Borrelli Enrico, Mohammed Abdul Rasheed, Barresi Costanza, Vupparaboina Kiran Kumar, Viggiano Pasquale, Boscia Francesco, Berni Alessandro, Introini Ugo, Reibaldi Michele, Bandello Francesco, Chhablani Jay
Department of Surgical Sciences, University of Turin, Turin, Italy.
Department of Ophthalmology, City of Health and Science Hospital, Turin, Italy.
Graefes Arch Clin Exp Ophthalmol. 2025 Feb 13. doi: 10.1007/s00417-025-06767-z.
To perform a three-dimensional assessment of the choroid, including choroidal volume and choroidal vascularity index (CVI), during the transition from intermediate to neovascular age-related macular degeneration (AMD), and following anti-VEGF therapy.
A total of 42 participants (42 eyes) with intermediate AMD at baseline who developed neovascular AMD within 3 months were included in the analysis. Optical coherence tomography (OCT) scans at follow-up visits (after transition to neovascular AMD and 12 months after the initiation of anti-VEGF therapy) were compared with values at the latest visit with evidence of intermediate AMD to quantify longitudinal choroidal changes. Enhanced depth imaging (EDI) OCT scans were analyzed to obtain the following metrics: (i) choroidal volume, (ii) choroidal stromal volume, (iii) choroidal vascular volume, and (iv) CVI.
At baseline, the mean (median; IQR) choroidal volume (i.e., including both the stromal and vascular components) was 0.156 mm³ (0.149; 0.065), increasing to 0.163 mm³ (0.148; 0.068) at the follow-up when treatment-naïve exudative MNV was first detected (p = 0.013). After 12 months of anti-VEGF therapy, it returned to near-baseline levels at 0.156 mm³ (0.146; 0.065; p = 0.457). Similarly, the choroidal stromal and choroidal volumes increased at MNV detection but returned to baseline after treatment. Conversely, no alterations in CVI were observed between the baseline and follow-up visits.
The transition from intermediate to exudative neovascular AMD is associated with a significant increase in choroidal volume, affecting both stromal and luminal components. After anti-VEGF treatment, these changes regress, returning to baseline levels.
在从中间型年龄相关性黄斑变性（AMD）向新生血管性AMD转变期间以及抗VEGF治疗后，对脉络膜进行三维评估，包括脉络膜体积和脉络膜血管指数（CVI）。
分析纳入了42名基线时为中间型AMD且在3个月内发展为新生血管性AMD的参与者（42只眼）。将随访时（转变为新生血管性AMD后以及抗VEGF治疗开始12个月后）的光学相干断层扫描（OCT）结果与最新一次有中间型AMD证据时的扫描结果进行比较，以量化脉络膜的纵向变化。分析增强深度成像（EDI）OCT扫描结果以获得以下指标：（i）脉络膜体积，（ii）脉络膜基质体积，（iii）脉络膜血管体积，以及（iv）CVI。
基线时，平均（中位数；四分位间距）脉络膜体积（即包括基质和血管成分）为0.156mm³（0.149；0.065），在首次检测到未经治疗的渗出性MNV的随访时增加至0.163mm³（0.148；0.068）（p = 0.013）。抗VEGF治疗12个月后，其恢复至接近基线水平，为0.156mm³（0.146；0.065；p = 0.457）。同样，在检测到MNV时脉络膜基质和脉络膜体积增加，但治疗后恢复至基线水平。相反，基线和随访之间未观察到CVI有变化。
从中间型到渗出性新生血管性AMD的转变与脉络膜体积显著增加有关，影响基质和管腔成分。抗VEGF治疗后，这些变化消退，恢复至基线水平。
