Subfoveal Choroidal Thickness as a Potential Predictor of Clinical Response to Stereotactic Radiotherapy for Neovascular Age-Related Macular Degeneration.
Subfoveal Choroidal Thickness as a Potential Predictor of Clinical Response to Stereotactic Radiotherapy for Neovascular Age-Related Macular Degeneration.
复制标题
黄斑中心凹下脉络膜厚度作为新生血管性年龄相关性黄斑变性立体定向放射治疗临床反应的潜在预测因子。
DOI：
10.3928/23258160-20180501-05
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
S. Grisanti
中科院分区：
文献类型：
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作者：
M. Ranjbar;Maximilian Kurz;A. Holzhey;D. Rades;S. Grisanti
背景与目的
立体定向放射治疗（SRT）是一种新的辅助治疗方式，已被证明可减少新生血管性年龄相关性黄斑变性（nAMD）患者重复玻璃体内注射（IVI）的需求。作者旨在确定对SRT临床反应的基线预测因素。
患者与方法
这是一项对接受SRT且随后至少有12个月完整随访的nAMD患者进行的回顾性、观察性病例系列研究。在SRT和一次强制性IVI之后，患者每4周接受一次检查，并根据需要进一步治疗。检查包括增强深度成像光谱域光学相干断层扫描（SD - OCT）以测量黄斑中心凹下脉络膜厚度（SFCT）和黄斑中心厚度（CMT）。患者数据从病历中获取，包括人口统计学资料、病程、病变大小、最佳矫正视力（BCVA）、既往IVI次数以及所用药物类型。
结果
共纳入35例患者的35只眼（年龄76.23±7.05岁），其中21只眼（60%）对SRT反应良好。年注射率从SRT前的6.86次降至之后的3.46次，而BCVA从基线时的0.49 logMAR提高到最终随访时的0.37 logMAR。从形态学角度来看，与基线相比，在12个月随访时CMT和SFCT分别降低了71μm和37μm。在所有研究的参数中，只有SFCT被证明具有显著意义，因为较高的基线SFCT被发现是SRT后所需IVI次数的强负向预测因子（回归系数：-0.678；P <.001）。
结论
基线SFCT可能有助于预测哪些nAMD患者对SRT反应更有利。作者发现基线SFCT较厚的眼睛在SRT后需要更少的IVI。[《眼科手术、激光与成像视网膜》2018年；49卷：320 - 328页]
BACKGROUND AND OBJECTIVE
Stereotactic radiotherapy (SRT) is a new adjuvant treatment modality that has been shown to reduce the need for repetitive intravitreal injections (IVIs) in patients with neovascular age-related macular degeneration (nAMD). The authors aimed to determine baseline predictors of clinical response to SRT.
PATIENTS AND METHODS
This was a retrospective, observational case series of patients with nAMD who underwent SRT and subsequently had at least 12 months of complete follow-up. After SRT and one mandatory IVI, patients were examined every 4 weeks and received further treatment on a pro re nata basis. Examination included enhanced depth imaging spectral-domain optical coherence tomography (SD-OCT) to measure subfoveal choroidal thickness (SFCT) and central macular thickness (CMT). Patients' data were retrieved from medical records and included demographics, disease duration, lesion size, best-corrected visual acuity (BCVA), previous number of IVIs, and type of drug applied.
RESULTS
A total of 35 eyes of 35 patients (76.23 years ± 7.05 years) were included, and 21 eyes (60%) responded well to SRT. The annual injection rate decreased from 6.86 before SRT to 3.46 afterward, whereas BCVA improved from 0.49 logMAR at baseline to 0.37 logMAR at final follow-up. From a morphologic point of view, CMT and SFCT decreased by 71 μm and 37 μm, respectively, at 12-month follow-up compared to baseline. Of all investigated parameters, only SFCT proved to be significant, as a higher baseline SFCT was found to be a strong negative predictor for the number of IVIs needed after SRT (regression coefficient: -0.678; P < .001).
CONCLUSIONS
Baseline SFCT may help predict which patients with nAMD will respond more favorably to SRT. The authors found eyes with a thicker baseline SFCT needed fewer IVIs after SRT. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:320-328.].