Grunwald Juan E, Metelitsina Tatyana I, Dupont Joan C, Ying Gui-Shuang, Maguire Maureen G
Department of Ophthalmology, Scheie Eye Institute, School of Medicine, University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA.
Invest Ophthalmol Vis Sci. 2005 Mar;46(3):1033-8. doi: 10.1167/iovs.04-1050.
In an earlier study, the authors reported that foveolar choroidal blood flow (ChBFlow) decreases in patients with AMD and drusen. To explore further the choroidal circulatory changes in patients with AMD, the relationship between ChBFlow and fundus features associated with increased risk of choroidal neovascularization (CNV) were investigated.
The study included 26 control eyes of 17 normal subjects and 163 eyes with early AMD characteristics of 123 patients with AMD. The AMD study eyes were divided into three groups according to increasing risk for development of CNV: (1) drusen > or =63 microm, no RPE hyperpigmentary changes in the study eye, and no CNV in the fellow eye; (2) drusen > or =63 microm, RPE hyperpigmentary changes in the study eye, and no CNV in the fellow eye; and (3) eyes with CNV in the fellow eye. Laser Doppler flowmetry was used to assess relative foveolar choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBFlow). Differences in the mean circulatory parameters were assessed by analysis of variance (ANOVA) and test of linear trend.
Mean ChBVel, ChBVol, and ChBFlow decreased with increased risk for CNV (linear trend, P < 0.05). The lowest circulatory parameters were observed in the eyes with the highest risk for CNV development. Trends for ChBVel and ChBFlow were still significant after adjustment for multiple factors.
There is a systematic decrease in choroidal circulatory parameters with an increase in the severity of AMD features associated with risk for the development of CNV, suggesting a role for ischemia in the development of CNV.
在一项早期研究中，作者报告称年龄相关性黄斑变性（AMD）和玻璃膜疣患者的黄斑部脉络膜血流（ChBFlow）减少。为了进一步探究AMD患者的脉络膜循环变化，研究了ChBFlow与脉络膜新生血管（CNV）风险增加相关的眼底特征之间的关系。
该研究纳入了17名正常受试者的26只对照眼以及123例AMD患者的163只具有早期AMD特征的眼睛。根据发生CNV风险的增加，将AMD研究眼分为三组：（1）玻璃膜疣≥63微米，研究眼无视网膜色素上皮（RPE）色素沉着改变，对侧眼无CNV；（2）玻璃膜疣≥63微米，研究眼有RPE色素沉着改变，对侧眼无CNV；（3）对侧眼有CNV的眼睛。使用激光多普勒血流仪评估黄斑部脉络膜相对血流速度（ChBVel）、血容量（ChBVol）和血流量（ChBFlow）。通过方差分析（ANOVA）和线性趋势检验评估平均循环参数的差异。
随着CNV风险增加，平均ChBVel、ChBVol和ChBFlow降低（线性趋势，P<0.05）。在发生CNV风险最高的眼睛中观察到最低的循环参数。在对多个因素进行调整后，ChBVel和ChBFlow的趋势仍然显著。
随着与CNV发生风险相关的AMD特征严重程度增加，脉络膜循环参数出现系统性降低，提示缺血在CNV发生中起作用。
