Đánh giá sự thay đổi của tân mạch hắc võng mạc bằng octa sau tiêm nội nhãn bevacizumab điều trị thoái hóa hoàng điểm tuổi già thể ướt

Abstract

Objective: Evaluate of the change of choroidal neovascularization by optical coherence  tomography angiography after intravitreal injection Bevacizumab in wet age-related macular degeneration. Subject and method: A prospective descriptive study was conducted on 37 eyes from 30 patients diagnosed with neovascular AMD, who received three consecutive monthly intravitreal Bevacizumab injections between September 2024 and August 2025 at Hong Son Eye Hospital. Result: Among 37 affected eyes, CNV type 1 accounted for 35.1%, type 2 for 37.8%, and type 3 for 27.0%. Qualitative results: The neovascular patterns observed included medusa 27%, sea fan 18.9%, disappearance of the surrounding capillary network 43.2%, and pruned vascular tree 10.8%,. The mean baseline CNV area was 1.56 ± 1.34 mm²; after the loading dose, it decreased by 18.27% to 1.27 ± 1.29 mm², and after three injections, it decreased by 49.37% to 0.81 ± 1.22 mm². Qualitatively, after 3 months, CNV morphology showed regression and disappearance of small branches and surrounding capillary networks, while the main feeder vessel remained unchanged. Vessel density and perfusion density at the foveal region were lower than those in the parafoveal and whole image areas; after 3 months, these parameters also changed, but the changes were not statistically significant. Conclusion: OCT-A is a noninvasive, safe and reliable method that provides detailed quantitative and qualitative imaging of CNV, allowing repeated monitoring throughout treatment. After three consecutive monthly intravitreal Bevacizumab injections, CNV demonstrated significant changes in both morphology and size, reflecting the treatment efficacy.