湿性老年性黄斑变性抗VEGF治疗中ORT的特征及临床意义
Characteristics and Clinical Significance of Outer Retinal Tubulation in Wet Age-macular Degeneration Treated by
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摘要: 目的 探讨湿性老年性黄斑变性(wet age-related macular degeneration, wAMD)患者在抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗过程中光学相干断层扫描(optical coherence tomography, OCT)上存在的外层视网膜套管样结构(outer retinal tubulation,ORT)的特征及临床意义。 方法 回顾性分析OCT图像上有ORT存在的wAMD患者,并在抗VEGF过程中利用OCT对这些患者进行随访观察,分析ORT的分布位置、形态特点、演变以及对抗VEGF治疗的反应。 结果 纳入研究的35例39眼的ORT均位于视网膜外核层,均出现于视网膜有过渗出或水肿的地方,抗VEGF治疗后发现38眼的ORT在数量和形态上保持稳定,1眼暂时消失后又出现。 结论 ORT因外层视网膜受损后残存的光感受器细胞重组形成,与抗VEGF治疗无关。Abstract: Objective To determine the characteristics and clinical significance of outer retinal tabulation (ORT) in wet age-related macular degeneration (wAMD) treated by anti-vascular endothelial growth factor (anti-VEGF) through optical coherence tomography (OCT). Methods The 35 wAMD patients with 39 ORT eyes treated by anti-VEGF were examined by OCT to determine the morphological features and evolution of the ORTs over time and their response to anti-VEGF. Results ORTs were located in the places that exudation or edema had happened in the outer nuclear layer of retina. 38 ORTs remained stable on both quantity and morphology. One ORT became invisible temporarily and then reappeared. Conclusion ORTs are reconstructed by photoreceptor cells that have survived after outer retina damages. There is no connection between anti-VEGF treatment and ORT formation.