Yang Hyun Seung, Jeon Sohee
Department of Ophthalmology, Seoul Shinsegae Eye Center, Seoul, Republic of Korea.
Biomedical Imaging Research Institute, Seoul Shinsegae Eye Center, Seoul, Republic of Korea.
Sci Rep. 2025 May 7;15(1):15966. doi: 10.1038/s41598-025-01094-z.
Type 1 macular neovascularization (MNV) is the most common type of MNV located in the sub-retinal pigment epithelium (RPE). Although type 1 MNV harbors significant clinical variabilities, the underlying pathomechanism has not been fully elucidated yet. The present study evaluated the characteristics of the choroidal feeding artery in 51 eyes with type 1 MNV using a multimodal imaging composite. In most cases (88.2%), a clear, visible connection between the MNV and choroidal artery was not confirmed. A seamless connection between the MNV and the underlying choroidal feeding artery was found in six of 51 eyes (11.8%). Patients with this aberrant choroidal feeding artery showed large pigment epithelial detachments (PED; P < 0.001) and sub-RPE deposits (P < 0.001) more frequently. Patients with aberrant choroidal feeding arteries achieved a dry macula of a similar percentage (P = 0.680) with more frequent anti-vascular endothelial growth factor injections (P = 0.005) and a switch to brolucizumab (P = 0.042) during a similar follow-up period (P = 0.305). Type 1 MNV with aberrant choroidal feeding arteries showed distinct characteristics from unimpeded blood flow (Large PED and sub-RPE deposits), suggesting that the aberrant choroidal arteries serve not only as a source of blood flow but also contribute to the development of MNV by arteriogenesis.
1型黄斑新生血管（MNV）是位于视网膜色素上皮（RPE）下最常见的MNV类型。尽管1型MNV存在显著的临床变异性，但其潜在的发病机制尚未完全阐明。本研究使用多模态成像复合体评估了51只患有1型MNV眼睛的脉络膜供血动脉的特征。在大多数情况下（88.2%），未确认MNV与脉络膜动脉之间有清晰可见的连接。在51只眼睛中有6只（11.8%）发现MNV与下方的脉络膜供血动脉之间存在无缝连接。患有这种异常脉络膜供血动脉的患者更频繁地出现大的色素上皮脱离（PED；P<0.001）和RPE下沉积物（P<0.001）。在相似的随访期（P=0.305）内，患有异常脉络膜供血动脉的患者实现干性黄斑的比例相似（P=0.680），但抗血管内皮生长因子注射更频繁（P=0.005）且更频繁地改用布罗珠单抗（P=0.042）。具有异常脉络膜供血动脉的1型MNV表现出与血流不受阻碍情况不同的特征（大的PED和RPE下沉积物），这表明异常的脉络膜动脉不仅是血流的来源，还通过动脉生成促进MNV的发展。
