Farinha Cláudia, Cachulo Maria Luz, Coimbra Rita, Alves Dalila, Nunes Sandrina, Pires Isabel, Marques João Pedro, Costa José, Martins Amélia, Sobral Isa, Barreto Patrícia, Laíns Inês, Figueira João, Ribeiro Luisa, Cunha-Vaz José, Silva Rufino
AIBILI-Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal.
Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), 3004-561 Coimbra, Portugal.
J Clin Med. 2020 May 2;9(5):1329. doi: 10.3390/jcm9051329.
Epidemiology of age-related macular degeneration (AMD) is based on staging systems relying on color fundus photography (CFP). We aim to compare AMD staging using CFP to multimodal imaging with optical coherence tomography (OCT), infra-red (IR), and fundus autofluorescence (FAF), in a large cohort from the Epidemiologic AMD Coimbra Eye Study. All imaging exams from the participants of this population-based study were classified by a central reading center. CFP images were graded according to the International Classification and Grading System for AMD and staged with Rotterdam classification. Afterward, CFP images were reviewed with OCT, IR, and FAF and stage update was performed if necessary. Early and late AMD prevalence was compared in a total of 1616 included subjects. In CFP-based grading, the prevalence was 14.11% for early AMD ( = 228) and 1.05% ( = 17) for late AMD, nine cases (0.56%) had neovascular AMD (nAMD) and eight (0.50%) geographic atrophy (GA). Using multimodal grading, the prevalence increased to 14.60% for early AMD ( = 236) and 1.61% ( = 26) for late AMD, with 14 cases (0.87%) of nAMD and 12 (0.74%) of GA. AMD staging was more accurate with the multimodal approach and this was especially relevant for late AMD. We propose that multimodal imaging should be adopted in the future to better estimate and compare epidemiological data in different populations.
年龄相关性黄斑变性（AMD）的流行病学基于依赖彩色眼底照相（CFP）的分期系统。我们旨在比较在科英布拉眼流行病学AMD研究的大型队列中，使用CFP进行的AMD分期与光学相干断层扫描（OCT）、红外（IR）和眼底自发荧光（FAF）的多模态成像。该基于人群的研究参与者的所有影像检查均由中央阅片中心进行分类。CFP图像根据AMD国际分类和分级系统进行分级，并采用鹿特丹分类法进行分期。之后，用OCT、IR和FAF对CFP图像进行复查，必要时进行分期更新。在总共1616名纳入的受试者中比较早期和晚期AMD的患病率。在基于CFP的分级中，早期AMD的患病率为14.11%（n = 228），晚期AMD为l.05%（n = 17），9例（0.56%）有新生血管性AMD（nAMD）和8例（0.50%）有地图样萎缩（GA）。使用多模态分级时，早期AMD的患病率增至14.60%（n = 236），晚期AMD为1.61%（n = 26），nAMD为14例（0.87%），GA为12例（0.74%）。多模态方法对AMD分期更准确，这在晚期AMD中尤为重要。我们建议未来应采用多模态成像，以便更好地估计和比较不同人群中的流行病学数据。
