Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Graefes Arch Clin Exp Ophthalmol. 2021 Sep;259(9):2671-2677. doi: 10.1007/s00417-021-05127-x. Epub 2021 Mar 2.
To determine the characteristics of eyes with treatment-naïve quiescent choroidal neovascularization (CNV) detected by optical coherence tomography angiography (OCTA).
Thirty-eight eyes of 37 treatment-naïve consecutive patients (30 men, 7 women, average 69.8 years) were studied. Quiescent CNVs were detected by OCTA (RTVue XR Avanti, Optovue, Fremont, CA) in all eyes. Swept-source OCT (SS-OCT; DRI-OCT, Topcon, Japan) confirmed the absence of exudation. The symptoms, visual acuity, CNV size, and status of the fellow eye were evaluated. Patients were followed longitudinally and the length of follow-up period and development of exudation were recorded for each patient. We also investigated patients' medical records from their referral hospitals in search of prior exudation.
All eyes with quiescent CNV were diagnosed at the initial visit with sub-retinal pigment epithelium CNVs, i.e., type 1 CNV, from the OCT and OCTA images. Prior exudation was confirmed in 15 eyes (39.5%) from their medical records of the referral hospitals. Symptoms were present in 18 eyes (47.3%). An exudative CNV was present in 12 of the fellow eyes. Exudation developed in 12 eyes (31.6%) during an average follow-up period of 25.1 months. One-half of the eyes had a prior exudation. The CNV at the baseline in eyes that developed exudation during the follow-up period was larger than eyes without exudation; however, the difference was not significant (0.59±0.47 vs 0.48±0.32 mm, P = 0.50).
Quiescent CNVs will develop exudation in approximately 30% of the eyes during a mean 2-year follow-up period. These findings must be remembered when investigating quiescent CNVs that could not be distinguished from eyes with former active CNV and naturally deactivate CNV.
确定光学相干断层扫描血管造影（OCTA）检测到的未经治疗的静止性脉络膜新生血管（CNV）的眼部特征。
研究了 37 例连续未经治疗的患者（30 名男性，7 名女性，平均 69.8 岁）的 38 只眼。所有眼睛均通过 OCTA（RTVue XR Avanti、Optovue、加利福尼亚州弗里蒙特）检测到静止性 CNV。扫频源 OCT（SS-OCT；DRI-OCT，Topcon，日本）证实无渗出。评估了症状、视力、CNV 大小和对侧眼的状态。对患者进行纵向随访，并记录每位患者的随访时间和渗出的发展情况。我们还从转诊医院的病历中调查了患者的既往渗出情况。
所有静止性 CNV 均在初始就诊时通过 OCT 和 OCTA 图像诊断为视网膜下色素上皮 CNV，即 1 型 CNV。从转诊医院的病历中确认了 15 只眼（39.5%）有既往渗出。18 只眼（47.3%）存在症状。12 只对侧眼存在渗出性 CNV。在平均 25.1 个月的随访期间，12 只眼（31.6%）出现渗出。有一半的眼睛有既往渗出。在随访期间发生渗出的眼睛的基线 CNV 比没有渗出的眼睛大；然而，差异无统计学意义（0.59±0.47 对 0.48±0.32mm，P=0.50）。
在平均 2 年的随访期间，约 30%的未经治疗的静止性 CNV 会发展为渗出。在调查无法与既往活动性 CNV 和自然失活性 CNV 区分的静止性 CNV 时，必须记住这些发现。
