Ashraf Mohammed, Souka Ahmed, Adelman Ron A
*Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; and †Department of Ophthalmology and Visual Studies, Yale Medical School, European Vitreo-retinal Society (EVRS).
Retina. 2017 Sep;37(9):1738-1745. doi: 10.1097/IAE.0000000000001423.
To study the effect of the vitreomacular interface on various wet age-related macular degeneration (AMD) characteristics including the size and type of choroidal neovascularization (CNV), choroidal thickness, and activity of the CNV.
This was a retrospective observational cross-sectional study. The study included 43 patients (51 eyes) with treatment-naive age-related macular degeneration. Twenty-six patients with wet AMD in one eye and dry AMD in the other eye were included in a paired-eye analysis. Patients underwent optical coherence tomography examination using Heidelberg Spectralis (spectral domain optical coherence tomography) at presentation to determine the type of CNV and the vitreomacular status. In addition, various parameters were measured including the choroidal thickness and horizontal width and vertical height measurements of the CNV.
There was no correlation between the height, width, activity or type of the CNV, and the presence or absence of vitreomacular adhesion. The mean choroidal thickness (using enhanced depth imaging) in cases with vitreomacular adhesion was 272.57 μm compared with 197.32 μm in cases with no vitreomacular adhesion, a statistically significant difference (P = 0.003). In the paired-eye study (21 patients), there was no significant difference between the eyes with wet AMD and dry AMD with regard to vitreomacular status or the choroidal thickness. In a subgroup analysis, patients with Type 1 CNV had a significantly higher percentage of vitreomacular adhesion compared with the other eye with dry AMD (P = 0.034).
In conclusion, the vitreomacular interface does seem to be associated with an increased choroidal thickness in cases of wet AMD. Furthermore, the association between the vitreomacular interface and wet AMD is more significant for Type 1 CNV.
研究玻璃体黄斑界面对于各种湿性年龄相关性黄斑变性(AMD)特征的影响,这些特征包括脉络膜新生血管(CNV)的大小和类型、脉络膜厚度以及CNV的活性。
这是一项回顾性观察性横断面研究。该研究纳入了43例未经治疗的年龄相关性黄斑变性患者(51只眼)。对26例一只眼为湿性AMD且另一只眼为干性AMD的患者进行了双眼配对分析。患者在就诊时使用海德堡谱域光学相干断层扫描仪(Heidelberg Spectralis)进行光学相干断层扫描检查,以确定CNV的类型和玻璃体黄斑状态。此外,还测量了各种参数,包括脉络膜厚度以及CNV的水平宽度和垂直高度。
CNV的高度、宽度、活性或类型与玻璃体黄斑粘连的有无之间无相关性。玻璃体黄斑粘连患者的平均脉络膜厚度(使用增强深度成像)为272.57μm,而无玻璃体黄斑粘连患者的平均脉络膜厚度为197.32μm,差异具有统计学意义(P = 0.003)。在双眼配对研究(21例患者)中,湿性AMD眼和干性AMD眼在玻璃体黄斑状态或脉络膜厚度方面无显著差异。在亚组分析中,1型CNV患者的玻璃体黄斑粘连百分比显著高于另一只干性AMD眼(P = 0.034)。
总之,在湿性AMD病例中,玻璃体黄斑界面似乎确实与脉络膜厚度增加有关。此外,玻璃体黄斑界面与湿性AMD之间的关联在1型CNV中更为显著。