دورية أكاديمية

Impact of Intra- and Subretinal Fluid on Vision Based on Volume Quantification in the HARBOR Trial.

التفاصيل البيبلوغرافية
العنوان: Impact of Intra- and Subretinal Fluid on Vision Based on Volume Quantification in the HARBOR Trial.
المؤلفون: Riedl S; OPTIMA - Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Vogl WD; OPTIMA - Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Waldstein SM; OPTIMA - Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Schmidt-Erfurth U; OPTIMA - Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria. Electronic address: ursula.schmidt-erfurth@meduniwien.ac.at., Bogunović H; OPTIMA - Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
المصدر: Ophthalmology. Retina [Ophthalmol Retina] 2022 Apr; Vol. 6 (4), pp. 291-297. Date of Electronic Publication: 2021 Dec 16.
نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Published by Elsevier Inc. on behalf of American Academy of Ophthalmology Country of Publication: United States NLM ID: 101695048 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-6530 (Electronic) Linking ISSN: 24686530 NLM ISO Abbreviation: Ophthalmol Retina Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Published by Elsevier Inc. on behalf of American Academy of Ophthalmology, [2017]-
مواضيع طبية MeSH: Subretinal Fluid*/diagnostic imaging , Vascular Endothelial Growth Factor A*, Child, Preschool ; Humans ; Intravitreal Injections ; Tomography, Optical Coherence ; Visual Acuity
مستخلص: Purpose: To investigate the functional associations of intraretinal fluid (IRF) and subretinal fluid (SRF) volumes at baseline and after the loading dose as well as fluid change after the first injection with best-corrected visual acuity (BCVA) in patients with neovascular age-related macular degeneration (nAMD) who received an anti-VEGF treatment over 24 months.
Design: Post hoc analysis of a phase III, randomized, multicenter trial in which ranibizumab was administered monthly or in a pro re nata regimen (HARBOR).
Participants: Study eyes of 1094 treatment-naïve patients with nAMD.
Methods: IRF and SRF volumes were segmented automatically on monthly spectral domain OCT images. Fluid volumes and changes thereof were included as covariates into longitudinal mixed-effects models, which modeled BCVA trajectories.
Main Outcome Measures: BCVA estimates corresponding to baseline, follow-up, and persistent IRF/SRF volumes after the loading dose; BCVA estimates of change in fluid volumes after the first injection; and marginal and conditional R 2 .
Results: Analysis of 22 494 volumetric scans revealed that foveal IRF consistently shows a negative correlation with BCVA at baseline and subsequent visits (-3.23 and -4.32 letters/100 nL, respectively). After the first injection, BCVA increased by +2.13 letters/100 nL decrease in foveal IRF. Persistent IRF was associated with lower baseline BCVA and less improvement. Foveal SRF correlated with better BCVA at baseline and subsequent visits (+6.52 and +1.42 letters/100 nL, respectively). After the first injection, SRF decrease was associated with significant vision gain (+5.88 letters/100 nL). Foveal fluid correlated more with BCVA than parafoveal IRF/SRF.
Conclusions: Although IRF consistently correlates with decreased function and recovery throughout therapy, SRF is associated with a more pronounced functional improvement. Moreover, SRF resolution provides increased benefit. Fluid-function correlation represents an essential base for the development of personalized treatment regimens, optimizing functional outcomes, and reducing treatment burden.
(Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: anti-VEGF therapy; deep-learning–based image analysis; intraretinal fluid; neovascular age-related macular degeneration; optical coherence tomography; structure-function correlation; subretinal fluid
المشرفين على المادة: 0 (Vascular Endothelial Growth Factor A)
تواريخ الأحداث: Date Created: 20211218 Date Completed: 20220411 Latest Revision: 20220608
رمز التحديث: 20231215
DOI: 10.1016/j.oret.2021.12.007
PMID: 34922038
قاعدة البيانات: MEDLINE
الوصف
تدمد:2468-6530
DOI:10.1016/j.oret.2021.12.007