Hu Zizhong, Su Yun, Xie Ping, Chen Lu, Ji Jiangdong, Feng Ting, Wu Shaowei, Liang Kang, Liu Qinghuai
Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
School of Electronic and Optic Engineering, Nanjing University of Science and Technology, Nanjing, 21000, China.
Graefes Arch Clin Exp Ophthalmol. 2019 Aug;257(8):1611-1619. doi: 10.1007/s00417-019-04315-0. Epub 2019 May 3.
To quantify the preoperative neovascular change pattern on the fibrovascular membrane (FVM) within 7 days after intravitreal injection of conbercept (IVC) using optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR).
Prospective, observational study of PDR patients with visible FVM receiving or not receiving IVC. Neovascular changes were assessed by OCTA pre-IVC and 1, 3, 5, and 7 days post-IVC. Vessel skeleton density (SD) and vessel density (VD) were quantified by an intensity-based optical microangiography algorithm. The interclass correlation coefficient (ICC) was calculated to assess the agreement between measurements. The SD and VD were compared between follow-ups using repeated-measures analysis in the IVC group.
The ICC was 0.992 (95% confidence interval [CI]: 0.982-0.996) for SD and 0.926 (95% CI: 0.838-0.912) for VD of neovascularization. The neovascularization on FVM significantly regressed in the IVC group (n = 16) compared with no IVC (n = 8) (p = 0.001 for SD and p < 0.001 for VD). The comparisons between consecutive follow-ups showed a statistically significant reduction in SD and VD at 1 and 3 days post-IVC. However, from day 3 onward, the SD and VD remained unchanged. There was no development or progression of tractional retinal detachment within the 7-day period after IVC.
OCTA-based quantification of the neovascularization on FVM in PDR is feasible, with high inter-reader agreement. The regression of neovascularization reaches a plateau 3 days after IVC.
This trial is registered with the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , registration number ChiCTR-IPR-17014160).
使用光学相干断层扫描血管造影（OCTA）对增殖性糖尿病视网膜病变（PDR）患者玻璃体内注射康柏西普（IVC）后7天内纤维血管膜（FVM）上的术前新生血管变化模式进行量化。
对有可见FVM的PDR患者进行前瞻性观察研究，这些患者接受或未接受IVC。在IVC前以及IVC后1、3、5和7天通过OCTA评估新生血管变化。通过基于强度的光学微血管造影算法对血管骨架密度（SD）和血管密度（VD）进行量化。计算组内相关系数（ICC）以评估测量之间的一致性。在IVC组中使用重复测量分析比较随访期间的SD和VD。
新生血管的SD的ICC为0.992（95%置信区间[CI]：0.982 - 0.996），VD的ICC为0.926（95%CI：0.838 - 0.912）。与未接受IVC的患者（n = 8）相比，IVC组（n = 16）中FVM上的新生血管明显消退（SD的p = 0.001，VD的p < 0.001）。连续随访之间的比较显示，IVC后1天和3天SD和VD有统计学意义的降低。然而，从第3天起，SD和VD保持不变。IVC后7天内未发生牵拉性视网膜脱离的进展或发展。
基于OCTA对PDR患者FVM上的新生血管进行量化是可行的，读者间一致性高。新生血管的消退在IVC后3天达到平台期。
本试验在中国临床试验注册中心注册（http://www.chictr.org.cn，注册号ChiCTR - IPR - 17014160）。
