AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy...AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.展开更多
AIM:To assess the long-term outcomes of treating macular edema(ME)associated with central retinal vein occlusion(CRVO)with a regimen of“5+pro re nata(PRN)”.METHODS:This retrospective study included 27 eyes of 27 pat...AIM:To assess the long-term outcomes of treating macular edema(ME)associated with central retinal vein occlusion(CRVO)with a regimen of“5+pro re nata(PRN)”.METHODS:This retrospective study included 27 eyes of 27 patients with ME associated with non-ischemic CRVO(non-iCRVO group,n=15)and ischemic CRVO(iCRVO group,n=12).The eyes were treated with five consecutive intravitreal injections of conbercept or ranibizumab,followed by reinjections as needed or PRN.Retinal laser photocoagulation or intravitreal dexamethasone implants(DEX)were implemented in both groups when necessary.The best-corrected visual acuity(BCVA,logMAR)and central retinal thickness(CRT)were recorded at baseline,at 1,2,3,4,5,6,and 12mo,and at the final visit.The efficacy rates of BCVA and CRT before and after treatment were calculated.The number of injections at each visit and the incidence of adverse events were also recorded.RESULTS:The patients,aged 59.4±15.1y,were followed up for 24.7±8.8mo(range:15-42mo).After treatment,BCVA improved significantly from 1.04±0.56 logMAR at baseline to 0.59±0.36 logMAR(P=0.038)at the final visit in all patients.Both the non-iCRVO and the iCRVO groups achieved improved BCVA compared to the baseline at all visit points,but there was no statistical significance(P=0.197 and 0.33,respectively).The mean CRT was statistically reduced compared to baseline at all visit points in all the eyes and in both groups(all P<0.001).The apparent effective rate was 22.22% for BCVA and 37.04% for CRT after the first injection,48.15%for BCVA and 62.96% for CRT after 5 consecutive injections,and 74.08% for BCVA and 100% for CRT at the end of follow up.The average number of injections in all patients was 9.0±2.4 at 12mo and 14.9±8.1 finally with no statistical significance between both groups(P>0.05).Laser treatment was applied to all eyes in the iCRVO group,while only 5 patients in the noniCRVO group.Six patients in the non-iCRVO group and 3 patients in the iCRVO group had a drug switch.DEX was applied to 4 eyes in the non-iCRVO group and 5 eyes in the iCRVO group.CONCLUSION:The 5+PRN anti-vascular endothelial growth factor(VEGF)regimen is found to be safe and effective for both iCRVO and non-iCRVO,especially in the iCRVO group.The best regimen for such patients needs to be further investigated.Adjuvant laser therapy and DEX are necessary in some cases.展开更多
基金Supported by General Program of National Natural Science Foundation of China(No.82471110)National Key Research and Development Program of China(No.2022YFC2502805)Postdoctoral Foundation of General Hospital of Central Theater Command(No.20210517KY04).
文摘AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.
文摘AIM:To assess the long-term outcomes of treating macular edema(ME)associated with central retinal vein occlusion(CRVO)with a regimen of“5+pro re nata(PRN)”.METHODS:This retrospective study included 27 eyes of 27 patients with ME associated with non-ischemic CRVO(non-iCRVO group,n=15)and ischemic CRVO(iCRVO group,n=12).The eyes were treated with five consecutive intravitreal injections of conbercept or ranibizumab,followed by reinjections as needed or PRN.Retinal laser photocoagulation or intravitreal dexamethasone implants(DEX)were implemented in both groups when necessary.The best-corrected visual acuity(BCVA,logMAR)and central retinal thickness(CRT)were recorded at baseline,at 1,2,3,4,5,6,and 12mo,and at the final visit.The efficacy rates of BCVA and CRT before and after treatment were calculated.The number of injections at each visit and the incidence of adverse events were also recorded.RESULTS:The patients,aged 59.4±15.1y,were followed up for 24.7±8.8mo(range:15-42mo).After treatment,BCVA improved significantly from 1.04±0.56 logMAR at baseline to 0.59±0.36 logMAR(P=0.038)at the final visit in all patients.Both the non-iCRVO and the iCRVO groups achieved improved BCVA compared to the baseline at all visit points,but there was no statistical significance(P=0.197 and 0.33,respectively).The mean CRT was statistically reduced compared to baseline at all visit points in all the eyes and in both groups(all P<0.001).The apparent effective rate was 22.22% for BCVA and 37.04% for CRT after the first injection,48.15%for BCVA and 62.96% for CRT after 5 consecutive injections,and 74.08% for BCVA and 100% for CRT at the end of follow up.The average number of injections in all patients was 9.0±2.4 at 12mo and 14.9±8.1 finally with no statistical significance between both groups(P>0.05).Laser treatment was applied to all eyes in the iCRVO group,while only 5 patients in the noniCRVO group.Six patients in the non-iCRVO group and 3 patients in the iCRVO group had a drug switch.DEX was applied to 4 eyes in the non-iCRVO group and 5 eyes in the iCRVO group.CONCLUSION:The 5+PRN anti-vascular endothelial growth factor(VEGF)regimen is found to be safe and effective for both iCRVO and non-iCRVO,especially in the iCRVO group.The best regimen for such patients needs to be further investigated.Adjuvant laser therapy and DEX are necessary in some cases.
