Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Ophthalmology, Tokyo Shinjuku Medical Center, Tokyo, Japan.
PLoS One. 2019 Feb 14;14(2):e0212055. doi: 10.1371/journal.pone.0212055. eCollection 2019.
Pachychoroid neovasculopathy (PNV) shares some anatomical features with other pachychoroid spectrum diseases, but little is known about the characteristics on the treatment with anti-vascular endothelial growth factor (VEGF). We investigated the effect of choroidal structure and responses to anti-VEGF on the prognosis of pachychoroid neovasculopathy (PNV) and other types of neovascular age-related macular degeneration (non-PNV). Twenty-one eyes with PNV and 34 eyes with non-PNV who had anti-VEGF treatment were retrospectively reviewed. Choroidal neovascularization (CNV) area at baseline was measured with fluorescein angiography (FAG). The luminal and stromal area in the choroid was measured by enhanced-depth-imaging (EDI) OCT at baseline and 1 month. The association between dry macula or LogMAR VA (visual acuity, VA) at 1 month and baseline values or changes in the luminal or stromal area at 1 month, baseline CNV area, or anti-VEGF drugs were analyzed in patients with or without PNV. In non-PNV, change of luminal area (coefficient = 7.0×10-5, p = 0.0001), baseline CNV area (coefficient = 0.18, p = 0.033), and aflibercept vs. ranibizumab (coefficient = 0.29, p = 0.0048) were chosen as predictors for dry macula by the model selection. Similarly, in non-PNV, change of luminal area (coefficient = 6.1×10-6, p = 0.033), baseline CNV area (coefficient = 0.034, p = 0.022), and aflibercept vs. ranibizumab (coefficient = 0.056, p = 0.0020) were chosen as predictors for greater VA improvement. In PNV, however, none of these factors was chosen as predictors for dry macula or VA improvement by the model selection. The result of the present study implied that structural response after anti-VEGF might be different between non-PNV and PNV in the treatment with anti-VEGF agents.
脉络膜增厚性新生血管病变（PNV）与其他脉络膜增厚谱疾病具有一些解剖学特征，但关于抗血管内皮生长因子（VEGF）治疗的特征知之甚少。我们研究了脉络膜结构和对抗 VEGF 反应对脉络膜增厚性新生血管病变（PNV）和其他类型新生血管性年龄相关性黄斑变性（非 PNV）预后的影响。回顾性分析了 21 只 PNV 眼和 34 只接受抗 VEGF 治疗的非 PNV 眼。使用荧光素血管造影（FAG）测量基线脉络膜新生血管（CNV）面积。使用增强深度成像（EDI）OCT 在基线和 1 个月时测量脉络膜的管腔和基质面积。分析了 PNV 患者和非 PNV 患者中 1 个月时干斑或 LogMAR 视力（VA）与基线值或 1 个月时管腔或基质面积变化、基线 CNV 面积或抗 VEGF 药物之间的关系。在非 PNV 中，通过模型选择，管腔面积变化（系数=7.0×10-5，p=0.0001）、基线 CNV 面积（系数=0.18，p=0.033）和阿柏西普与雷珠单抗（系数=0.29，p=0.0048）被选为干斑的预测因子。同样，在非 PNV 中，管腔面积变化（系数=6.1×10-6，p=0.033）、基线 CNV 面积（系数=0.034，p=0.022）和阿柏西普与雷珠单抗（系数=0.056，p=0.0020）被选为 VA 改善更大的预测因子。然而，在 PNV 中，通过模型选择，这些因素均未被选为干斑或 VA 改善的预测因子。本研究结果表明，在抗 VEGF 药物治疗中，非 PNV 和 PNV 之间抗 VEGF 后的结构反应可能不同。
