Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan .
Retina. 2022 May 1;42(5):942-948. doi: 10.1097/IAE.0000000000003395.
To evaluate the changes of blood circulation within the polypoidal lesions by OCT angiography in eyes with polypoidal choroidal vasculopathy after combination therapy with aflibercept and photodynamic therapy.
A total of 46 eyes from 46 patients who underwent the combination therapy for polypoidal choroidal vasculopathy were followed for more than 6 months. OCT angiography, covering an area 6 mm2 × 6 mm2 including the macula, were performed at baseline, 2 weeks, and 3 months and 6 months post-treatment.
The subretinal fluid resolved within 3 months after treatment in 44 eyes (95.7%), and 27 eyes (58.7%) showed no recurrence, with no additional treatment. Seventeen eyes (37.0%) showed recurrence, and two eyes (4.3%) showed poor response. On OCT angiography at 2 weeks after treatment, flow signals were detected in 3 of 27 eyes (11.1%) without recurrence and in 8 of 19 eyes (42.1%) with recurrence or poor responses. A detectable flow signal at 2 weeks was significantly associated with recurrence or poor response (P = 0.032).
Persistent flow signals within polyps on OCT angiography at 2 weeks after combination therapy suggest less effectiveness of the initial treatment.
通过 OCT 血管造影评估接受抗 VEGF 联合光动力疗法治疗后的息肉状脉络膜血管病变患者息肉状病变内血液循环的变化。
对 46 例（46 只眼）接受抗 VEGF 联合光动力疗法治疗的息肉状脉络膜血管病变患者进行了超过 6 个月的随访。在基线、治疗后 2 周、3 个月和 6 个月时进行 OCT 血管造影检查，覆盖黄斑区 6mm2×6mm2 区域。
44 只眼（95.7%）的视网膜下液在治疗后 3 个月内消退，27 只眼（58.7%）无复发，无需额外治疗。17 只眼（37.0%）出现复发，2 只眼（4.3%）出现治疗反应不佳。在治疗后 2 周的 OCT 血管造影检查中，无复发的 27 只眼中有 3 只（11.1%）眼和复发或治疗反应不佳的 19 只眼中有 8 只（42.1%）眼检测到血流信号。在 2 周时检测到血流信号与复发或治疗反应不佳显著相关（P=0.032）。
治疗后 2 周 OCT 血管造影检查显示息肉内持续存在血流信号提示初始治疗效果不佳。
