of 2.65 injections over 6 months. Best-corrected visual acuity improved from 62.2 to 68.5 letters (p = 0.004), with regression of exudation in 24 eyes (82.7%). Baseline CNV was classified into tree-in-bud (16 eyes), medusa (9 eyes), or sea-fan (4 eyes) pattern. At 6 months, no abnormal blood flow was observed in CNV in 13 eyes. Eyes with complete regression or evolution towards an indistinct pattern showed more often a complete regression of exudation than eyes with unchanged pattern (p = 0.007). The mean CNV surface significantly decreased from 0.19 to 0.08 mm (p < 0.0001).
An unchanged pattern was more often associated with exudation persistence, while a complete regression or evolution towards indistinct pattern was always associated with vascular inactivity. However, variable changes in mCNV were observed after anti-VEGF. Thus, OCT-A could be more useful in the diagnosis than in the follow-up of mCNV.
使用雷珠单抗治疗后，通过光学相干断层扫描血管造影（OCT-A）研究近视性脉络膜新生血管（mCNV）的形态学变化。
对连续24个月的患者进行回顾性分析。所有初治的mCNV患者在基线时进行彩色照片、光谱域OCT和OCT-A成像，并在部分病例中进行荧光素血管造影。在基线和6个月时对CNV形态进行分类。还比较了CNV病变表面。
纳入29例平均年龄为70.3±10.1岁的患者。他们在6个月内平均接受了2.65次注射。最佳矫正视力从62.2提高到68.5个字母（p = 0.004），24只眼（82.7%）的渗出物消退。基线CNV分为芽生状（16只眼）、水母状（9只眼）或海扇状（4只眼）。在6个月时，13只眼中的CNV未观察到异常血流。与模式未改变的眼相比，完全消退或演变为不清晰模式的眼渗出物完全消退的情况更常见（p = 0.007）。平均CNV表面从0.19显著减小至0.08平方毫米（p < 0.0001）。
模式未改变更常与渗出物持续存在相关，而完全消退或演变为不清晰模式总是与血管无活性相关。然而，抗VEGF治疗后mCNV出现了可变变化。因此，OCT-A在mCNV的诊断中可能比随访中更有用。
