Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.
Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, Connecticut.
Ophthalmol Retina. 2021 Sep;5(9):868-878. doi: 10.1016/j.oret.2020.12.002. Epub 2020 Dec 9.
To investigate the underlying reason for the previously observed impact of baseline lesion size, number, and circularity on geographic atrophy (GA) growth rate.
Retrospective analysis of a multicenter, prospective, randomized controlled trial.
Age-Related Eye Disease Study participants with GA secondary to nonexudative age-related macular degeneration.
We manually delineated atrophic lesions on color fundus photographs of 318 eyes with GA followed up over at least 2 visits (mean follow-up duration, 5.1 ± 3.0 years). We calculated GA area growth rate for each eye based on the first and last visit. GA perimeter-adjusted growth rate was defined as the ratio between GA area growth rate and mean GA perimeter between the first and last visit for each eye.
GA area growth rate, growth rate of the square root of GA area, and GA perimeter-adjusted growth rate.
GA area growth rate was correlated strongly with mean GA perimeter (r = 0.66). GA area growth rate was associated with baseline GA area (r = 0.39; P < 0.001), lesion number (r = 0.10; P < 0.001), and circularity index (r = 0.28; P < 0.001). The use of the square root of GA area reduced the influence of baseline GA area (but not lesion number or circularity) on GA growth rate. In comparison, GA perimeter-adjusted growth rate (0.098 ± 0.062 mm/year) was not correlated with baseline GA area (r = 0.005; P = 0.20), lesion number (r = 0.00009; P = 0.86), or circularity index (r = 0.007; P = 0.14). GA perimeter-adjusted growth rate was 50.0% higher in eyes whose fellow eyes showed GA at any visit (0.102 ± 0.062 mm/year) than in eyes whose fellow eyes never demonstrated GA during follow-up (0.068 ± 0.049 mm/year).
The growth rate of GA area is associated strongly with lesion perimeter. This relationship explains the previously observed influences of baseline GA size, lesion number, and circularity on GA growth rate. GA perimeter-adjusted growth rate is uncorrelated with the 3 morphologic factors and may serve as a surrogate outcome measure to monitor GA progression in future studies.
探究既往研究中基线病灶大小、数量和形态学圆度对年龄相关性黄斑变性继发地图状萎缩（GA）进展速度的影响的潜在原因。
多中心、前瞻性、随机对照临床试验的回顾性分析。
年龄相关性眼病研究中继发于非渗出性年龄相关性黄斑变性的 GA 患者。
我们对 318 只接受 GA 随访的眼进行了眼底彩照的手动描绘，这些眼至少接受了 2 次随访（平均随访时间 5.1 ± 3.0 年）。我们根据首次和末次随访计算了每只眼的 GA 面积增长率。GA 周径校正增长率定义为每只眼首次和末次随访之间的 GA 面积增长率与平均 GA 周径的比值。
GA 面积增长率、GA 面积平方根增长率和 GA 周径校正增长率。
GA 面积增长率与平均 GA 周径呈强相关性（r = 0.66）。GA 面积增长率与基线 GA 面积（r = 0.39；P < 0.001）、病灶数量（r = 0.10；P < 0.001）和形态学圆度指数（r = 0.28；P < 0.001）相关。使用 GA 面积平方根可降低基线 GA 面积（但不能降低病灶数量或形态学圆度）对 GA 增长率的影响。相比之下，GA 周径校正增长率（0.098 ± 0.062 mm/年）与基线 GA 面积（r = 0.005；P = 0.20）、病灶数量（r = 0.00009；P = 0.86）或形态学圆度指数（r = 0.007；P = 0.14）均不相关。在随访期间任何一次随访时同胞眼存在 GA 的眼（0.102 ± 0.062 mm/年）的 GA 周径校正增长率比同胞眼在随访期间从未出现 GA 的眼（0.068 ± 0.049 mm/年）高 50.0%。
GA 面积增长率与病灶周径密切相关。这种关系解释了既往研究中基线 GA 大小、病灶数量和形态学圆度对 GA 增长率的影响。GA 周径校正增长率与 3 种形态学因素无关，可能作为未来研究中监测 GA 进展的替代终点指标。
