Kamao Hiroyuki, Goto Katsutoshi, Date Yuto, Hiraki Ryutaro, Mizukawa Kenichi, Miki Atsushi
Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0114, Okayama, Japan.
Shirai Eye Hospital, 1339 Takasecho Kamitakase, Mitoyo 767-0001, Kagawa, Japan.
J Clin Med. 2024 Sep 12;13(18):5394. doi: 10.3390/jcm13185394.
: To assess the clinical characteristics of patients with macular neovascularization (MNV) with no drusen in the fellow eye, we investigated the incidence of MNV in fellow eyes and the outcomes of intravitreal aflibercept (IVA) monotherapy in MNV eyes of patients with unilateral MNV with a punctate hyperfluorescence spot (PHS) in the fellow eye. : We retrospectively studied 58 treatment-naïve patients with unilateral MNV with no drusen in the fellow eye. Patients were classified into a PHS group ( = 29) or no-PHS group ( = 29) based on the presence of PHS. We evaluated the incidence of MNV in the fellow eye, and the retreatment rate after initiation of three monthly aflibercept injections over one year. : Fellow eyes in the PHS group had a thicker choroid ( < 0.05) and higher prevalence of pachychoroid pigment epitheliopathy (PPE) ( < 0.001). MNV eyes in the PHS group had a thicker choroid ( = 0.09). The PHS group had a lower retreatment rate ( < 0.05) and required fewer injections ( < 0.05) than the no-PHS group. MNV developed in one eye in both the PHS and no-PHS groups, and both cases occurred in areas of hypofluorescence on indocyanine green angiography within the PPE area before the onset of MNV. : The PHS group frequently exhibited pachychoroid disease characteristics and responded better to IVA monotherapy than the no-PHS group. These groups may represent distinct populations of patients with unilateral MNV with no drusen in the fellow eye.
为评估对侧眼无玻璃膜疣的黄斑新生血管（MNV）患者的临床特征，我们调查了对侧眼中MNV的发生率以及在对侧眼有一个点状高荧光斑（PHS）的单侧MNV患者的MNV眼中玻璃体内注射阿柏西普（IVA）单药治疗的效果。我们回顾性研究了58例对侧眼无玻璃膜疣的初治单侧MNV患者。根据是否存在PHS将患者分为PHS组（n = 29）或无PHS组（n = 29）。我们评估了对侧眼中MNV的发生率，以及在一年中每月注射三次阿柏西普起始治疗后的再治疗率。PHS组的对侧眼脉络膜更厚（P<0.05），厚脉络膜色素上皮病变（PPE）的患病率更高（P<0.001）。PHS组的MNV眼脉络膜更厚（P = 0.09）。PHS组的再治疗率低于无PHS组（P<0.05），且所需注射次数更少（P<0.05）。PHS组和无PHS组均有一只眼发生MNV，且两例均发生在MNV发病前PPE区域内吲哚菁绿血管造影的低荧光区域。PHS组经常表现出厚脉络膜疾病特征，且比无PHS组对IVA单药治疗反应更好。这些组可能代表对侧眼无玻璃膜疣的单侧MNV患者的不同群体。
