目的：识别新生血管性年龄相关性黄斑变性（neovascular age-related macular degeneration,NVAMD）患者接受抗血管内皮生长因子（vascular endothelial growth factor,VEGF）药物治疗后出现的黄斑萎缩事件，并评估其治疗前的眼部解剖结构变化。方法：回顾 2014 全年期间由采用抗 VEGF 药物治疗的所有 NVAMD 患者，这些患者的随访时间均超过 12 个月，并评估了从首次治疗（通常在 2014 年前）至 2018 年 6 月最后一次随访期间的所有谱域光学相干断层扫描（spectral domain-optical coherence tomography, SD-OCT）图像。结果：在既定的研究流程中，共识别出 278 例 NVAMD 患者的 342 眼，其中 47 眼发生了黄斑萎缩。从治疗开始到黄斑萎缩出现的中位时间为 29.6 个月（四分位距：17.7-43.4）。在发生萎缩的区域中，发现了三种黄斑结构改变（部分眼睛存在不止一种改变）：在 25 眼中观察到血管化色素上皮脱离（pigment epithelial detachment,PED）的塌陷和脉络膜新生血管（choroidal neovascularization，CNV）的消退；在 15 眼中观察到视网膜下高反射物质和(或)视网膜下纤维化的形成；在 13 眼中观察到黄斑萎缩与大玻璃膜疣及色素改变相关联，呈现出通常称为地图状萎缩的典型模式。结论：这些数据表明，在某些情况下，CNV 可能补偿脉络膜的缺血状态，而 CNV 的消退则可能使 RPE 细胞和光感受器暴露于缺血性损伤和萎缩的风险之中。

Background/Aims: To identify incident macular atrophy and evaluate antecedent anatomic alterations in eyes with neovascular age-related macular degeneration (NVAMD) that were treated with anti-vascular endothelial growth factor (anti-VEGF) agents. Methods: All patients treated with anti-VEGF agents for NVAMD by one of the authors during the 2014 calendar year who had follow up ≥ 12 months had evaluation of all SD-OCT scans from first treatment (usually prior to 2014) to last follow up through June 2018.  Results: The ascertainment procedure identified 342 eyes of 278 patients with NVAMD among which 47 developed macular atrophy. The median time from treatment initiation to development of macular atrophy was 29.6 (interquartile range, 17.7 - 43.4) months. Three macular alterations were identified in areas that developed atrophy (some eyes had more than one); collapse of a vascularized pigment epithelial detachment (PED) and regression of choroidal neovascularization (CNV) in 25 eyes, development of subretinal hyper-reflective material and/or subretinal fibrosis in 15 eyes, or atrophy occurring in association with large drusen and pigmentary changes resulting in an arc of atrophy in a pattern typically referred to as geographic atrophy in 13 eyes. Conclusions: These data suggest that in some instances CNV may compensate for choroidal ischemia and the loss of CNV may expose retinal pigmented epithelial cells and photoreceptors to ischemic damage and atrophy.

目的：评估炎非感染性葡萄膜炎继发炎性脉络膜新生血管(inflammatory choroidal neovascularization, iCNV)的临床特征及眼底多模式影像表现。方法：采用回顾性观察性研究，采用眼底荧光素血管造影(fundus fluorescein angiography, FFA)、吲哚菁绿血管造影(Indocyanine green angiography, ICGA)、谱域相干光断层扫描(spectral domain optical coherence tomography, SD-OCT)联合光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)等多种眼底影像学方法，对纳入患者的眼底进行检查，分析非感染性iCNV的面积、分型、位置及形态等影像学特征与临床特征的关系。结果：研究共纳入39例患者，对48只患眼中的51处iCNV病灶进行了评估。纳入患者年龄为(35.28±13.62)岁。其中3例患眼出现多灶性CNV。SD-OCT显示92.16%(47/51)的iCNV为2型CNV，17.65%(9/51)的iCNV出现海绵征，13.72%(7/51)的iCNV伴有局灶脉络膜凹陷。ICGA造影期间，74.50%的iCNV病灶(38/51)伴有弱荧光病灶，25.49%的病例(13/51)显示脉络膜高通透性表现。OCTA enface图像显示iCNV形态多样，包括焦点状(15例，29.41%)、盘状/海扇状(16例，31.37%)、枯树状(9例，17.65%)、星状(9例，17.65%)及弥漫网状(2例，3.92%)。其中，枯树状及星状iCNV提示iCNV为非活动性(P＜0.01)。结论：非感染性iCNV与炎性病灶关系密切，在SD-OCT，ICGA上皆具特征性的影像表现。OCTA能直观地观察到iCNV的形态。这些多模式影像特征为临床医生提供了对于非感染性iCNV重要的鉴别诊断依据，有助于制定有效的诊疗方案。

Objective: To evaluate the clinical characteristics and multimodal imaging features of non-infectious inflammatory choroidal neovascularization (iCNV). Methods: In this study retrospective, observational study, multimodal imaging examinations, including fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA), were used to observe the morphology of non-infectious iCNV in patients diagnosed with uveitis. The area of iCNV, CNV types, CNV morphology and other imaging characteristics were further analyzed. Results: A total of 39 patients were included, with 48 affected eyes and 51 iCNV were identified. The average age of the included patients was 35.28±13.62 years. Among the affected eyes, 3 presented with multifocal CNV, and 92.16% of iCNV were classified as type 2 CNV. iCNV exhibited diverse morphologies, including focal-like pattern (15 cases, 29.41%),sea-fan pattern(16 cases, 31.37%), dead-tree pattern CNV(9 cases, 17.65%), stellar pattern (9 cases, 17.65%), and diffuse reticular (2 cases, 3.92%). Notably, tree-like and stellar pattern iCNV showed a significant correlation with non-active CNV (P < 0.01). Conclusions: Non-infectious iCNV is closely related to inflammatory lesions, exhibiting characteristic imaging features on SD-OCT and ICGA. OCTA allows for direct observation of the morphology of iCNV. These multimodal imaging characteristics provide important diagnostic criteria for clinicians, aiding in the formulation of effective treatment plans.

目的：比较水合氯醛和阿佛丁两种药物对小鼠的麻醉作用以及不同激光能量对脉络膜新生血管造模成功率的影响。方法：24只C57/BL6小鼠随机分为3组，分别予以200，300和400 mW的532 nm激光进行视网膜光凝；每组再按1:1分为2个亚组，随机使用4.3%水合氯醛或1.2%阿佛丁进行小鼠腹腔注射麻醉。在激光光凝后第4，7，1 0和1 4天进行视网膜荧光素造影(Fundus Fluorescein Angiography，FFA)、SD-OCT检查，在第1 4天时对脉络膜行IB4染色检查。结果：阿佛丁和水合氯醛诱导小鼠进入麻醉时间长分别为(120±30) s和(150±45) s，持续时间分别为(30±15) min和(50±20) min，差异均有统计学意义(均P=0.0001)；发生不可逆性白内障的比率分别为2/24和1/24，麻醉导致的死亡数分别为1和0只，差异均无统计学意义(P =0.551，P =0.300)。200，300和400 mW三个激光能量组的造模成功率分别为9.38%，37.5%和93.75%，差异有统计学意义(P=0.0001)。FFA显示：造模成功的小鼠在4 d时荧光素渗漏达到高峰，随后荧光素溢漏的面积逐渐减小。结论：与阿佛丁相比，水合氯醛对小鼠的麻醉维持时间长且不会增加病死率和不可逆性白内障的发生率；400 mW的532 nm激光能量是诱发CNV的较好设置。

Objective: To compare the narcotic effects of chloral hydrate and avertin in mouse models and the success rate of choroidal neovascularization (CNV) mouse model establishment with different energy hierarchy of laser. Methods: Twenty-four mice were randomized into 3 groups, the 532 nm laser was used with different power levels of 200, 300 and 400 mW for each group. In each group, the chloral hydrate was used for 4 mice and avertin for the other 4 mice at random. On day 4, 7, 10 and 14, all mice were tested by the fundus fluorescein angiography (FFA), SD-OCT, and the choroid was stained with the isolectin B4 conjugated AF488 on day 14. Results: The anesthesia induction time of avertin and chloral hydrate was (120±30) s and (150±45) s, and the duration of anesthesia was (30±15) min and (50±20) min, the differences were statistically significant (all P=0.0001); the incidence of irreversible cataract of avertin models and chloral hydrate models was 2/24 and 1/24, the number of death in two models was 1 and without statistical significance (P=0.551, P=0.300). With the increase of laser energy, the success rate of experiments was also gradually increased, from 9.38%, 37.5% to 93.75% (P=0.0001) in 200, 300 and 400 mW group, respectively. According to the results of FFA, the peak of fluorescence leaking was at day 4 after the laser burning, and was gradually reduced. Conclusion: Compared with avertin chloral hydrate can improve the duration of anesthesia without increasing the risk of cataract and mortality. As for the 532 nm laser, the 400 mW energy could be an optimal parameter for the laser-induced CNV.