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

Huixun Jia ¹Bing Lu ²Zhi Zhao ¹Yang Yu ¹Fenghua Wang ³Minwen Zhou ⁴Xiaodong Sun⁵

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作者信息

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. 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;Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai,China;National Clinical Research Center for Eye Diseases,Shanghai,China
3. 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;Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai,China;National Clinical Research Center for Eye Diseases,Shanghai,China;Shanghai Engineering Center for Visual Science and Photomedicine,Shanghai,China;Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China
4. 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;Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai,China;National Clinical Research Center for Eye Diseases,Shanghai,China;Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China
5. 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;Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai,China;National Clinical Research Center for Eye Diseases,Shanghai,China;Shanghai Engineering Center for Visual Science and Photomedicine,Shanghai,China;Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases,Shanghai,China;Clinical
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Abstract

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.Partici-pants 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 pro-portion 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±17.17 pm)and non-responders(11.01±14.10 pm)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 significantly associated with a response to anti-VEGF therapy at 6 months.

Key words

Age-related macular degeneration/Choroidal neovascularization/Optical coherence tomography angiography/Anti-VEGF

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基金项目

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)

Shanghai Hospital Development Center(SHDC2020CR5014)

出版年

2024

眼视光学杂志(英文版)

ISSN：

段落导航