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息肉样脉络膜血管病变患者的脉络膜厚度分布及临床结局

Choroidal thickness profile and clinical outcomes in eyes with polypoidal choroidal vasculopathy.

作者信息

Kim Young Ho, Lee Boram, Kang Edward, Oh Jaeryung

机构信息

Department of Ophthalmology, Korea University College of Medicine, 73 Inchon-ro, Sungbuk-ku, Seoul, 02841, South Korea.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Jul;259(7):1711-1721. doi: 10.1007/s00417-020-05051-6. Epub 2021 Jan 8.

DOI:10.1007/s00417-020-05051-6
PMID:33417092
Abstract

PURPOSE

To investigate the relationship between choroidal thickness (CT) profile and clinical outcomes after anti-vascular endothelial growth factor (VEGF) treatment in polypoidal choroidal vasculopathy (PCV).

METHODS

Medical records of patients diagnosed with PCV who received anti-VEGF treatment over 12 months were reviewed. Subfoveal CT (SFCT) and peripapillary CT (PCT) were measured on swept-source optical coherence tomography images. Patients were divided into various groups based on choroidal profiles including SFCT, nasal PCT (nPCT) and ratio of SFCT to nPCT (SFCT/nPCT). Clinical outcomes were compared between the thin and thick CT groups.

RESULTS

A total of 65 patients with PCV patients were included. After ant-VEGF treatment, SFCT was significantly decreased after anti-VEGF treatment (P = 0.001), but nasal PCT (nPCT) was not. Clinical outcomes were not different between the thin and thick SFCT groups. Total number of injections during the 12 months was significantly fewer in the thin nPCT group (3.4 ± 1.3) than in the thick nPCT group (4.5 ± 1.8) (P = 0.020). Complete resolution after loading injections was more frequently observed in the high SFCT/nPCT ratio (> 1.9) group (87.9%) than in the low SFCT/nPCT ratio (≤ 1.90) group (59.4%) (P = 0.009). The ratio of SFCT/nPCT showed the best predictive ability for poor responders (area under curve = 0.771).

CONCLUSION

These results suggest that baseline nPCT and SFCT/nPCT ratio could be a good biomarker that reflects clinical outcomes after anti-VEGF treatment in PCV.

摘要

目的

探讨息肉样脉络膜血管病变(PCV)患者抗血管内皮生长因子(VEGF)治疗后脉络膜厚度(CT)轮廓与临床结局之间的关系。

方法

回顾了12个月内接受抗VEGF治疗的PCV患者的病历。在扫频光学相干断层扫描图像上测量黄斑中心凹下CT(SFCT)和视乳头周围CT(PCT)。根据脉络膜轮廓将患者分为不同组,包括SFCT、鼻侧PCT(nPCT)以及SFCT与nPCT之比(SFCT/nPCT)。比较薄CT组和厚CT组的临床结局。

结果

共纳入65例PCV患者。抗VEGF治疗后,SFCT显著降低(P = 0.001),但鼻侧PCT(nPCT)未降低。薄SFCT组和厚SFCT组的临床结局无差异。薄nPCT组12个月内的总注射次数(3.4±1.3)明显少于厚nPCT组(4.5±1.8)(P = 0.020)。高SFCT/nPCT比值(>1.9)组(87.9%)比低SFCT/nPCT比值(≤1.90)组(59.4%)更频繁地观察到负荷注射后完全消退(P = 0.009)。SFCT/nPCT比值对无反应者显示出最佳预测能力(曲线下面积 = 0.771)。

结论

这些结果表明,基线nPCT和SFCT/nPCT比值可能是反映PCV患者抗VEGF治疗后临床结局的良好生物标志物。

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