非新生血管性年龄相关性黄斑变性中玻璃膜疣体积与脉络膜参数的相关性
ASSOCIATION OF DRUSEN VOLUME WITH CHOROIDAL PARAMETERS IN NONNEOVASCULAR AGE-RELATED MACULAR DEGENERATION.
作者信息
Balasubramanian Siva, Lei Jianqin, Nittala Muneeswar G, Velaga Swetha B, Haines Jonathan, Pericak-Vance Margaret A, Stambolian Dwight, Sadda SriniVas R
机构信息
*Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California; †Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; ‡First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; §Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, Ohio; ¶John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida; and **Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
出版信息
Retina. 2017 Oct;37(10):1880-1887. doi: 10.1097/IAE.0000000000001428.
PURPOSE
The choroid is thought to be relevant to the pathogenesis of nonneovascular age-related macular degeneration, but its role has not yet been fully defined. In this study, we evaluate the relationship between the extent of macular drusen and specific choroidal parameters, including thickness and intensity.
METHODS
Spectral domain optical coherence tomography images were collected from two distinct, independent cohorts with nonneovascular age-related macular degeneration: Amish (53 eyes of 34 subjects) and non-Amish (40 eyes from 26 subjects). All spectral domain optical coherence tomography scans were obtained using the Cirrus HD-OCT with a 512 × 128 macular cube (6 × 6 mm) protocol. The Cirrus advanced retinal pigment epithelium analysis tool was used to automatically compute drusen volume within 3 mm (DV3) and 5 mm (DV5) circles centered on the fovea. The inner and outer borders of the choroid were manually segmented, and the mean choroidal thickness and choroidal intensity (i.e., brightness) were calculated. The choroidal intensity was normalized against the vitreous and nerve fiber layer reflectivity. The correlation between DV and these choroidal parameters was assessed using Pearson and linear regression analysis.
RESULTS
A significant positive correlation was observed between normalized choroidal intensity and DV5 in the Amish (r = 0.42, P = 0.002) and non-Amish (r = 0.33, P = 0.03) cohorts. Also, DV3 showed a significant positive correlation with normalized choroidal intensity in both the groups (Amish: r = 0.30, P = 0.02; non-Amish: r = 0.32, P = 0.04). Choroidal thickness was negatively correlated with normalized choroidal intensity in both Amish (r = -0.71, P = 0.001) and non-Amish (r = -0.43, P = 0.01) groups. Normalized choroidal intensity was the most significant constant predictor of DV in both the Amish and non-Amish groups.
CONCLUSION
Choroidal intensity, but not choroidal thickness, seems to be associated with drusen volume in Amish and non-Amish populations. These observations suggest that choroidal parameters beyond thickness warrant further study in the setting of age-related macular degeneration.
目的
脉络膜被认为与非新生血管性年龄相关性黄斑变性的发病机制相关，但其作用尚未完全明确。在本研究中，我们评估黄斑玻璃膜疣的范围与特定脉络膜参数之间的关系，包括厚度和强度。
方法
从两个不同的、独立的非新生血管性年龄相关性黄斑变性队列中收集光谱域光学相干断层扫描图像：阿米什人队列（34名受试者的53只眼）和非阿米什人队列（26名受试者的40只眼）。所有光谱域光学相干断层扫描均使用Cirrus HD-OCT以512×128黄斑立方体（6×6 mm）协议获得。使用Cirrus高级视网膜色素上皮分析工具自动计算以黄斑中心凹为中心的3 mm（DV3）和5 mm（DV5）圆圈内的玻璃膜疣体积。手动分割脉络膜的内边界和外边界，并计算平均脉络膜厚度和脉络膜强度（即亮度）。脉络膜强度根据玻璃体和神经纤维层反射率进行归一化。使用Pearson和线性回归分析评估DV与这些脉络膜参数之间的相关性。
结果
在阿米什人队列（r = 0.42，P = 0.002）和非阿米什人队列（r = 0.33，P = 0.03）中，归一化脉络膜强度与DV5之间观察到显著正相关。此外，两组中DV3与归一化脉络膜强度均呈显著正相关（阿米什人队列：r = 0.30，P = 0.02；非阿米什人队列：r = 0.32，P = 0.04）。在阿米什人队列（r = -0.71，P = 0.001）和非阿米什人队列（r = -0.43，P = 0.01）中，脉络膜厚度与归一化脉络膜强度均呈负相关。在阿米什人和非阿米什人队列中，归一化脉络膜强度都是DV最显著的常数预测因子。
结论
在阿米什人和非阿米什人群中，脉络膜强度而非脉络膜厚度似乎与玻璃膜疣体积相关。这些观察结果表明，在年龄相关性黄斑变性的背景下，除厚度外的脉络膜参数值得进一步研究。
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