Optical coherence tomography angiography of types 1 and 2 choroidal neovascularization in age-related macular degeneration during anti-VEGF therapy: evaluation of a new quantitative method
Optical coherence tomography angiography of types 1 and 2 choroidal neovascularization in age-related macular degeneration during anti-VEGF therapy: evaluation of a new quantitative method
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DOI：
10.1038/s41433-019-0429-8
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发表时间：
2019-09-01
期刊：
影响因子：
3.9
通讯作者：
Pauleikhoff, Daniel
中科院分区：
文献类型：
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作者：
Faatz, Henrik;Farecki, Marie-Louise;Pauleikhoff, Daniel
目的本初步研究的目的是测试脉络膜新生血管（CNV）血管形态的数学参数是否可以作为生物标志物，并研究这些参数在抗血管内皮生长因子（VEGF）治疗期间的变化。方法对28例脱出性年龄相关性黄斑变性（AMD）患者进行治疗初期CNV诊断。抗vegf治疗前后行oct血管造影（OCT-A） （Avanti/FA Optovue）。OCT-A数据集导出到外部图像处理程序，通过边缘检测完成血管骨架化。在此基础上计算治疗前后CNV的总血管长度、节段数和分形维数（FD）。比较VA、中央视网膜厚度（RT）等其他临床参数。结果抗vegf治疗显著减少了CNV的总血管长度（平均值652像素比397像素，p < 0.0001），以及CNV的单个血管段数量（平均值117比76，p < 0.0001）。在治疗期间，CNV的FD也显著降低（平均1.23 vs. 1.16, p < 0.0001）。这些参数在治疗期间的变化与VA的增加和rt的降低相对应。结论本初步研究表明，OCT-A的数学参数可以可视化和描述AMD中CNV的血管模式。治疗期间的变化与CNV已建立的“活性”参数显著相关，因此这些参数（尤其是FD）的变化可能代表额外的CNV“活性”生物标志物。
Purpose The aim of this pilot study was to test whether mathematical parameters of the vascular morphology of choroidal neovascularization (CNV) can be used as biomarkers and to investigate how these parameters change during anti-vascular endothelial growth factor (VEGF) therapy.Methods Treatment-naive CNV in exudative age-related macular degeneration (AMD) was diagnosed in 28 patients. OCT-angiography (OCT-A) (Avanti/FA Optovue) performed before and after anti-VEGF therapy. The OCT-A data sets were exported to an external image processing program and vessel skeletonization was accomplished by means of edge detection. Based on this technique the total vessel length, the number of segments and the fractal dimension (FD) of the CNV were calculated before and after therapy. The results were compared with other clinical parameters such as VA and central retinal thickness (RT).Results The total vessel length of the CNV was significantly reduced by anti-VEGF-therapy (mean value 652 pixels vs. 397 pixels; p < 0.0001), as well as the number of individual vessel segments of the CNV (mean value 117 vs. 76; p < 0.0001). The FD of the CNV also decreased significant reduction during therapy (mean 1.23 vs. 1.16, p < 0.0001). The changes in these parameters during treatment corresponded with an increase in VA and a reduction in RT.Conclusion This pilot study demonstrates that the vascular pattern of CNV in AMD can be visualized and described using mathematical parameters of OCT-A. The changes during therapy correlate significantly with established "activity" parameters of CNV, so changes in these parameters (especially FD) may represent additional CNV "activity" biomarkers.