Vofo Brice Nguedia, Galarza Pablo, Chowers Itay, Levy Jaime
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
J Ophthalmol. 2022 Jul 31;2022:5746238. doi: 10.1155/2022/5746238. eCollection 2022.
The primary aim was to evaluate the use of optical coherence tomography angiography (OCTA) versus fluorescein angiography (FA) for detecting and monitoring retinal neovascularization (NV) in patients with proliferative diabetic retinopathy (PDR) receiving treatment with anti-vascular endothelial growth factor (anti-VEGF).
Treatment-naïve patients with PDR, willing to begin anti-VEGF treatment without laser from 9/2018-2/2020 were included. FA and OCTA scans were obtained at baseline, and a second OCTA scan was performed after 6 months of anti-VEGF therapy. We calculated sensitivity and specificity for two masked graders with respect to identifying NV on OCTA versus FA. Using ImageJ software, we also measured the change in NV size, at baseline and 6-month follow-up.
Ten eyes in eight patients were included, of which three eyes in three patients received a 6-month follow-up examination. Mean age was 51.7 ± 11.2 years, and 75% of patients were male. Overall, 21 NV sites in the 10 eyes were identified both clinically and on FA. Using OCTA scans, the sensitivity and specificity for both graders were extremely high, ranging from 95.2% to 100%. At 6-month follow-up, NV size decreased by 69.8%.
These results suggest that OCTA may provide a suitable alternative to FA for visualizing, measuring, and monitoring changes in retinal NV in patients with PDR who receive anti-VEGF therapy.
主要目的是评估光学相干断层扫描血管造影(OCTA)与荧光素血管造影(FA)在检测和监测接受抗血管内皮生长因子(抗VEGF)治疗的增殖性糖尿病视网膜病变(PDR)患者视网膜新生血管形成(NV)方面的应用。
纳入2018年9月至2020年2月间初治的、愿意在不进行激光治疗的情况下开始抗VEGF治疗的PDR患者。在基线时进行FA和OCTA扫描,并在抗VEGF治疗6个月后进行第二次OCTA扫描。我们计算了两名盲法分级者在通过OCTA与FA识别NV方面的敏感性和特异性。使用ImageJ软件,我们还测量了基线和6个月随访时NV大小的变化。
纳入了8例患者的10只眼,其中3例患者的3只眼接受了6个月的随访检查。平均年龄为51.7±11.2岁,75%的患者为男性。总体而言,10只眼中的21个NV部位在临床和FA上均被识别。使用OCTA扫描,两名分级者的敏感性和特异性都极高,范围为95.2%至100%。在6个月的随访中,NV大小减少了69.8%。
这些结果表明,对于接受抗VEGF治疗的PDR患者,OCTA可能是一种合适的替代FA的方法,用于可视化、测量和监测视网膜NV的变化。