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OCT angiography-based monitoring of neovascular regression on fibrovascular membrane after preoperative intravitreal conbercept injection

  • Retinal Disorders
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Abstract

Purpose

To quantify the preoperative neovascular change pattern on the fibrovascular membrane (FVM) within 7 days after intravitreal injection of conbercept (IVC) using optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR).

Methods

Prospective, observational study of PDR patients with visible FVM receiving or not receiving IVC. Neovascular changes were assessed by OCTA pre-IVC and 1, 3, 5, and 7 days post-IVC. Vessel skeleton density (SD) and vessel density (VD) were quantified by an intensity-based optical microangiography algorithm. The interclass correlation coefficient (ICC) was calculated to assess the agreement between measurements. The SD and VD were compared between follow-ups using repeated-measures analysis in the IVC group.

Results

The ICC was 0.992 (95% confidence interval [CI]: 0.982–0.996) for SD and 0.926 (95% CI: 0.838–0.912) for VD of neovascularization. The neovascularization on FVM significantly regressed in the IVC group (n = 16) compared with no IVC (n = 8) (p = 0.001 for SD and p < 0.001 for VD). The comparisons between consecutive follow-ups showed a statistically significant reduction in SD and VD at 1 and 3 days post-IVC. However, from day 3 onward, the SD and VD remained unchanged. There was no development or progression of tractional retinal detachment within the 7-day period after IVC.

Conclusion

OCTA–based quantification of the neovascularization on FVM in PDR is feasible, with high inter-reader agreement. The regression of neovascularization reaches a plateau 3 days after IVC.

Clinical Trial Registration

This trial is registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn, registration number ChiCTR-IPR-17014160).

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Acknowledgements

Mr. Song Zhang from Colinico Meditec, Inc. (Shanghai, China) provided guidance on the use of optical coherence tomography to obtain fibrovascular membrane data.

Funding

This study was supported by the National Key Project of Research and Development Plan (no. 2017YFA0104101) and General Project of the National Natural Science Fund (no. 81770973). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Zizhong Hu and Yun Su contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, Jiangsu, 210029, People’s Republic of China

    Zizhong Hu, Yun Su, Ping Xie, Lu Chen, Jiangdong Ji, Kang Liang & Qinghuai Liu

  2. School of Electronic and Optic Engineering, Nanjing University of Science and Technology, Nanjing, 21000, China

    Ting Feng & Shaowei Wu

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  1. Zizhong Hu
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Correspondence to Qinghuai Liu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Clinical Trial Registration: http://www.chictr.org.cn Unique identifier: ChiCTR-IPR-17014160.

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Hu, Z., Su, Y., Xie, P. et al. OCT angiography-based monitoring of neovascular regression on fibrovascular membrane after preoperative intravitreal conbercept injection. Graefes Arch Clin Exp Ophthalmol 257, 1611–1619 (2019). https://doi.org/10.1007/s00417-019-04315-0

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