Tang Wenyi, Liu Wei, Guo Jingli, Zhang Lili, Xu Gezhi, Wang Keyan, Chang Qing
Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
Eye Vis (Lond). 2022 Jul 2;9(1):25. doi: 10.1186/s40662-022-00297-z.
The aim of the study was to investigate the changes in the periarterial capillary-free zone (paCFZ) after anti-vascular endothelial growth factor (VEGF) therapy in patients with branch retinal vein occlusion (BRVO) by wide-field swept-source optical coherence tomography angiography (SS-OCTA) and assess their associations with clinical outcomes.
In this retrospective observational study of 54 treatment-naïve BRVO patients with macular edema, we reviewed the findings of 12 × 12 mm SS-OCTA at baseline, 3, 6, and 12 months after intravitreal ranibizumab injections. The paCFZ and major retinal artery areas were measured on SS-OCTA images. The paCFZ area to artery area (P/A) ratio was calculated.
The paCFZ areas and P/A ratios of first- and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes (all P < 0.01), but there were no differences in the first- and second-order artery areas (P = 0.20 and 0.25, respectively). The paCFZ areas and P/A ratios decreased significantly at 3, 6, and 12 months after anti-VEGF therapy (all P < 0.01). The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity (BCVA), central retinal thickness, and their improvements at 3, 6, and 12 months (all P < 0.05). Baseline BCVA and P/A ratios of first- and second-order arteries were independently associated with the final BCVA in multivariate linear regression.
Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO. Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.
本研究旨在通过广角扫频源光学相干断层扫描血管造影（SS-OCTA）研究视网膜分支静脉阻塞（BRVO）患者抗血管内皮生长因子（VEGF）治疗后动脉周围无毛细血管区（paCFZ）的变化，并评估其与临床结局的相关性。
在这项对54例初治黄斑水肿型BRVO患者的回顾性观察研究中，我们回顾了玻璃体内注射雷珠单抗后基线、3个月、6个月和12个月时12×12 mm SS-OCTA的检查结果。在SS-OCTA图像上测量paCFZ和主要视网膜动脉面积。计算paCFZ面积与动脉面积（P/A）之比。
BRVO患眼一级和二级动脉的paCFZ面积及P/A比显著大于对侧眼（均P<0.01），但一级和二级动脉面积无差异（分别为P=0.20和0.25）。抗VEGF治疗后3个月、6个月和12个月，paCFZ面积及P/A比显著降低（均P<0.01）。基线P/A比与基线最佳矫正视力（BCVA）、中心视网膜厚度及其在3个月、6个月和12个月时的改善情况显著相关（均P<0.05）。在多变量线性回归中，基线BCVA以及一级和二级动脉的P/A比与最终BCVA独立相关。
广角SS-OCTA显示抗VEGF治疗可使BRVO患者的paCFZ参数显著改善。SS-OCTA上较小的基线P/A比往往预示着抗VEGF治疗12个月后有更好的视力结局。
