OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY CHANGES IN EARLY TYPE 3 NEOVASCULARIZATION AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY CHANGES IN EARLY TYPE 3 NEOVASCULARIZATION AFTER ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT
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DOI：
10.1097/iae.0000000000001447
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发表时间：
2017-10-01
影响因子：
3.3
通讯作者：
Souied, Eric H.
中科院分区：
文献类型：
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作者：
Miere, Alexandra;Querques, Giuseppe;Souied, Eric H.
目的：探讨抗血管内皮生长因子治疗1年后继发于渗出性年龄相关性黄斑变性的未经治疗的3型新生血管的光学相干断层扫描血管造影（OCTA）的形态学变化。所有患者在基线时均接受了彩色眼底照片/MultiColor（Heidelberg Engineering）成像、荧光素血管造影、吲哚菁绿色血管造影、结构光谱域OCT和OCTA Optovue RTVue XR Avanti（Optovue），并在第12个月时重复OCTA和结构光谱域OCT。定性分析的3 × 3 OCTA检查在基线和第12个月进行了比较，以评估抗血管内皮生长因子therapy.Results后的变化：共15个治疗初治的眼睛的15个连续的患者被纳入分析。在前数据抗血管内皮生长因子治疗（5.75 +/- 1.48次注射雷珠单抗，6.33 +/- 1.21次注射阿柏西普）后12个月随访时，OCTA显示13/15只眼睛的深毛细血管丛异常持续存在。在外层视网膜和脉络膜毛细血管中，7/15例患者的初始病变变得不可检测，伴有脉络膜毛细血管萎缩。9/15眼异常血管复合体在视网膜外节段以簇状病变的形式持续存在，8例在脉络膜毛细血管节段伴有视网膜下色素上皮新生血管。光学相干断层扫描血管造影显示，丛状异常视网膜外病变，经常与脉络膜毛细血管内的小线索样血流信号，在抗血管内皮生长因子治疗1年后，变得不可检测或发展成视网膜下色素上皮新生血管形成。
Purpose: To investigate the morphologic changes on optical coherence tomography angiography (OCTA) of treatment-naive Type 3 neovascularization secondary to exudative age-related macular degeneration after 1 year of anti-vascular endothelial growth factor therapy.Methods: Consecutive patients diagnosed with treatment-naive early-stage Type 3 neovascularization were enrolled in this retrospective study. All patients underwent color fundus photographs/MultiColor (Heidelberg Engineering) imaging, fluorescein angiography, indocyanine green angiography, structural spectral domain OCT, and OCTA Optovue RTVue XR Avanti (Optovue) at baseline, and repeated OCTA and structural spectral domain OCT at Month 12. Qualitative analysis of the 3 x 3 OCTA examinations at baseline and Month 12 was then compared, to assess changes after anti-vascular endothelial growth factor therapy.Results: A total of 15 treatment-naive eyes of 15 consecutive patients were included in the analysis. At 12-month follow-up after pro-re-data anti-vascular endothelial growth factor therapy (5.75 +/- 1.48 injections of ranibizumab, and injections of 6.33 +/- 1.21 of aflibercept), OCTA demonstrated persistence of the deep capillary plexus abnormalities in 13/15 eyes. In the outer retina and choriocapillaris, the initial lesion became undetectable in 7/15 cases, accompanied by choriocapillaris atrophy. The abnormal vascular complex persisted in the form of a tuft-shaped lesion in the outer retinal segmentation in 9/15 eyes, which in the choriocapillaris segmentation was associated with sub-retinal pigment epithelium neovascularization in 8 cases.Conclusion: Optical coherence tomography angiography showed that the tuft-shaped abnormal outer retinal lesion, frequently associated with a small clew-like flow signal in the choriocapillaris, after 1 year of anti-vascular endothelial growth factor therapy, either becomes undetectable or develops sub-retinal pigment epithelium neovascularization.