NGHIÊN CỨU SỰ THAY ĐỔI MẬT ĐỘ MẠCH MÁU VÀ MẬT ĐỘ TƯỚI MÁU VÙNG HOÀNG ĐIỂM TRÊN CHỤP CẮT LỚP QUANG HỌC MẠCH MÁU (OCTA) SAU TIÊM NỘI NHÃN BEVACIZUMAB Ở BỆNH NHÂN THOÁI HÓA HOÀNG ĐIỂM TUỔI GIÀ THỂ ƯỚT

Abstract

Objective: To investigate changes in macular vessel density and perfusion density on optical coherence tomography angiography (OCT-A) after intravitreal Bevacizumab injection in patients with neovascular age-related macular degeneration (nAMD). Materials and Methods: A prospective descriptive study was conducted on 37 eyes of 30 patients with nAMD who were indicated for monthly intravitreal Bevacizumab injections over three consecutive months, from September 2024 to August 2025 at Hong Son Eye Hospital. Vessel density and perfusion density were analyzed in the central, inner, outer, and full macular regions. Results: In all 37 studied eyes, central vessel density was lower compared to inner, outer, and full macular regions. After 3 months of treatment, central vessel density decreased from 7.29 ± 5.77 to 6.41 ± 5.25; while inner density increased from 13.09 ± 5.23 to 13.10 ± 4.75, outer density increased from 13.88 ± 4.57 to 14.45 ± 3.87, and full macular density increased from 13.44 ± 4.60 to 14.00 ± 3.91. These changes were not statistically significant (p > 0.05). Regarding perfusion density, the central region (16.90 ± 13.83%) was significantly lower than the inner (31.45 ± 13.40%), outer (33.62 ± 11.74%), and full macular regions (32.55 ± 11.76%). After 3 months, central perfusion density decreased to 14.10 ± 11.81%, inner perfusion density decreased to 30.62 ± 11.64%, while outer density increased to 34.65 ± 9.12% and full macular density increased to 33.59 ± 9.91%. These changes were not statistically significant (p > 0.05). A strong correlation was observed between vessel density and perfusion density before and after treatment; however, no correlation was found between these OCT-A parameters and either central retinal thickness or neovascular lesion area or vision. Conclusions: OCT-A is a safe, reliable, and repeatable imaging modality to evaluate wet AMD treatment. After three consecutive monthly intravitreal Bevacizumab injections, changes in vessel density and perfusion density on OCT-A did not reach statistical significance. A linear correlation was found between vessel density and perfusion density, but no association was observed with central retinal thickness or neovascular lesion area or improved vision.