Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei, Taiwan.
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Sci Rep. 2021 Sep 10;11(1):18068. doi: 10.1038/s41598-021-97652-2.
To investigate choroidal neovascularization (CNV) characteristics after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with neovascular age-related macular degeneration by optical coherence tomography angiography (OCTA) and to assess the potential predictive role of combined qualitative and quantitative biomarkers for disease activity. Patients diagnosed with type 1 or type 2 CNV via multimodal imaging who had received anti-VEGF treatment were retrospectively reviewed. Qualitative and quantitative CNV responses on OCTA after serial injections were analyzed. The enrolled eyes were divided into two groups based on treatment intervals during follow-up, including an active group with less than 12 weeks intervals and a stable group with 12 weeks or longer intervals. Fifty-six eyes of 56 patients were included in the study. Twenty-seven eyes (48.2%) were classified as the "active group", and 29 eyes (51.8%) were categorized as the "silent group". Qualitative biomarkers of CNV showed significant differences between the two groups (branching capillaries: 48.1% vs 6.9%, p = 0.001; anastomoses and loops: 81.5% vs 13.8%, p < 0.001; peripheral arcade: 40.7% vs 10.3%, p = 0.013, and hypointense halo: 81.5% vs 41.4%, p = 0.002). A significantly higher vessel density was found in the active group (median 39.6% vs 30.5%, p = 0.003). "Anastomoses and loops" and "vessel density" predicted an active CNV status with a probability of 93.7% and achieved the best performance. The combination of two potential biomarkers of CNV on OCTA shows good discrimination for the prediction of recurrent exudation auxiliary to structural OCT that might associate with disease activity.
利用光相干断层扫描血管造影术（OCTA）研究抗血管内皮生长因子（anti-VEGF）治疗后新生血管性年龄相关性黄斑变性患者脉络膜新生血管（CNV）的特征，并评估定性和定量生物标志物联合对疾病活动性的潜在预测作用。回顾性分析经多模态成像诊断为 1 型或 2 型 CNV 且接受抗 VEGF 治疗的患者。分析了连续注射后 OCTA 上 CNV 的定性和定量反应。根据随访期间的治疗间隔，将纳入的眼睛分为两组，包括间隔小于 12 周的活跃组和间隔 12 周或更长时间的稳定组。该研究纳入了 56 例 56 只眼。27 只眼（48.2%）被归类为“活跃组”，29 只眼（51.8%）归类为“沉默组”。CNV 的定性生物标志物在两组之间存在显著差异（分支毛细血管：48.1%比 6.9%，p=0.001；吻合和环：81.5%比 13.8%，p<0.001；周边拱廊：40.7%比 10.3%，p=0.013，低信号晕：81.5%比 41.4%，p=0.002）。活跃组的血管密度显著升高（中位数 39.6%比 30.5%，p=0.003）。“吻合和环”和“血管密度”对活跃型 CNV 状态的预测概率为 93.7%，表现最佳。OCTA 上两个 CNV 潜在生物标志物的组合对复发渗出物的预测具有良好的区分能力，可能与疾病活动相关。
