Department of Medical-Surgical Sciences and Biotechnologies, UOC Ophthalmology, Sapienza University of Rome, Terracina, Italy.
Department of Ophthalmology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
Retina. 2018 Feb;38(2):245-252. doi: 10.1097/IAE.0000000000001540.
To investigate the risk factors predictive for the development of neovascular age-related macular degeneration (NVAMD) by means of spectral-domain optical coherence tomography.
Retrospective study of 73 eyes graded Stage 2 and Stage 3 according to the AMD International Grading System with minimum follow-up of 24 months. Drusenoid pigment epithelial detachment, hyperreflective foci, external limiting membrane, inner ellipsoid band, and retinal pigment epithelium integrity were analyzed at baseline and last follow-up. Binary logistic regression model analyzed significant predictors of neovascular conversion.
The discontinuity of external limiting membrane, inner ellipsoid band, and retinal pigment epithelium bands were significantly more prevalent in the NVAMD group at baseline and last follow-up (P < 0.001). Hyperreflective foci represented the single most important predictor of neovascular conversion (Exp [B], 15.15; P = 0.005) as confirmed by Kaplan-Meier curve (P = 0.002). Drusenoid pigment epithelial detachment width was significantly greater in NVAMD group than control subjects at baseline and last follow-up (P < 0.001), and its delta value also resulted a significant neovascular predictor (Exp [B], 0.99; P = 0.04).
Hyperreflective foci significantly increase the risk of NVAMD progression. The delta width of drusenoid pigment epithelial detachment also predicts disease progression, integrating the stratification of NVAMD progression risk.
通过频域光相干断层扫描（OCT）研究预测新生血管性年龄相关性黄斑变性（NVAMD）发生的危险因素。
回顾性研究 73 只眼，根据 AMD 国际分级系统分为 2 期和 3 期，最低随访 24 个月。在基线和最后一次随访时分析了玻璃膜疣性色素上皮脱离、高反射灶、外节膜、内椭圆体带和视网膜色素上皮完整性。二元逻辑回归模型分析了新生血管转化的显著预测因素。
在基线和最后一次随访时，外节膜、内椭圆体带和视网膜色素上皮带的不连续性在 NVAMD 组中更为常见（P<0.001）。高反射灶是新生血管转化的唯一最重要的预测因素（Exp[B]，15.15；P=0.005），这一点也得到了 Kaplan-Meier 曲线的证实（P=0.002）。NVAMD 组在基线和最后一次随访时的玻璃膜疣性色素上皮脱离宽度明显大于对照组（P<0.001），其差值也是显著的新生血管预测因素（Exp[B]，0.99；P=0.04）。
高反射灶显著增加了 NVAMD 进展的风险。玻璃膜疣性色素上皮脱离的 delta 值也预测了疾病的进展，整合了 NVAMD 进展风险的分层。
