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Invest Ophthalmol Vis Sci. 2020 May 11;61(5):11. doi: 10.1167/iovs.61.5.11.
The purpose of this study was to evaluate macular preganglionic function and to verify its relationship with retinal and choroidal morphology in patients with intermediate age-related macular degeneration (iAMD) patients.
All included patients performed multifocal electroretinogram (mfERG) for investigating on macular function from the central 15° of foveal eccentricity, spectral domain optical coherence tomography (SD-OCT) for studying retinal structure, enhanced depth imaging OCT (EDI-OCT) for the measure of choroidal vascularity index (CVI), and OCT-angiography (OCTA) for the evaluation of vessel density (VD) in the superficial and deep capillary plexus, and choriocapillaris (CC) layer.
Twenty-seven patients with iAMD and 20 age-matched control eyes were analyzed. Significantly (P < 0.01) delayed and reduced mfERG responses in the central 0 to 2.5°, paracentral 2.5 to 5°, and overall 0 to 5° areas, as well as increased CVI values in both foveal (1 mm centered to the fovea) and fovea + parafovea areas (3 mm centered to the fovea), increased foveal and parafoveal (annular area of 1-3 mm centered to the fovea) retinal pigment epithelium thickness, and volume and parafoveal outer retinal volume were found in iAMD eyes as compared to controls. Moreover, iAMD eyes showed significantly (P < 0.01) reduced foveal and parafoveal OCTA-VD values in the CC layer when compared to controls. In the iAMD group, not significant (P > 0.01) correlations were found between morphological and functional parameters.
Our findings support a dysfunction of photoreceptors and bipolar cells in both foveal and parafoveal areas in the presence of outer retina, CC, and choroidal structural changes, however, not significantly correlated. The observed enlargement of luminal choroidal area (measured by CVI) is possibly compensatory to CC vascular insufficiency.
本研究旨在评估中间型年龄相关性黄斑变性（iAMD）患者的黄斑节前功能，并验证其与视网膜和脉络膜形态的关系。
所有纳入的患者均进行多焦视网膜电图（mfERG）检查，以评估黄斑中央 15°视野的功能；采用光谱域光学相干断层扫描（SD-OCT）检查视网膜结构；采用增强深度成像 OCT（EDI-OCT）测量脉络膜血管指数（CVI）；采用 OCT 血管造影（OCTA）评估浅层和深层毛细血管丛以及脉络膜毛细血管（CC）层的血管密度（VD）。
共分析了 27 例 iAMD 患者和 20 例年龄匹配的对照组眼。与对照组相比，iAMD 眼的中央 0 至 2.5°、旁中央 2.5 至 5°和整体 0 至 5°区域的 mfERG 反应明显延迟和减少（P<0.01），同时在中央 1 毫米和中央加旁中央 3 毫米区域的 CVI 值也增加；视网膜色素上皮厚度和体积以及旁中心 1-3 毫米区域的外层视网膜体积增加；此外，iAMD 眼的中央和旁中央 CC 层的 OCTA-VD 值明显降低（P<0.01）。在 iAMD 组中，形态学和功能参数之间未发现显著相关性（P>0.01）。
我们的研究结果支持在存在外视网膜、CC 和脉络膜结构改变的情况下，光感受器和双极细胞在中央和旁中央区域功能障碍，但相关性不显著。观察到的脉络膜管腔面积增大（通过 CVI 测量）可能是 CC 血管不足的代偿反应。
