Zhang Yumeng, Zhang Jingfa, Sun Xiaodong
Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, School of Medicine, Shanghai 200080, China.
National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China.
J Ophthalmol. 2022 Sep 28;2022:1272524. doi: 10.1155/2022/1272524. eCollection 2022.
To investigate the effect and underlying mechanism of intravitreal antivascular endothelial growth factor (VEGF) in patients with putative or visible choroidal neovascularization (CNV) secondary to central serous chorioretinopathy (CSCR) with optical coherence tomography angiography (OCTA).
In a retrospective cohort study, 16 eyes of 15 treatment-naïve CSCR patients were included and divided into two groups: a putative CNV group with nonhomogenous hyperreflectivity in the slab of choriocapillaris and a visible CNV group with obvious tangled vascular network in the slab of choriocapillaris in OCTA. Patients were recorded with best-corrected visual acuity (BCVA). The parameters, evaluated by OCTA, included central macular thickness (CMT), the height of subretinal fluid (SRF), the number of hyperreflective foci (HRF), and the area of putative or visible CNV.
Compared with the baseline, visual acuity was improved significantly at the last follow-up, and CMT and the height of SRF were decreased significantly ( < 0.0001). The number of HRF was also declined in the outer retina and the choriocapillaris layer (=0.0343). Although the visible CNV area in the eyes represented virtually unchanged during anti-VEGF treatment (=0.4015), the area of putative CNV displayed an obvious reduction (=0.0081).
Anti-VEGF is effective in treating CSCR coexisting putative or visible CNV. Early initiation of anti-VEGF therapy benefits CSCR patients with putative CNV detected by OCTA. nonhomogenous hyperreflectivity in the choriocapillaris layer in OCTA indicates putative CNV in patients with CSCR, implying early treatment with anti-VEGF.
利用光学相干断层扫描血管造影（OCTA）研究玻璃体内注射抗血管内皮生长因子（VEGF）对疑似或可见性脉络膜新生血管（CNV）继发于中心性浆液性脉络膜视网膜病变（CSCR）患者的疗效及潜在机制。
在一项回顾性队列研究中，纳入15例初治CSCR患者的16只眼，并分为两组：OCTA检查显示脉络膜毛细血管层存在非均匀性高反射的疑似CNV组，以及脉络膜毛细血管层存在明显血管网络紊乱的可见性CNV组。记录患者的最佳矫正视力（BCVA）。通过OCTA评估的参数包括中心黄斑厚度（CMT）、视网膜下液（SRF）高度、高反射灶（HRF）数量以及疑似或可见性CNV的面积。
与基线相比，末次随访时视力显著提高，CMT和SRF高度显著降低（<0.0001）。外层视网膜和脉络膜毛细血管层的HRF数量也有所下降（=0.0343）。虽然抗VEGF治疗期间患眼的可见性CNV面积基本未变（=0.4015），但疑似CNV面积明显减小（=0.0081）。
抗VEGF治疗对合并疑似或可见性CNV的CSCR有效。对于OCTA检测到疑似CNV的CSCR患者，早期开始抗VEGF治疗有益。OCTA检查中脉络膜毛细血管层的非均匀性高反射提示CSCR患者存在疑似CNV，意味着应尽早使用抗VEGF进行治疗。
