Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore; Save Sight Institute, University of Sydney, Camperdown, Australia.
Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore.
Ophthalmol Retina. 2021 Feb;5(2):126-140. doi: 10.1016/j.oret.2020.07.005. Epub 2020 Jul 14.
To describe the systemic and ocular features of fellow eyes' association with nonexudative neovascularization (NV) based on OCT angiography (OCTA) and to identify longitudinal morphologic changes associated with progression to exudation.
Cohort study of contralateral eye in patients with neovascular age-related macular degeneration (nAMD) in 1 eye.
Patients with nAMD in one eye were eligble for inclusion and enrolled between June 2015 and Jan 2017. The study eye was the contralateral eye that was free of nAMD with a minimum follow-up of 1 year.
Progressive multimodal imaging was performed on both eyes. Nonexudative NV was detected on OCTA in the study eye and quantitative changes analyzed. Nonexudative NV eyes were divided into progression to exudation or not during a minimum of 12 months follow-up.
Association between systemic and ocular characteristics with nonexudative NV were determined. Change in OCTA size, vessel density, and vessel length density were compared between visits as predictors of progression to exudation.
Among 229 study eyes, 21 (9.1%) had nonexudative NV detected on OCTA at baseline. Hyperlipidemia (adjusted odds ratio [AOR], 1.3; 95% confidence interval [CI], 1.10-3.20; P = 0.04), triglycerides (AOR, 2.84 per mmol/L; 95% CI, 1.06-4.35 per mmol/L; P = 0.02), and baseline lesion size in the presenting eye (AOR, 1.6 per 500 μm; 95% CI, 1.21-3.25 per 500 μm; P = 0.03) were associated significantly with nonexudative NV in the study eye. In the study eye nonexudative NV group, 8 (38%) progressed to exudation, with a mean time to exudation of 377 ± 138 days. The progressor group had larger baseline NV size (1834 ± 552.8 μm vs. 910 ± 461.7 μm; P < 0.01), higher increase in vessel density/year (8.3 ± 4.1%/year vs. 1.1 ± 2.5%/year; P ≤ 0.01), and higher increase in vessel length density/year (15.6 ± 10.6% vs. 1.9 ± 3.6%; P = 0.02). The change in lesion size per year was similar in both groups.
Patients with nonexudative NV in the study eye had significant differences in ocular and systemic characteristics. More than a third of study eyes with nonexudative NV at baseline progressed to exudation, suggesting that close monitoring is essential. OCT angiography features associated with exudation include a larger baseline lesion size, increase in vessel density, and vessel length density.
根据 OCT 血管造影（OCTA）描述与非渗出性新生血管（NV）相关的对侧眼的系统和眼部特征，并确定与渗出进展相关的纵向形态变化。
对一只眼患有新生血管性年龄相关性黄斑变性（nAMD）的患者的对侧眼进行的队列研究。
患有 nAMD 的患者被纳入研究，纳入时间为 2015 年 6 月至 2017 年 1 月。研究眼为无 nAMD 的对侧眼，随访时间至少为 1 年。
对双眼进行了进行性多模式成像。在研究眼中使用 OCTA 检测非渗出性 NV，并分析定量变化。在至少 12 个月的随访期间，将非渗出性 NV 眼分为进展为渗出或不进展为渗出。
确定与非渗出性 NV 相关的系统和眼部特征之间的关系。比较各次就诊时 OCTA 大小、血管密度和血管长度密度的变化，以预测渗出进展。
在 229 只研究眼中，21 只（9.1%）在基线时通过 OCTA 检测到非渗出性 NV。高脂血症（校正优势比 [AOR]，1.3；95%置信区间 [CI]，1.10-3.20；P=0.04）、甘油三酯（AOR，2.84 每 mmol/L；95% CI，每 mmol/L 1.06-4.35；P=0.02）和首发眼中的基线病变大小（AOR，每 500μm 增加 1.6；95% CI，每 500μm 增加 1.21-3.25；P=0.03）与研究眼中的非渗出性 NV 显著相关。在研究眼的非渗出性 NV 组中，8 只（38%）进展为渗出，渗出的平均时间为 377±138 天。进展组的基线 NV 大小更大（1834±552.8μm vs. 910±461.7μm；P<0.01），血管密度/年增加更高（8.3±4.1%/年 vs. 1.1±2.5%/年；P≤0.01），血管长度密度/年增加更高（15.6±10.6% vs. 1.9±3.6%；P=0.02）。两组的病变大小年增长率相似。
研究眼中患有非渗出性 NV 的患者在眼部和全身特征方面存在显著差异。超过三分之一的研究眼在基线时存在非渗出性 NV，这表明需要密切监测。与渗出相关的 OCTA 特征包括更大的基线病变大小、血管密度和血管长度密度增加。
