Nittala Muneeswar Gupta, Hogg Ruth E, Luo Yan, Velaga Swetha Bindu, Silva Rufino, Alves Dalila, Staurenghi Giovanni, Chakravarthy Usha, Sadda SriniVas R
Doheny Eye Institute, Los Angeles, California.
Center for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
Ophthalmol Retina. 2019 Feb;3(2):112-121. doi: 10.1016/j.oret.2018.09.017. Epub 2018 Sep 27.
To evaluate the thickness of the outer retinal layers and its relationship with visual function in fellow eyes of participants with unilateral neovascular age-related macular degeneration (AMD).
Longitudinal study.
We enrolled 105 subjects with unilateral neovascular AMD from 3 clinical centers in Europe.
The fellow eye, without advanced AMD, was selected for the study. Subjects were followed up with visits occurring every 6 months for 2 years. Spectral domain optical coherence tomography volume scans were collected at 3 clinical sites, in Belfast, Northern Ireland; Coimbra, Portugal; and Milan, Italy. Detailed manual segmentation of outer retinal layers was performed using the custom-designed and validated grading software 3D OCTOR. Thickness measurements for neurosensory retina, photoreceptor layer (PRL) outer segments, retinal pigment epithelium plus drusen (RPE+drusen) complex, and choroidal layers from each sector of the standard macular grid were obtained. Measures of vison were distance visual acuity, near visual acuity, Smith-Kettlewell Institute low-luminance acuity score, and reading speed. Subjects were grouped based on the presence or absence of subretinal drusenoid deposits (SDDs) for further analysis.
Change in thickness of retinal layers and change in measures of vision.
In all, 85 eyes were included in the analysis. The average duration of follow-up was 20.5 ± 5.8 months. By the final visit, the RPE+drusen complex was significantly thinner when compared with baseline (29.7 μm vs. 34.09 μm; P = 0.03). Low-luminance deficit was significantly worse at the final visit (P < 0.001) and correlated with PRL outer segment thickness (r = 0.33; P =0.02). The RPE+drusen complex was significantly thicker in eyes with SDDs compared with that in those without SDDs (30.67 μm vs. 28.64 μm; P = 0.02). PRL outer segments became significantly thinner over time in eyes with SDDs compared with those in eyes without SDDs.
The RPE+drusen complex layer becomes thinner over time in fellow eyes of subjects with unilateral neovascular AMD. The rate of PRL outer segment thinning was higher in eyes with SDDs than in eyes without SDDs. These findings are preliminary steps in the identification of early biomarkers for detecting and monitoring the progression of AMD.
评估单侧新生血管性年龄相关性黄斑变性（AMD）患者对侧眼的视网膜外层厚度及其与视觉功能的关系。
纵向研究。
我们从欧洲的3个临床中心招募了105名单侧新生血管性AMD患者。
选择没有晚期AMD的对侧眼进行研究。对受试者进行为期2年的随访，每6个月进行一次检查。在北爱尔兰贝尔法斯特、葡萄牙科英布拉和意大利米兰的3个临床地点收集了光谱域光学相干断层扫描容积扫描图像。使用定制设计并经验证的分级软件3D OCTOR对视网膜外层进行详细的手动分割。获得标准黄斑网格各区域的神经感觉视网膜、光感受器层（PRL）外段、视网膜色素上皮加玻璃膜疣（RPE+玻璃膜疣）复合体以及脉络膜层的厚度测量值。视觉测量指标包括远视力、近视力、史密斯-凯特尔韦尔研究所低亮度视力评分和阅读速度。根据是否存在视网膜下类玻璃膜疣沉积物（SDD）对受试者进行分组，以进行进一步分析。
视网膜各层厚度的变化和视觉指标的变化。
总共85只眼纳入分析。平均随访时间为20.5±5.8个月。到最后一次随访时，RPE+玻璃膜疣复合体与基线相比明显变薄（29.7μm对34.09μm；P=0.03）。最后一次随访时低亮度视力缺陷明显更严重（P<0.001），且与PRL外段厚度相关（r=0.33；P=0.02）。与没有SDD的眼睛相比，有SDD的眼睛的RPE+玻璃膜疣复合体明显更厚（30.67μm对28.64μm；P=0.02）。与没有SDD的眼睛相比，有SDD的眼睛的PRL外段随时间明显变薄。
单侧新生血管性AMD患者对侧眼的RPE+玻璃膜疣复合体层随时间变薄。有SDD的眼睛的PRL外段变薄速度高于没有SDD的眼睛。这些发现是识别用于检测和监测AMD进展的早期生物标志物的初步步骤。
