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Abstract(s)
Objetivo: Estudar a correlação entre o número de tratamentos e os parâmetros quantitativos em OCT-A da neovascularização coroideia (NVC) secundária à degenerescência macular relacionada com a idade (DMIn). Métodos: Estudo transversal após amostragem consecutiva de doentes com DMIn exsudativa (grupo 1) e indivíduos sem patologia vascular (grupo 2). Avaliação imagiológica (retinografia; OCT-B; OCT-A) e do processo clínico (número de injecções intravitreas (IIV); duração da doença). No grupo 1 foi analisada a camada retiniana externa avascular e no grupo 2 o complexo vascular superficial. As NVC foram delineadas automaticamente em Matlab. A análise quantitativa envolveu: área, densidade vascular (DV), lacunaridade e análise da dimensão fractal (DF). A análise estatística compreendeu comparação de médias e associação entre as variáveis de interesse. Resultados: Inclusão de 131 doentes (131 olhos): idade média 78.38 +/- 9.7 anos, 34% eram mulheres (comparação de médias entre grupos p >0.05). No grupo 1 o número médio de IIV foi 23.4 +/- 15 e a duração da doença média 56.8 +/- 33.3 meses. O valor médio da área vascular foi 3.6 +/-3.2 mm2; a DV 45.5 +/ 13.7%; a lacunaridade 1.95 +/- 0.6 e a DF 1.35 +/- 0.13. No grupo 2 o valor médio da DF foi 1.63 +/-0.04 (p <0.01). Verificou-se: associação entre duração da doença e: número de IIV (r=0.763, p<0.01), DF (r=0.321, p<0.01) e DV (r=-0.183, p =0.02); correlação linear moderada entre a DF e o número de IIV (r = 0.431, p < 0,01). Conclusões: A análise da dimensão fractal pode ser um biomarcador útil na avaliação quantitativa da resposta ao tratamento com fármacos intravítreos.
ABSTRACT - Objective: To study the correlation between the number of treatments and OCT-A quantitative analysis of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Retrospective review of the medical records of consecutive patients with exudative AMD observed during re-treatment (group 1) and patients without vascular diseases (group 2). All patients underwent funduscopic evaluation, Swept-source Optical Coherence TomographyAngiography (SS-OCT-A) and OCT-B scans. CNVs delineation and quantitative analysis were performed automatically using Matlab. In group 2, FD of the superficial retinal plexus was accessed. The statistical analysis comprised means comparison and investigation of the association between variables of interest using univariate and multivariate stepwise linear regression analysis. Results: 126 patients (126 eyes) were included in this study. The mean age in the cohort was 79.5 ± 8.9 years, 97 (77%) were female patients Groups were age and sex matched. In group 1, the mean intravitreal injections number (IVI) was 21 +/- 12; mean disease duration was 56.8 +/- 33.3 months; mean area was 3.64 +/-3.2 mm2; mean vessel density was 45.50 +/ 13.7%; mean lacunarity was 1.95 +/- 0.6 and mean FD was 1.35 +/- 0.13. In group 2, the mean FD was 1.63 +/-0.04 (p<0.01). Disease duration was associated positively with IVI (r=0.763, p<0.01), FD (r=0.321, p<0.01) and VD (r=-0.183, p=0.02). There was a moderate linear relationship between FD and the number of IIV (r = 0.431, p<0.01), Conclusion: Fractal dimension analysis can be a valuable biomarker in the quantitative assessment of CNV changes after anti-VEGF therapy.
ABSTRACT - Objective: To study the correlation between the number of treatments and OCT-A quantitative analysis of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Retrospective review of the medical records of consecutive patients with exudative AMD observed during re-treatment (group 1) and patients without vascular diseases (group 2). All patients underwent funduscopic evaluation, Swept-source Optical Coherence TomographyAngiography (SS-OCT-A) and OCT-B scans. CNVs delineation and quantitative analysis were performed automatically using Matlab. In group 2, FD of the superficial retinal plexus was accessed. The statistical analysis comprised means comparison and investigation of the association between variables of interest using univariate and multivariate stepwise linear regression analysis. Results: 126 patients (126 eyes) were included in this study. The mean age in the cohort was 79.5 ± 8.9 years, 97 (77%) were female patients Groups were age and sex matched. In group 1, the mean intravitreal injections number (IVI) was 21 +/- 12; mean disease duration was 56.8 +/- 33.3 months; mean area was 3.64 +/-3.2 mm2; mean vessel density was 45.50 +/ 13.7%; mean lacunarity was 1.95 +/- 0.6 and mean FD was 1.35 +/- 0.13. In group 2, the mean FD was 1.63 +/-0.04 (p<0.01). Disease duration was associated positively with IVI (r=0.763, p<0.01), FD (r=0.321, p<0.01) and VD (r=-0.183, p=0.02). There was a moderate linear relationship between FD and the number of IIV (r = 0.431, p<0.01), Conclusion: Fractal dimension analysis can be a valuable biomarker in the quantitative assessment of CNV changes after anti-VEGF therapy.
Description
Keywords
Oftalmologia Degenerescência macular Envelhecimento Crescimento anti-endotélio vascular Análise da dimensão fractal Neovascularização coroideia Tomografia de coerência óptica Angiografia Age-related macular degeneration Elderly Anti vascular endotelial growth Lacunarity Fractal dimension analysis Choroidal neovascularisation Optical coherence tomography Angiography
Citation
Reis-Cabral D, Rodrigues P, Pereira T, Camacho P, Vila Franca M, Caldeira Rosa P, et al. Parâmetros quantitativos em OCT-A na avaliação da resposta ao tratamento com anti-VEGF em doentes com neovascularização secundária à degenerescência macular relacionada com a idade. Rev Soc Port Oftalmol. 2018;42(2).
Publisher
Sociedade Portuguesa de Oftalmologia