外视网膜层增厚预示渗出性新生血管性年龄相关性黄斑变性的发病。

Outer Retinal Layer Thickening Predicts the Onset of Exudative Neovascular Age-Related Macular Degeneration.

机构信息

Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy; The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.

Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy.

出版信息

Am J Ophthalmol. 2021 Nov;231:19-27. doi: 10.1016/j.ajo.2021.05.015. Epub 2021 May 28.

DOI:10.1016/j.ajo.2021.05.015

PMID:34058152

Abstract

PURPOSE

To assess changes in outer retinal layer (ORL) thickness before the development of exudative macular neovascularization (MNV) in eyes with age-related macular degeneration.

DESIGN

Retrospective observational case series.

METHODS

Eyes with age-related macular degeneration that eventually developed exudative MNV followed with sequential optical coherence tomography for ≥2 years before the exudation occurred were enrolled. The ORL thickness was automatically calculated by the optical coherence tomography software for each sector of the early treatment diabetic retinopathy study map at each follow-up visit. The ORL thickness change from baseline to the day when the exudative MNV developed was compared between sectors that eventually developed exudative MNV and those that did not.

RESULTS

Forty-seven eyes (47 patients) were included. At baseline (24 ± 3 months before exudative MNV), mean (standard deviation) ORL thickness of sectors that eventually developed exudative MNV was similar to that of sectors that did not (85.2 [8.2] µm vs 86.8 [5.7] µm, P = .08). ORL thickness significantly increased in sectors that developed exudative MNV compared with those that did not (+5.8 [10.4] µm vs -2.8 [3.6] µm, P < .01). The regression model based on these data predicted an increase in ORL thickness from baseline of +4.2% 55 days and +11.1% 30 days before exudative MNV was detected. The ORL thickness of areas that did not develop exudative MNV did not change.

CONCLUSION

Thickening of the ORL begins in the area where exudative MNV will develop long before the exudation, accelerating significantly in the last 2 months. The occurrence of exudative MNV could be predicted by 2 months using this simple analysis.

摘要

目的

评估与年龄相关的黄斑变性患者在渗出性黄斑新生血管（MNV）发生前外层视网膜（ORL）厚度的变化。

设计

回顾性观察性病例系列。

方法

纳入最终发生渗出性 MNV 且在渗出发生前至少连续 2 年接受光学相干断层扫描（OCT）随访的年龄相关性黄斑变性眼。OCT 软件自动计算每个早期治疗糖尿病视网膜病变研究（ETDRS）地图区域的 ORL 厚度，每个随访时间点均进行测量。比较最终发生渗出性 MNV 和未发生渗出性 MNV 的区域，比较从基线到发生渗出性 MNV 时 ORL 厚度的变化。

结果

纳入 47 只眼（47 例患者）。在基线时（发生渗出性 MNV 前 24 ± 3 个月），最终发生渗出性 MNV 的区域 ORL 厚度与未发生渗出性 MNV 的区域相似（85.2 [8.2] µm vs 86.8 [5.7] µm，P =.08）。与未发生渗出性 MNV 的区域相比，发生渗出性 MNV 的区域 ORL 厚度显著增加（+5.8 [10.4] µm vs -2.8 [3.6] µm，P <.01）。基于这些数据的回归模型预测，从基线开始 ORL 厚度将增加+4.2%，在检测到渗出性 MNV 前 55 天，以及增加+11.1%，在检测到渗出性 MNV 前 30 天。未发生渗出性 MNV 的区域 ORL 厚度无变化。