Berni Alessandro, Oakley Jonathan D, Dolz-Marco Rosa, Gallego-Pinazo Roberto, Cimorosi Francesca, Ghilardi Andrea, Russakoff Daniel B, Barresi Costanza, Introini Ugo, Reibaldi Michele, Bandello Francesco, Borrelli Enrico
The IRCCS San Raffaele Scientific Institute (A.B., C.B., U.I., F.B.), Milan, Italy; Vita-Salute San Raffaele University Milan (A.B., C.B., U.I., F.B.), Milan, Italy.
Voxeleron Inc. (J.D.O., D.B.R.), Austin, Texas, United States.
Am J Ophthalmol. 2025 Jan;269:181-188. doi: 10.1016/j.ajo.2024.08.024. Epub 2024 Aug 31.
This study aims to quantify the volume of intraretinal fluid (IRF), subretinal fluid (SRF), and subretinal pigment epithelium (sub-RPE) fluid in treatment-naïve Type 3 macular neovascularization (MNV) eyes with age-related macular degeneration (AMD) and to investigate the correlation of these fluid volumes with visual acuity (VA) outcomes at baseline and following antivascular endothelial growth factor (VEGF) treatment.
Retrospective, clinical cohort study.
In this study, we analyzed patients diagnosed with exudative AMD and treatment-naïve Type 3 MNV undergoing a loading dose of anti-VEGF therapy. Using a validated deep-learning segmentation strategy, we processed optical coherence tomography (OCT) B-scans to segment and quantify IRF (i.e., both in the inner and outer retina), SRF, and sub-RPE fluid volumes at baseline. The study correlated baseline fluid volumes with baseline and short-term VA outcomes postloading dose of anti-VEGF injections.
Forty-six eyes from 46 patients were included in this study. Visual acuity was 0.51 ± 0.30 LogMAR at baseline and 0.33 ± 0.20 LogMAR after the loading dose of anti-VEGF (P = .001). Visual acuity at the follow-up visit was 0.40 ± 0.17 LogMAR in patients with no complete resolution of retinal fluid and 0.31 ± 0.20 LogMAR in eyes without retinal fluid after treatment (P = .225). In the multivariable analysis, the IRF volume in the inner retina (P = .032) and the distance of the MNV from the fovea (P = .037) were predictors of visual acuity at baseline. The baseline IRF volume in the inner retina also predicted the visual acuity at follow-up (P = .023).
The present study highlights the fluid volume in the inner retina as a crucial predictor of short-term visual outcomes in Type 3 MNV, underscoring the detrimental effect of IRF on neuroretinal structures.
本研究旨在量化初治的年龄相关性黄斑变性（AMD）3型黄斑新生血管（MNV）患眼中视网膜内液（IRF）、视网膜下液（SRF）和视网膜色素上皮下（sub-RPE）液的体积，并研究这些液体积与基线及抗血管内皮生长因子（VEGF）治疗后视力（VA）结果的相关性。
回顾性临床队列研究。
在本研究中，我们分析了被诊断为渗出性AMD且初治的3型MNV并接受抗VEGF治疗负荷剂量的患者。使用经过验证的深度学习分割策略，我们处理光学相干断层扫描（OCT）B扫描，以在基线时分割和量化IRF（即视网膜内层和外层）、SRF和sub-RPE液体积。该研究将基线液体积与抗VEGF注射负荷剂量后的基线和短期VA结果相关联。
本研究纳入了46例患者的46只眼。基线时视力为0.51±0.30 LogMAR，抗VEGF负荷剂量后为0.33±0.20 LogMAR（P = 0.001）。在视网膜液未完全消退的患者中，随访时视力为0.40±0.17 LogMAR，治疗后无视网膜液的眼中视力为0.31±0.20 LogMAR（P = 0.225）。在多变量分析中，视网膜内层的IRF体积（P = 0.032）和MNV距黄斑中心凹的距离（P = 0.037）是基线时视力的预测因素。视网膜内层的基线IRF体积也可预测随访时的视力（P = 0.023）。
本研究强调视网膜内层的液体积是3型MNV短期视力结果的关键预测因素，突出了IRF对神经视网膜结构的有害影响。
