Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia.
Retina. 2023 Nov 1;43(11):2019-2026. doi: 10.1097/IAE.0000000000003896.
To study the status of retinal pigment epithelium in nonexudative and active choroidal neovascularization (CNV) in neovascular age-related macular degeneration.
Only treatment-naïve neovascular age-related macular degeneration patients were enrolled in this prospective case-control study, including 17 eyes with nonexudative CNV (6 males and 11 females, 74.9 ± 10.0 years) and 28 eyes with active CNV (8 males and 20 females, 69.3 ± 6.8 years). All patients received a comprehensive ophthalmic examination, optical coherence tomography, dark-field scanning laser ophthalmoscopy, and fundus autofluorescence. The status of the retinal pigment epithelium was assessed with ImageJ software as the brightness of the CNV region on transillumination optical coherence tomography, dark-field scanning laser ophthalmoscopy, and fundus autofluorescence images. Choroidal neovascularization vessel density was measured based on optical coherence tomography angiography.
The brightness of CNV region in nonexudative CNV was statistically significantly lower than in active CNV with both optical coherence tomography transillumination ( P = 0.004) and dark-field scanning laser ophthalmoscopy ( P = 0.0015). No difference in brightness of the CNV region between nonexudative and active CNV was found based on fundus autofluorescence ( P = 0.44). The vessel density of nonexudative CNV was statistically significantly higher than that of active CNV with a median value of 64.5% (95% confidential interval [CI] 53.4-79.0%) and 55.3% (95% CI 52.2-60.0%), respectively ( P = 0.05).
Multimodal imaging revealed substantial alteration of the retinal pigment epithelium in active CNV but not in nonexudative CNV which correlates with the higher vessel density of nonexudative CNV.
研究非渗出性和活动性脉络膜新生血管（CNV）在新生血管性年龄相关性黄斑变性中的视网膜色素上皮状态。
本前瞻性病例对照研究仅纳入未经治疗的新生血管性年龄相关性黄斑变性患者，包括 17 只非渗出性 CNV 眼（6 名男性和 11 名女性，74.9±10.0 岁）和 28 只活动性 CNV 眼（8 名男性和 20 名女性，69.3±6.8 岁）。所有患者均接受全面眼科检查、光学相干断层扫描、暗场扫描激光检眼镜和眼底自发荧光检查。使用 ImageJ 软件评估视网膜色素上皮状态，将 CNV 区域在光透过光学相干断层扫描、暗场扫描激光检眼镜和眼底自发荧光图像上的亮度作为评估指标。根据光学相干断层扫描血管造影测量脉络膜新生血管血管密度。
非渗出性 CNV 的 CNV 区域亮度在光透过光学相干断层扫描（P=0.004）和暗场扫描激光检眼镜（P=0.0015）下均明显低于活动性 CNV。非渗出性 CNV 和活动性 CNV 的 CNV 区域亮度在眼底自发荧光下无差异（P=0.44）。非渗出性 CNV 的血管密度明显高于活动性 CNV，中位数分别为 64.5%（95%可信区间[CI]53.4-79.0%）和 55.3%（95% CI52.2-60.0%）（P=0.05）。
多模态成像显示活动性 CNV 中视网膜色素上皮发生了实质性改变，但在非渗出性 CNV 中没有改变，这与非渗出性 CNV 的血管密度较高有关。
