Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.
Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Acta Ophthalmol. 2021 Mar;99(2):207-214. doi: 10.1111/aos.14525. Epub 2020 Jun 29.
To explore the short-term vascular and structural changes of type 3 neovascularization using optical coherence tomography angiography (OCT-A) when treated with a combination of photodynamic therapy (PDT) and intravitreal bevacizumab (IVB), and to evaluate the course of different sequences of the combined therapies.
Thirty eyes of 29 treatment-naïve patients with a type 3 neovascularization were included in this prospective observational cohort study. They were all treated with PDT and IVB 2 weeks apart, starting either with PDT (PDT-first group) or IVB (IVB-first group). Optical coherence tomography angiography (OCT-A) imaging was performed at week 0, 2, 4 and 18, and best corrected visual acuity (BCVA) at week 0 and 18. Vascular, structural and functional features were graded and analysed over time.
In all patients, at all follow-up visits, vascular and structural features were significantly more often decreased or resolved than unchanged or increased. Best corrected visual acuity (BCVA) significantly improved at 18 weeks. Vascular, structural and functional outcomes were all slightly better in the PDT-first group compared to the IVB-first group, although not statistically significant.
Combined treatment of PDT and IVB is effective in short-term for type 3 neovascularization based on vascular and structural features. Initial treatment with PDT tended to be more effective than with IVB.
使用光相干断层扫描血管造影术（OCT-A）探讨光动力疗法（PDT）联合玻璃体内贝伐单抗（IVB）治疗 3 型新生血管时的短期血管和结构变化，并评估联合治疗不同序贯的过程。
本前瞻性观察性队列研究纳入 29 例未经治疗的 3 型新生血管患者的 30 只眼。所有患者均接受 PDT 和 IVB 治疗，间隔 2 周，分别从 PDT（PDT 组）或 IVB（IVB 组）开始。在第 0、2、4 和 18 周进行光学相干断层扫描血管造影（OCT-A）成像，在第 0 和 18 周进行最佳矫正视力（BCVA）。对血管、结构和功能特征进行分级和随时间分析。
在所有患者的所有随访中，血管和结构特征较不变或增加更常减少或消退。18 周时最佳矫正视力（BCVA）显著提高。与 IVB 组相比，PDT 组的血管、结构和功能结局均略好，但无统计学意义。
基于血管和结构特征，PDT 和 IVB 联合治疗 3 型新生血管在短期内是有效的。初始治疗采用 PDT 比 IVB 更有效。
