厚脉络膜新生血管病变中的视网膜下高反射物质、萎缩及视网膜内液

Subretinal Hyperreflective Material, Atrophy, and Intraretinal Fluid in Pachychoroid Neovasculopathy.

作者信息

Baek Jiwon, Ra Ho, Lee Seung Hoon, Cheung Gemmy, Lee Won Ki

机构信息

Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Gyeonggi-do, Republic of Korea; Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Am J Ophthalmol. 2025 Aug 23. doi: 10.1016/j.ajo.2025.08.048.

DOI:10.1016/j.ajo.2025.08.048

PMID:40854450

Abstract

PURPOSE

To assess the association between subretinal hyperreflective material (SHRM), atrophy, and intraretinal fluid (IRF) in pachychoroid neovasculopathy (PNV).

DESIGN

Retrospective observational study.

SUBJECTS

A total of 120 eyes diagnosed with PNV and treated with anti-vascular endothelial growth factor for more than 1 year.

METHODS

Central macular thickness (CMT), best-corrected visual acuity (BCVA), and the presence of SHRM, atrophy, fibrosis, subretinal fluid (SRF), and IRF were assessed at baseline, 3 months, and 1 year. SHRM and atrophy areas were also quantitatively measured. Comparisons were made between eyes with SHRM (SHRM [+]) and without SHRM (SHRM [-]) at baseline.

MAIN OUTCOME MEASURES

Incidence and area of SHRM, development of atrophy and fibrosis, presence and resolution of IRF and SRF, changes in CMT and BCVA.

RESULTS

At baseline, 57 eyes (47.5%) exhibited SHRM, which regressed in 85% after 1 year. Atrophy developed in 40% of eyes at 1 year, with 83.3% occurring in SHRM (+) eyes. Fibrosis was observed in 21.7% of eyes, with 92.3% in SHRM (+). IRF was more prevalent in SHRM (+) (all P ≤ 0.010) and showed limited resolution compared with SRF (McNemar P = 0.099 vs. P < 0.001). SHRM (+) eyes had thinner CMT and worse BCVA.

CONCLUSION

SHRM at baseline was associated with the development of atrophy, fibrosis, and IRF in PNV. Although most SHRM regressed after treatment, it frequently resulted in residual atrophy.

摘要

目的

评估厚脉络膜新生血管病变（PNV）中视网膜下高反射物质（SHRM）、萎缩与视网膜内液（IRF）之间的关联。

设计

回顾性观察研究。

研究对象

共120只诊断为PNV且接受抗血管内皮生长因子治疗超过1年的眼睛。

方法

在基线、3个月和1年时评估中心黄斑厚度（CMT）、最佳矫正视力（BCVA）以及SHRM、萎缩、纤维化、视网膜下液（SRF）和IRF的存在情况。还对SHRM和萎缩区域进行了定量测量。在基线时对有SHRM（SHRM [+]）和无SHRM（SHRM [-]）的眼睛进行比较。

主要观察指标

SHRM的发生率和面积、萎缩和纤维化的发展、IRF和SRF的存在及消退情况、CMT和BCVA的变化。

结果

基线时，57只眼睛（47.5%）出现SHRM，1年后85%消退。1年时40%的眼睛出现萎缩，其中83.3%发生在SHRM（+）的眼睛中。21.7%的眼睛观察到纤维化，92.3%发生在SHRM（+）的眼睛中。IRF在SHRM（+）的眼睛中更常见（所有P≤0.010），与SRF相比，其消退有限（McNemar检验，P = 0.099对P < 0.001）。SHRM（+）的眼睛CMT更薄，BCVA更差。