Optical Coherence Tomography Angiography Signs of Vascular Abnormalization With Antiangiogenic Therapy for Choroidal Neovascularization
Optical Coherence Tomography Angiography Signs of Vascular Abnormalization With Antiangiogenic Therapy for Choroidal Neovascularization
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DOI：
10.1016/j.ajo.2015.04.012
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发表时间：
2015-07-01
影响因子：
4.2
通讯作者：
Spaide, Richard F.
中科院分区：
文献类型：
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作者：
Spaide, Richard F.
目得：研究脉络膜新生血管（CNV）的血管外观，通过反复玻璃体内注射抗血管内皮生长因子（VEGF）治疗，这被认为会导致短暂的血管正常化，沿着血管减少和渗漏。设计：回顾性病例系列，对该主题进行展望。方法：对来自社区视网膜转诊实践的继发于年龄相关性黄斑变性的接受治疗的CNV患者进行了光学相干断层扫描血管造影评估，频谱幅度去相关脉络膜新生血管形态的14个连续patients.RESULTS：患者的平均年龄为78.4（标准差+/- 9.3）岁，8男6女，17眼。病变的平均最大线性尺寸为3600 μ m。抗VEGF注射的平均次数为47（+/- 21）。CNV中的血管的血管直径即使在小的病变中也显得很大，其中供血血管接近视网膜的主要拱状血管的大小。血管分支点少，大血管间吻合连接多。有一个可视化的insulines.CONCLUSIONS：本研究的结果不支持假设的血管正常化的眼睛接受经常性的定期antiangiogenic治疗的毛细血管缺乏。所观察到的“异常”的血管可以解释为周期性修剪血管生成的血管芽的血管生长因子撤出在面对畅通的动脉生成。由于眼睛是一个容易获得的VEGF实验室，其中表达的特征也可以应用于身体其他地方的新血管形成，如肿瘤。(C)2015年，Elsevier Inc. All rights reserved.
PURPOSE: To investigate the vascular appearance of choroidal neovascularization (CNV) treated with recurrent intravitreous anti vascular endothelial growth factor (VEGF) injections, which have been proposed to cause transient vascular normalization along with decreased vascularity and leakage.DESIGN: Retrospective case series with perspective on the topic.METHODS: Patients with treated CNV secondary to age-related macular degeneration from a community-based retinal referral practice were evaluated with optical coherence tomography angiography employing split-spectrum amplitude decorrelation. The choroidal neovascular morphology of the 17 eyes of 14 consecutive patients was described.RESULTS: The mean age of the patients, 8 men and 6 women, was 78.4 (standard deviation +/- 9.3) years. The mean greatest linear dimension of the lesion was 3600 mu m. The mean number of anti-VEGF injections Was 47 (+/- 21). The vascular diameter of the vessels in the CNV appeared large even in small lesions, with feeder vessels approaching the size of the major arcade vessels of the retina. The vessels had few branch points and many vascular anastomotic connections among larger vessels. There was a paucity of capillaries visualized within the lesions.CONCLUSIONS: The findings of this study do not support the hypothesis of vascular normalization in eyes receiving recurrent periodic antiangiogenic treatment. The observed "abnormalization" of the vessels may be explained by periodic pruning of angiogenic vascular sprouts by VEGF withdrawal in the face of unimpeded arteriogenesis. As the eye is a readily accessible VEGF laboratory, features expressed therein may also apply to neovascularization elsewhere in the body, such as in tumors. (C) 2015 by Elsevier Inc. All rights reserved.