Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institutes of Medical Sciences, New Delhi, India.
Middle East Afr J Ophthalmol. 2024 Jun 14;30(2):63-67. doi: 10.4103/meajo.meajo_173_21. eCollection 2023 Apr-Jun.
The purpose of this study was to identify biomarkers that predict the response of treatment-naive idiopathic choroidal neovascularization (iCNV) to anti-VEGF treatment.
Fourteen eyes diagnosed with iCNV underwent a dilated fundus examination, Swept Source Optical Coherence Tomography (SS-OCT) and Optical Coherence Tomography - Angiography (OCT-A), and were given an anti-VEGF injection. The same examinations were repeated at every follow-up visit. Analysis of the pre- and posttreatment images was done to identify possible biomarkers which were evaluated to check association with decreased need for multiple anti-VEGF injections.
At presentation, 11 patients showed a compact pattern, while three patients showed an arborizing pattern on OCT angiography (P = 1). On follow-up imaging, seven patients showed a marked response, five patients showed a moderate response, and two patients showed a mild response to anti-VEGF injection. Among the seven patients showing a marked response, only one required a repeat injection (P = 0.03). On analysis of SS-OCT, a novel Retinal Pigment Epithelium (RPE) healing response was observed in posttreatment imaging of six patients (P = 0.59).
A "marked" response to the first anti-VEGF injection results in a more sustained response and is a positive prognostic factor. RPE healing response is an interesting observation that merits further evaluation. Morphology of neovascular membranes has no effect on long-term need for multiple anti-VEGF injections.
本研究旨在确定可预测未经治疗的特发性脉络膜新生血管（iCNV）对抗 VEGF 治疗反应的生物标志物。
14 只诊断为 iCNV 的眼睛接受了散瞳眼底检查、扫频源光学相干断层扫描（SS-OCT）和光相干断层扫描血管造影（OCT-A），并接受了抗 VEGF 注射。每次随访时都会重复进行相同的检查。分析治疗前后的图像以识别可能的生物标志物，并评估其与减少对多次抗 VEGF 注射的需求的关联。
在就诊时，11 名患者在 OCT 血管造影上显示出致密模式，而 3 名患者显示出分支模式（P = 1）。在随访成像上，7 名患者对抗 VEGF 注射有明显反应，5 名患者有中度反应，2 名患者有轻度反应。在显示明显反应的 7 名患者中，仅 1 名需要重复注射（P = 0.03）。在 SS-OCT 分析中，6 名患者在治疗后成像中观察到新的视网膜色素上皮（RPE）愈合反应（P = 0.59）。
首次抗 VEGF 注射的“明显”反应可导致更持久的反应，是一个积极的预后因素。RPE 愈合反应是一个有趣的观察结果，值得进一步评估。新生血管膜的形态对多次抗 VEGF 注射的长期需求没有影响。
