Schlanitz Ferdinand G, Baumann Bernhard, Kundi Michael, Sacu Stefan, Baratsits Magdalena, Scheschy Ulrike, Shahlaee Abtin, Mittermüller Tamara J, Montuoro Alessio, Roberts Philipp, Pircher Michael, Hitzenberger Christoph K, Schmidt-Erfurth Ursula
Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Br J Ophthalmol. 2017 Feb;101(2):198-203. doi: 10.1136/bjophthalmol-2016-308422. Epub 2016 Apr 4.
To quantify the change in drusen volume over time and identify its prognostic value for individual risk assessment.
A prospective observational study over a minimum of 3 years and maximum of 5 years and follow-up examination every 3 months was conducted at the ophthalmology department of the Medical University of Vienna. 109 patients presenting early and intermediate age-related macular degeneration (AMD) were included, of which 30 patients concluded a regular follow-up for at least 3 years. 50 eyes of 30 patients were imaged every 3 months using spectral-domain and polarisation-sensitive optical coherence tomography (OCT). Drusen volume was measured using an automated algorithm. Data of a 6-month follow-up were segmented manually by expert graders.
Gradings from 24 000 individual B-scans showed solid correlation between manual and automated segmentation with an initial mean drusen volume of 0.17 mm. The increase in drusen volume was shown to be comparable among all eyes, and a model for long-term drusen volume development could be fitted as a cubic polynomial function and an R=0.955. Spontaneous drusen regression was observed in 22 of 50 eyes. In this group, four eyes developed choroidal neovascularisation and three geographic atrophy.
Drusen volume increase over time can be described by a cubic function. Spontaneous regression appears to precede conversion to advanced AMD. OCT might be a promising tool for predicting the individual risk of progression of AMD.
量化玻璃膜疣体积随时间的变化，并确定其在个体风险评估中的预后价值。
在维也纳医科大学眼科进行了一项前瞻性观察研究，为期至少3年、最长5年，每3个月进行一次随访检查。纳入109例早、中期年龄相关性黄斑变性（AMD）患者，其中30例患者完成了至少3年的定期随访。对30例患者的50只眼睛每3个月使用光谱域和偏振敏感光学相干断层扫描（OCT）进行成像。使用自动算法测量玻璃膜疣体积。6个月随访的数据由专业分级人员手动分割。
对24000次个体B扫描的分级显示，手动分割与自动分割之间具有强相关性，初始平均玻璃膜疣体积为0.17立方毫米。所有眼睛的玻璃膜疣体积增加情况相似，可以用三次多项式函数拟合长期玻璃膜疣体积发展模型，R = 0.955。在50只眼睛中有22只观察到玻璃膜疣自发消退。在这组眼睛中，4只眼睛发生了脉络膜新生血管，3只眼睛发生了地图样萎缩。
玻璃膜疣体积随时间的增加可用三次函数描述。自发消退似乎先于向晚期AMD的转变。OCT可能是预测AMD个体进展风险的一种有前景的工具。
