使用扫频源光学相干断层扫描技术观察年龄相关性黄斑变性中与视网膜下玻璃膜疣样沉积物相关的脉络膜变化
Choroidal Changes Associated With Subretinal Drusenoid Deposits in Age-related Macular Degeneration Using Swept-source Optical Coherence Tomography.
作者信息
Laíns Inês, Wang Jay, Providência Joana, Mach Steven, Gil Pedro, Gil João, Marques Marco, Armstrong Grayson, Garas Shady, Barreto Patrícia, Kim Ivana K, Vavvas Demetrios G, Miller Joan W, Husain Deeba, Silva Rufino, Miller John B
机构信息
Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal.
Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
出版信息
Am J Ophthalmol. 2017 Aug;180:55-63. doi: 10.1016/j.ajo.2017.05.021. Epub 2017 Jun 1.
PURPOSE
To compare choroidal vascular features of eyes with and without subretinal drusenoid deposits (SDD), using swept-source optical coherence tomography (SS OCT).
DESIGN
Multicenter, cross-sectional study.
METHODS
We prospectively recruited patients with intermediate age-related macular degeneration (AMD), without other vitreoretinal pathology. All participants underwent complete ophthalmic examination, color fundus photography (used for AMD staging), and spectral-domain OCT (to evaluate the presence of SDD). SS OCT was used to obtain automatic macular choroidal thickness (CT) maps, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. For data analysis, we considered mean choroidal thickness as the arithmetic mean value of the 9 ETDRS sectors. SS OCT en face images of choroidal vasculature were also captured and converted to binary images. Choroidal vascular density (CVD) was calculated as a percent area occupied by choroidal vessels in a 6-mm-diameter submacular circular. Choroidal vessel volume was calculated by multiplying the average CVD by macular area and CT. Multilevel mixed linear models (to account for the inclusion of 2 eyes of same subject) were performed for analysis.
RESULTS
We included 186 eyes (n = 118 subjects), 94 (50.5%) presenting SDD. Multiple regression analysis revealed that, controlling for age, eyes with SDD presented a statistically thinner mean CT (ß = -21.9, P = .006) and CT in all the individual ETDRS fields (ß ≤ -18.79, P ≤ .026). Mean choroidal vessel volume was also significantly reduced in eyes with SDD (ß = -0.003, P = .007). No significant associations were observed with mean CVD.
CONCLUSION
In subjects with intermediate AMD, choroidal thickness and vessel volume are reduced in the presence of subretinal drusenoid deposits.
目的
使用扫频光学相干断层扫描（SS OCT）比较有无视网膜下类玻璃膜疣沉积物（SDD）的眼睛的脉络膜血管特征。
设计
多中心横断面研究。
方法
我们前瞻性招募了患有中度年龄相关性黄斑变性（AMD）且无其他玻璃体视网膜病变的患者。所有参与者均接受了全面的眼科检查、彩色眼底照相（用于AMD分期）和光谱域OCT（以评估SDD的存在）。根据早期糖尿病性视网膜病变研究（ETDRS）分区，使用SS OCT获取自动黄斑脉络膜厚度（CT）图。数据分析时，我们将平均脉络膜厚度视为9个ETDRS分区的算术平均值。还采集了脉络膜血管系统的SS OCT正面图像并转换为二值图像。脉络膜血管密度（CVD）计算为直径6毫米的黄斑下圆形区域中脉络膜血管所占的面积百分比。脉络膜血管体积通过将平均CVD乘以黄斑面积和CT来计算。采用多级混合线性模型（考虑同一受试者的两只眼睛）进行分析。
结果
我们纳入了186只眼睛（n = 118名受试者），其中94只（50.5%）有SDD。多元回归分析显示，在控制年龄后，有SDD的眼睛平均CT在统计学上更薄（β = -21.9，P = .006），并且在所有单个ETDRS区域的CT也更薄（β≤ -18.79，P≤ .026）。有SDD的眼睛的平均脉络膜血管体积也显著减少（β = -0.003，P = .007）。未观察到与平均CVD有显著关联。
结论
在中度AMD患者中，存在视网膜下类玻璃膜疣沉积物时脉络膜厚度和血管体积会减少。
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