Department of Ophthalmology, Harkness Eye Institute, Columbia University, New York, NY 10032, USA.
Br J Ophthalmol. 2010 Dec;94(12):1618-23. doi: 10.1136/bjo.2009.166843. Epub 2010 Jun 7.
To demonstrate and quantify the dynamic remodelling process of soft drusen resorption and new drusen formation in age-related macular degeneration (AMD) with novel interactive methods.
Twenty patients with large soft drusen bilaterally and without advanced AMD were imaged at baseline and again at a mean interval of 2 years (40 eyes, 80 images). Each of the 40 serial pairs of images was precisely registered by an automated technique. The drusen were segmented by a user-interactive method based on a background levelling algorithm and classified into three groups: new drusen (only in the final image), resorbed drusen (present initially but not in the final image) and stable drusen (present in both images). We measured each of these classes as well as the absolute change in drusen |D1-D0| and the dynamic drusen activity (creation and resorption) D(new)+D(resorbed).
Mean dynamic activity for the right eye (OD) was 7.33±5.50%, significantly greater than mean absolute change (2.71±2.89%, p=0.0002, t test), with similar results for the left eye (OS). However, dynamic activity OD compared with OS (mean 7.33±5.50 vs 7.91±4.16%, NS) and absolute net change OD versus OS (2.71±2.89 vs 3.46±3.97%, NS) tended to be symmetrical between fellow eyes.
Dynamic remodelling processes of drusen resorption and new drusen formation are distinct disease activities that can occur simultaneously and are not captured by change in total drusen load. Dynamic changes occur at rates more than twice that of net changes, and may be a useful marker of disease activity.
利用新的交互式方法，展示并量化年龄相关性黄斑变性（AMD）中软玻璃膜疣吸收和新玻璃膜疣形成的动态重塑过程。
对 20 名双侧大软玻璃膜疣且无晚期 AMD 的患者进行基线和平均 2 年（40 只眼，80 张图像）的再次成像。通过自动技术精确地对这 40 对连续的图像进行配准。采用基于背景水平算法的用户交互方法对玻璃膜疣进行分割，并将其分为三组：新玻璃膜疣（仅在最终图像中）、吸收的玻璃膜疣（最初存在但不在最终图像中）和稳定的玻璃膜疣（在两张图像中均存在）。我们测量了这些类别中的每一个类别，以及玻璃膜疣的绝对值变化 |D1-D0| 和动态玻璃膜疣活动（生成和吸收）D(new)+D(resorbed)。
右眼（OD）的平均动态活动为 7.33±5.50%，明显大于平均绝对变化（2.71±2.89%，p=0.0002，t 检验），左眼（OS）也有类似结果。然而，OD 的动态活动与 OS 相比（均值 7.33±5.50%与 7.91±4.16%，无统计学差异），以及 OD 的绝对净变化与 OS 相比（2.71±2.89%与 3.46±3.97%，无统计学差异），在双眼之间趋于对称。
玻璃膜疣吸收和新玻璃膜疣形成的动态重塑过程是不同的疾病活动，可以同时发生，并且不能通过总玻璃膜疣负荷的变化来捕捉。动态变化的发生速度是净变化速度的两倍以上，可能是疾病活动的有用标志物。
