Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia.
Br J Ophthalmol. 2021 May;105(5):711-715. doi: 10.1136/bjophthalmol-2020-315935. Epub 2020 Jun 30.
To examine the added predictive value of microperimetric sensitivity and low luminance deficit (LLD; difference between photopic and low luminance visual acuity (VA)) to information from colour fundus photography (CFP) for progression to late age-related macular degeneration (AMD) in individuals with bilateral large drusen.
140 participants with bilateral large drusen underwent baseline microperimetry testing, VA measurements and CFP. They were then reviewed at 6-monthly intervals to 36 months, to determine late AMD progression. Microperimetry pointwise sensitivity SD (PSD), LLD and the presence of pigmentary abnormalities on CFPs were determined. Predictive models based on these parameters were developed and examined.
Baseline microperimetry PSD and presence of pigmentary abnormalities were both significantly associated with time to develop late AMD (p≤0.004), but LLD was not (p=0.471). The area under the receiver operating characteristic curve (AUC) for discriminating between eyes that progressed to late AMD based on models using microperimetry PSD (AUC=0.68) and LLD (AUC=0.58) alone was significantly lower than that based on CFP grading for the presence of pigmentary abnormalities (AUC=0.80; both p<0.005). Addition of microperimetry and/or LLD information to a model that included CFP grading did not result in any improvement in its predictive performance (AUC=0.80 for all; all p≥0.66).
While microperimetry, but not LLD, was significantly and independently associated with AMD progression at the population level, this study observed that both measures were suboptimal at predicting progression at the individual level when compared to conventional CFP grading and their addition to the latter did not improve predictive performance.
探讨微视野敏感度和低亮度缺损（LLD；明适应和低亮度视力（VA）之间的差异）对有双侧大玻璃膜疣的个体向晚期年龄相关性黄斑变性（AMD）进展的信息的预测价值，这些个体的信息来自眼底彩色照相术（CFP）。
140 名双侧大玻璃膜疣患者进行了基线微视野检查、VA 测量和 CFP。然后每 6 个月复查一次，共 36 个月，以确定晚期 AMD 的进展情况。确定微视野点敏感性 SD（PSD）、LLD 和 CFP 上色素异常的存在。根据这些参数开发并检查了预测模型。
基线微视野 PSD 和色素异常的存在均与发生晚期 AMD 的时间显著相关（p≤0.004），但 LLD 无相关性（p=0.471）。基于微视野 PSD（AUC=0.68）和 LLD（AUC=0.58）的模型区分进展为晚期 AMD 的眼睛的受试者工作特征曲线（ROC）下面积（AUC）明显低于基于 CFP 分级评估色素异常存在的模型（AUC=0.80；p<0.005）。在包括 CFP 分级的模型中添加微视野和/或 LLD 信息并没有改善其预测性能（所有 AUC=0.80；p≥0.66）。
虽然微视野检查，但不是 LLD，与人群水平的 AMD 进展显著且独立相关，但与传统的 CFP 分级相比，这两种方法在个体水平上预测进展的效果都不理想，并且将其添加到后者中并不能提高预测性能。
