关注OCT血管成像检测的CNV血管形态特征动态变化对抗VEGF治疗后新生血管性AMD应答反应的预测作用

摘要

抗血管内皮生长因子(VEGF)药物玻璃体腔注射是治疗新生血管性年龄相关性黄斑变性(nAMD)的一线治疗方案,如何更好地预测患眼治疗后的应答反应是临床上面临的重要挑战.光相干断层扫描血管成像(OCTA)可对治疗前后脉络膜新生血管(CNV)的血管形态变化进行动态随访观察,OCTA显示的血管形态和结构变化信息丰富了临床医师对nAMD治疗预后判断的新概念和新理论,认为这些综合信息可以成为一种活体血管生物标志物,有助于医生对活动性CNV的认识并深入理解抗VEGF治疗应答及抵抗的机制.因此,OCTA应当成为nAMD诊断、治疗和随访中的一种标准检查策略,我们应当重视OCTA下CNV血管形态特征的变化在nAMD抗VEGF治疗应答判断方面的重要指导意义.%Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is a first line therapy for neovascular age-related macular degeneration (nAMD).However,how to predict the respond for antiVEGF treatment is still a challenge in clinic practice.Optical coherence tomography angiography (OCTA) can offer dynamic following-up for choroidal neovascularization (CNV) in nAMD after antiangiogenic therapy.The change of vascular morphology based on OCTA enriches the novel theory of prognosis for tveatment of nAMD and can be considered as a biomarker of neovascularization in vivo,which can help us to evaluate the activity of CNV and understand the mechanism of anti-VEGF resistance.So,OCTA should be a standard strategy during the diagnosis,treatment and follow-up of nAMD.We should pay more attention to the guiding significance in the prognosis evaluation of nAMD basis on character of vascular morphology by OCTA following antiangiogenic therapy.