年龄相关性黄斑变性患者黄斑新生血管形态影响治疗需求和1年后视力结果。

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Michael Grün, Kai Rothaus, Martin Ziegler, Albrecht Lommatzsch, Clemens Lange, Henrik Faatz
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引用次数: 0

摘要

背景/目的:评价光学相干断层扫描(OCT)和OCT血管造影参数在预测therapy-naïve新生血管性年龄相关性黄斑变性(nAMD)患者一年后的治疗需求和视力结果方面的潜力。方法:对96只新诊断为nAMD的therapy-naïve眼进行回顾性研究。所有眼睛接受基线OCT和OCTA检查。随后进行初始上传后的随访OCT,包括三次玻璃体内注射抗血管内皮生长因子(anti-VEGF),每隔四周注射一次。定性和定量评估OCT参数,包括视网膜内液(IRF)、视网膜下液(SRF)、色素上皮脱离(PED)和视网膜中央厚度(CRT)。基线时的黄斑新生血管(MNV)形态用面积、血管总长度、血流密度和分形维数来描述。治疗1年后OCT和OCTA参数与最佳矫正视力(BCVA)和静脉注射次数相关。结果:持续视网膜下积液(SRF)或同时存在视网膜内积液(IRF)和SRF的眼睛对静脉注射的需求显著增加(p < 0.01)。此外,基线时色素上皮脱离(PED)的存在(p < 0.05)、基线时PED的高度(p < 0.01)、上传后PED的存在(p < 0.01)和上传后PED的高度(p < 0.01)均与ivi数量增加相关。上传过程中PED高度降低,ivi数量减少(p < 0.01)。上述参数对1年后BCVA无影响(p < 0.05)。基线视网膜中央厚度(CRT)与12个月时BCVA恶化有关(p < 0.05),但与静脉注射次数无关。随访1年时,CRT与BCVA恶化(p < 0.01)、ivi增多(p < 0.01)相关,而CRT降低与BCVA好转(p < 0.05)、ivi减少(p < 0.01)相关。在OCTA中,mnv的面积和总血管长度与1年后BCVA相关(p < 0.01),但对ivi数量无影响(p < 0.05)。血流密度对两项指标均无影响(p < 0.05)。分形维数与1年后BCVA (p < 0.01)和ivi数(p < 0.05)相关。结论:OCT的MNV面积、血管长度和分形维数,以及基线和随访后OCT的流体分布,可作为治疗需求和一年后视力结果的指标。进一步的研究需要更长的观察期和使用深度学习模型来改进分析,并验证这些发现在临床实践中的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Morphology of Macular Neovascularization in Age-Related Macular Degeneration Influences Treatment Requirement and Visual Outcome After 1 Year.

Background/Objectives: To evaluate the potential of Optical Coherence Tomography (OCT) and OCT angiography parameters in predicting treatment requirements and visual outcomes after one year in therapy-naïve eyes with neovascular age-related macular degeneration (nAMD). Methods: A retrospective study of 96 therapy-naïve eyes newly diagnosed with nAMD was carried out. All eyes received baseline OCT and OCTA. Follow-up OCT after initial upload was then carried out, involving three intravitreal injections (IVIs) with anti-Vascular Endothelial Growth Factor (anti-VEGF) at four-week intervals. OCT parameters, including intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelium detachment (PED), and central retinal thickness (CRT), were assessed qualitatively and quantitatively. Macular Neovascularization (MNV) morphology at baseline was described in terms of area, total vessel length, flow density, and fractal dimension. OCT and OCTA parameters were correlated with best corrected visual acuity (BCVA) and number of administered IVIs after 1 year of treatment. Results: Eyes with persistent subretinal fluid (SRF) or both intraretinal fluid (IRF) and SRF after upload showed a significantly higher need for IVIs (p < 0.01). Also, pigment epithelium detachment (PED) presence at baseline (p < 0.05), PED height at baseline (p < 0.01), PED presence after upload (p < 0.01), and PED height after upload (p < 0.01) were each correlated with a greater number of IVIs. Decrease in PED height during upload was accompanied by a lower number of IVIs (p < 0.01). All the aforementioned parameters had no influence on BCVA after 1 year (p > 0.05). Baseline central retinal thickness (CRT) was linked to worse BCVA at 12 months (p < 0.05), but not the number of IVIs. Follow-up CRT correlated with worse BCVA (p < 0.01) and more IVIs (p < 0.01), while CRT decrease was associated with better BCVA (p < 0.05) and fewer IVIs (p < 0.01) at 1 year. In OCTA, area and total vessel length of MNVs were correlated with BCVA after 1 year (p < 0.01) but had no influence on number of IVIs (p > 0.05). Flow density had no influence on either outcome parameter (p > 0.05). Fractal dimension was associated with BCVA (p < 0.01) and number of IVIs (p < 0.05) after 1 year. Conclusions: MNV area, vessel length, and fractal dimension in OCTA, along with fluid distribution in OCT at baseline and after follow-up, may serve as indicators of treatment needs and visual outcomes after one year. Further studies with longer observation periods and the use of deep learning models are needed to improve analyses and to verify the applicability of these findings to clinical practice.

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来源期刊
Journal of Personalized Medicine
Journal of Personalized Medicine Medicine-Medicine (miscellaneous)
CiteScore
4.10
自引率
0.00%
发文量
1878
审稿时长
11 weeks
期刊介绍: Journal of Personalized Medicine (JPM; ISSN 2075-4426) is an international, open access journal aimed at bringing all aspects of personalized medicine to one platform. JPM publishes cutting edge, innovative preclinical and translational scientific research and technologies related to personalized medicine (e.g., pharmacogenomics/proteomics, systems biology). JPM recognizes that personalized medicine—the assessment of genetic, environmental and host factors that cause variability of individuals—is a challenging, transdisciplinary topic that requires discussions from a range of experts. For a comprehensive perspective of personalized medicine, JPM aims to integrate expertise from the molecular and translational sciences, therapeutics and diagnostics, as well as discussions of regulatory, social, ethical and policy aspects. We provide a forum to bring together academic and clinical researchers, biotechnology, diagnostic and pharmaceutical companies, health professionals, regulatory and ethical experts, and government and regulatory authorities.
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