Progression of Retinal Pigment Epithelial Atrophy in Antiangiogenic Therapy of Neovascular Age-Related Macular Degeneration

被引:69
作者
Schuetze, Christopher [1 ]
Wedl, Manuela [1 ]
Baumann, Bernhard [2 ]
Pircher, Michael [2 ]
Hitzenberger, Christoph K. [2 ]
Schmidt-Erfurth, Ursula [1 ]
机构
[1] Med Univ Vienna, Dept Ophthalmol, A-1090 Vienna, Austria
[2] Med Univ Vienna, Ctr Med Phys & Biomed Engn, A-1090 Vienna, Austria
基金
奥地利科学基金会;
关键词
OPTICAL COHERENCE TOMOGRAPHY; ENDOTHELIAL GROWTH-FACTOR; GEOGRAPHIC ATROPHY; HYPERREFLECTIVE FOCI; TREATMENTS TRIALS; RANIBIZUMAB; EYE; PREVALENCE; REDUCTION; DISEASE;
D O I
10.1016/j.ajo.2015.02.020
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE: To monitor retinal pigment epithelial (RPE) atrophy progression during antiangiogenic therapy of neovascular age-related macular degeneration (AMD) over 2 years using polarization-sensitive optical coherence tomography (OCT). DESIGN: Prospective interventional case series. METHODS: SETTING: Clinical practice. STUDY POPULATION: Thirty patients (31 eyes) with treatment-naive neovascular AMD. OBSERVATION PROCEDURES: Standard intravitreal therapy (0.5 mg ranibizumab) was administered monthly during the first year and pro re nata (PRN; as-needed) during the second year. Spectral-domain (SD) OCT and polarization-sensitive OCT (selectively imaging the RPE) examinations were performed at baseline and at 1, 3, 6, 12, and 24 months using a standardized protocol. RPE-related changes were evaluated using a semi-automated polarization-sensitive OCT segmentation algorithm and correlated with SD OCT and fundus autofluorescence (FAF) findings. MAIN OUTCOME MEASURES: RPE response, geographic atrophy (GA) progression. RESULTS: Atrophic RPE changes included RPE thinning, RPE porosity, focal RPE atrophy, and development of GA. Early RPE loss (ie, RPE porosity, focal atrophy) increased progressively during initial monthly treatment and remained stable during subsequent PRN-based therapy. GA developed in 61% of eyes at month 24. Mean GA area increased from 0.77 mm(2) at 12 months to 1.10 mm(2) (standard deviation = 1.09 mm(2)) at 24 months. Reactive accumulation of RPE-related material at the lesion borders increased until month 3 and subsequently decreased. " CONCLUSIONS: Progressive RPE atrophy and GA developed in the majority of eyes. RPE migration signifies certain RPE plasticity. Polarization-sensitive OCT specifically images RPE-related changes in neovascular AMD, contrary to conventional imaging methods. Polarization-sensitive OCT allows for precisely monitoring the sequence of RPE-related morphologic changes. (C) 2015 The Authors. Published by Elsevier Inc.
引用
收藏
页码:1100 / 1114
页数:15
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