抗血管内皮生长因子治疗后新生血管性年龄相关性黄斑变性脉络膜毛细血管再灌注的地形分析。
Topographical Analysis of the Choriocapillaris Reperfusion After Loading Anti-VEGF Therapy in Neovascular AMD.
机构信息
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy.
出版信息
Transl Vis Sci Technol. 2022 Sep 1;11(9):18. doi: 10.1167/tvst.11.9.18.
PURPOSE
The purpose of this study was to evaluate choriocapillaris vascular density changes around macular neovascularization (MNV) before and after anti-vascular endothelium growth factor (VEGF) injections by optical coherence tomography angiography (OCTA).
METHODS
Treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV were included. En face optical coherence tomography angiograms were analyzed for percentage of choriocapillaris (CC) flow deficit percentage (FD%), the FD average area (FDa), and the FD number (FDn) in 5 progressive 200-µm-wide concentric rings (R1, R2, R3, R4, and R5) surrounding the dark halo around the MNV. The OCTA acquisition was performed at the following visits: (i) before the loading phase of intravitreal injection of aflibercept or ranibizumab (T1), and (ii) 1 month after the last intravitreal injection of loading phase comprising 3 monthly injections (T2).
RESULTS
A total of 30 eyes of 30 Caucasian patients with treatment naïve neurovascular AMD (nAMD) were included in the study. All rings showed a progressive FD% reduction at T2 in comparison to T1 values indicating gradual CC reperfusion of the peripheral rings. Furthermore, we found a progressive contraction of the FD average area in all the rings considered (P < 0.05). On the other hand, at T2, a significant increase in the FD number of the 5 rings was displayed, as compared to T1 (P < 0.05).
CONCLUSIONS
Our analysis showed topographical CC reperfusion after loading anti-VEGF therapy. CC flow deficits were greater around the associated dark halo before treatment, followed by a progressive recovery of CC flow after intravitreal therapy.
TRANSLATIONAL RELEVANCE
OCTA may be used to assess the development and progression of MNV but also in assessing response to intravitreal injections of anti-VEGF.
目的
本研究旨在通过光相干断层扫描血管造影术（OCTA）评估黄斑新生血管（MNV）治疗前和治疗后脉络膜毛细血管血管密度的变化。
方法
纳入未经治疗的渗出性 AMD 且为 1 型 MNV 的患者。对视盘上方 OCTA 进行分析，以评估脉络膜毛细血管（CC）血流缺损百分比（FD%）、FD 平均面积（FDa）和 FD 数量（FDn）在围绕 MNV 暗晕的 5 个连续 200μm 宽同心环（R1、R2、R3、R4 和 R5）中的百分比。OCTA 采集在以下就诊时进行：（i）玻璃体内注射阿柏西普或雷珠单抗负荷期前（T1），和（ii）在包含 3 次每月注射的负荷期最后一次玻璃体内注射后 1 个月（T2）。
结果
本研究共纳入 30 只眼 30 例未经治疗的伴有新生血管的神经退行性年龄相关性黄斑变性（nAMD）的高加索患者。与 T1 值相比，所有环在 T2 时均显示 FD%逐渐降低，表明周边环的 CC 再灌注逐渐增加。此外，我们发现所有考虑的环的 FD 平均面积均逐渐收缩（P<0.05）。另一方面，与 T1 相比，T2 时 5 个环的 FD 数量显著增加（P<0.05）。
结论
我们的分析显示，在进行抗 VEGF 治疗的负荷期后，出现了脉络膜毛细血管的局部再灌注。在治疗前，与相关的暗晕相关的脉络膜毛细血管血流缺损较大，随后在玻璃体内治疗后，脉络膜毛细血管血流逐渐恢复。
翻译提示
“MNV”是“macular neovascularization”的缩写，直译为“黄斑新生血管”，但为了保持前后一致，本文将其翻译为“MNV”。
“OCTA”是“optical coherence tomography angiography”的缩写，直译为“光相干断层扫描血管造影术”，为了保持前后一致，本文将其翻译为“OCTA”。
“FD%”是“flow deficit percentage”的缩写，直译为“血流缺损百分比”，为了保持前后一致，本文将其翻译为“FD%”。
“FDa”是“FD average area”的缩写，直译为“FD 平均面积”，为了保持前后一致，本文将其翻译为“FDa”。
“FDn”是“FD number”的缩写，直译为“FD 数量”，为了保持前后一致，本文将其翻译为“FDn”。
“nAMD”是“neovascular AMD”的缩写，直译为“新生血管性 AMD”，为了保持前后一致，本文将其翻译为“nAMD”。
“R1、R2、R3、R4 和 R5”是“5 progressive 200-µm-wide concentric rings”的缩写，直译为“5 个连续 200μm 宽同心环”，为了保持前后一致，本文将其翻译为“R1、R2、R3、R4 和 R5”。
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