Vitreous, Retina, Macula Consultants of New York and LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.
Retina. 2012 Jul;32(7):1265-71. doi: 10.1097/IAE.0b013e31824453ac.
To investigate the association of fundus features with choroidal thickness in eyes with early age-related macular degeneration.
Consecutive patients with age-related macular degeneration were evaluated. Major exclusionary criteria included late age-related macular degeneration (central geographic atrophy or choroidal neovascularization), macular laser therapy, myopia greater than -6 diopters, past vitreoretinal surgery, or central serous chorioretinopathy. Charts and multimodal imaging were reviewed for refraction, cataract, hypertension, diabetes, open-angle glaucoma, β-zone peripapillary atrophy, fundus tessellation, pigmentary changes, drusen, subretinal drusenoid deposits (also known as reticular pseudodrusen). Data measured from enhanced-depth imaging spectral-domain optical coherence tomography included subfoveal choroidal thickness, central foveal thickness, outer nuclear layer thickness, inner segment to retinal pigment epithelium aggregate thickness, presence of subretinal drusenoid deposit, and outer retinal hyperreflective layers (including the band corresponding to overlap between retinal pigment epithelium apical processes and outer segments). Correlations were calculated among the measured variables, fundus features, open-angle glaucoma, and visual acuity.
In 90 eyes of 70 early age-related macular degeneration patients with mean visual acuity 20/31 (logarithm of the minimum angle of resolution 0.193), subfoveal choroidal thickness showed a significant inverse correlation with age (P = 0.004) and increasing myopic spherical equivalent refractive error (P = 0.023). Subfoveal choroidal thickness was thinner in eyes with fundus tessellation (P < 0.001), subretinal drusenoid deposit (P = 0.023), an absence of conventional drusen (P < 0.001), the presence of β-zone peripapillary atrophy (P < 0.001), and in eyes with a diagnosis of open-angle glaucoma (P = 0.003) or an absent band on optical coherence tomography corresponding to overlap between outer segment and retinal pigment epithelium apical processes (P = 0.022).
Major ocular manifestations in early age-related macular degeneration and open-angle glaucoma are associated with the choroid-the main blood supply in the eye. Theories concerning the pathogenesis of these two diseases should incorporate interactions involving the choroid.
研究眼底特征与早期年龄相关性黄斑变性患者脉络膜厚度的关系。
连续评估年龄相关性黄斑变性患者。主要排除标准包括晚期年龄相关性黄斑变性（中央性地图状萎缩或脉络膜新生血管形成）、黄斑激光治疗、近视大于-6 屈光度、既往玻璃体视网膜手术或中心性浆液性脉络膜视网膜病变。回顾图表和多模态成像以评估屈光度、白内障、高血压、糖尿病、开角型青光眼、β 区视盘周围萎缩、眼底网格状图案、色素变化、玻璃膜疣、脉络膜下玻璃膜疣样沉积物（也称为网状假性玻璃膜疣）。从增强深度成像谱域光学相干断层扫描中测量的数据包括：黄斑下脉络膜厚度、中心凹下脉络膜厚度、外核层厚度、内节至视网膜色素上皮集合厚度、脉络膜下玻璃膜疣样沉积物的存在以及外视网膜高反射层（包括视网膜色素上皮顶端过程和外节重叠处的带）。在 70 名早期年龄相关性黄斑变性患者的 90 只眼中，平均视力为 20/31（最小角分辨率对数 0.193），黄斑下脉络膜厚度与年龄呈显著负相关（P = 0.004），并与近视性球镜等效屈光误差的增加呈正相关（P = 0.023）。在眼底网格状图案（P < 0.001）、脉络膜下玻璃膜疣样沉积物（P = 0.023）、无常规玻璃膜疣（P < 0.001）、β 区视盘周围萎缩（P < 0.001）以及开角型青光眼（P = 0.003）或光学相干断层扫描中无对应于外节和视网膜色素上皮顶端过程重叠的带（P = 0.022）的眼中，黄斑下脉络膜厚度较薄。
早期年龄相关性黄斑变性和开角型青光眼的主要眼部表现与脉络膜有关，脉络膜是眼睛的主要血液供应。这两种疾病发病机制的理论应包括涉及脉络膜的相互作用。
