使用多模态方法在近B亚组中从中间型年龄相关性黄斑变性转变为地图状萎缩

Conversion from Intermediate Age-Related Macular Degeneration to Geographic Atrophy in a Proxima B Subcohort Using a Multimodal Approach.

作者信息

Schmitz-Valckenberg Steffen, Braun Martina D, Thiele Sarah, Ferrara Daniela, Honigberg Lee, Gao Simon S, Chen Hao, Steffen Verena, Holz Frank G, Saßmannshausen Marlene

机构信息

GRADE Reading Center and Department of Ophthalmology, University of Bonn, Bonn, Germany.

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

出版信息

Ophthalmologica. 2021;244(6):523-534. doi: 10.1159/000517881. Epub 2021 Jun 25.

DOI:10.1159/000517881

PMID:34348335

Abstract

INTRODUCTION

This retrospective analysis assessed geographic atrophy (GA) progression in fellow eyes from the Proxima B trial intermediate age-related macular degeneration (iAMD) subcohort using high-resolution multimodal imaging anchored on optical coherence tomography (OCT).

METHODS

Thirty-two patients from the Proxima B iAMD subcohort were assessed; all had GA with no macular neovascularization (MNV) in the contralateral eye. Imaging data, including color fundus photography, fluorescein angiography, near-infrared reflectance, fundus autofluorescence (FAF), and spectral-domain OCT, were obtained. Features preceding progression/conversion to advanced AMD (drusen, reticular pseudodrusen [RPD], MNV, incomplete/complete retinal pigment epithelium and outer retinal atrophy [iRORA/cRORA]) were assessed.

RESULTS

Of 30 fellow eyes with available follow-up images, 12 converted to GA (FAF), 2 converted to MNV, and 16 were nonconverters during the review period (median: 17.8 months). iRORA/cRORA features (present in all converters at baseline) were identified on OCT in eyes that progressed to GA. Median time interval from iRORA to cRORA and from cRORA to GA was 7 months each. GA development/progression was either drusen- or RPD-associated (n = 6 each). Eyes with baseline RPD showed faster GA progression versus eyes with drusen (1.49 vs. 0.38 mm2/year).

CONCLUSIONS

RPD presence was associated with rapid GA lesion enlargement and may provide an early indication of faster GA progression.

摘要

引言

本回顾性分析使用以光学相干断层扫描（OCT）为基础的高分辨率多模态成像，评估了Proxima B试验中年龄相关性黄斑变性（iAMD）亚组对侧眼中地理萎缩（GA）的进展情况。

方法

对Proxima B iAMD亚组的32例患者进行了评估；所有患者对侧眼均有GA且无黄斑新生血管（MNV）。获取了包括彩色眼底照相、荧光素血管造影、近红外反射、眼底自发荧光（FAF）和光谱域OCT在内的成像数据。评估了进展/转化为晚期AMD之前的特征（玻璃膜疣、网状假性玻璃膜疣[RPD]、MNV、不完全/完全视网膜色素上皮和外层视网膜萎缩[iRORA/cRORA]）。

结果

在30例有可用随访图像的对侧眼中，12例在观察期内转化为GA（FAF），2例转化为MNV，16例未发生转化（中位数：17.8个月）。在进展为GA的眼中，OCT上发现了iRORA/cRORA特征（所有转化者在基线时均存在）。从iRORA到cRORA以及从cRORA到GA的中位时间间隔均为7个月。GA的发展/进展与玻璃膜疣或RPD相关（各有6例）。与有玻璃膜疣的眼睛相比，基线有RPD的眼睛GA进展更快（1.49 vs. 0.38 mm2/年）。