Parrulli Salvatore, Airaldi Matteo, Folegani Valentina, Erba Stefano, Govetto Andrea, Zicarelli Federico, Invernizzi Alessandro, Staurenghi Giovanni, Cereda Matteo G
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy.
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Milan, Italy.
Can J Ophthalmol. 2025 Aug;60(4):243-251. doi: 10.1016/j.jcjo.2024.11.001. Epub 2024 Nov 30.
To analyze longitudinal changes of retinal neovessels (NV) in eyes with proliferative diabetic retinopathy (PDR) after 3 monthly intravitreal injections (IVI) of ranibizumab by means of different imaging modalities, particularly focusing on optical coherence tomography (OCT) and OCT-angiography (OCT-A) features.
Prospective, monocentric study, Luigi Sacco Hospital, Milan. Consecutive patients with PDR were enrolled. All patients underwent color fundus photography (CFP), fluorescein angiography (FA), SD-OCT, and OCT-A at baseline (t0) and after 3 monthly IVI of ranibizumab (t1). Neovessels (NVs) were classified as flat, elevated, flat-elevated, or table-top using OCT scans and further analyzed on FIJI. Qualitative and quantitative NV characteristics were evaluated. Vessel density (VD) was calculated as the mean of all the white pixels of the NV and expressed as a percentage of the area of the NV (VD = NV area × 100).
Thirty-six NVs in 10 patients were studied. The regression of NVs at t1 was partial in 66.7% of cases and complete in 33.3%. Table-top NV demonstrated more frequently a complete regression (P = .03). A significant reduction of the NV area, perimeter, and VD was observed at t1 (P < .001). NVs that showed a complete regression had higher mean VD values at t0 compared with NVs, which showed a partial regression (P = .02). Flat NVs had more frequently a complete vitreous attachment, while table-top showed more often a partial vitreous detachment with focal NV adhesion (P < .05). A complete regression was more often observed for NVs with a partial vitreous detachment and focal NV adhesion at t0 (10/12), while most of the NVs with a complete vitreous attachment showed a partial regression (18/24) (P < .001).
The table-top configuration of the neovessel, higher VD values at baseline, and the presence of a focal adhesion of the vitreous over the NV were factors associated with a higher risk of complete regression of the NV in response to 3 monthly IVI of ranibizumab.
通过不同成像方式分析增殖性糖尿病视网膜病变（PDR）患者在每月一次玻璃体内注射（IVI）雷珠单抗3次后的视网膜新生血管（NV）的纵向变化，尤其关注光学相干断层扫描（OCT）和OCT血管造影（OCT-A）特征。
前瞻性单中心研究，米兰路易吉·萨科医院。纳入连续的PDR患者。所有患者在基线时（t0）以及每月一次IVI雷珠单抗3次后（t1）均接受彩色眼底照相（CFP）、荧光素血管造影（FA）、SD-OCT和OCT-A检查。使用OCT扫描将新生血管（NVs）分类为扁平、隆起、扁平-隆起或桌面状，并在FIJI上进一步分析。评估NV的定性和定量特征。血管密度（VD）计算为NV所有白色像素的平均值，并表示为NV面积的百分比（VD = NV面积×100）。
研究了10例患者的36个NV。在t1时，66.7%的病例中NV部分消退，33.3%完全消退。桌面状NV更常表现为完全消退（P = 0.03）。在t1时观察到NV面积、周长和VD显著减少（P < 0.001）。与部分消退的NV相比，完全消退的NV在t0时平均VD值更高（P = 0.02）。扁平NV更常具有完全的玻璃体附着，而桌面状NV更常表现为部分玻璃体脱离伴局灶性NV粘连（P < 0.05）。在t0时，部分玻璃体脱离伴局灶性NV粘连的NV更常观察到完全消退（10/12），而大多数具有完全玻璃体附着的NV表现为部分消退（18/24）（P < 0.001）。
新生血管的桌面状形态、基线时较高的VD值以及玻璃体在NV上的局灶性粘连是与每月一次IVI雷珠单抗3次后NV完全消退风险较高相关的因素。
