Abstract：
OBJECTIVE: To investigate the formation and absorption of avascular subretinal hyperreflective material (avSHRM) in neovascular age-related macular degeneration (nAMD) based on optical coherence tomography angiography (OCTA) characteristics.
METHODS: Prospective cohort study METHODS: This study included patients with treatment-naïve nAMD and followed up for 3 months. Subjects were classified into avSHRM group and non-avSHRM group based on the presence of avSHRM at baseline. Quantitative OCTA characteristics including explant area, perimeter, vessel area, density, length, junctions, endpoints, lacunarity, maximum vessel caliber, vessel dispersion, and fractal dimension were assessed, three-dimensional volume and optical density ratio (ODR) of avSHRM were measured. Comparison analyses, correlate coefficients and regression models were applied to explore factors associated with avSHRM formation and absorption.
RESULTS: 88 eyes from 88 patients (39 females) were enrolled. Compared to non-avSHRM group, avSHRM group exhibit a more intricate vasculature, characterized by higher value of macular neovascularization (MNV) perimeter, vessel area, total vessel length, total number of junctions and total number of endpoints (all P < 0.05), as well as the maximum vessel caliber (P < 0.001). In the multivariate model, which has been adjusted for age, gender, and types of medications, avSHRM absorption was correlated with baseline average vessel length, maximum vessel caliber and avSHRM ODR (standardized β = 0.274, -0.367 and -0.334; P = 0.049, 0.010 and 0.018, respectively), with an adjusted R² of 0.453.
CONCLUSIONS: Quantitative OCTA measurements can be utilized for assessing the dynamics of avSHRM in nAMD. Patients with more complex vasculature are at a higher risk of avSHRM formation. Average vessel length, maximum vessel diameter and avSHRM ODR play a role in its absorption.
METHODS: Prospective cohort study METHODS: This study included patients with treatment-naïve nAMD and followed up for 3 months. Subjects were classified into avSHRM group and non-avSHRM group based on the presence of avSHRM at baseline. Quantitative OCTA characteristics including explant area, perimeter, vessel area, density, length, junctions, endpoints, lacunarity, maximum vessel caliber, vessel dispersion, and fractal dimension were assessed, three-dimensional volume and optical density ratio (ODR) of avSHRM were measured. Comparison analyses, correlate coefficients and regression models were applied to explore factors associated with avSHRM formation and absorption.
RESULTS: 88 eyes from 88 patients (39 females) were enrolled. Compared to non-avSHRM group, avSHRM group exhibit a more intricate vasculature, characterized by higher value of macular neovascularization (MNV) perimeter, vessel area, total vessel length, total number of junctions and total number of endpoints (all P < 0.05), as well as the maximum vessel caliber (P < 0.001). In the multivariate model, which has been adjusted for age, gender, and types of medications, avSHRM absorption was correlated with baseline average vessel length, maximum vessel caliber and avSHRM ODR (standardized β = 0.274, -0.367 and -0.334; P = 0.049, 0.010 and 0.018, respectively), with an adjusted R² of 0.453.
CONCLUSIONS: Quantitative OCTA measurements can be utilized for assessing the dynamics of avSHRM in nAMD. Patients with more complex vasculature are at a higher risk of avSHRM formation. Average vessel length, maximum vessel diameter and avSHRM ODR play a role in its absorption.
摘要：
目的：根据光学相干血管成像(OCTA)的特点，探讨新生血管性年龄相关性黄斑变性(nAMD)患者视网膜下高反射物质(avSHRM)的形成和吸收。
方法：前瞻性队列研究方法：本研究纳入初治nAMD患者，随访3个月。根据基线时avSHRM的存在将受试者分为avSHRM组和非avSHRM组。定量OCTA特征，包括外植体面积，周边,船舶面积,密度,长度,连接处,端点,疏漏，最大船舶口径,容器分散，并对分形维数进行了评估，测量了avSHRM的三维体积和光密度比（ODR）。比较分析，相关系数和回归模型用于探索与avSHRM形成和吸收相关的因素。
结果：纳入88例患者（39例女性）的88只眼。与非AVSHRM组相比，AVSHRM组表现出更复杂的脉管系统，以黄斑新生血管(MNV)周长值较高为特征，船舶面积,血管总长度,节点总数和端点总数（均P<0.05），以及最大血管口径（P<0.001）。在多变量模型中，已经根据年龄进行了调整，性别,以及药物的种类,avSHRM吸收与基线平均血管长度相关，最大血管口径和avSHRMODR（标准β=0.274、-0.367和-0.334；P分别=0.049、0.010和0.018），调整后的R²为0.453。
结论：定量OCTA测量可用于评估nAMD中avSHRM的动力学。具有更复杂脉管系统的患者具有更高的avSHRM形成风险。平均血管长度，最大血管直径和AVSHRMODR在其吸收中起作用。
方法：前瞻性队列研究方法：本研究纳入初治nAMD患者，随访3个月。根据基线时avSHRM的存在将受试者分为avSHRM组和非avSHRM组。定量OCTA特征，包括外植体面积，周边,船舶面积,密度,长度,连接处,端点,疏漏，最大船舶口径,容器分散，并对分形维数进行了评估，测量了avSHRM的三维体积和光密度比（ODR）。比较分析，相关系数和回归模型用于探索与avSHRM形成和吸收相关的因素。
结果：纳入88例患者（39例女性）的88只眼。与非AVSHRM组相比，AVSHRM组表现出更复杂的脉管系统，以黄斑新生血管(MNV)周长值较高为特征，船舶面积,血管总长度,节点总数和端点总数（均P<0.05），以及最大血管口径（P<0.001）。在多变量模型中，已经根据年龄进行了调整，性别,以及药物的种类,avSHRM吸收与基线平均血管长度相关，最大血管口径和avSHRMODR（标准β=0.274、-0.367和-0.334；P分别=0.049、0.010和0.018），调整后的R²为0.453。
结论：定量OCTA测量可用于评估nAMD中avSHRM的动力学。具有更复杂脉管系统的患者具有更高的avSHRM形成风险。平均血管长度，最大血管直径和AVSHRMODR在其吸收中起作用。
