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视网膜血管瘤样增生的脉络膜比典型渗出性年龄相关性黄斑变性更薄,渗出灶更大。

Thinner choroid and greater drusen extent in retinal angiomatous proliferation than in typical exudative age-related macular degeneration.

机构信息

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Am J Ophthalmol. 2013 Apr;155(4):743-9, 749.e1-2. doi: 10.1016/j.ajo.2012.11.001. Epub 2013 Jan 11.

Abstract

PURPOSE

To compare choroidal thickness and extent and density of drusen between eyes with typical exudative age-related macular degeneration (AMD) and eyes with retinal angiomatous proliferation (RAP).

DESIGN

Observational case series.

METHODS

Twenty-four eyes with typical exudative AMD and 20 eyes with RAP were included. Subfoveal choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Eyes were classified into 3 groups according to the extent of drusen distribution in the fundus photograph. Density of drusen was estimated based on optical coherence tomography images of the fellow eye. The proportion of the length beneath the drusen per the entire length of the Bruch membrane was defined as the density of drusen. Subfoveal choroidal thickness, extent of drusen distribution, and the density of drusen were compared between typical exudative AMD and RAP.

RESULTS

Mean ± standard deviation subfoveal choroidal thickness in eyes with typical exudative AMD and eyes with RAP was 184.9 ± 68.5 μm and 139.0 ± 65.5 μm, respectively (P = .035). The mean density of drusen was 0.06 ± 0.08 and 0.24 ± 0.12, respectively (P < .001). In the typical exudative AMD group, 19, 3, and 2 eyes were included in the small extent group (<one third), intermediate extent group (one third to two thirds), and large extent group (>two thirds), respectively. In the RAP group, 3, 14, and 3 eyes were included in each aforementioned group, respectively (P = .001).

CONCLUSIONS

The thinner subfoveal choroidal thickness and greater extent and density of drusen in RAP than the typical exudative AMD may suggest compromised choroidal perfusion in the development of RAP.

摘要

目的

比较典型渗出性年龄相关性黄斑变性(AMD)眼和视网膜血管瘤样增生(RAP)眼的脉络膜厚度、脉络膜脱离范围和脉络膜脱离密度。

设计

观察性病例系列。

方法

纳入 24 只典型渗出性 AMD 眼和 20 只 RAP 眼。使用增强深度成像光学相干断层扫描测量黄斑中心凹下脉络膜厚度。根据眼底照片中脉络膜脱离范围将眼分为 3 组。根据对侧眼的光学相干断层扫描图像估计脉络膜脱离密度。将脉络膜脱离下的 Bruch 膜长度与整个 Bruch 膜长度的比例定义为脉络膜脱离密度。比较典型渗出性 AMD 眼和 RAP 眼的黄斑中心凹下脉络膜厚度、脉络膜脱离范围和脉络膜脱离密度。

结果

典型渗出性 AMD 眼和 RAP 眼的平均±标准偏差黄斑中心凹下脉络膜厚度分别为 184.9±68.5μm 和 139.0±65.5μm(P=0.035)。脉络膜脱离密度的平均值分别为 0.06±0.08 和 0.24±0.12(P<0.001)。在典型渗出性 AMD 组中,小范围组(<1/3)、中范围组(1/3 至 2/3)和大范围组(>2/3)分别纳入 19、3 和 2 只眼。在 RAP 组中,每个上述组分别纳入 3、14 和 3 只眼(P=0.001)。

结论

与典型渗出性 AMD 相比,RAP 眼脉络膜厚度更薄、脉络膜脱离范围更大、脉络膜脱离密度更高,这可能表明在 RAP 的发生发展过程中脉络膜灌注受损。

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