目的:本研究的目的是使用光学相干断层扫描(OCT)确定的定量参数,比较由新生血管性年龄相关性黄斑变性(n-AMD)引起的1型和2型黄斑新生血管(MNV)对玻璃体内抗血管内皮生长因子(VEGF)治疗的反应。此外,本研究还旨在评估这些定量参数与最佳矫正视力(BCVA)的变化以及一年内需要的玻璃体内注射抗VEGF的数量之间的联系.
方法:在我们的回顾性和观察性研究中,对90例诊断为n-AMD并采用"Prorenata"方法接受玻璃体内注射抗VEGF治疗的患者的90只眼数据进行评估.使用先前拍摄的光学相干断层扫描血管造影(OCTA)图像来区分现有MNV的亚型。在谱域OCT检查中,记录基线和第12个月时的中央黄斑厚度(CMT)和中央黄斑体积(CMV)值.还记录每个患者在12个月随访期间玻璃体内注射抗VEGF的次数。在MNV类型之间比较获得的数据。
结果:在研究中检查的n-AMD病例中,1型MNV占56.66%,2型MNV占43.34%。2型MNV眼的平均基线BCVAlogMAR值(1.15±0.43)高于1型MNV眼的平均基线BCVAlogMAR值(0.76±0.42)(p=0.001)。同样,2型MNV眼的平均基线CMT和CMV值高于1型MNV眼的平均基线CMT和CMV值(分别为424.89±49.46μm与341.39±37.06μm;9.17±0.89μm3vs.8.49±0.53μm3;p<0.05)。经过12个月的治疗,2型MNV受试者的BCVA的logMAR值(0.86±0.42)高于1型MNV受试者的logMAR值(0.57±0.37)(p=0.001)。观察到2型MNV(分别为379.11±46.36μm和8.66±0.79μm3)的受试者在第12个月的平均CMT和CMV值高于1型MNV(分别为296.95±33.96μm和8.01±0.52mm3)(p<0.05)。在2型MNV中,基线和12个月BCVAlogMAR值与基线CMV呈正相关(p<0.05).同样,在2型MNV中,12个月BCVAlogMAR值与12个月CMV之间呈正相关(p<0.05)。两组在12个月时玻璃体内注射抗VEGF的总次数相似(p=0.851)。
结论:在这项研究中,我们对MNV病例进行了亚型分析,我们观察到在第12个月的开始和结束时视觉功能变差,与1型MNV病例相比,2型MNV组的CMT和CMV值均较高。此外,我们发现在2型MNV病例中BCVAlogMAR值和CMV值之间存在显著相关性.在这些案件的后续行动中,CMT,这是一种更广泛使用的定量方法,和CMV,这是一个较新的OCT测量参数,可能在患者随访和治疗效果评估中更有用,特别是2型MNV病例。
OBJECTIVE: The aim of this study was to compare the responses of type 1 and type 2 macular neovascularizations (MNV) caused by neovascular type age-related macular degeneration (n-AMD) to intravitreal anti-vascular endothelial growth factor (VEGF) treatments using quantitative parameters determined by optical coherence tomography (OCT). Additionally, it was also intended to assess the connections between these quantitative parameters and changes in best-corrected visual acuity (BCVA) and the number of intravitreal anti-VEGF injections required within a year.
METHODS: In our retrospective and observational study, the data of 90 eyes of 90 patients diagnosed with n-AMD and treated with intravitreal anti-VEGF with the \"Pro re nata\" method were evaluated. Subtypes of existing MNVs were distinguished with previously taken optical coherence tomography angiography (OCTA) images. In spectral domain OCT examinations, central macular thickness (CMT) and central macular volume (CMV) values were recorded at baseline and 12th month. The number of intravitreal anti-VEGF injections during the 12 month follow-up period was also recorded for each patient. Obtained data were compared between MNV types.
RESULTS: Of the n-AMD cases examined in the study, 56.66% had type 1 MNV and 43.34% had type 2 MNV. The mean baseline BCVA logMAR values in eyes with type 2 MNV (1.15 ± 0.43) were higher than those observed in eyes with type 1 MNV (0.76 ± 0.42) (p = 0.001). Similarly, mean baseline CMT and CMV values in eyes with type 2 MNV were higher than those observed in eyes with type 1 MNV (respectively 424.89 ± 49.46 μm vs. 341.39 ± 37.06 μm; 9.17 ± 0.89 μm3 vs. 8.49 ± 0.53 μm3; p < 0.05). After 12 months of treatment, logMAR values of BCVA (0.86 ± 0.42) in subjects with type 2 MNV were higher than those in subjects with type 1 MNV (0.57 ± 0.37) (p = 0.001). Mean CMT and CMV values at 12th month in subjects with type 2 MNV (379.11 ± 46.36 μm and 8.66 ± 0.79 μm3, respectively) were observed to be higher than those with type 1 MNV (296.95 ± 33.96 μm and 8.01 ± 0.52 mm3, respectively) (p < 0.05). In type 2 MNVs, positive correlations were observed between both baseline and 12th month BCVA logMAR values and baseline CMV (p < 0.05). Similarly, in type 2 MNVs, a positive correlation was observed between 12th month BCVA logMAR values and 12th month CMV (p < 0.05). The total number of intravitreal anti-VEGF injections at 12 months was similar in both groups (p = 0.851).
CONCLUSIONS: In this study, in which we performed a subtype analysis of MNV cases, we observed that the visual function was worse at the beginning and the end of the 12th month, and the CMT and CMV values were higher in the type 2 MNV group compared to the type 1 MNV cases. In addition, we found significant correlations between BCVA logMAR values and CMV values in type 2 MNV cases. In the follow-up of these cases, CMT, which is a more widely used quantitative method, and CMV, which is a newer OCT measurement parameter, may be more useful in patient follow-up and evaluation of treatment efficacy, especially for type 2 MNV cases.