典型渗出型年龄相关性黄斑变性和息肉状脉络膜血管病变的玻璃体内膜界面。
Vitreomacular interface in typical exudative age-related macular degeneration and polypoidal choroidal vasculopathy.
机构信息
Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
出版信息
Ophthalmology. 2011 May;118(5):853-9. doi: 10.1016/j.ophtha.2010.09.001. Epub 2010 Nov 20.
PURPOSE
To investigate the association in Japanese between posterior vitreous attachment and the pathologies of typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV), 2 major forms of exudative AMD.
DESIGN
Retrospective observational case series.
PARTICIPANTS
A total of 378 eyes from 302 subjects (132 with typical AMD, 126 with PCV, 120 controls) from the University of Tokyo Hospital.
METHODS
Posterior vitreous detachment (PVD) and vitreomacular adhesion (VMA) were investigated by B-mode ultrasonography and spectral-domain optical coherence tomography (SD-OCT), respectively. The greatest linear dimension (GLD) of initial photodynamic therapy (PDT) in a subset of the patients (n=92) receiving PDT was also investigated.
MAIN OUTCOME MEASURES
Number of eyes with complete PVD and with VMA. The GLD of initial PDT.
RESULTS
In typical AMD eyes, the frequency of complete PVD was significantly lower (63 [56.8%] of 111 eyes) than in the controls (52 [70.3%] of 74 eyes, risk ratio [RR] 0.76, P=0.021) and the frequency of VMA tended to be higher (14/115 [12.2%] in typical AMD eyes and 6/86 [7.0%] in the controls, RR 2.15, P=0.099). The frequency of complete PVD [77 [63.1%] of the 122 eyes] and VMA (9/108 [8.3%]) in PCV eyes was the same as the controls (RR 0.91, P=0.415 and RR 1.29, P=0.615). In patients with unilateral exudative AMD, the frequency of complete PVD was lower in typical AMD eyes than in fellow eyes (odds ratio [OR] 0.111, P=0.026) and VMA was observed in 7 (17.5%) and 3 (7.5%) typical AMD and fellow eyes, respectively (OR 2.33, P=0.34), whereas in PCV eyes, the frequency of complete PVD was higher (OR 8.00, P=0.045) and the frequency of VMA was the same as in the fellow eyes (OR 0.80, P=1.00). The GLD of the eyes without complete PVD or with VMA was significantly larger than that in the eyes with complete PVD in typical AMD eyes (P=0.042) and the same as that in the eyes with complete PVD in PCV eyes (P=0.67).
CONCLUSIONS
There is an association between posterior vitreous attachment and typical AMD. However, this association is not evident in PCV.
目的
研究日本玻璃体后脱离与典型年龄相关性黄斑变性（AMD）和息肉样脉络膜血管病变（PCV）这两种渗出性 AMD 主要形式的相关性。
设计
回顾性观察性病例系列。
参与者
来自东京大学医院的 302 名受试者（132 名患有典型 AMD，126 名患有 PCV，120 名对照）的 378 只眼。
方法
通过 B 型超声和谱域光相干断层扫描（SD-OCT）分别研究玻璃体后脱离（PVD）和玻璃体黄斑粘连（VMA）。还研究了接受光动力疗法（PDT）的患者亚组（n=92）中初始 PDT 的最大线性尺寸（GLD）。
主要观察指标
完全 PVD 和 VMA 的眼数。初始 PDT 的 GLD。
结果
在典型 AMD 眼中，完全 PVD 的频率明显低于对照组（63 [56.8%] 眼）（52 [70.3%] 眼，风险比[RR]0.76，P=0.021），而 VMA 的频率倾向于更高（14/115 [12.2%] 眼和 6/86 [7.0%] 眼，RR 2.15，P=0.099）。PCV 眼的完全 PVD [77 [63.1%] 眼]和 VMA [9/108 [8.3%]）与对照组相同（RR 0.91，P=0.415 和 RR 1.29，P=0.615）。在单侧渗出性 AMD 患者中，典型 AMD 眼中完全 PVD 的频率低于对侧眼（比值比[OR]0.111，P=0.026），在 7 只（17.5%）和 3 只（7.5%）典型 AMD 眼和对侧眼观察到 VMA（OR 2.33，P=0.34），而在 PCV 眼中，完全 PVD 的频率较高（OR 8.00，P=0.045），VMA 的频率与对侧眼相同（OR 0.80，P=1.00）。无完全 PVD 或 VMA 的眼的 GLD 明显大于典型 AMD 眼中有完全 PVD 的眼（P=0.042），与 PCV 眼中有完全 PVD 的眼相同（P=0.67）。
结论
玻璃体后附着与典型 AMD 之间存在关联。然而，这种关联在 PCV 中并不明显。
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