Department of Ophthalmology, Eye and ENT Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.
Department of Ophthalmology, Institute of Human Barrier Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Am J Ophthalmol. 2019 Dec;208:103-110. doi: 10.1016/j.ajo.2019.07.013. Epub 2019 Aug 1.
To investigate the incidence of fellow eye (FE) neovascular age-related macular degeneration (nAMD) in patients with unilateral nAMD according to FE drusen type.
Retrospective cohort study.
Between January 2013 and June 2016, 434 consecutive patients with naïve nAMD were enrolled. We selected 280 eligible patients with treatment-naïve, unilateral nAMD for analysis (280/280 = 100% patients were followed up at 2 years; 50/280 = 17.9% patients were followed up at 5 years). The incidence and hazard ratios (HR) of FE nAMD according to age, sex, choroidal thickness, nAMD subtype, and drusen type were analyzed.
The 5-year incidence of FE nAMD was 20.9%. The incidences of the soft plus subretinal drusenoid deposits (SDD), soft drusen only, and SDD only groups were 76.4%, 46.2%, and 25.7%, respectively; they were significantly higher than the no drusen group (vs 3.6%; P < .001, P < .001, P < .001). There was no significant difference between the pachydrusen and no drusen groups (7.1% vs 3.6%; P = .101). The multivariate Cox regression hazard model revealed older age (HR, 1.053; P = .031) and drusen type were significant (P = .001). Compared with the no drusen group, the soft drusen plus SDD, soft drusen only, and SDD groups showed an HR of 18.460 (P = .001), 8.302 (P = .015), and 5.465 (P = .082), respectively. Pachydrusen was not shown to be a significant risk factor compared to the no drusen group (HR, 2.417; P = .281).
The incidence of FE nAMD was significantly different with respect to drusen type. Soft drusen plus SDD had the highest risk of neovascular AMD, followed by soft drusen only and SDD only.
根据对侧眼（FE）玻璃膜疣类型，调查单侧 nAMD 患者中 FE 新生血管性年龄相关性黄斑变性（nAMD）的发生率。
回顾性队列研究。
2013 年 1 月至 2016 年 6 月期间，连续纳入了 434 例初治 nAMD 患者。我们选择了 280 例初治单侧 nAMD 的合格患者进行分析（280/280=100%患者在 2 年内得到随访；50/280=17.9%患者在 5 年内得到随访）。分析了 FE nAMD 的发生率及年龄、性别、脉络膜厚度、nAMD 亚型和玻璃膜疣类型的危险比（HR）。
FE nAMD 的 5 年发生率为 20.9%。软玻璃膜疣+下视网膜渗出性（SDD）、单纯软玻璃膜疣和单纯 SDD 组的发生率分别为 76.4%、46.2%和 25.7%，显著高于无玻璃膜疣组（分别为 3.6%；P<0.001，P<0.001，P<0.001）。厚玻璃膜疣与无玻璃膜疣组之间无显著差异（7.1%比 3.6%；P=0.101）。多变量 Cox 回归风险模型显示，年龄较大（HR，1.053；P=0.031）和玻璃膜疣类型是显著的（P=0.001）。与无玻璃膜疣组相比，软玻璃膜疣+SDD、单纯软玻璃膜疣和单纯 SDD 组的 HR 分别为 18.460（P=0.001）、8.302（P=0.015）和 5.465（P=0.082）。与无玻璃膜疣组相比，厚玻璃膜疣不是一个显著的危险因素（HR，2.417；P=0.281）。
FE nAMD 的发生率与玻璃膜疣类型有显著差异。软玻璃膜疣+SDD 的新生血管性 AMD 风险最高，其次是单纯软玻璃膜疣和单纯 SDD。
