scholarly journals Assessment of conbercept therapy for high myopia macular neovascularization by optical coherence tomography angiography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lu-Na Cheng ◽  
Yu-Xi Lin ◽  
Lei Liu ◽  
Xu-He Zhang ◽  
Yan-Qi Xue ◽  
...  

Abstract This study aimed to evaluate the efficacy and safety of the intravitreal injection of conbercept in the treatment of macular neovascularization (MNV) secondary to high myopia and to observe the application of optical coherence tomography angiography (OCTA) in the treatment follow-up. We reviewed the medical records of 20 patients (21 eyes) with MNV secondary to high myopia who were enrolled in the Department of Ophthalmology of the First Hospital of China Medical University between May 2018 and January 2020. Each patient received one or more intravitreal injections of conbercept (0.5 mg/0.05 mL). The treatment was conducted according to a 1 + PRN (pro re nata) regimen. The changes of best corrected visual acuity (BCVA), central macular thickness (CMT), and selected MNV and flow areas measured by OCTA were observed over a 6-month follow-up period. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 1.03 ± 0.61 before treatment and improved to 0.83 ± 0.59 (P = 0.007), 0.78 ± 0.62 (P = 0.001), 0.81 ± 0.73 (P = 0.027), and 0.79 ± 0.72 (P = 0.023) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. The mean CMT was 358.16 ± 206.11 μm before treatment and decreased to 295.38 ± 178.70 μm (P = 0.003), 288.34 ± 165.60 μm (P = 0.004), 284.36 ± 163.07 μm (P = 0.005), and 283.00 ± 160.32 μm (P = 0.004) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. Nineteen eyes (90.5%) had stable or improved vision at 6 months of follow-up. One month after conbercept injection, in OCTA images, the small-diameter blood vessels of the MNV decreased, the intertwined small blood vessels decreased or even disappeared, and the main or larger-diameter blood vessels were still present. The mean selected MNV and blood flow areas were 0.62 ± 0.81 and 0.22 ± 0.27 mm2, respectively, before treatment and decreased to 0.23 ± 0.33 and 0.07 ± 0.08 mm2 (P = 0.04 for both), respectively, 1 month after treatment. No drug-related systemic or ocular adverse effects were observed. Our results suggest that conbercept can effectively and safely improve BCVA and reduce CMT in patients with myopic MVN (mMNV). OCTA can be used to observe MNV area, blood flow area, and MNV morphological changes after treatment with conbercept, thus providing a reference for treatment follow-up.

2021 ◽  
Vol 8 ◽  
Author(s):  
Zheng Zhang ◽  
Yue Qi ◽  
Wenbin Wei ◽  
Zi-Bing Jin ◽  
Wen Wang ◽  
...  

Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow.Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery.Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P < 0.01) and CPA (all P < 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P < 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P < 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant.Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.


2020 ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Yishuang Xu ◽  
Zuohuizi Yi ◽  
...  

Abstract Background: Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA.Methods: A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA.Results: For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p=0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level.Conclusion: Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Yishuang Xu ◽  
Zuohuizi Yi ◽  
...  

Abstract Background Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA. Methods A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA. Results For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p = 0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p < 0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p < 0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level. Conclusion Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.


Retina ◽  
2017 ◽  
Vol 37 (3) ◽  
pp. 460-465 ◽  
Author(s):  
Ichiro Maruko ◽  
Richard F. Spaide ◽  
Hideki Koizumi ◽  
Shota Sawaguchi ◽  
Takahiko Izumi ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jang Ryul Park ◽  
ByungKun Lee ◽  
Min Ji Lee ◽  
Kyuseok Kim ◽  
Wang-Yuhl Oh

AbstractWe developed a method to measure the relative blood flow speed using optical coherence tomography angiography (OCTA) in retina and choroid, and investigated the feasibility of this method for assessing microcirculatory function in rat models of sepsis and hemorrhagic shock. Two sepsis models, 6-h severe sepsis without treatment and 30-h moderate sepsis maintaining mean arterial pressure, and volume controlled hemorrhagic shock and fluid resuscitation model were used to see the change of microcirculation. The blood flow index (BFI), which was calculated from the OCTA images to represent the average relative blood flow, was decreasing during the 6-h severe sepsis model. Its change is in parallel with the mean arterial blood pressure (MAP) and blood lactate levels. In the 30-h moderate sepsis model, the BFI was decreased while maintaining MAP, and lactate was increased. In the hemorrhagic shock model, the change of BFI is in line with MAP and lactate levels. In all models, BFI change is more sensitive in choroid than in retina. This study presents the OCTA-based retinal and choroidal microcirculatory blood flow monitoring method and shows its utility for assessment of critical illness.


2015 ◽  
Vol 08 (04) ◽  
pp. 1550012 ◽  
Author(s):  
Qinqin Zhang ◽  
Maureen Neitz ◽  
Jay Neitz ◽  
Ruikang K. Wang

Purpose: To provide a geographical map of choroidal thickness (CT) around the macular region among subjects with low, moderate and high myopia. Methods: 20 myopic subjects (n = 40 eyes) without other identified pathologies participated in this study: 20 eyes of ≤ 3 diopters (D) (low myopic), 10 eyes between -3 and -6D (moderate myopic), and 10 eyes of ≥ 6D (high myopic). The mean age of subjects was 30.2 years (± 7.6 years; range, 24 to 46 years). A 1050 nm spectral-domain optical coherence tomography (SD-OCT) system, operating at 120 kHz imaging rate, was used in this study to simultaneously capture 3D anatomical images of the choroid and measure intraocular length (IOL) in the subject. The 3D OCT images of the choroid were segmented into superior, inferior, nasal and temporal quadrants, from which the CT was measured, representing radial distance between the outer retinal pigment epithelium (RPE) layer and inner scleral border. Measurements were made within concentric regions centered at fovea centralis, extended to 5 mm away from fovea at 1 mm intervals in the nasal and temporal directions. The measured IOL was the distance from the anterior cornea surface to the RPE in alignment along the optical axis of the eye. Statistical analysis was performed to evaluate CT at each geographic region and observe the relationship between CT and the degree of myopia. Results: For low myopic eyes, the IOL was measured at 24.619 ± 0.016 mm. The CT (273.85 ± 49.01 μm) was greatest under fovea as is in the case of healthy eyes. Peripheral to the fovea, the mean CT decreased rapidly along the nasal direction, reaching a minimum of 180.65 ± 58.25μm at 5 mm away from the fovea. There was less of a change in thickness from the fovea in the temporal direction reaching a minimum of 234.25 ± 42.27 μm. In contrast to the low myopic eyes, for moderate and high myopic eyes, CTs were thickest in temporal region (where CT = 194.94 ± 27.28 and 163 ± 34.89 μm, respectively). Like the low myopic eyes, moderate and high myopic eyes had thinnest CTs in the nasal region (where CT = 100.84 ± 16.75 and 86.64 ± 42.6μm, respectively). High myopic eyes had the longest mean IOL (25.983 ± 0.021mm), while the IOL of moderate myopia was 25.413 ± 0.022 mm (**p < 0.001). The CT reduction rate was calculated at 31.28 μm/D (diopter) from low to moderate myopia, whilst it is 13.49 μm/D from moderate to high myopia. The similar tendency was found for the IOL reduction rate in our study: 0.265 mm/D from low to moderate myopia, and 0.137 mm/D from moderate to high myopia. Conclusion: The CT decreases and the IOL increases gradually with the increase of myopic condition. The current results support the theory that choroidal abnormality may play an important role in the pathogenesis of myopic degeneration.


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