Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
Medical Science Research Center, Korea University College of Medicine, Seoul, South Korea.
Sci Rep. 2019 Oct 2;9(1):14153. doi: 10.1038/s41598-019-50637-8.
We aimed to evaluate the relationship between the capillary abnormalities including nonperfusion area (NPA) in optical coherence tomography angiography (OCTA) images and the recurrence of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF; bevacizumab). The records of 40 patients who underwent intravitreal bevacizumab injection for ME secondary to BRVO and had at least six months of follow-up were reviewed. Central retinal thickness (CRT; μm) and macular edema type were evaluated prior to treatment. After ME resolution, nonperfusion areas in the 1 mm (NPA1) and 1-3 mm (NPA3) zones on the Early Treatment Diabetic Retinopathy Study (ETDRS) circle within the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using OCTA images. Furthermore, other microvascular abnormalities in the both SCP and DCP were compared between groups. ME recurred in 25 of 40 (62.5%) eyes. The NPA1 of the SCP and DCP (p = 0.002, 0.004, respectively), NPA3 of the SCP and DCP (p = 0.002, 0.008, respectively), and initial CRT (p = 0.022) differed significantly between eyes with and without ME recurrence. In multivariate logistic regression analyses, the NPA1 of the DCP (OR: 344.718; p = 0.029) and NPA3 of the SCP (OR: 4.072; p = 0.018) were significantly associated with ME recurrence. Other microvascular abnormalities were not significantly different between two groups. The central NPA and parafoveal NPA of the SCP in OCTA images correlated strongly with ME recurrence in BRVO patients after intravitreal anti-VEGF injection.
我们旨在评估光学相干断层扫描血管造影（OCTA）图像中的毛细血管异常（包括无灌注区[NPA]）与分支静脉阻塞（BRVO）继发的黄斑水肿（ME）复发之间的关系，这些患者接受了玻璃体内抗血管内皮生长因子（抗-VEGF；贝伐单抗）注射治疗。回顾了 40 例因 BRVO 继发 ME 接受玻璃体内贝伐单抗注射治疗且至少随访 6 个月的患者记录。在治疗前评估了中央视网膜厚度（CRT；μm）和黄斑水肿类型。在 ME 消退后，使用 OCTA 图像测量了浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）内 ETDRS 环上 1mm（NPA1）和 1-3mm（NPA3）区内的无灌注区。此外，还比较了两组 SCP 和 DCP 中其他微血管异常。40 只眼中有 25 只（62.5%）复发 ME。SCP 和 DCP 的 NPA1（p=0.002，0.004）、SCP 和 DCP 的 NPA3（p=0.002，0.008）和初始 CRT（p=0.022）在有和无 ME 复发的眼中差异有统计学意义。在多变量逻辑回归分析中，DCP 的 NPA1（OR：344.718；p=0.029）和 SCP 的 NPA3（OR：4.072；p=0.018）与 ME 复发显著相关。两组之间其他微血管异常无显著差异。OCTA 图像中 SCP 的中央 NPA 和旁中心 NPA 与 BRVO 患者玻璃体内抗-VEGF 注射后 ME 复发密切相关。
