Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2012 Jun 14;53(7):3663-72. doi: 10.1167/iovs.12-9619.
To investigate the relationship between subfoveal choroidal thickness, choroidal vascular hyperpermeability, and complement factor H (CFH) gene polymorphism in typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).
Fifty-eight patients with typical AMD and 63 patients with PCV underwent fluorescein angiography, indocyanine green angiography (IA), and spectral-domain optical coherence tomography (OCT) using enhanced depth imaging (EDI). Subfoveal choroidal thickness was measured using EDI-OCT images, and choroidal hyperpermeability was evaluated using late-phase IA images. The major AMD-associated single-nucleotide polymorphisms were genotyped in 86 patients.
Mean subfoveal choroidal thickness was significantly lower in eyes with typical AMD than that in eyes with PCV (P = 0.025). Subfoveal choroidal thickness was greater in eyes with choroidal hyperpermeability than that in eyes without it in typical AMD (P < 0.001) and PCV (P = 0.020), and in the fellow eyes of typical AMD (P < 0.001) and PCV (P = 0.027). In eyes without choroidal hyperpermeability, the mean subfoveal choroidal thickness was greater in PCV than that in typical AMD (P = 0.001). Choroidal thickness decreased after photodynamic therapy combined with intravitreal ranibizumab in typical AMD (P = 0.016) and PCV (P = 0.036). In eyes with PCV, the I62V polymorphism in the CFH gene contributed to choroidal thickness (P = 0.043).
Choroidal thickness is related to the AMD subtypes, choroidal hyperpermeability, and I62V CFH gene polymorphism. In eyes without choroidal hyperpermeability, EDI-OCT is useful as an auxiliary measure for differentiating typical AMD and PCV.
探讨特发性年龄相关性黄斑变性（AMD）和息肉状脉络膜血管病变（PCV）中脉络膜下厚度、脉络膜血管通透性与补体因子 H（CFH）基因多态性之间的关系。
对 58 例特发性 AMD 患者和 63 例 PCV 患者进行荧光素血管造影、吲哚青绿血管造影（IA）和频域光相干断层扫描（OCT），并采用增强深度成像（EDI）。采用 EDI-OCT 图像测量黄斑下脉络膜厚度，采用晚期 IA 图像评估脉络膜通透性。对 86 例患者进行主要 AMD 相关单核苷酸多态性基因分型。
与 PCV 相比，特发性 AMD 眼的黄斑下脉络膜厚度明显较低（P = 0.025）。在特发性 AMD（P < 0.001）和 PCV（P = 0.020）以及特发性 AMD 的对侧眼（P < 0.001）和 PCV（P = 0.027）中，脉络膜通透性增加的眼的黄斑下脉络膜厚度大于脉络膜通透性未增加的眼。在脉络膜通透性未增加的眼中，PCV 的黄斑下脉络膜厚度大于特发性 AMD（P = 0.001）。特发性 AMD 和 PCV 经光动力疗法联合玻璃体内雷珠单抗治疗后，黄斑下脉络膜厚度均降低（P = 0.016 和 P = 0.036）。在 PCV 眼中，CFH 基因的 I62V 多态性与脉络膜厚度有关（P = 0.043）。
脉络膜厚度与 AMD 亚型、脉络膜通透性和 CFH 基因 I62V 多态性有关。在脉络膜通透性无增加的眼中，EDI-OCT 可作为区分特发性 AMD 和 PCV 的辅助手段。
