Simader Christian, Sayegh Ramzi G, Montuoro Alessio, Azhary Malek, Koth Anna Lucia, Baratsits Magdalena, Sacu Stefan, Prünte Christian, Kreil David P, Schmidt-Erfurth Ursula
Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Am J Ophthalmol. 2014 Sep;158(3):557-66.e1. doi: 10.1016/j.ajo.2014.05.026. Epub 2014 May 28.
To identify reliable criteria based on spectral-domain optical coherence tomography (SD OCT) to monitor disease progression in geographic atrophy attributable to age-related macular degeneration (AMD) compared with lesion size determination based on fundus autofluorescence (FAF).
Prospective longitudinal observational study.
setting: Institutional. study population: A total of 48 eyes in 24 patients with geographic atrophy. observation procedures: Eyes with geographic atrophy were included and examined at baseline and at months 3, 6, 9, and 12. At each study visit best-corrected visual acuity (BCVA), FAF, and SD OCT imaging were performed. FAF images were analyzed using the region overlay device. Planimetric measurements in SD OCT, including alterations or loss of outer retinal layers and the RPE, as well as choroidal signal enhancement, were performed with the OCT Toolkit. main outcome measures: Areas of interest in patients with geographic atrophy measured from baseline to month 12 by SD OCT compared with the area of atrophy measured by FAF.
Geographic atrophy lesion size increased from 8.88 mm² to 11.22 mm² based on quantitative FAF evaluation. Linear regression analysis demonstrated that results similar to FAF planimetry for determining lesion progression can be obtained by measuring the areas of outer plexiform layer thinning (adjusted R(2) = 0.93), external limiting membrane loss (adjusted R(2) = 0.89), or choroidal signal enhancement (R(2) = 0.93) by SD OCT.
SD OCT allows morphologic markers of disease progression to be identified in geographic atrophy and may improve understanding of the pathophysiology of atrophic AMD.
确定基于频域光学相干断层扫描（SD OCT）的可靠标准，以监测年龄相关性黄斑变性（AMD）所致地图样萎缩的疾病进展，并与基于眼底自发荧光（FAF）的病变大小测定进行比较。
前瞻性纵向观察研究。
地点：机构研究。研究人群：24例地图样萎缩患者共48只眼。观察程序：纳入地图样萎缩眼，并在基线以及第3、6、9和12个月进行检查。每次研究访视时均进行最佳矫正视力（BCVA）、FAF和SD OCT成像。使用区域叠加设备分析FAF图像。使用OCT Toolkit对SD OCT进行面积测量，包括视网膜外层和视网膜色素上皮（RPE）的改变或缺失，以及脉络膜信号增强。主要观察指标：通过SD OCT测量地图样萎缩患者从基线到第12个月的感兴趣区域，并与通过FAF测量的萎缩面积进行比较。
基于定量FAF评估，地图样萎缩病变大小从8.88mm²增加到11.22mm²。线性回归分析表明，通过测量外层神经丛层变薄面积（调整R² = 0.93）、外界膜缺失面积（调整R² = 0.89）或SD OCT测量的脉络膜信号增强面积（R² = 0.93），可获得与FAF平面测量法相似的用于确定病变进展的结果。
SD OCT可识别地图样萎缩中疾病进展的形态学标志物，并可能增进对萎缩性AMD病理生理学的理解。
