Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto City, Japan; and.
Department of Ophthalmology, Red Cross Otsu Hospital, Otsu City, Japan.
Retina. 2022 Jun 1;42(6):1020-1027. doi: 10.1097/IAE.0000000000003426.
The purpose of this study was to investigate the predictors of retinal pigment epithelium (RPE) tear development after treatment for neovascular age-related macular degeneration using swept source optical coherence tomography angiography.
This prospective study included 152 treatment-naïve eyes with neovascular age-related macular degeneration without high myopia that were followed up for 1 year after treatment. Eligible eyes were classified into eyes with or without RPE tear development. They were matched in a 1:2 ratio. The areas of choroidal neovascularization (CNV) and RPE detachment (pigment epithelial detachment [PED]) were measured from optical coherence tomography angiography and OCT en face images, respectively. The optical coherence tomography angiography-specific parameters representing CNV status were analyzed.
Eight (5.3%) of the 152 eyes developed RPE tears (RPE tear group). After matching, 16 eyes without RPE tears were analyzed (non-RPE tear group). The ratio of the CNV/PED area was lower in the RPE tear group than that in the non-RPE tear group (P = 0.007). The PED area was broader (P = 0.008), and PED height was greater in the RPE tear group (P = 0.04). Optical coherence tomography angiography-specific parameters did not differ between the two groups.
Neovascular age-related macular degeneration with pretreatment broad PED, high PED, and small CNV area relative to the PED area has a high risk of RPE tear development after therapy. However, CNV status may not have an association.
本研究旨在利用扫频源光相干断层扫描血管造影术(SS-OCTA)探讨治疗新生血管性年龄相关性黄斑变性(nAMD)后视网膜色素上皮(RPE)撕裂的预测因素。
本前瞻性研究纳入了 152 例未经治疗且无高度近视的 nAMD 患者,这些患者在治疗后随访 1 年。将有或无 RPE 撕裂的眼进行分类,按 1:2 比例进行匹配。通过 SS-OCTA 和 OCT 额状面图像分别测量脉络膜新生血管(CNV)和 RPE 脱离(色素上皮脱离 [PED])的面积。分析 SS-OCTA 特定参数以反映 CNV 状态。
152 只眼中有 8 只(5.3%)发生 RPE 撕裂(RPE 撕裂组)。经匹配后,对 16 只无 RPE 撕裂的眼进行分析(非 RPE 撕裂组)。RPE 撕裂组的 CNV/PED 面积比低于非 RPE 撕裂组(P=0.007)。RPE 撕裂组的 PED 面积更宽(P=0.008),PED 高度更高(P=0.04)。两组间 SS-OCTA 特定参数无差异。
治疗前 PED 宽、PED 高、CNV 面积与 PED 面积比小的 nAMD 患者在治疗后发生 RPE 撕裂的风险较高。但是,CNV 状态可能与 RPE 撕裂无关联。