Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography
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 facto...
| Հիմնական հեղինակներ: | , , , , , , |
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| Ձևաչափ: | Հոդված |
| Լեզու: | English |
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BMC
2022-05-01
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| Շարք: | Eye and Vision |
| Խորագրեր: | |
| Առցանց հասանելիություն: | https://doi.org/10.1186/s40662-022-00287-1 |
| _version_ | 1829114559730810880 |
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| author | Huixun Jia Bing Lu Zhi Zhao Yang Yu Fenghua Wang Minwen Zhou Xiaodong Sun |
| author_facet | Huixun Jia Bing Lu Zhi Zhao Yang Yu Fenghua Wang Minwen Zhou Xiaodong Sun |
| author_sort | Huixun Jia |
| collection | DOAJ |
| description | 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. 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 ± 17.17 μm) and non-responders (11.01 ± 14.10 μm) 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. |
| first_indexed | 2024-12-12T15:56:20Z |
| format | Article |
| id | doaj.art-bc797ee7c78e46a6bb8a32a3e7f8d4bb |
| institution | Directory Open Access Journal |
| issn | 2326-0254 |
| language | English |
| last_indexed | 2024-12-12T15:56:20Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Eye and Vision |
| spelling | doaj.art-bc797ee7c78e46a6bb8a32a3e7f8d4bb2022-12-22T00:19:29ZengBMCEye and Vision2326-02542022-05-019111010.1186/s40662-022-00287-1Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiographyHuixun Jia0Bing Lu1Zhi Zhao2Yang Yu3Fenghua Wang4Minwen Zhou5Xiaodong Sun6Department of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineDepartment of Ophthalmology, Shanghai General Hospital (Shanghai First People’s Hospital), Shanghai Jiao Tong University School of MedicineAbstract 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 ± 17.17 μm) and non-responders (11.01 ± 14.10 μm) 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.https://doi.org/10.1186/s40662-022-00287-1Age-related macular degenerationChoroidal neovascularizationOptical coherence tomography angiographyAnti-VEGF |
| spellingShingle | Huixun Jia Bing Lu Zhi Zhao Yang Yu Fenghua Wang Minwen Zhou Xiaodong Sun Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography Eye and Vision Age-related macular degeneration Choroidal neovascularization Optical coherence tomography angiography Anti-VEGF |
| title | Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography |
| title_full | Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography |
| title_fullStr | Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography |
| title_full_unstemmed | Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography |
| title_short | Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography |
| title_sort | prediction of the short term efficacy of anti vegf therapy for neovascular age related macular degeneration using optical coherence tomography angiography |
| topic | Age-related macular degeneration Choroidal neovascularization Optical coherence tomography angiography Anti-VEGF |
| url | https://doi.org/10.1186/s40662-022-00287-1 |
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