背景:为了报告继发于血管样条纹的脉络膜新生血管形成患者的渗出复发风险和长期预后,根据其形态和特点通过光学相干断层扫描血管造影。
方法:回顾性分析三家医院的电子病历。我们招募了临床诊断为血管样条纹脉络膜新生血管的患者,这些患者的最低随访时间为12个月。从每个记录中,我们提取了一般的人口统计数据,最佳矫正视力(基线,在每次疾病复发之前和之后以及最后一次存档),治疗类型,最后一次玻璃体内注射和疾病复发之间的时间,通过光学相干断层扫描对新生血管病变形态进行分类,和光学相干断层扫描血管造影。近视脉络膜新生血管患者用作对照。通过Cohen-Kappa测试评估了观察者之间的一致性。利用显著性的chi2检验计算赔率比。对于重复测量,用ANOVA评估视敏度随时间的变化,α值为0.05,具有统计学显著性。
结果:我们在研究组中招募了30例患者,在对照组中招募了14例患者。在研究小组中,基线和最终BCVA分别为0.861±0.59和1.095±0.61logMAR(p=0.1)。
方法:1.045±0.57和0.617±0.53logMAR(p<0.05)。在研究小组中,OCTA的主要CNV类型是混合的(37%),和隔行扫描(57%)在对照组。基线时的混合模式和齿轮模式增加了研究组的复发几率(p=0.09)。研究组患者在每次复发时需要更多的玻璃体内注射以达到疾病控制(3.5±1.5vs.1.4±0.2,p<0.01)。
结论:在血管样条纹和CNV患者中,抗VEGF治疗的益处随着时间的推移而消失。光学相干断层扫描血管造影的病变特征可以帮助医生预测复发的风险。
背景:回顾性注册,IRB批准。
BACKGROUND: To report the risk of exudation recurrence and long-term outcomes in patients with choroidal neovascularization secondary to angioid streaks, according to its morphology and characteristics by optical coherence tomography angiography.
METHODS: Retrospective analysis of electronic medical records from three hospitals. We enrolled patients with a clinical diagnosis of angioid streaks choroidal neovascularization that had a minimum follow-up of 12 months. From each record, we extracted general demographic data, best corrected visual acuity (baseline, before and after each disease recurrence and last on file), type of treatment, time between last intravitreal injection and disease recurrence, and classification of the neovascular lesion morphology by optical coherence tomography, and optical coherence tomography angiography. Patients with myopic choroidal neovascularization were used as controls. Interobserver agreement was assessed with a Cohen-Kappa test. The Odds ratio was calculated with a chi2 test for significance. Visual acuity change through time was evaluated with an ANOVA for repeated measurements with an alpha value of 0.05 for statistical significance.
RESULTS: We enrolled 30 patients in the study group and 14 in the control group. In the study group, the baseline and final BCVA were 0.861 ± 0.59 and 1.095 ± 0.61 logMAR (p = 0.1) respectively.
METHODS: 1.045 ± 0.57 and 0.617 ± 0.53 logMAR (p < 0.05). In the study group, the predominant CNV type by OCTA was mixed (37%), and interlacing (57%) in the control group. Mixed and cog-wheel patterns at baseline had increased Odds for recurrence in the study group (p = 0.09). Patients in the study group required more intravitreal injections on each recurrence episode to achieve disease control (3.5 ± 1.5 vs.1.4 ± 0.2, p < 0.01).
CONCLUSIONS: The benefits of anti-VEGF treatment are lost over time in patients with angioid streaks and CNV. Lesion characteristics by optical coherence tomography angiography could help physicians predict the risk of recurrence.
BACKGROUND: Retrospective registered, and IRB approved.