Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
Department of Bioengineering, University of Washington, Seattle, Washington, United States.
Invest Ophthalmol Vis Sci. 2023 Oct 3;64(13):16. doi: 10.1167/iovs.64.13.16.
Choroidal changes before and after anti-VEGF therapy were investigated in eyes with exudative AMD to determine if there was a difference between eyes with macular neovascularization (MNV) that arises from the choroid (type 1 or 2) versus the retinal circulation (type 3).
Patients with treatment-naïve AMD were imaged with swept-source optical coherence tomography angiography using a 12 × 12-mm scan pattern. The mean choroidal thickness and choroidal vascularity index (CVI) were measured within 5-mm and 11-mm fovea-centered circles before, at the onset of, and after anti-VEGF therapy.
Forty-one eyes of 37 patients were included; 24 eyes with type 1 MNV, 4 eyes with type 2 MNV, and 13 eyes with type 3 MNV. Within the 5-mm and 11-mm circles, the mean choroidal thickness and CVI measurements increased from pretreatment to the onset of exudation (P ≤ 0.03). The mean choroidal thickness and CVI measurements decreased from the onset of exudation to after treatment (P < 0.001). No significant changes in mean choroidal thickness or CVI were observed when comparing measurements before or after treatment (P ≥ 0.38). No significant differences in mean choroidal thickness or CVI measurements were observed between eyes with type 1 or 2 MNV and type 3 MNV.
In treatment-naïve AMD eyes with MNV, the choroidal thickness and vascularity increased at the onset of exudation and then decreased after anti-VEGF therapy. This finding suggests that these choroidal changes develop in response to the proangiogenic milieu before treatment and in response to treatment, regardless of the site of origin for the MNV.
研究湿性年龄相关性黄斑变性（AMD）患者在抗血管内皮生长因子（VEGF）治疗前后脉络膜的变化，以确定源于脉络膜（1 型或 2 型）与视网膜循环（3 型）的黄斑新生血管（MNV）之间是否存在差异。
使用 12×12mm 扫描模式的扫频源光学相干断层扫描血管造影对未经治疗的 AMD 患者进行成像。在抗 VEGF 治疗前、发病时和治疗后，在 5mm 和 11mm 以黄斑为中心的圆圈内测量平均脉络膜厚度和脉络膜血管指数（CVI）。
共纳入 37 例 41 只眼；24 只眼为 1 型 MNV，4 只眼为 2 型 MNV，13 只眼为 3 型 MNV。在 5mm 和 11mm 圆圈内，平均脉络膜厚度和 CVI 测量值从治疗前增加到渗出开始（P≤0.03）。从渗出开始到治疗后，平均脉络膜厚度和 CVI 测量值降低（P＜0.001）。与治疗前后的测量值相比，平均脉络膜厚度或 CVI 无明显变化（P≥0.38）。1 型或 2 型 MNV 与 3 型 MNV 眼之间，平均脉络膜厚度或 CVI 测量值无显著差异。
在未经治疗的伴有 MNV 的 AMD 眼中，脉络膜厚度和血管密度在渗出开始时增加，然后在抗 VEGF 治疗后减少。这一发现表明，这些脉络膜变化是在治疗前的促血管生成环境中发展的，并且是对抗 VEGF 治疗的反应，而与 MNV 的起源部位无关。
