Department of Ophthalmology, Eye and ENT Hospital of Fudan University , Shanghai, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University , Shanghai, China.
Curr Eye Res. 2020 Dec;45(12):1556-1562. doi: 10.1080/02713683.2020.1767790. Epub 2020 May 22.
: To describe the optical coherence tomography angiography (OCTA) features of active inflammatory choroidal neovascularization (CNV) and characterize the early responses of anti-vascular endothelial growth factor (VEGF) treatment for inflammatory CNV. : OCT angiography images of inflammatory CNV were acquired and analyzed using the RTVue XR Avanti with AngioVue at baseline as well as fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT). OCTA scans were sequentially obtained 1 day before treatment, 1 day, 7 days, 14 days, and 30 days after anti-VEGF injection. Changes of the selected area and flow area of CNV on OCTA were measured along with those of the central macular thickness (CMT) on corresponding SD-OCT. : 19 eyes of 18 uveitic patients (mean age: 36.83 ± 10.05 years) presenting with active CNV were included in the prospective case series. The OCTA showed a 100% sensitivity for inflammatory CNV detection in 23 of 23 CNV lesions, revealing prevailing two neovascular phenotypes: vascular loops and intertwined nets. After anti-VEGF injection, as early as the 1-day follow-up, the mean selected area and the mean flow area of inflammatory CNV on OCTA were significantly reduced (both < .05) while the average CMT on SD-OCT did not change until the 7-day follow-up. OCTA was able to detect the reincrease of capillary density and vessel size predominantly in the second phenotype 14-30 days after anti-VEGF injection. : OCTA not only allows for noninvasive detection of inflammatory CNV with a high sensitivity but also facilitates its sequential observation after anti-VEGF treatment. The treatment outcomes are observable at day 1 post treatment. OCTA may be a useful tool for diagnosing inflammatory CNV and evaluating the early response to anti-VEGF treatment.
描述活性炎症性脉络膜新生血管（CNV）的光相干断层扫描血管造影（OCTA）特征，并对炎症性 CNV 的抗血管内皮生长因子（VEGF）治疗的早期反应进行特征描述。在基线时使用 RTVue XR Avanti 联合 AngioVue 采集和分析炎症性 CNV 的 OCT 血管造影图像，以及荧光素血管造影和谱域光相干断层扫描（SD-OCT）。在抗 VEGF 注射前 1 天、注射后 1 天、7 天、14 天和 30 天，依次进行 OCTA 扫描。测量 OCTA 上 CNV 的选定区域和血流区域的变化，以及相应 SD-OCT 上的中央黄斑厚度（CMT）的变化。本前瞻性病例系列纳入了 18 例（平均年龄 36.83 ± 10.05 岁）患有活动性 CNV 的葡萄膜炎患者的 19 只眼。OCTA 对 23 处 CNV 病变中的 23 处炎症性 CNV 的检测具有 100%的敏感性，显示出两种主要的新生血管表型：血管环和交织网。抗 VEGF 注射后，早在第 1 天的随访中，OCTA 上炎症性 CNV 的选定区域和血流区域的平均面积明显减小（均<0.05），而 SD-OCT 上的平均 CMT 直到第 7 天的随访才发生变化。在抗 VEGF 注射后 14-30 天，OCTA 能够检测到第二种表型中毛细血管密度和血管大小的重新增加。OCTA 不仅可以非侵入性地检测炎症性 CNV，而且具有较高的敏感性，还可以在抗 VEGF 治疗后对其进行连续观察。治疗结果可在治疗后第 1 天观察到。OCTA 可能是诊断炎症性 CNV 和评估抗 VEGF 治疗早期反应的有用工具。
