美国和英国三级医疗中心息肉样脉络膜血管病变的特征及种族差异
Characteristics and racial variations of polypoidal choroidal vasculopathy in tertiary centers in the United States and United Kingdom.
作者信息
Alasil Tarek, Munoz Nelida, Keane Pearse A, Tufail Adnan, Coady Patrick A, Novais Eduardo, de Carlo Talisa E, Baumal Caroline R, Waheed Nadia K, Duker Jay S, Adelman Ron A
机构信息
Department of Ophthalmology and Visual Sciences, School of Medicine, Yale University, New Haven, CT USA.
Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK.
出版信息
Int J Retina Vitreous. 2017 Apr 17;3:9. doi: 10.1186/s40942-017-0060-4. eCollection 2017.
PURPOSE
To evaluate the characteristics and racial variations amongst patients with polypoidal choroidal vasculopathy (PCV) in the United States and the United Kingdom.
METHODS
Fundus photos and indocyanine green angiography images were evaluated in a multicenter retrospective study to establish the diagnosis of PCV. Visual acuity (VA) was recorded in ETDRS letter count.
RESULTS
Eighty eyes of 71 PCV patients (average age of 69.4 ± 10.4 years) were included in the analysis. Of the total 71 subjects, 46 (65%) were women, 33 (46.5%) were Blacks, 16 (22.5%) were Whites, 19 (26.8%) were Asians and 3 (4.2%) belonged to other races. The Black subgroup had vision gain of 3.5 letters. The White and Asian subgroups had vision loss of 13.1 and 3.5 letters, respectively. There was female predominance in Blacks (67%), Whites (69%), and Asians (58%). PCV was found to be a bilateral disease in 14 patients (20%). There was significant decrease of 7 letters with every decade increase in age (p = 0.005). Final VA was worse in males when compared to females (p = 0.042), and worse in Whites when compared to Blacks (p = 0.005). For every 10 letters worse in initial VA upon diagnosis with PCV, the final VA was worse by 6 letters (p < 0.001). The location of the polypoidal lesion within the macula was associated with significant decrease of 14 letters in BCVA (p = 0.02). The length of follow up was significantly associated with worse visual outcome (p = 0.012). Final VA had no significant correlation with the lens status, or the different treatment modalities.
CONCLUSIONS
Based on our cohort from tertiary centers in the United States and United Kingdom, PCV is a bilateral disease in one-fifth of patients. It features a variable female predominance based on ethnicity. Increased age, worse vision upon initial presentation, longer follow up and macular location of the polyp were associated with worse visual outcome.
目的
评估美国和英国息肉样脉络膜血管病变（PCV）患者的特征及种族差异。
方法
在一项多中心回顾性研究中，对眼底照片和吲哚菁绿血管造影图像进行评估以确诊PCV。视力（VA）以ETDRS字母计数记录。
结果
分析纳入了71例PCV患者的80只眼（平均年龄69.4±10.4岁）。在总共71名受试者中，46名（65%）为女性，33名（46.5%）为黑人，1名（22.5%）为白人，19名（26.8%）为亚洲人，3名（4.2%）属于其他种族。黑人亚组视力提高了3.5个字母。白人和亚洲亚组视力分别下降了13.1和3.5个字母。黑人（67%）、白人（69%）和亚洲人（58%）中女性占优势。14例患者（20%）的PCV为双侧疾病。年龄每增加十岁，视力显著下降7个字母（p = 0.005）。与女性相比，男性的最终视力更差（p = 0.042），与黑人相比，白人的最终视力更差（p = 0.005）。PCV诊断时初始视力每差10个字母，最终视力就差6个字母（p < 0.001）。黄斑区内息肉样病变的位置与最佳矫正视力显著下降14个字母相关（p = 0.02）。随访时间长短与较差的视力结果显著相关（p = 0.012）。最终视力与晶状体状态或不同治疗方式无显著相关性。
结论
基于我们来自美国和英国三级中心的队列研究，PCV在五分之一的患者中为双侧疾病。其特征是基于种族的女性优势各异。年龄增加、初始就诊时视力较差、随访时间较长以及息肉位于黄斑区与较差的视力结果相关。
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