The association of choroidal structure and its response to anti-VEGF treatment with the short-time outcome in pachychoroid neovasculopathy
The association of choroidal structure and its response to anti-VEGF treatment with the short-time outcome in pachychoroid neovasculopathy
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DOI：
10.1371/journal.pone.0212055
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发表时间：
2019-02-14
期刊：
影响因子：
3.7
通讯作者：
Obata, Ryo
中科院分区：
文献类型：
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作者：
Azuma, Keiko;Tan, Xue;Obata, Ryo
厚脉络膜新生血管病(PNV)与其他厚脉络膜病有一些共同的解剖特征，但抗血管内皮细胞生长因子(VEGF)治疗的特点却鲜为人知。我们研究了脉络膜结构和对抗血管内皮生长因子的反应对厚脉络膜新生血管病(PNV)和其他类型的新生血管性老年性黄斑变性(Non-PNV)预后的影响。对21只PNV患者和34只非PNV患者进行了抗血管内皮生长因子治疗。用荧光素血管造影术(FAG)测量基线时脉络膜新生血管(CNV)面积。用增强深度成像(EDI)OCT分别在基线和1个月时测量脉络膜的管腔和基质面积。分析有无PNV患者1个月时的干性黄斑或LogMAR VA与基线值或1个月时管腔或间质区域的变化、基线CNV面积或抗血管内皮生长因子药物的关系。在非PNV组，模型选择管腔面积变化(系数=7.0x10(-5)，p=0.0001)、基础CNV面积变化(系数=0.18，p=0.033)、阿普利康与雷尼比珠单抗(系数=0.29，p=0.0048)作为干性黄斑的预测因子。类似地，在非PNV中，管腔面积的变化(系数=6.1x10(-6)，p=0.033)、基线CNV面积的变化(系数=0.034，p=0.022)以及阿普利康与雷尼比珠单抗相比(系数=0.056，p=0.0020)被选为VA改善更大的预测因素。然而，在PNV中，通过模型选择，这些因素都没有被选为干性黄斑或视力改善的预测因子。本研究结果提示，非PNV组和PNV组在应用抗血管内皮生长因子药物治疗时，抗VEGF后的结构反应可能不同。
Pachychoroid neovasculopathy (PNV) shares some anatomical features with other pachychoroid spectrum diseases, but little is known about the characteristics on the treatment with anti-vascular endothelial growth factor (VEGF). We investigated the effect of choroidal structure and responses to anti-VEGF on the prognosis of pachychoroid neovasculopathy (PNV) and other types of neovascular age-related macular degeneration (non-PNV). Twenty-one eyes with PNV and 34 eyes with non-PNV who had anti-VEGF treatment were retrospectively reviewed. Choroidal neovascularization (CNV) area at baseline was measured with fluorescein angiography (FAG). The luminal and stromal area in the choroid was measured by enhanced-depth-imaging (EDI) OCT at baseline and 1 month. The association between dry macula or LogMAR VA (visual acuity, VA) at 1 month and baseline values or changes in the luminal or stromal area at 1 month, baseline CNV area, or anti-VEGF drugs were analyzed in patients with or without PNV. In non-PNV, change of luminal area (coefficient = 7.0x10(-5), p = 0.0001), baseline CNV area (coefficient = 0.18, p = 0.033), and aflibercept vs. ranibizumab (coefficient = 0.29, p = 0.0048) were chosen as predictors for dry macula by the model selection. Similarly, in non-PNV, change of luminal area (coefficient = 6.1x10(-6), p = 0.033), baseline CNV area (coefficient = 0.034, p = 0.022), and aflibercept vs. ranibizumab (coefficient = 0.056, p = 0.0020) were chosen as predictors for greater VA improvement. In PNV, however, none of these factors was chosen as predictors for dry macula or VA improvement by the model selection. The result of the present study implied that structural response after anti-VEGF might be different between non-PNV and PNV in the treatment with anti-VEGF agents.