Department of Ophthalmology and Bioengineering, UPMC Eye Center, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA 15213, USA.
Invest Ophthalmol Vis Sci. 2012 Apr 2;53(4):1742-51. doi: 10.1167/iovs.11-9338.
To assess the relative risk of an eye's conversion to wet age-related macular degeneration (AMD) based primarily on drusen measurements obtained from analysis of digitized images.
Four hundred forty-four subjects (820 eyes) enrolled in the Age-Related Eye Disease Study (AREDS I) and 78 subjects (129 eyes) from the Prophylactic Treatment of AMD trial (PTAMD) were studied retrospectively. Drusen size, distribution, drusen area, and hyperpigmentation in two central macular regions on baseline fundus images were determined using an image analysis algorithm. The relative risk for choroidal neovascularization (CNV) based on drusen area, presence of one or five large drusen, hyperpigmentation, and fellow eye status was calculated.
Odds ratios (ORs) for measured drusen area within the 1000- and 3000-μm regions were 1.644* (1.251-2.162) and 1.278 (0.927-1.762) for AREDS eyes and 0.832 (0.345-2.005) and 1.094 (0.524-2.283) for PTAMD eyes (P < 0.05). In the 1000-μm region, respective ORs for the presence of a large druse, hyperpigmentation, and fellow eye affected were 2.60, 1.71, and 6.44 for AREDS eyes and 8.24, 1.37, and 17.56* for PTAMD eyes; for the 3000-μm region, ORs were 3.45*, 3.40*, and 4.59* for AREDS and nonsignificant, 6.58, and 11.62* for PTAMD eyes, respectively.
Total drusen area, presence of large drusen, and the presence of hyperpigmentation were not consistent risk factors for an eye's development of CNV. Risk depended on study cohort as well as location. Having an affected fellow eye was the strongest and most consistent risk factor across all models. A larger drusen area does not necessarily increase an eye's risk of conversion to CNV.
主要通过分析数字化图像获得的 玻璃膜疣 测量值，评估眼睛向湿性年龄相关性黄斑变性（AMD）转化的相对风险。
回顾性研究参加年龄相关性眼病研究（AREDS I）的 444 名受试者（820 只眼）和参加 AMD 预防性治疗试验（PTAMD）的 78 名受试者（129 只眼）。使用图像分析算法确定基线眼底图像上两个中央黄斑区域的玻璃膜疣大小、分布、玻璃膜疣面积和色素沉着。根据玻璃膜疣面积、一个或五个大玻璃膜疣、色素沉着和对侧眼状态计算脉络膜新生血管（CNV）的相对风险。
AREDS 眼在 1000-μm 和 3000-μm 区域内测量的玻璃膜疣面积的优势比（OR）分别为 1.644*（1.251-2.162）和 1.278（0.927-1.762），PTAMD 眼分别为 0.832（0.345-2.005）和 1.094（0.524-2.283）（P<0.05）。在 1000-μm 区域，AREDS 眼大玻璃膜疣、色素沉着和对侧眼受累的相应 OR 分别为 2.60、1.71 和 6.44，PTAMD 眼分别为 8.24、1.37 和 17.56*；在 3000-μm 区域，AREDS 眼的 OR 分别为 3.45*、3.40和 4.59，PTAMD 眼分别为 6.58 和 11.62*，无统计学意义。
总玻璃膜疣面积、大玻璃膜疣的存在和色素沉着并不是眼睛发生脉络膜新生血管的一致危险因素。风险取决于研究队列以及位置。对侧眼受累是所有模型中最强和最一致的危险因素。更大的玻璃膜疣面积不一定会增加眼睛发生 CNV 的风险。
