Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States.
Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.
Invest Ophthalmol Vis Sci. 2024 Sep 3;65(11):32. doi: 10.1167/iovs.65.11.32.
To evaluate the response of type 1 and type 2 macular neovascularization (MNV) components under anti-vascular endothelial growth factor (VEGF) treatment in age-related macular degeneration (AMD) using projection-resolved optical coherence tomography angiography (PR-OCTA).
This retrospective study included eyes with treatment-naïve exudative AMD treated with anti-VEGF injections under a pro re nata (PRN) protocol over 1 year. Two-dimensional MNV areas and three-dimensional MNV volumes were derived from macular PR-OCTA scans using an automated convolutional neural network. MNV was detected as flow signal within the outer retinal slab. Type 1 components and type 2 components were analyzed separately.
Of 17 enrolled eyes, 12 eyes were pure type 1 MNV and five eyes were type 2 MNV. In eyes with pure type 1, the total (sum of type 1 and type 2 components) MNV area and volume did not change from baseline to 6 months or 12 months (P > 0.05). In eyes with type 2 MNV, the total MNV area significantly decreased from the baseline to 6 months (P = 0.0074) and 12 months (P = 0.014). The total type 2 MNV volume also decreased from baseline visit to visits at 6 months and at 12 months, nearing statistical signifiicance (P = 0.061 and P = 0.074). In eyes with type 2 MNV, the type 1 component increased from 0.093 mm2 to 0.30 mm2 (P = 0.058), and the type 2 component decreased from 0.37 mm2 at 6 months to 0 at 12 months (P = 0.0087).
Type 1 and type 2 MNV may have different response under PRN anti-VEGF treatment over 1 year.
使用投影分辨光相干断层扫描血管造影术（PR-OCTA）评估年龄相关性黄斑变性（AMD）中 1 型和 2 型黄斑新生血管（MNV）成分对血管内皮生长因子（VEGF）治疗的反应。
本回顾性研究纳入了 17 只接受抗 VEGF 注射治疗的治疗初发渗出性 AMD 眼，采用按需治疗（PRN）方案治疗 1 年。使用自动卷积神经网络从黄斑 PR-OCTA 扫描中得出二维 MNV 面积和三维 MNV 体积。MNV 是在外视网膜板内检测到的血流信号。分别分析 1 型成分和 2 型成分。
在纳入的 17 只眼中，12 只眼为单纯 1 型 MNV，5 只眼为 2 型 MNV。在单纯 1 型眼中，从基线到 6 个月或 12 个月，总 MNV 面积和体积没有变化（P > 0.05）。在 2 型 MNV 眼中，总 MNV 面积从基线到 6 个月（P = 0.0074）和 12 个月（P = 0.014）显著减少。从基线到 6 个月和 12 个月，总 2 型 MNV 体积也减少，接近统计学意义（P = 0.061 和 P = 0.074）。在 2 型 MNV 眼中，1 型成分从 0.093mm2增加到 0.30mm2（P = 0.058），2 型成分从 6 个月的 0.37mm2减少到 12 个月的 0（P = 0.0087）。
在 1 年的 PRN 抗 VEGF 治疗中，1 型和 2 型 MNV 可能有不同的反应。
