[1]高鸽,孙娜,姜媛,等.抗血管内皮生长因子治疗前后脉络膜新生血管的光学相干断层扫描血管成像分析[J].眼科新进展,2019,39(9):845-848.[doi:10.13389/j.cnki.rao.2019.0192]
　GAO Ge,SUN Na,JIANG Yuan,et al.Optical coherence tomography angiography analysis of choroidal neovascularization before and after treatment with anti-vascular endothelial growth factor[J].Recent Advances in Ophthalmology,2019,39(9):845-848.[doi:10.13389/j.cnki.rao.2019.0192]
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抗血管内皮生长因子治疗前后脉络膜新生血管的光学相干断层扫描血管成像分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年9期
页码:
845-848
栏目:
应用研究
出版日期:
2019-09-05

文章信息/Info

Title:
Optical coherence tomography angiography analysis of choroidal neovascularization before and after treatment with anti-vascular endothelial growth factor
作者:
高鸽; 孙娜; 姜媛; 郑波
710004　陕西省西安市，西安市第四医院眼科
Author(s):
GAO Ge; SUN Na; JIANG Yuan; ZHENG Bo
Department of Ophthalmology,the Fourth Hospital of Xi ’an,Xi ’an 710004，Shaanxi Province，China
关键词:
光学相干断层扫描血管成像; 抗血管内皮生长因子治疗; 脉络膜新生血管
Keywords:
optical coherence tomography angiography; anti-vascular endothelial growth factor; choroidal neovascularization
分类号:
R773.4
DOI:
10.13389/j.cnki.rao.2019.0192
文献标志码:
A
摘要:
目的　应用光学相干断层扫描血管成像(optical coherence tomography angiography，OCTA)观察抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗后不同类型脉络膜新生血管（choroidal neovascularization,CNV）的应答反应，分析应答差异及CNV的特征。方法　收集我院经荧光素眼底血管造影联合吲哚菁绿血管造影确诊为CNV的患者52例（55眼），所有患眼在治疗前及随访中均行最佳矫正视力(best corrected visual acuity，BCVA)、眼底及OCTA检查。一方面按照CNV病因分组，观察不同病因CNV治疗后BCVA及黄斑中心凹视网膜厚度的差异；另一方面按照CNV形态及视网膜层间有无积液分组，观察各组治疗前后BCVA及黄斑中心凹视网膜厚度的差异。结果　年龄相关性黄斑变性并发CNV、特发性CNV治疗前后BCVA及黄斑中心凹视网膜厚度均较治疗前明显改善，差异均有统计学意义（均为P<0.05）；病理性近视合并CNV及脉络膜炎合并CNV治疗前后黄斑中心凹视网膜厚度差异均无统计学意义（均为P>0.05）。CNV血管粗大且视网膜层间有积液组及CNV血管细小且视网膜层间有积液组治疗前后BCVA、黄斑中心凹视网膜厚度均有明显改善，差异均有统计学意义（均为P<0.05）；CNV血管粗大且视网膜层间无积液组治疗前后BCVA差异无统计学意义（P>0.05）。结论　不同类型的CNV对抗VEGF治疗的应答存在差异，CNV的形态学特征一定程度上能够反映新生血管的活动性及成熟性，有助于预测抗VEGF治疗的应答反应。
Abstract:
Objective　To observe the responsion of different types of choroidal neovascularization (CNV) after anti-vascular endothelial growth factor(VEGF) treatment by using optical coherence tomography angiography (OCTA),and analyze the difference and characteristics of CNV.Methods　Collected fifty-two patients (55 eyes) with CNV diagnosed by fluorescein fundus angiography and indocyanine green angiography in our hospital.All eyes were examined by best corrected visual acuity (BCVA),fundus and OCTA before treatment and during follow-up.On the one hand,grouped according to the etiology of CNV,the differences of BCVA and macular fovea retinal thickness were observed before and after treatment.On the other hand,grouped according to the morphology of CNV and the presence or absence of hydroretinal effusion,the differences of BCVA and retinal thickness of macular fovea before and after treatment were observed.Results　BCVA and macular fovea retinal thickness after treatment of age-related macular degeneration with CNV and idiopathic CNV were significantly improved compared with those before treatment,the difference was statistically significant (all P<0.05);there was no significant difference in macular fovea retinal thickness between pathological myopia with CNV and choroiditis with CNV before and after treatment (all P>0.05).BCVA and macular fovea retinal thickness were significantly improved in CNV group with enlarged retinal vessel,small retinal vessel and enlarged retinal vessel before and after treatment (all P<0.05);there was no significant difference in BCVA before and after treatment in CNV group with large vessels and no hydroretinal effusion (P>0.05).Conclusion　Different types of CNV respond differently to anti-VEGF therapy.The morphological characteristics of CNV can reflect the activity and maturity of neovascularization to a certain extent,and help to predict the response to anti-VEGF therapy.

参考文献/References:

［1］　SALOMON Y C，SYLVIA N B，TYPHAINE G,LISE D,SANDRINE A,FRANCK F,et al.Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab［J］.Jpn J Ophthalmol，2015,59:36-42.
［2］　LI X X,XU G Z,WANG Y S,XUN X U,LIU X L,TANG S B,et al.Safety and efficacy of Conbercept in neovascular age-related macular degeneration:Result from a 12-month randomized phase 2 study:Aurora study［J］.Ophthamology,2014,121(9):1740-1747.
［3］　SUN X D,WANG F H.Standardize intraocular injection to reduce the risk of intraocular inflammation［J］.Chin J Ophthalmol,2012,48(2):100-102.
［4］　LARSEN M,SCHMIDT E U,LANZETTA P,WOLF S,SIMADER C,TOKAJI E,et al.Verteporfin plus Ranibizumab for choroidal neovascularization in age-relateg macular degeneration:twelve-month MONT BLANC study results［J］.Ophthalmology,2012,119(5):992-1000.
［5］　ZHANG H，LIU Z L，SUN P，GU F.Intravitreal bevacizumab for treatment of subfoveal idiopathic choroidal neovascularization：Resuits of a 1-year prospective tria［J］.Am J Ophthalmol，2012，153(2)：300-306.
［6］　WANG M,ZHOU Y.To understand the clinical value of OCT angiography［J］.Chin J Exp Ophthalmol,2016,34(12):1057-1060.
［7］　SAVASTANO M C，LUMBROSO B，RISPOLI M.In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography［J］.Retina，2015，35(11)：2196-2203.
［8］　SIEMERINK M J,AUGUSTIN A J,SCHLINGEMANN R.Mechanisms of ocular angiogenesis and its molecular mediators［J］.Dev Ophthalmol,2010,46:4-20.
［9］　PIERMAROCCHI S，GIUSEPPE L G，MAURO S,FEDERICO F,TATIANA S，ELISABETTA P,et al.Photodynamic therapy increases the eligibility for feeder vessel treatment of choroidal neovascularization caused by age-related macular degeneration［J］.Am J Ophthalmol，2002，133(4)：572-575.
［10］　MIERE A,SEMOUN O,COHEN S Y,EIAMEEN A,SROUR M,JUNQ C,et al.Optical coherence tomography angiography features of subretinal fibrosis in age-related macular degeneration［J］.Retina,2015,35(11):2275-2284.
［11］　DANSINGANI K K,FREUND K B.Optical coherence tomography angiography reveals mature,tangled vascular networks in eyes with neovascular age-related macular degeneration showing resistance to geographic atrophy［J］.Ophthalmic Surg Lasers Imaging Retina,2015,46(9):907-912.
［12］　AL-SHEIKH M,LAFE N A,PHASUKKIJWATANA N,SADDA S R,SARRAF D.Biomakers of neovascular activity in age-related macular degeneration using OCT agiography［J］.Retina,2018,38(2):220-230.
［13］　SUN X D,SONG Z Y,WANG F H.Strategy of anti-vascular engothelial growth factor A in the treatment of age-related macular degeneration in follow-up and retreatment［J］.Chin J Exp Ophthalmol,2012,30（5）:385-387.

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备注/Memo

备注/Memo:
西安市第四医院科研孵化基金（编号：FZ-24）
更新日期/Last Update: 2019-08-26