Xia Fan, Xing Peiyu, Zhang Hao, Niu Tongtong, Wang Qi, Hua Rui
Department of Ophthalmology, The Fourth People's Hospital of Shenyang, China Medical University, Shenyang 110001, China.
Department of Ophthalmology, First Hospital of China Medical University, Shenyang 110001, China.
Diagnostics (Basel). 2023 Sep 21;13(18):3017. doi: 10.3390/diagnostics13183017.
We performed a retrospective, observational study of 51 eyes in 51 treatment-naïve patients with polypoidal choroidal vasculopathy (PCV), whose lesion ranged within the 6 × 6 mm scope of optical coherence tomography angiography (OCTA). The patients were divided into an ill-defined group and a well-defined group based on the pattern of branching vascular network (BVN) on OCTA. BVN morphology was not related to baseline best-corrected visual acuity (BCVA). However, the BCVA in the ill-defined BVN group (-0.18 [interquartile range: -0.40 to 0.00]) was significantly improved after anti-vascular endothelial growth factor (VEGF) injections, compared with that (0.00 [interquartile range: -0.18 to 0.00]) in the well-defined group (z = 2.143, = 0.032). Multiple logistic regression analysis showed that male sex, fewer injections, and the presence of polypoidal lesions on OCTA images at baseline predicted a poor prognosis in patients with polypoidal lesions on OCTA images after anti-VEGF therapy (all < 0.05). Finally, BCVA at baseline and the number of injections were protective factors for BCVA after anti-VEGF therapy (all < 0.05). In contrast, a history of hypertension and macular edema at baseline were risk factors for BCVA after anti-VEGF injections (all < 0.05). Our results revealed the visual and morphological prognosis of patients with active subfoveal circumscribed PCV after anti-VEGF therapy.
我们对51例初治的息肉样脉络膜血管病变（PCV）患者的51只眼进行了一项回顾性观察研究，这些患者病变范围在光学相干断层扫描血管造影（OCTA）的6×6mm范围内。根据OCTA上分支血管网络（BVN）的形态，将患者分为边界不清组和边界清晰组。BVN形态与基线最佳矫正视力（BCVA）无关。然而，与边界清晰组（z = 2.143，P = 0.032）相比，边界不清的BVN组患者在抗血管内皮生长因子（VEGF）注射后BCVA（-0.18[四分位数间距：-0.40至0.00]）有显著改善。多因素logistic回归分析显示，男性、注射次数较少以及基线时OCTA图像上存在息肉样病变预示抗VEGF治疗后OCTA图像上有息肉样病变的患者预后较差（均P < 0.05）。最后，基线时的BCVA和注射次数是抗VEGF治疗后BCVA的保护因素（均P < 0.05）。相比之下，高血压病史和基线时黄斑水肿是抗VEGF注射后BCVA的危险因素（均P < 0.05）。我们的研究结果揭示了抗VEGF治疗后活动性中心凹局限性PCV患者的视力和形态学预后。
