Shijo Taiyo, Sakurada Yoichi, Tanaka Koji, Miki Akiko, Sugiyama Atsushi, Onoe Hajime, Chubachi Aya, Kikushima Wataru, Wakatsuki Yu, Yoneyama Seigo, Mori Ryusaburo, Kashiwagi Kenji
Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, 409-3821, Yamanashi, Japan.
Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.
Sci Rep. 2022 Mar 18;12(1):4715. doi: 10.1038/s41598-022-08626-x.
To investigate the incidence and risk of advanced age-related macular degeneration (AMD), including geographic atrophy (GA) and macular neovascularization (MNV), in eyes with drusenoid pigment epithelial detachment (PED). Eighty-five eyes with drusenoid PED from 85 patients (77.2 ± 7.0 years, male/female: 44/41) were included in this study. Patients were followed up every 1-3 months via spectral-domain optical coherence tomography (SD-OCT) and color fundus photography. If exudation was observed on SD-OCT, fluorescein and indocyanine green angiography were performed to confirm the MNV subtype accordingly. The maximum follow-up period was 60 months. During the study period, GA developed in 8 eyes while MNV also developed in 8 eyes. The Kaplan-Meier estimator revealed that the cumulative incidence for 60 months was 17.9% and 12.2% for GA and MNV, respectively. In eyes developing MNV, retinal angiomatous proliferation was the most common. Cox regression analysis revealed that baseline PED width was the only factor associated with advanced AMD. (p = 0.0026, Cox regression analysis). The 5-year cumulative incidence of advanced AMD, including GA and MNV, was approximately 30% in eyes with drusenoid PED among the Japanese elderly. A larger baseline PED width was the only risk factor for advanced AMD.
为了研究类玻璃膜疣色素上皮脱离（PED）眼发生晚期年龄相关性黄斑变性（AMD）（包括地图样萎缩（GA）和黄斑新生血管形成（MNV））的发生率和风险。本研究纳入了85例患者的85只类玻璃膜疣PED眼（年龄77.2±7.0岁，男/女：44/41）。通过频域光学相干断层扫描（SD-OCT）和彩色眼底照相术对患者进行每1 - 3个月一次的随访。如果在SD-OCT上观察到渗出，则相应地进行荧光素和吲哚菁绿血管造影以确认MNV亚型。最长随访期为60个月。在研究期间，8只眼发生了GA，8只眼也发生了MNV。Kaplan-Meier估计显示，GA和MNV在60个月时的累积发生率分别为17.9%和12.2%。在发生MNV的眼中，视网膜血管瘤样增殖最为常见。Cox回归分析显示，基线PED宽度是与晚期AMD相关的唯一因素（p = 0.0026，Cox回归分析）。在日本老年人中，类玻璃膜疣PED眼中包括GA和MNV在内的晚期AMD的5年累积发生率约为30%。较大的基线PED宽度是晚期AMD的唯一危险因素。
