光学相干断层扫描-光栅扫描和手动分割在年龄相关性黄斑变性中确定玻璃膜疣体积。

Optical coherence tomography-raster scanning and manual segmentation in determining drusen volume in age-related macular degeneration.

机构信息

Department of Ophthalmology, University of California, San Diego Jacobs Retina Center and Shiley Eye Center, University of California, San Diego School of Medicine, La Jolla, CA, USA.

出版信息

Retina. 2010 Mar;30(3):431-5. doi: 10.1097/IAE.0b013e3181bd2f94.

DOI:10.1097/IAE.0b013e3181bd2f94

PMID:19952989

Abstract

PURPOSE

Drusen are the hallmark of age-related macular degeneration (AMD), and substantial evidence exists that the amount of drusen and their effect on retinal pigment epithelium is a strong predictor of progression of AMD and vision loss. Until recently, it was not possible to quantitate the volume of the drusen. However, the use of image-stabilized scanning laser ophthalmoscope or spectral domain-optical coherence tomography (OCT) has enabled determination of drusen volume of this abnormal material. The purpose of this study was to assess the correlation of drusen volume with Age-Related Eye Disease Study (AREDS) grade and drusen area in dry AMD.

METHODS

Thirty-six eyes from 18 patients with nonexudative AMD with visual acuity between 20/16 and 20/160 were studied. Spectral domain-OCT or simultaneous OCT scans were taken as color fundus photographs (35 degrees ) of each eye. Early Treatment Diabetic Retinopathy Study visions were also recorded. The full AREDS score excluding late-stage AMD was determined by agreement between two trained observers. Drusen volume was determined by examination of a series of 96 spectral domain-OCT scans taken from arcade to arcade for a length of 6 mm. The volume was determined by calculating the drusen area in each scan and determining the drusen volume by calculating the effective volume of each cut using National Institutes of Health Image J. Drusen were identified and outlined manually, not using an automated algorithm.

RESULTS

There was a strong and significant correlation between drusen volume and AREDS-determined drusen area (P < 0.0001, r = 0.78). In addition, there was a correlation between AREDS classification and drusen volume (P = 0.023, r = 0.43) as determined by pairwise correlation.

CONCLUSION

Drusen volume as determined by spectral domain-OCT correlates with AREDS-determined drusen area and AREDS grade in nonexudative AMD. The correlation is not perfect, however, because drusen area and volume average 40% and 82% of the variation, respectively. Drusen volume can provide additional information in grading the severity of eyes with dry AMD.

摘要

目的

玻璃膜疣是年龄相关性黄斑变性（AMD）的标志，大量证据表明玻璃膜疣的数量及其对视网膜色素上皮的影响是 AMD 进展和视力丧失的强有力预测指标。直到最近，还不可能对玻璃膜疣的体积进行定量。然而，使用图像稳定的扫描激光检眼镜或光谱域光学相干断层扫描（OCT）已经能够确定这种异常物质的玻璃膜疣体积。本研究的目的是评估玻璃膜疣体积与干性 AMD 的年龄相关性眼病研究（AREDS）分级和玻璃膜疣面积的相关性。

方法

研究了 18 名无渗出性 AMD 患者的 36 只眼，这些患者的视力在 20/16 和 20/160 之间。对每只眼的光谱域-OCT 或同时 OCT 扫描进行彩色眼底照片（35 度）拍摄。还记录了早期糖尿病性视网膜病变研究的视力。通过两名经过培训的观察者之间的一致意见确定了完整的 AREDS 评分，不包括晚期 AMD。通过从拱廊到拱廊对 96 个光谱域-OCT 扫描进行检查，以 6 毫米的长度确定玻璃膜疣体积。通过计算每个扫描中的玻璃膜疣面积，并使用美国国立卫生研究院的 Image J 确定每个切割的有效体积来确定玻璃膜疣体积。手动识别和勾勒玻璃膜疣，不使用自动算法。