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评估冠状动脉疾病作为网状假性色素沉着的危险因素。

Evaluation of coronary artery disease as a risk factor for reticular pseudodrusen.

机构信息

Centre for Public Health, Queen's University Belfast, Belfast, UK.

VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.

出版信息

Br J Ophthalmol. 2018 Apr;102(4):483-489. doi: 10.1136/bjophthalmol-2017-310526. Epub 2017 Aug 19.

Abstract

PURPOSE

Reticular pseudodrusen (RPD) are a risk factor for late age-related macular degeneration (AMD). Associations between RPD and coronary artery disease (CAD) have been reported from small case-control studies. This study investigated the association of RPD within a predominantly CAD cohort.

METHODS

A subgroup of subjects from a multicentre randomised controlled trial of CT coronary angiography (CTCA) underwent ultrawide field (UWF) retinal imaging CAD determined by CTCA and was categorised as normal, non-obstructive or obstructive. Specific AMD features in UWF images were graded. Standardised grids were used to record the spatial location of AMD features, including RPD. Multivariate confounder adjusted regression models assessed the association between RPD and CAD.

RESULTS

The 534 participants were aged 27-75 years (mean 58±9 years; 425 (80%) ≥50 years) with a male preponderance (56%). Within the study sample, 178 (33%) had no CAD, 351 (66%) had CAD. RPD was detected in 30 participants (5.6%) and bilaterally in 23. Most participants with bilateral RPD had intermediate AMD 17 (74%). After adjustment for potential confounders (age, sex, drusen >125 µm, smoking status), multivariate analysis found no significant association between CAD and RPD (OR 1.31; 95% CI (0.57 to 3.01); p=0.52). A significant association was identified between RPD and intermediate AMD (OR 3.18; 95% CI (1.61 to 6.27); p=0.001).

CONCLUSION

We found no evidence to support an association between CAD and RPD. RPD was strongly associated with intermediate AMD features.

TRIAL REGISTRATION NUMBER

NCT01149590, Post results.

摘要

目的

网状假性玻璃膜疣(RPD)是晚期年龄相关性黄斑变性(AMD)的一个危险因素。从小样本病例对照研究中报告了 RPD 与冠状动脉疾病(CAD)之间的关联。本研究调查了在主要 CAD 队列中 RPD 的相关性。

方法

来自 CT 冠状动脉造影(CTCA)多中心随机对照试验的一个亚组受试者接受了超广角(UWF)视网膜成像,CAD 通过 CTCA 确定,并分为正常、非阻塞性或阻塞性。UWF 图像中的特定 AMD 特征被分级。使用标准化网格记录 AMD 特征(包括 RPD)的空间位置。多变量混杂因素调整回归模型评估了 RPD 与 CAD 之间的关联。

结果

534 名参与者年龄为 27-75 岁(平均 58±9 岁;425(80%)≥50 岁),男性居多(56%)。在研究样本中,178 名(33%)无 CAD,351 名(66%)有 CAD。30 名参与者(5.6%)检测到 RPD,23 名参与者双侧 RPD。大多数双侧 RPD 患者有中度 AMD 17 例(74%)。在调整潜在混杂因素(年龄、性别、>125μm 大小的玻璃膜疣、吸烟状况)后,多变量分析发现 CAD 与 RPD 之间无显著相关性(OR 1.31;95%CI(0.57 至 3.01);p=0.52)。RPD 与中度 AMD 之间存在显著相关性(OR 3.18;95%CI(1.61 至 6.27);p=0.001)。

结论

我们没有发现证据支持 CAD 与 RPD 之间存在关联。RPD 与中度 AMD 特征密切相关。

试验注册号

NCT01149590,结果公布后。

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