Zhu Juming, Peng Qing, Su Tu, Wang Minli, Wang Fang
Department of Ophthalmology, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.
Department of Ophthalmology, The Fourth Affiliated Hospital of Nantong University, Yancheng City No. 1 People's Hospital, Yancheng, Jiangsu 224000, P.R. China.
Exp Ther Med. 2021 Jan;21(1):59. doi: 10.3892/etm.2020.9491. Epub 2020 Nov 19.
In the present study, the efficacy of three consecutive anti-VEGF treatments in patients with neovascular macular degeneration (nAMD) was assessed by optical coherence tomography angiography (OCT-A). A total of 23 eyes with nAMD were treated with intravitreal injections (IVIs) of ranibizumab once a month for three consecutive months. There were eight follow-up time-points: Prior to the initial IVI and on days 1, 3, 7, 14, 30, 60 and 90 after the first IVI. The follow-up examinations consisted of measurements of the best-corrected visual acuity (BCVA), the height of retinal pigmented epithelium detachment (RPED), the greatest linear dimension (GLD), choroidal neovascularization (CNV) flow area, whole retinal thickness and four-quadrant retinal thickness. The results indicated that, when compared with the baseline, the BCVA gradually improved after IVI and improved significantly on days 60 and 90 (P<0.05); the RPED and GLD improved after IVI, with a significant improvement on days 30, 60 and 90 (all, P<0.05); the CNV flow area was gradually shortened in the early stage after IVI but rebounded on day 30, while the difference was statistically significant on day 14 (P<0.05). The temporal retinal thickness was statistically significant on day 30 (P<0.05) and there were statistically significant differences in nasal and inferior retinal thickness on days 14 and 30 compared with prior to IVI (all, P<0.05). The BCVA was positively correlated with the RPED, GLD, CNV flow area and nasal retinal thickness (all, P<0.05). In conclusion, OCT-A may provide an effective reference to guide the evaluation, treatment and monitoring of nAMD. The present study was registered in the Chinese Clinical Trial Registry (CChiTR; no. ChiCTR1900023607; http://www.chictr.org.cn/listbycreater.aspx).
在本研究中,通过光学相干断层扫描血管造影(OCT-A)评估了连续三次抗血管内皮生长因子(VEGF)治疗对新生血管性黄斑变性(nAMD)患者的疗效。共有23只患nAMD的眼睛接受了玻璃体内注射(IVI)雷珠单抗治疗,每月一次,连续三个月。有八个随访时间点:初次IVI前以及首次IVI后的第1、3、7、14、30、60和90天。随访检查包括测量最佳矫正视力(BCVA)、视网膜色素上皮脱离(RPED)的高度、最大线性尺寸(GLD)、脉络膜新生血管(CNV)血流面积、整个视网膜厚度和四个象限的视网膜厚度。结果表明,与基线相比,IVI后BCVA逐渐改善,在第60天和第90天显著改善(P<0.05);IVI后RPED和GLD改善,在第30、60和90天有显著改善(均P<0.05);IVI后早期CNV血流面积逐渐缩短,但在第30天反弹,而在第14天差异有统计学意义(P<0.05)。颞侧视网膜厚度在第30天有统计学意义(P<0.05),与IVI前相比,在第14天和第30天鼻侧和下方视网膜厚度有统计学意义的差异(均P<0.05)。BCVA与RPED、GLD、CNV血流面积和鼻侧视网膜厚度呈正相关(均P<0.05)。总之,OCT-A可为指导nAMD的评估、治疗和监测提供有效的参考。本研究已在中国临床试验注册中心注册(CChiTR;编号:ChiCTR1900023607;http://www.chictr.org.cn/listbycreater.aspx)。