Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography  

作　　者：Huixun Jia Bing Lu Zhi Zhao Yang Yu Fenghua Wang Minwen Zhou Xiaodong Sun 

机构地区：[1]Department of Ophthalmology,Shanghai General Hospital(Shanghai First People’s Hospital),Shanghai Jiao Tong University School of Medicine,100 Hai Ning Road,Shanghai,200080,People’s Republic of China [2]Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai,China [3]National Clinical Research Center for Eye Diseases,Shanghai,China [4]Shanghai Engineering Center for Visual Science and Photomedicine,Shanghai,China [5]Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China [6]Clinical Research Institute,Shanghai Jiao Tong University School of Medicine,Shanghai,China

出　　处：《Eye and Vision》2024年第3期21-30,共10页眼视光学杂志（英文）

基　　金：supported by Frontier Project of Hospital Development Center(SHDC12016105);Clinical Research Innovation Team Project of Shanghai General Hospital(CTCCR-2016A02);Scientific Project of Shanghai Municipal Health Commission(201940151);Shanghai Collaborative Innovation Center for Translational Medicine(TM201917);Shanghai Hospital Development Center(SHDC2020CR2040B and SHDC2020CR5014).

摘　　要：Background To evaluate whether the specific choroidal neovascularization(CNV)characteristics measured using optical coherence tomography angiography(OCTA)can predict the 6-month prognosis of neovascular age-related macular degeneration(nAMD)after anti-vascular endothelial growth factor(anti-VEGF)therapy.Methods Patients with type 1,type 2,or mixed-type neovascularization(NV)were prospectively included.Participants underwent an initial loading phase of three consecutive monthly intravitreal injections of Conbercept(0.5 mg)and were switched to a pro re nata(PRN)treatment strategy.OCTA images were evaluated for eyes that underwent follow-up assessments for more than 6 months.CNV lesions were manually segmented,and the CNV area,vessel area,greatest vascular caliber(GVC),and greatest linear dimension(GLD)were compared between responders and non-responders.Two masked graders independently measured the above-mentioned parameters using OCTA,and consistency was assessed using the intraclass correlation coefficient(ICC)values.Multiple logistic regression analysis was performed to evaluate the effect of a 3-month change in the CNV area,GLD,and GVC on the 6-month response to anti-VEGF agents.Results Among the 60 eyes of 60 patients with nAMD,39 were responders and 21 were non-responders.The proportion of CNV types was significantly different between responders and non-responders(P=0.009).Patients with type 2 or mixed NV seemed more likely to respond to the treatment(28.2%vs.0.0%,and 30.8%vs.23.8%,respectively).The change in GVC showed a significant difference between responders(−4.98±17.17μm)and non-responders(11.01±14.10μm)after three monthly intravitreal anti-VEGF injections.Multiple logistic regression analysis showed that only the change in GVC remained significant after controlling for baseline GVC,injection number,and CNV type(adjusted OR=1.083;P=0.008).Conclusions Type 2 and mixed-type NV were significantly associated with a better response to anti-VEGF therapy.Changes in GVC after 3 months of treatment were sig

关 键 词：Age-related macular degeneration Choroidal neovascularization Optical coherence tomography angiography ANTI-VEGF 

分 类 号：R774.5[医药卫生—眼科]