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1.
Jpn J Ophthalmol ; 68(3): 211-215, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38609716

RESUMEN

PURPOSE: To investigate the association between the arm-to-choroidal circulation time (ACT) on indocyanine green angiography (IA) and clinical profile in patients with polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Single-center retrospective study. METHODS: We included 38 eyes of 38 patients with PCV diagnosed using multimodal imaging and did not undergo previous treatment. All patients were treated with monthly aflibercept injections for 3 months and treat-and-extend regimens for the subsequent 12 months. Posterior vortex vein ACT was assessed on the first visit using Heidelberg IA. The patients were divided into two groups: ACT ≥20 s (L group; eight eyes) and ACT <20 s (S group; 30 eyes). The clinical profiles before and after treatment were analyzed to assess associations with ACT. RESULTS: The mean ACT was 16.39±3.3 s (L group: 21.25±1.49 s, women:men=2:6, mean age: 77.3±6.5 years; S group: 15.10±2.17 s, women:men=7:23, mean age: 75.5±6.9 years). No significant difference was observed in the mean subfoveal choroidal thickness between the L and the S groups (176±75 µm vs. 230±79 µm, P=0.10). However, there were significant differences between the L and S groups in retinal fluid accumulation and hemorrhage recurrence (eight/eight eyes, 100% vs. 13/30 eyes, 43%, P<0.001), mean aflibercept injections (8.8±1.6 vs. 7.0±1.6, P<0.01) during the 12-month period, and the number of polypoidal lesions (1.8±0.7 vs. 1.3±0.5, P<0.05). CONCLUSION: Patients with PCV and ACT >20 s are more likely to experience exudative change recurrence in the retina during treatment because they have more polypoidal lesions.


Asunto(s)
Coroides , Fondo de Ojo , Vasculopatía Coroidea Polipoidea , Pólipos , Receptores de Factores de Crecimiento Endotelial Vascular , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Inhibidores de la Angiogénesis/administración & dosificación , Inhibidores de la Angiogénesis/uso terapéutico , Velocidad del Flujo Sanguíneo/fisiología , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Colorantes/administración & dosificación , Angiografía con Fluoresceína/métodos , Estudios de Seguimiento , Verde de Indocianina/administración & dosificación , Inyecciones Intravítreas , Imagen Multimodal , Vasculopatía Coroidea Polipoidea/diagnóstico , Vasculopatía Coroidea Polipoidea/tratamiento farmacológico , Pólipos/diagnóstico , Pólipos/tratamiento farmacológico , Pólipos/fisiopatología , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Proteínas Recombinantes de Fusión/administración & dosificación , Proteínas Recombinantes de Fusión/uso terapéutico , Flujo Sanguíneo Regional/fisiología , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Agudeza Visual
2.
Graefes Arch Clin Exp Ophthalmol ; 262(1): 43-51, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37668741

RESUMEN

PURPOSE: To assess 6-month outcomes of switching from aflibercept to faricimab in eyes with refractory neovascular age-related macular degeneration (nAMD) previously requiring monthly injections. METHODS: This multicenter retrospective study examined nAMD eyes receiving monthly aflibercept injections switched to faricimab administered monthly up to 4 injections followed by injections at a minimum of 2-month intervals as per drug labeling. Data regarding age, sex, number of previous injections, treatment intervals, and best-corrected visual acuity (BCVA) were collected. Central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and maximal pigment epithelial detachment (PED) height were measured by optical coherence tomography. RESULTS: The study included 130 eyes of 124 patients. At 6 months, 53 eyes (40.8%) continued on faricimab treatment (Group 1), while 77 eyes (59.2%) discontinued faricimab for various reasons (Group 2) the most common being worse exudation. There were no significant differences between the two groups at baseline. In Group 1, CRT and SFCT significantly decreased at 1 month (P = 0.013 and 0.008), although statistical significance was lost at 6 months (P = 0.689 and 0.052). BCVA and maximal PED height showed no significant changes; however, mean treatment intervals were extended from 4.4 ± 0.5 weeks at baseline to 8.7 ± 1.7 weeks at 6 months (P < 0.001) in Group 1. No clear predictors of response were identified. CONCLUSION: Switching from aflibercept to faricimab allowed for extension of treatment intervals from monthly to bimonthly in roughly 40% of eyes, suggesting that faricimab may be considered in refractory nAMD cases.


Asunto(s)
Anticuerpos Biespecíficos , Degeneración Macular , Desprendimiento de Retina , Degeneración Macular Húmeda , Humanos , Resultado del Tratamiento , Estudios de Seguimiento , Estudios Retrospectivos , Inyecciones Intravítreas , Receptores de Factores de Crecimiento Endotelial Vascular/uso terapéutico , Proteínas Recombinantes de Fusión/uso terapéutico , Desprendimiento de Retina/tratamiento farmacológico , Tomografía de Coherencia Óptica/métodos , Degeneración Macular/diagnóstico , Degeneración Macular/tratamiento farmacológico , Inhibidores de la Angiogénesis/uso terapéutico , Degeneración Macular Húmeda/diagnóstico , Degeneración Macular Húmeda/tratamiento farmacológico
3.
Graefes Arch Clin Exp Ophthalmol ; 261(12): 3475-3480, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37615698

RESUMEN

PURPOSE: Posterior vortex vein pulsation on Heidelberg indocyanine green angiography (HRA-IA) video is reported to indicate the presence of congestion in these vessels. This study aimed to determine the relationship between posterior vortex vein pulsation, choroidal thickness, and choroidal vascular hyperpermeability (CVH) in polypoidal choroidal vasculopathy (PCV). METHODS: Forty-three eyes of 43 patients who had not received previous treatment and were diagnosed with PCV using multimodal imaging were included and retrospectively investigated. On initial visit, presence or absence of pulsation in the posterior vortex vein was analysed using HRA-IA. Subfoveal choroidal thickness (SFCT) was assessed, and patients were divided into the SFCT ≥ 200 µm and < 200 µm (P and NP, respectively) groups. Presence or absence of CVH was investigated using IA in the late phase, and the associations between the three parameters were analysed. RESULTS: Posterior vortex vein pulsation was detected in 24/43 eyes (55%). There were 27 eyes in the P group (mean SFCT, 286 ± 48 µm) and 16 eyes in the NP group (mean SFCT, 143 ± 41 µm). Pulsation was detected in 10 eyes (37%) in the P group and 14 eyes (88%) in the NP group. Incidence of pulsation was significantly higher in the NP group (P < 0.05). There were 17 (40%) patients with CVH-13 (48%) and four (25%) in the P and NP groups, respectively (P = 0.1994). There was no correlation between the presence or absence of pulsation and CVH (P = 0.1994). CONCLUSION: Congestion of the vortex vein is potentially associated with the pathogenesis of PCV with a thin choroid.


Asunto(s)
Neovascularización Coroidal , Pólipos , Humanos , Vasculopatía Coroidea Polipoidea , Neovascularización Coroidal/diagnóstico , Angiografía con Fluoresceína/métodos , Estudios Retrospectivos , Coroides/patología , Tomografía de Coherencia Óptica , Verde de Indocianina/farmacología , Pólipos/diagnóstico
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