Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Retina. 2024 Sep 1;44(9):1478-1485. doi: 10.1097/IAE.0000000000004159.
To investigate associations between quantitative vascular measurements derived from intravenous fluorescein angiography (IVFA) and baseline characteristics on optical coherence tomography (OCT) in neovascular age-related macular degeneration (nAMD) patients.
The authors prospectively recruited patients with active choroidal neovascularization secondary to AMD over 50 years old, presenting to a single center in Toronto, Canada from 2017 to 2023. Ultra-widefield IVFA images were processed using the artificial intelligence RETICAD FAassist system to extract quantitative information on blood flow, perfusion, and blood-retinal-barrier (BRB) permeability. Associations between IVFA parameters with functional and anatomical outcomes were examined using univariable and multivariable regression models.
Eighty-one nAMD eyes and seven healthy control eyes were included. Compared with healthy controls, BRB permeability in the central and peripheral retina was significantly higher in nAMD patients (P < 0.001). On univariable analysis, BRB permeability measured centrally was significantly associated with central macular thickness (P = 0.035), whereas perfusion and blood flow measured centrally were significantly associated with macular volume (P = 0.043 and 0.037, respectively). On multivariable analysis, BRB permeability remained significantly associated with central macular thickness (P = 0.026).
Central BRB permeability measured on IVFA was significantly associated with baseline central macular thickness in nAMD patients. Future work should longitudinally explore associations between IVFA parameters and clinical characteristics in diverse nAMD populations.
探究从静脉内荧光素血管造影（IVFA）获得的定量血管测量值与新生血管性年龄相关性黄斑变性（nAMD）患者的基线特征之间的关联。
作者前瞻性招募了 2017 年至 2023 年期间在加拿大多伦多的一个单一中心就诊的年龄在 50 岁以上、因 AMD 而出现脉络膜新生血管的活跃患者。使用人工智能 RETICAD FAassist 系统处理超广角 IVFA 图像，以提取血流、灌注和血视网膜屏障（BRB）通透性的定量信息。使用单变量和多变量回归模型检查 IVFA 参数与功能和解剖学结果之间的关联。
纳入了 81 只 nAMD 眼和 7 只健康对照眼。与健康对照组相比，nAMD 患者的中央和周边视网膜 BRB 通透性明显更高（P < 0.001）。单变量分析显示，中央 BRB 通透性与中心黄斑厚度显著相关（P = 0.035），而中央测量的灌注和血流与黄斑体积显著相关（P = 0.043 和 0.037）。多变量分析显示，BRB 通透性仍与中央黄斑厚度显著相关（P = 0.026）。
IVFA 测量的中央 BRB 通透性与 nAMD 患者的基线中央黄斑厚度显著相关。未来的工作应该在不同的 nAMD 人群中进行纵向研究，以探索 IVFA 参数与临床特征之间的关联。
