Retina Disorders and Ophthalmic Genetics, Stein Eye Institute, University of California-Los Angeles, Los Angeles, California, United States.
Department of Ophthalmology, St. Franziskus-Hospital, Münster, Germany.
Invest Ophthalmol Vis Sci. 2019 Aug 1;60(10):3310-3319. doi: 10.1167/iovs.18-26478.
To analyze the evolution of type 1 neovascularization associated with vascularized serous pigment epithelial detachment (vsPED) using three-dimensional, volumetric, en face optical coherence tomography angiography (OCTA).
This was a retrospective case series from four tertiary medical centers. OCTA images were analyzed at baseline and at the 3-, 6-, 12-, 18-, and 24-month follow-up visit when available. Visual acuity, number of injections, PED maximal height and PED area and volume, and choroidal neovascularization (CNV) flow area and progression were determined at each visit. Qualitative and quantitative analysis of CNV progression (including CNV/PED flow area) and final PED morphology was performed to determine anatomic outcomes.
Twenty-four eyes in 22 patients were studied. Median follow-up was 20 months. Across all eyes, maximum PED height decreased from 395.5 to 369.5 μm while CNV/PED flow ratio increased from 27.3% to 40.2%. Median visual acuity was unchanged at 20/40. Final PED outcomes included filled fibrovascular versus persistent vsPED. Filled vsPEDs decreased in PED height and volume and displayed a multilayered morphology in contrast to persistent vsPEDs. Fibrovascular PEDs received on average seven less injections as compared to persistent vsPEDs.
Three-dimensional, volumetric, en face OCTA analysis of vsPED progression illustrated two anatomic outcomes: filled, typically multilayered fibrovascular PED versus persistent vsPED. The filled multilayered PED displayed a reduction in PED height and volume, greater CNV/PED flow ratio, and fewer anti-VEGF injections versus the persistent vsPED and may represent a more stable anatomic outcome while the persistent vsPED may indicate a more unstable morphology.
使用三维、容积、面光相干断层扫描血管造影（OCTA）分析与血管化浆液性色素上皮脱离（vsPED）相关的 1 型新生血管的演变。
这是来自四个三级医疗中心的回顾性病例系列研究。在基线和 3、6、12、18 和 24 个月的随访时（如有）分析 OCTA 图像。在每次就诊时确定视力、注射次数、PED 最大高度和 PED 面积和体积以及脉络膜新生血管（CNV）流量面积和进展情况。进行 CNV 进展（包括 CNV/PED 流量面积）和最终 PED 形态的定性和定量分析，以确定解剖结果。
22 例患者的 24 只眼进行了研究。中位随访时间为 20 个月。所有眼的最大 PED 高度从 395.5μm 下降到 369.5μm，而 CNV/PED 流量比从 27.3%增加到 40.2%。中位数视力保持在 20/40。最终 PED 结果包括填充的纤维血管化与持续 vsPED。与持续 vsPED 相比，填充的 vsPED 在 PED 高度和体积上减小，并显示出多层形态。纤维血管化 PED 平均接受的注射次数比持续 vsPED 少 7 次。
对 vsPED 进展的三维、容积、面 OCTA 分析表明存在两种解剖结果：填充的、典型的多层纤维血管化 PED 与持续 vsPED。填充的多层 PED 显示 PED 高度和体积减小、更大的 CNV/PED 流量比和更少的抗 VEGF 注射次数，与持续 vsPED 相比，可能代表更稳定的解剖结果，而持续 vsPED 可能表明更不稳定的形态。
