年龄相关性眼病研究 2（CAREDS2）中的类脂性假性黄斑星状玻璃疣特征及其与类胡萝卜素的关系，该研究是妇女健康倡议的一项辅助研究。
Reticular Pseudodrusen Characteristics and Associations in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2), an Ancillary Study of the Women's Health Initiative.
机构信息
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
出版信息
Ophthalmol Retina. 2021 Aug;5(8):721-729. doi: 10.1016/j.oret.2020.12.019. Epub 2020 Dec 30.
PURPOSE
To determine the prevalence and morphologic features of reticular pseudodrusen (RPD) and their association with participant demographics and age-related macular degeneration (AMD) status in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) sample, an ancillary study of the Women's Health Initiative Observational Study.
DESIGN
Cross-sectional, multicenter, natural history study.
PARTICIPANTS
Nine hundred and twenty-seven eyes from 466 postmenopausal women 69 to 101 years of age.
METHODS
Multimodal imaging, including spectral-domain (SD) OCT and infrared reflectance (IR), were used to identify RPD characteristics, including location (within or outside the 6-mm diameter circle centered at the macula), presence of peripapillary RPD, pattern of RPD, and RPD area. Age-related macular degeneration features from SD OCT, IR, and color photographs also were assessed and AMD severity was categorized.
MAIN OUTCOME MEASURES
Reticular pseudodrusen prevalence using SD OCT and IR imaging and AMD status.
RESULTS
Reticular pseudodrusen were present in 130 eyes (14% of eyes, 16% of participants), with increasing prevalence with age: 7% in those younger than 78 years, 14% in those 78 to 83 years of age, and 30% in those older than 83 years. Using clinical classification of AMD with color photography, RPD were seen in 2.4% of eyes with no AMD or aging changes, 11.5% in early AMD, 25.1% in intermediate AMD, and 51.1% in late AMD. Mean RPD area was 17.4 mm (standard deviation, 14.7 mm). Ribbon morphologic RPD (53%) was more common than dot morphologic RPD (36%). Reticular pseudodrusen mostly were located both within and outside the 6-mm circle with primarily superior retinal distribution. Reticular pseudodrusen were visualized with corresponding color fundus photography in only 38 eyes (4% of total eyes). Participants with and without RPD had a visual acuity±standard error of 77.9 ± 1.4 letters and 81.3 ± 0.4 letters, respectively (P = 0.02).
CONCLUSIONS
The prevalence of RPD in CAREDS2 increased with age and was associated with AMD severity. Reticular pseudodrusen were detected in eyes without other features of AMD and could represent an earlier disease state. Multimodal imaging with SD OCT and IR has significantly greater sensitivity for visualizing RPD than color fundus photography.
目的
在 Women's Health Initiative 观察研究的辅助研究——Carotenoids in Age-Related Eye Disease Study 2（CAREDS2）样本中，确定网状假性尘（RPD）的患病率和形态特征及其与参与者人口统计学和年龄相关性黄斑变性（AMD）状态的关系。
设计
横断面、多中心、自然史研究。
参与者
927 只眼睛来自 466 名绝经后妇女，年龄 69 至 101 岁。
方法
多模态成像，包括光谱域（SD）OCT 和红外反射（IR），用于识别 RPD 特征，包括位置（在黄斑中心 6 毫米直径圆内或外）、是否存在视盘周围 RPD、RPD 模式和 RPD 面积。还评估了 SD OCT、IR 和彩色照片中的 AMD 特征，并对 AMD 严重程度进行了分类。
主要观察指标
使用 SD OCT 和 IR 成像的网状假性尘患病率和 AMD 状态。
结果
130 只眼睛（占眼睛的 14%，参与者的 16%）存在网状假性尘，患病率随年龄增加而增加：7%在小于 78 岁的人群中，14%在 78 至 83 岁的人群中，30%在大于 83 岁的人群中。使用彩色摄影的 AMD 临床分类，无 AMD 或老化改变的眼睛中 RPD 占 2.4%，早期 AMD 占 11.5%，中期 AMD 占 25.1%，晚期 AMD 占 51.1%。平均 RPD 面积为 17.4mm（标准差 14.7mm）。带状形态的 RPD（53%）比点状形态的 RPD（36%）更常见。网状假性尘主要位于 6mm 圆内和外，主要位于视网膜上方。只有 38 只眼睛（占总眼睛的 4%）在彩色眼底照片中显示出相应的 RPD。有和没有 RPD 的参与者的视力±标准误差分别为 77.9±1.4 个字母和 81.3±0.4 个字母（P=0.02）。
结论
CAREDS2 中 RPD 的患病率随年龄增长而增加，并与 AMD 严重程度相关。在没有其他 AMD 特征的眼睛中检测到网状假性尘，可能代表一种更早的疾病状态。SD OCT 和 IR 的多模态成像对 RPD 的可视化具有明显更高的敏感性，比彩色眼底摄影更敏感。
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