Multimodal imaging features of retinal neovascularization in response to 3 anti-VEGF injections.

Salvatore Parrulli, Matteo Airaldi, Valentina Folegani, Stefano Erba, Andrea Govetto, Federico Zicarelli, Alessandro Invernizzi, Giovanni Staurenghi, Matteo G Cereda
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Abstract

Objective: To analyze longitudinal changes of retinal neovessels (NV) in eyes with proliferative diabetic retinopathy (PDR) after 3 monthly intravitreal injections (IVI) of ranibizumab by means of different imaging modalities, particularly focusing on optical coherence tomography (OCT) and OCT-angiography (OCT-A) features.

Methods: Prospective, monocentric study, Luigi Sacco Hospital, Milan. Consecutive patients with PDR were enrolled. All patients underwent color fundus photography (CFP), fluorescein angiography (FA), SD-OCT, and OCT-A at baseline (t0) and after 3 monthly IVI of ranibizumab (t1). Neovessels (NVs) were classified as flat, elevated, flat-elevated, or table-top using OCT scans and further analyzed on FIJI. Qualitative and quantitative NV characteristics were evaluated. Vessel density (VD) was calculated as the mean of all the white pixels of the NV and expressed as a percentage of the area of the NV (VD = NV area × 100).

Results: Thirty-six NVs in 10 patients were studied. The regression of NVs at t1 was partial in 66.7% of cases and complete in 33.3%. Table-top NV demonstrated more frequently a complete regression (P = .03). A significant reduction of the NV area, perimeter, and VD was observed at t1 (P < .001). NVs that showed a complete regression had higher mean VD values at t0 compared with NVs, which showed a partial regression (P = .02). Flat NVs had more frequently a complete vitreous attachment, while table-top showed more often a partial vitreous detachment with focal NV adhesion (P < .05). A complete regression was more often observed for NVs with a partial vitreous detachment and focal NV adhesion at t0 (10/12), while most of the NVs with a complete vitreous attachment showed a partial regression (18/24) (P < .001).

Conclusions: The table-top configuration of the neovessel, higher VD values at baseline, and the presence of a focal adhesion of the vitreous over the NV were factors associated with a higher risk of complete regression of the NV in response to 3 monthly IVI of ranibizumab.

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3次抗vegf注射后视网膜新生血管的多模态影像学特征。
目的:通过不同的成像方式,特别是光学相干断层扫描(OCT)和OCT血管造影(OCT- a)特征,分析增生性糖尿病视网膜病变(PDR)眼在3个月玻璃体内注射雷尼单抗(IVI)后视网膜新生血管(NV)的纵向变化。方法:米兰Luigi Sacco医院前瞻性单中心研究。连续入组PDR患者。所有患者在基线(t1)和3个月的雷尼单抗IVI (t1)后接受彩色眼底摄影(CFP)、荧光素血管造影(FA)、SD-OCT和OCT-A。使用OCT扫描将新血管(NVs)分为扁平、升高、扁平或桌面,并进一步分析FIJI。定性和定量评价NV特征。血管密度(VD)计算为NV所有白色像素的平均值,并表示为NV面积的百分比(VD = NV面积 × 100)。结果:10例患者共36例NVs。NVs在t1时部分回归的病例占66.7%,完全回归的病例占33.3%。桌面NV更频繁地显示完全回归(P = .03)。在t1时观察到NV面积、周长和VD显著减少(P < 0.001)。完全回归的NVs在0时的平均VD值高于NVs,显示部分回归(P = .02)。平面眼更多的是完全的玻璃体附着,而桌面眼更多的是部分玻璃体脱离并局灶性玻璃体附着(P < 0.05)。在10(10/12)时,伴有部分玻璃体脱离和局灶性粘连的NV更常出现完全消退,而大部分玻璃体完全附着的NV出现部分消退(18/24)(P < 0.001)。结论:新血管的桌面结构,基线时较高的VD值,以及玻璃体在NV上的局灶粘连的存在,是在3个月静脉注射雷尼单抗后NV完全消退的高风险相关因素。
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来源期刊
CiteScore
3.20
自引率
4.80%
发文量
223
审稿时长
38 days
期刊介绍: Official journal of the Canadian Ophthalmological Society. The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.
期刊最新文献
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