Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Duke-NUS Medical School, Singapore, National University of Singapore, Singapore; and.
Retina. 2022 Jan 1;42(1):114-122. doi: 10.1097/IAE.0000000000003285.
To evaluate whether optical coherence tomography (OCT) can determine polypoidal lesion (PL) perfusion in polypoidal choroidal vasculopathy eyes after 12 months of aflibercept monotherapy. Polypoidal lesion perfusion status, assessed by indocyanine green angiography, is an important anatomical outcome in polypoidal choroidal vasculopathy management.
Post hoc data from a prospective randomized, open-label, study in eyes with polypoidal choroidal vasculopathy undergoing monotherapy with aflibercept evaluated PL perfusion status based on indocyanine green angiography (gold standard) and OCT features from baseline to 12 months.
Individual PLs (110 in total) from 48 eyes (48 patients) showed at 12 months; 57/110 PLs (51.8%) were closed on indocyanine green angiography. At 12 months, eyes with closed PLs were more likely to have the following OCT features: 1) no subretinal fluid (67.1% vs. 32.9%), 2) smaller pigment epithelial detachment height (67.2 [±43.8] vs. 189.2 [±104.9] μm), 3) densely hyperreflective pigment epithelial detachment contents (84.0% vs. 16.0%), 4) an absence of a hyperreflective ring(64.0% vs. 36.0%), and a 5) indistinct overlying retinal pigment epithelial (71.4% vs. 28.6%) (all P < 0.05). The three highest performing OCT features that differentiated perfused from closed PLs were (1), (3), and (4) (area under the receiver operating characteristic curve 0.85, 0.73, and 0.70, respectively). A combination of these three features achieved an area under the receiver operating characteristic curve of 0.90.
Polypoidal lesion closure, an important anatomical treatment outcome in polypoidal choroidal vasculopathy typically defined by indocyanine green angiography, can be accurately detected by specific OCT features.
评估光学相干断层扫描（OCT）能否在接受阿柏西普单药治疗 12 个月后确定息肉样脉络膜血管病变（PCV）眼中的息肉样病变（PL）灌注情况。通过吲哚菁绿血管造影评估的 PL 灌注状态是 PCV 管理中的一个重要解剖学结果。
对接受阿柏西普单药治疗的 PCV 患者进行的前瞻性随机、开放标签、研究的事后数据分析，根据吲哚菁绿血管造影（金标准）和基线至 12 个月的 OCT 特征评估 PL 灌注情况。
48 只眼（48 例患者）的 110 个单独 PL 在 12 个月时显示；110 个 PL 中有 57 个（51.8%）在吲哚菁绿血管造影上闭合。在 12 个月时，PL 闭合的眼睛更可能具有以下 OCT 特征：1）无视网膜下积液（67.1%对 32.9%），2）较小的色素上皮脱离高度（67.2[±43.8]μm 对 189.2[±104.9]μm），3）浓密高反射性色素上皮脱离内容物（84.0%对 16.0%），4）无高反射性环（64.0%对 36.0%），5）覆盖的视网膜色素上皮不明显（71.4%对 28.6%）（均 P<0.05）。区分灌注与未灌注 PL 的三个性能最高的 OCT 特征分别为（1）、（3）和（4）（受试者工作特征曲线下面积分别为 0.85、0.73 和 0.70）。这三个特征的组合获得了 0.90 的受试者工作特征曲线下面积。
PCV 中典型的重要解剖学治疗结果息肉样病变（PL）闭合，通常通过吲哚菁绿血管造影定义，可通过特定的 OCT 特征准确检测到。
