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Brinkmann M, Viggiano P, Boscia G, Müller T, Castellino N, Schweighofer J, Boscia F, Toro MD, El-Shabrawi Y. Analysis of Choriocapillaris Reperfusion Topography Following Faricimab Treatment for Neovascular Age-Related Macular Degeneration in Therapy-Naïve Patients. Ophthalmol Ther 2024; 13:1981-1992. [PMID: 38801614 PMCID: PMC11178690 DOI: 10.1007/s40123-024-00967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in treatment-naïve age-related macular degeneration (AMD) after faricimab application using optical coherence tomography angiography (OCTA). METHODS Twenty-five eyes of 25 treatment-naïve individuals who underwent intravitreal faricimab injections for neovascular AMD (nAMD) with type 1 MNV were included. Spectral-domain optical coherence tomography (SD-OCT) images and en-face swept-source OCTA images were analyzed, and the percentage of CC flow deficit (FD%), FD average area (FDa) and FD number (FDn) in five progressive 20.0-μm-wide concentric rings (R1, R2, R3, R4 and R5) surrounding the dark halo around the MNV were calculated. Image acquisition was carried out prior to the first faricimab injection (T0) and 1 month after the injection (T1). RESULTS The topographical sub-analysis revealed noteworthy changes in all rings at T1 compared to T0. There was a notable progressive reduction in FD% at T1 compared to T0 values across all rings, indicating a gradual CC reperfusion following anti-VEGF treatment. Additionally, the average size of FD decreased after the loading phase. Although not reaching statistical significance, there was a progressive reduction in the FDa across all rings. CONCLUSION Our study highlights a CC FD reduction following the administration of three consecutive faricimab injections. This effect was detected in all rings surrounding the dark halo. These observations suggest a partial CC reperfusion surrounding the MNV, potentially serving as an indicator for disease regression.
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Affiliation(s)
- Max Brinkmann
- Department of Ophthalmology, Klinikum Klagenfurt, 9020, Klagenfurt, Austria.
- Department of Ophthalmology, Universitätsklinikum Schleswig-Holstein, 23564, Lübeck, Germany.
| | - Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Tom Müller
- Department of Ophthalmology, Klinikum Klagenfurt, 9020, Klagenfurt, Austria
| | | | - Jakob Schweighofer
- Department of Ophthalmology and Optometry, Medical University of Vienna, 1090, Vienna, Austria
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy
| | - Mario Damiano Toro
- Public Health Department, Eye Clinic, University of Naples Federico II, 80133, Naples, Italy.
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079, Lublin, Poland.
| | - Yosuf El-Shabrawi
- Department of Ophthalmology, Klinikum Klagenfurt, 9020, Klagenfurt, Austria
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Vallino V, Berni A, Coletto A, Serafino S, Bandello F, Reibaldi M, Borrelli E. Structural OCT and OCT angiography biomarkers associated with the development and progression of geographic atrophy in AMD. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06497-8. [PMID: 38689123 DOI: 10.1007/s00417-024-06497-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/12/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Geographic atrophy (GA) is an advanced, irreversible, and progressive form of age-related macular degeneration (AMD). Structural optical coherence tomography (OCT) and OCT angiography (OCTA) have been largely used to characterize this stage of AMD and, more importantly, to define biomarkers associated with the development and progression of GA in AMD. METHODS Articles pertaining to OCT and OCTA biomarkers related to the development and progression of GA with relevant key words were used to search in PubMed, Researchgate, and Google Scholar. The articles were selected based on their relevance, reliability, publication year, published journal, and accessibility. RESULTS Previous reports have highlighted various OCT and OCTA biomarkers linked to the onset and advancement of GA. These biomarkers encompass characteristics such as the size, volume, and subtype of drusen, the presence of hyperreflective foci, basal laminar deposits, incomplete retinal pigment epithelium and outer retinal atrophy (iRORA), persistent choroidal hypertransmission defects, and the existence of subretinal drusenoid deposits (also referred to as reticular pseudodrusen). Moreover, biomarkers associated with the progression of GA include thinning of the outer retina, photoreceptor degradation, the distance between retinal pigment epithelium and Bruch's membrane, and choriocapillaris loss. CONCLUSION The advent of novel treatment strategies for GA underscores the heightened need for prompt diagnosis and precise monitoring of individuals with this condition. The utilization of structural OCT and OCTA becomes essential for identifying distinct biomarkers associated with the initiation and progression of GA.
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Affiliation(s)
- Veronica Vallino
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Alessandro Berni
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Coletto
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Sonia Serafino
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Francesco Bandello
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, Turin, Italy.
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
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Brinkmann M, Viggiano P, Boscia G, Danckwardt M, Susantija E, Müller T, Castellino N, Schweighofer J, Boscia F, Toro MD, El-Shabrawi Y. Analysis of Choriocapillaris Reperfusion Topography following Faricimab Treatment for Neovascular Age-Related Macular Degeneration in Non-Treatment-Naïve Patients. Diagnostics (Basel) 2024; 14:901. [PMID: 38732315 PMCID: PMC11083352 DOI: 10.3390/diagnostics14090901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
To assess changes in choriocapillaris (CC) vascular density surrounding macular neovascularization (MNV) in age-related macular degeneration (AMD) when transitioning from various anti-VEGF treatments to faricimab, using optical coherence tomography angiography (OCTA). 25 eyes of 22 individuals who underwent intravitreal faricimab injections for neovascular AMD with type 1 MNV were included. OCTA images were obtained prior to (T0), after one (T1), and after three faricimab injections (T2); Noteworthy changes occurred in the first ring at T2 in comparison to T0. The percentage of CC flow deficit (FD%), FD average area (FDa), and FD number (FDn) in 5 rings (R1-R5) surrounding the dark halo around the MNV were calculated. A reduction in FD% at T2 compared to T0 (50.5 ± 10.2% at T0, 46.4 ± 10.6% at T2; p = 0.020) was seen, indicating CC reperfusion. Additionally, we observed a reduction in the average FDa (140.2 ± 172.1% at T0, 93.7 ± 101.8% at T2; p = 0.029). Our study highlights an FD% after three consecutive faricimab injections. The most pronounced effect was observed in the first ring, directly adjacent to the dark halo, suggesting a partial CC reperfusion surrounding the MNV, potentially indicating disease regression.
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Affiliation(s)
- Max Brinkmann
- Department of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, Austria; (T.M.)
- Department of Ophthalmology, Universitätsklinikum Schleswig-Holstein, 23564 Lübeck, Germany; (M.D.); (E.S.)
| | - Pasquale Viggiano
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, 70121 Bari, Italy; (P.V.); (G.B.); (F.B.)
| | - Giacomo Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, 70121 Bari, Italy; (P.V.); (G.B.); (F.B.)
| | - Mathis Danckwardt
- Department of Ophthalmology, Universitätsklinikum Schleswig-Holstein, 23564 Lübeck, Germany; (M.D.); (E.S.)
| | - Evelyn Susantija
- Department of Ophthalmology, Universitätsklinikum Schleswig-Holstein, 23564 Lübeck, Germany; (M.D.); (E.S.)
| | - Tom Müller
- Department of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, Austria; (T.M.)
| | - Niccolò Castellino
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy;
| | - Jakob Schweighofer
- Department of Ophthalmology and Optometry, Medical University of Vienna, 1090 Vienna, Austria;
| | - Francesco Boscia
- Department of Translational Biomedicine Neuroscience, University of Bari “Aldo Moro”, 70121 Bari, Italy; (P.V.); (G.B.); (F.B.)
| | - Mario Damiano Toro
- Eye Clinic, Public Health Department, University of Naples Federico II, 80133 Naples, Italy
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland
| | - Yosuf El-Shabrawi
- Department of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, Austria; (T.M.)
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Sha F, Li H, Zhang L, Liang F. Evidence for Genetic Causal Relationships Between Multiple Immune-Mediated Inflammatory Diseases and Age-Related Macular Degeneration: A Univariable and Multivariable Mendelian Randomization Study. Ophthalmol Ther 2024; 13:955-967. [PMID: 38315350 PMCID: PMC10912070 DOI: 10.1007/s40123-024-00895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION With the global aging population on the rise, age-related macular degeneration (AMD) poses a growing healthcare burden. Prior research hints at immune-mediated inflammatory diseases (IMIDs) potentially elevating AMD risk via diverse mechanisms. However, causality remains disputed as a result of confounding factors. Hence, our Mendelian randomization (MR) study aims to untangle this link, mitigating confounding effects to explore the IMID-AMD causal relationship. This study aims to investigate the causal relationship between IMIDs and AMD, providing new strategies for the prevention and treatment of AMD in clinical practice. METHODS This study was registered with PROSPERO, CRD42023469815. We obtained data on IMIDs and AMD from Genome-Wide Association Studies (GWAS) summary statistics and the FinnGen consortium. Rigorous selection steps were applied to screen for eligible instrumental single nucleotide polymorphisms (SNPs). We conducted univariate Mendelian randomization, inverse variance-weighted (IVW), weighted median, Mendelian randomization-Egger (MR-Egger), and multivariate Mendelian randomization (MVMR) analyses. Various sensitivity analysis methods were employed to assess pleiotropy and heterogeneity. The aim was to explore the causal relationships between IMIDs and AMD. RESULTS The MR analysis revealed that Crohn's disease (CD) (IVW: odd ratios (OR) 1.05, 95% CI (confidence interval) 1.01-1.10, p = 0.007), rheumatoid arthritis (RA) (IVW: OR 1.09, 95% CI 1.04-1.15, p = 0.0001), and type 1 diabetes (T1D) (IVW: OR 1.05, 95% CI 1.02-1.09, p = 0.001) were correlated with an elevated risk of AMD, while multiple sclerosis (MS) (IVW: OR 2.78E-18, 95% CI 2.23E-31 to 3.48E-05, p = 0.008) appeared to be protective against AMD. These findings were supported by an array of MR analysis methodologies and the MVMR approach. CONCLUSION Our study results, based on MR, provide genetic evidence indicating a causal relationship between specific IMIDs and AMD. CD, RA, and T1D are factors increasing the risk of AMD, while MS may have a protective effect.
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Affiliation(s)
- Fuhui Sha
- The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hongmei Li
- The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Longyao Zhang
- The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Fengming Liang
- Eye School of Chengdu, University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention and Cure and Visual Function Protection with Traditional Chinese Medicine Laboratory, Chengdu, Sichuan Province, China.
- Retinal Image Technology and Chronic Vascular Disease Prevention and Control and Collaborative Innovation Center, Chengdu, Sichuan Province, China.
- Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
- Sichuan Integrated Traditional Chinese and Western Medicine Myopia Prevention and Treatment Center, Sichuan Vision Protection Science Popularization Base, Chengdu, Sichuan Province, China.
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