Eskişehir Osmangazi University Hospital, Clinic of Ophthalmology, Eskişehir, Turkey
Turk J Ophthalmol. 2020 Mar 5;50(1):6-14. doi: 10.4274/tjo.galenos.2019.00359.
Age-related macular degeneration (AMD) is the most common cause of central vision loss in individuals aged 65 years and older in developed countries. Earlier imaging systems did not enable visualization of the peripheral retina in diseases affecting the macula. With the introduction of new-generation devices, the peripheral retina is easily visualized. In our study, we aimed to evaluate the incidence of peripheral retinal changes in the color and autofluorescence fundus images of patients with AMD.
In the study group, 550 eyes of 277 patients who were diagnosed with AMD and 90 eyes of 45 healthy patients in the control group were evaluated. An ultra-wide-angle imaging device was used to record standard 200° color and autofluorescence fovea-centered fundus images followed by superior and inferior fundus images obtained using the device’s fixation light. The fundus images were examined in 3 sections: zone 1, zone 2, and zone 3.
Evaluation of color fundus images revealed peripheral retinal changes in 67.8% of the 550 AMD eyes and 47.8% of the healthy eyes. Drusen was the most common peripheral retinal change. Evaluation of autofluorescence images revealed peripheral autofluorescence changes in 39.6% of the AMD eyes and 28.9% of the healthy eyes. Hypoautofluorescence was the most common autofluorescence change.
Peripheral retinal changes were more common in AMD patients than the control group, indicating that AMD is not only a macular disease, but can affect the entire retina. Future prospective studies will elucidate the relationship between these peripheral retinal changes and patients’ genetic features and their importance in prognosis, diagnosis, and treatment.
年龄相关性黄斑变性（AMD）是发达国家 65 岁及以上人群中导致中心视力丧失的最常见原因。早期的成像系统无法观察到影响黄斑的周边视网膜。随着新一代设备的问世，很容易观察到周边视网膜。在我们的研究中，我们旨在评估 AMD 患者的眼底彩照和自发荧光图像中周边视网膜变化的发生率。
在研究组中，评估了 277 例 AMD 患者的 550 只眼和 45 例健康对照组患者的 90 只眼。使用超广角成像设备记录标准的 200°黄斑中心凹彩色和自发荧光眼底图像，然后使用设备的固视灯获取上方和下方眼底图像。眼底图像在 3 个区域进行检查：区域 1、区域 2 和区域 3。
对眼底彩照的评估显示，550 只 AMD 眼中有 67.8%和 47.8%的健康眼中出现了周边视网膜变化。 玻璃膜疣是最常见的周边视网膜改变。对自发荧光图像的评估显示，AMD 眼中有 39.6%和健康眼中有 28.9%出现了周边自发荧光变化。低自发荧光是最常见的自发荧光改变。
AMD 患者的周边视网膜变化比对照组更为常见，这表明 AMD 不仅是一种黄斑疾病，还可能影响整个视网膜。未来的前瞻性研究将阐明这些周边视网膜变化与患者的遗传特征之间的关系及其在预后、诊断和治疗中的重要性。
