VanNasdale Dean A, Elsner Ann E, Malinovsky Victor E, Peabody Todd D, Kohne Kimberly D, Haggerty Bryan P, Clark Christopher A
Indiana University School of Optometry, Bloomington, Indiana*
Optom Vis Sci. 2018 Apr;95(4):277-291. doi: 10.1097/OPX.0000000000001197.
Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss. Complementary imaging techniques can be used to better characterize and quantify pathological changes associated with AMD. By assessing specific light-tissue interactions, polarization-sensitive imaging can be used to detect tissue disruption early in the disease process.
The aim of this study was to compare variability in central macular polarization properties in patients with nonexudative AMD and age-matched control subjects.
A scanning laser polarimeter (GDx, LDT/CZM) was used to acquire 15 × 15-degree macular images in 10 subjects diagnosed with nonexudative AMD and 10 age-matched control subjects. The coefficient of variation (COV, SD/mean) was used to quantify variability in pixel intensity in the central 3.3° of the macula for custom images emphasizing multiply scattered light (the depolarized light image) and polarization-retaining light (the maximum of the parallel detector image). The intensity COV was compared across subject categories using paired t tests for each image type.
The COV in the central macula was significantly higher in the AMD subject group (average, 0.221; 95% confidence interval [CI], 0.157 to 0.265) when compared with matched control subjects (average 0.120; 95% CI, 0.107 to 0.133) in the depolarized light image (P = .01). The COV in the maximum of the parallel detector image was not statistically different between the two subject groups (AMD average, 0.162 [95% CI, 0.138 to 0.185]; control average, 0.137 [95% CI, 0.115 to 0.158]; P = .21).
Variability in multiply scattered light is higher than that of light that is more polarization preserving in patients with nonexudative AMD. Multiple scattering may act as an early indicator representing disruption to the macula in early AMD.
年龄相关性黄斑变性(AMD)是不可逆视力丧失的主要原因。辅助成像技术可用于更好地表征和量化与AMD相关的病理变化。通过评估特定的光与组织相互作用,偏振敏感成像可用于在疾病过程早期检测组织破坏。
本研究的目的是比较非渗出性AMD患者与年龄匹配的对照受试者黄斑中心偏振特性的变异性。
使用扫描激光偏振仪(GDx,LDT/CZM)在10例诊断为非渗出性AMD的受试者和10例年龄匹配的对照受试者中获取15×15度的黄斑图像。变异系数(COV,标准差/平均值)用于量化黄斑中心3.3°区域内自定义图像像素强度的变异性,这些自定义图像分别强调多次散射光(去偏振光图像)和保留偏振光(平行探测器图像的最大值)。使用配对t检验比较每种图像类型各受试者类别之间的强度COV。
在去偏振光图像中,与匹配的对照受试者(平均值0.120;95%置信区间[CI],0.107至0.133)相比,AMD受试者组黄斑中心的COV显著更高(平均值,0.221;95%CI,0.157至0.265)(P = 0.01)。两组受试者在平行探测器图像最大值处的COV无统计学差异(AMD平均值,0.162[95%CI,0.138至0.185];对照组平均值,0.137[95%CI,0.115至0.158];P = 0.21)。
在非渗出性AMD患者中,多次散射光的变异性高于偏振保留性更强的光。多次散射可能是早期AMD黄斑破坏的早期指标。