Mori Hidetsugu, Yamada Haruhiko, Takahashi Kanji
Department of Ophthalmology, Kansai Medical University, 5-1, Shinmachi 2-chome, Hirakata, Osaka, Japan.
Graefes Arch Clin Exp Ophthalmol. 2020 Sep;258(9):1863-1869. doi: 10.1007/s00417-020-04760-2. Epub 2020 May 29.
To investigate factors contributing to the visual prognosis of choroidal neovascularization (CNV) secondary to angioid streaks (AS) in a long-term follow-up (> 5 years) study.
Twenty-one patients (32 eyes) affected by CNV secondary to AS were enrolled retrospectively and divided into three groups according to the period of CNV recurrence from the final treatment: group A, no recurrence for more than 12 months; group B, no recurrence for 6-12 months; and group C, no recurrence for < 6 months or ongoing. According to the above classification, we assessed best-corrected visual acuity (BCVA), peau d'orange area, the number of photodynamic treatments and/or intravitreal antiangiogenic drug injections, central choroidal thickness (CCT) and central retinal thickness (CRT) using optical coherence tomography, and enlargement of retinal pigment epithelium (RPE) atrophy.
The median follow-up time was 91 months. The median logarithm of the minimum angle of resolution BCVA significantly deteriorated from 0 at baseline to 1 at final follow-up (p < 0.05). Especially, final BCVA in group A showed worst visual outcome despite lowest number of treatments. Peau d'orange areas at baseline were found in 32 eyes (100%). There were no significant differences between initial CRT and final CRT. Median CCT was significantly reduced from 188 μm at baseline to 96 μm at final follow-up (p < 0.05). The median number of treatments was 3.5. Enlargement of RPE atrophy at baseline was found in 31 eyes (96.8%).
Despite the regression of CNV secondary to AS following treatment, the visual prognosis was poor due to the presence of peau d'orange areas, choroidal thinning, and increased RPE atrophy.
在一项长期随访（>5年）研究中，调查影响血管样条纹（AS）继发脉络膜新生血管（CNV）视觉预后的因素。
回顾性纳入21例（32只眼）AS继发CNV患者，根据末次治疗后CNV复发时间分为三组：A组，复发间隔超过12个月；B组，复发间隔6 - 12个月；C组，复发间隔<6个月或仍在复发。根据上述分类，我们使用光学相干断层扫描评估最佳矫正视力（BCVA）、橘皮样区域、光动力治疗和/或玻璃体内抗血管生成药物注射次数、中心脉络膜厚度（CCT）和中心视网膜厚度（CRT），以及视网膜色素上皮（RPE）萎缩扩大情况。
中位随访时间为91个月。最小分辨角对数视力的中位数从基线时的0显著恶化至末次随访时的1（p<0.05）。特别是，A组尽管治疗次数最少，但最终BCVA显示出最差的视觉结果。32只眼（100%）在基线时发现有橘皮样区域。初始CRT和最终CRT之间无显著差异。中位CCT从基线时的188μm显著降至末次随访时的96μm（p<0.05）。治疗次数中位数为3.5次。31只眼（96.8%）在基线时发现有RPE萎缩扩大。
尽管治疗后AS继发CNV有所消退，但由于存在橘皮样区域、脉络膜变薄和RPE萎缩增加，视觉预后较差。
