Shi Yan-Mei, Xie Xiao, Wang Wen-Qi, Yuan Xiao-Meng, Zhang Zhi-Ping, Wang Hong-Yan, Meng Jie, Kong Ze-Hao, Jing Xia, Liu Ting-Ting
The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China.
Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan 250002, Shandong Province, China.
Int J Ophthalmol. 2025 Aug 18;18(8):1490-1497. doi: 10.18240/ijo.2025.08.10. eCollection 2025.
To quantitatively assess central macular thickness (CMT), macular neovascularization (MNV) area, vascular tortuosity (VT), and vascular dispersion (VDisp) in neovascular age-related macular degeneration (nAMD), type 1 and type 2 MNV, by means of optical coherence tomography (OCT) and OCT angiography (OCTA) techniques.
In this retrospective and observational case series, patients were classified into type 1 or type 2 MNV groups. A comprehensive panel of OCT and OCTA metrics was evaluated, including CMT, MNV area, VT, and VDisp. All subjects underwent a standardized intravitreal conbercept (IVC) regimen [3+ (PRN)] with a 12-month follow-up. MNV area was obtained by manual measurements with OCTA software, and VT and VDisp were calculated by automated analysis with Image J software.
A total of 101 participants were included, with 51 patients in the type 1 MNV group (mean age 67.32±9.12y) and 50 patients in the type 2 MNV group (mean age 64.74±5.21y). The mean number of IVC injections was 3.98±1.53 for type 1 MNV and 3.73±0.81 for type 2 MNV. Both subtypes exhibited significant improvements in visual acuity, accompanied by marked reductions in CMT and MNV area (<0.05) at 12mo after treatment. In type 2 MNV, VT significantly decreased (<0.05), whereas no significant change was observed in VT for type 1 MNV. VDisp did not significantly changed in either sybtypes. Moreover, in type 1 MNV, final best-corrected visual acuity (BCVA) using logMAR correlated positively with both pre- and post-treatment CMT, while in type 2 MNV, a significant positive correlation was found between the number of injections and final CMT.
This study shows that conbercept treatment significantly improves visual acuity and macular structure in both type 1 and type 2 MNV with reductions in CMT and MNV area. The significant reduction in VT in type 2 MNV suggests its potential as a biomarker for disease activity. The findings imply the quantitative assessment useful for the stratification, prognostication, and personalized management of MNV in nAMD.
通过光学相干断层扫描（OCT）和OCT血管造影（OCTA）技术，定量评估新生血管性年龄相关性黄斑变性（nAMD）中1型和2型黄斑新生血管（MNV）的中心黄斑厚度（CMT）、黄斑新生血管面积、血管迂曲度（VT）和血管离散度（VDisp）。
在这个回顾性观察病例系列中，患者被分为1型或2型MNV组。评估了一组全面的OCT和OCTA指标，包括CMT、MNV面积、VT和VDisp。所有受试者均接受标准化的玻璃体内康柏西普（IVC）方案[3 +（按需）]并进行12个月的随访。MNV面积通过OCTA软件手动测量获得，VT和VDisp通过Image J软件自动分析计算。
共纳入101名参与者，1型MNV组51例患者（平均年龄67.32±9.12岁），2型MNV组50例患者（平均年龄64.74±5.21岁）。1型MNV的IVC注射平均次数为3.98±1.53次，2型MNV为3.73±0.81次。两种亚型在治疗后12个月时视力均有显著改善，同时CMT和MNV面积显著降低（<0.05）。在2型MNV中，VT显著降低（<0.05），而1型MNV的VT未观察到显著变化。两种亚型的VDisp均无显著变化。此外，在1型MNV中，使用logMAR的最终最佳矫正视力（BCVA）与治疗前和治疗后的CMT均呈正相关，而在2型MNV中，注射次数与最终CMT之间存在显著正相关。
本研究表明，康柏西普治疗可显著改善1型和2型MNV的视力和黄斑结构，同时降低CMT和MNV面积。2型MNV中VT的显著降低表明其作为疾病活动生物标志物的潜力。这些发现意味着定量评估对nAMD中MNV的分层、预后和个性化管理有用。
