Choroidal Changes in Eyes With Polypoidal Choroidal Vasculopathy After Anti-VEGF Therapy Imaged With Swept-Source OCT Angiography.
Choroidal Changes in Eyes With Polypoidal Choroidal Vasculopathy After Anti-VEGF Therapy Imaged With Swept-Source OCT Angiography.
复制标题
抗VEGF治疗后，用扫荡的源oct血管造影成像的抗VEGF治疗后，脉络膜脉络膜脉络膜脉络膜病变的眼睛变化。
DOI：
10.1167/iovs.62.15.5
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发表时间：
2021-12-01
影响因子：
4.4
通讯作者：
Rosenfeld PJ
中科院分区：
文献类型：
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作者：
Shen M;Zhou H;Kim K;Bo Q;Lu J;Laiginhas R;Jiang X;Yan Q;Iyer P;Trivizki O;Shi Y;de Sisternes L;Durbin MK;Feuer W;Gregori G;Wang RK;Sun X;Wang F;Yu SY;Rosenfeld PJ
采用扫描源光学相干断层扫描血管造影术研究血管内皮生长因子（VEGF）抑制剂治疗后息肉状脉络膜血管病（PCV）患者脉络膜的变化及其与色素上皮脱落（PED）的关系。入选了未接受过治疗的PCV患者，并接受了抗VEGF治疗。在治疗前后测量平均脉络膜厚度（MCT）、脉络膜血管指数（CVI）和PED体积。纳入了来自33例患者的34只未经治疗的PCV眼睛。治疗后PED体积明显减小（P < 0.05）。MCT从基线时的223.0 ± 79.6 µm降至治疗后的210.9 ± 76.2 µm（P < 0.001）。基线时的CVI为0.599 ± 0.024，治疗后的CVI为0.602 ± 0.023（P = 0.16）。PED体积减少与MCT测量值减少之间存在相关性（r = 0.47; P = 0.006）。此外，PED体积减少与CVI测量值增加之间存在相关性（r =-0.63; P < 0.001）。在PCV初治眼中，PED体积的减少与MCT的减少和CVI测量值的增加相关。我们建议，在基线时，PCV病变作为脉络膜动脉和静脉循环之间的高容量动静脉分流，导致渗出进入脉络膜基质。我们建议，治疗后，通过血管分流的血流量减少，多余的基质渗出被吸收，从新生血管病变渗出减少，导致脉络膜变薄，PED的决议，并增加CVI由于吸收多余的脉络膜渗出。
Swept-source optical coherence tomography angiography was used to investigate choroidal changes and their association with pigment epithelial detachments (PEDs) in eyes with polypoidal choroidal vasculopathy (PCV) after treatment with vascular endothelial growth factor (VEGF) inhibitors. Patients with treatment-naïve PCV were included and underwent anti-VEGF therapy. Mean choroidal thickness (MCT), choroidal vascularity index (CVI), and PED volume measurements were obtained before and after treatment. Thirty-four treatment-naïve PCV eyes from 33 patients were included. The PED volume decreased after treatment (P < 0.05). The MCT decreased from 223.0 ± 79.6 µm at baseline to 210.9 ± 76.2 µm after treatment (P < 0.001). The CVI at baseline was 0.599 ± 0.024, and the CVI after treatment was 0.602 ± 0.023 (P = 0.16). There was a correlation between the decreased PED volumes and the decreased MCT measurements (r = 0.47; P = 0.006). Also, there was a correlation between the decreased PED volumes and the increased CVI measurements (r = −0.63; P < 0.001). In treatment-naïve eyes with PCV, the decreases in PED volumes were correlated with the decrease in MCT and the increase in CVI measurements. We propose that, at baseline, the PCV lesions serve as high-volume arteriovenous shunts between choroidal arterial and venous circulation, causing transudation into the choroidal stroma. We propose that, after treatment, the blood flow through the vascular shunt is reduced, the excess stromal transudation is resorbed, and the exudation from the neovascular lesion is reduced, resulting in thinning of the choroid, resolution of the PEDs, and an increase in the CVI due to the resorption of excess choroidal transudation.