The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cleveland Clinic, Cleveland, Ohio, United States.
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States.
Invest Ophthalmol Vis Sci. 2022 Jun 1;63(6):17. doi: 10.1167/iovs.63.6.17.
To evaluate the association of fluid volatility with ellipsoid zone (EZ) integrity and subretinal hyperreflective material (SHRM) volume during anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (nAMD).
This study was a post hoc analysis of the OSPREY study. Retinal volatility was quantified as the standard deviation across weeks 12 to 56 for six optical coherence tomography (OCT) metrics: central subfield thickness (CST), total fluid (TF) volume, subretinal fluid (SRF) volume, intraretinal fluid (IRF) volume, macular total retinal fluid index (TRFI), and central macular TRFI. Eyes with volatility ≤ 25th or ≥ 75th percentile values were compared.
Eyes with low volatility in several exudative metrics showed greater change from baseline in SHRM volume at week 12 than eyes with high volatility. During the maintenance phase (weeks 12-56), eyes exhibiting high SRF volatility demonstrated increased SHRM volume compared to eyes with low SRF volatility (P = 0.027). Eyes exhibiting high volatility in CST, TF, and SRF demonstrated less improvement in EZ total attenuation (P < 0.001, P = 0.033, and P = 0.043, respectively) than eyes with low volatility. Early exudative instability (i.e., between weeks 4-8 or weeks 8-12) in multiple parameters (i.e., CST, TF, IRF, macular TRFI, or central macular TRFI) was associated with greater volatility during the maintenance phase (P < 0.05).
Greater volatility in exudative OCT metrics, particularly SRF volatility, was associated with a greater increase in SHRM and less improvement in EZ integrity, suggesting that volatility is detrimental to multiple anatomic features in nAMD. Early exudative instability during the loading phase of treatment was associated with longer-term volatility in exudation.
评估在新生血管性年龄相关性黄斑变性（nAMD）的抗血管内皮生长因子（VEGF）治疗期间，液体内含物波动性与椭圆体带（EZ）完整性和视网膜下高反射物质（SHRM）体积之间的相关性。
这是 OSPREY 研究的事后分析。使用 6 项光学相干断层扫描（OCT）指标的标准差（12 至 56 周）来量化视网膜内的液体内含物波动性：中央视网膜神经纤维层厚度（CST）、总液体积（TF）、视网膜下液体积（SRF）、视网膜内液体积（IRF）、黄斑区总视网膜液指数（TRFI）和中央黄斑区 TRFI。比较波动性处于第 25 百分位数和第 75 百分位数以下或以上的眼。
在几种渗出性指标中，波动性较低的眼在第 12 周时 SHRM 体积的变化大于波动性较高的眼。在维持阶段（12-56 周），表现出高 SRF 波动性的眼与低 SRF 波动性的眼相比，SHRM 体积增加（P = 0.027）。在 CST、TF 和 SRF 中表现出高波动性的眼与低波动性的眼相比，EZ 总衰减的改善程度较小（P < 0.001、P = 0.033 和 P = 0.043）。在多个参数（CST、TF、IRF、黄斑区 TRFI 或中央黄斑区 TRFI）中，在早期（4-8 周或 8-12 周）存在渗出性不稳定性，与维持阶段的波动性更大相关（P < 0.05）。
在渗出性 OCT 指标中，尤其是 SRF 波动性更大，与 SHRM 更大的增加和 EZ 完整性的改善较小相关，这表明波动性对 nAMD 的多个解剖特征不利。在治疗的加载阶段早期渗出性不稳定与长期渗出性波动相关。
