Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
Department of Bioengineering, University of Washington, Seattle, Washington, United States.
Invest Ophthalmol Vis Sci. 2021 Dec 1;62(15):5. doi: 10.1167/iovs.62.15.5.
Swept-source optical coherence tomography angiography was used to investigate choroidal changes and their association with pigment epithelial detachments (PEDs) in eyes with polypoidal choroidal vasculopathy (PCV) after treatment with vascular endothelial growth factor (VEGF) inhibitors.
Patients with treatment-naïve PCV were included and underwent anti-VEGF therapy. Mean choroidal thickness (MCT), choroidal vascularity index (CVI), and PED volume measurements were obtained before and after treatment.
Thirty-four treatment-naïve PCV eyes from 33 patients were included. The PED volume decreased after treatment (P < 0.05). The MCT decreased from 223.0 ± 79.6 µm at baseline to 210.9 ± 76.2 µm after treatment (P < 0.001). The CVI at baseline was 0.599 ± 0.024, and the CVI after treatment was 0.602 ± 0.023 (P = 0.16). There was a correlation between the decreased PED volumes and the decreased MCT measurements (r = 0.47; P = 0.006). Also, there was a correlation between the decreased PED volumes and the increased CVI measurements (r = -0.63; P < 0.001).
In treatment-naïve eyes with PCV, the decreases in PED volumes were correlated with the decrease in MCT and the increase in CVI measurements. We propose that, at baseline, the PCV lesions serve as high-volume arteriovenous shunts between choroidal arterial and venous circulation, causing transudation into the choroidal stroma. We propose that, after treatment, the blood flow through the vascular shunt is reduced, the excess stromal transudation is resorbed, and the exudation from the neovascular lesion is reduced, resulting in thinning of the choroid, resolution of the PEDs, and an increase in the CVI due to the resorption of excess choroidal transudation.
应用扫频源光相干断层扫描血管造影术观察脉络膜变化及其与脉络膜新生血管（PCV）患者接受血管内皮生长因子（VEGF）抑制剂治疗后色素上皮脱离（PED）的关系。
纳入未经治疗的 PCV 患者，并进行抗 VEGF 治疗。治疗前后分别进行平均脉络膜厚度（MCT）、脉络膜血管指数（CVI）和 PED 体积测量。
纳入 33 例 34 只未经治疗的 PCV 眼。治疗后 PED 体积减小（P < 0.05）。MCT 从基线时的 223.0 ± 79.6 µm 降至治疗后的 210.9 ± 76.2 µm（P < 0.001）。基线时 CVI 为 0.599 ± 0.024，治疗后为 0.602 ± 0.023（P = 0.16）。PED 体积的减小与 MCT 测量值的减小呈正相关（r = 0.47；P = 0.006）。此外，PED 体积的减小与 CVI 测量值的增加呈负相关（r = -0.63；P < 0.001）。
在未经治疗的 PCV 眼中，PED 体积的减小与 MCT 的减小和 CVI 测量值的增加有关。我们提出，在基线时，PCV 病变充当脉络膜动脉和静脉循环之间高容量动静脉分流，导致渗出到脉络膜基质中。我们提出，在治疗后，血管分流的血流减少，多余的基质渗出被吸收，新生血管病变的渗出减少，导致脉络膜变薄，PED 消退，以及由于多余脉络膜渗出的吸收，CVI 增加。
