Flores Rita, Carneiro Ângela, Neri Guilherme, Fradinho Ana C, Quenderra Bruno, Barata Maria João, Tenreiro Sandra, Seabra Miguel C
Department of Ophthalmology, Centro Hospitalar de Lisboa Central EPE, 1169-050 Lisbon, Portugal.
NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal.
Diagnostics (Basel). 2022 May 22;12(5):1290. doi: 10.3390/diagnostics12051290.
Age-related macular degeneration (AMD) is a multifactorial disease, whose complete pathogenesis is still unclear. Local hemodynamics may play a crucial role in its manifestation and progression. To evaluate choroidal and retinal vascular parameters, a total of 134 eyes were analyzed, 100 with intermediate AMD and 34 age matched healthy controls. 131 eyes of 104 patients were eligible for complete image assessment and 3 eyes were excluded for insufficient image quality: Group 1: intermediate AMD (n = 97) and Group 2: healthy controls (n = 34). Spectral domain optic coherence tomography (SD-OCT) with enhanced depth imaging (EDI) and optic coherence tomography angiography (OCT-A) were acquired using Spectralis (Heidelberg Engineering). Choroid and retinal capillary plexus were evaluated and image binarization was used to obtain quantitative data. Mean age was 77.67 years old (YO) and 67.2% were women. Total subfoveal choroidal area and luminal area were significantly reduced in Group 1 compared with Group 2 (0.88 mm2 and 0.40 mm2 vs. 1.24 mm2 and 0.55 mm2, respectively) (p < 0.05). Regarding choriocapillary flow density, AMD eyes recorded reduced values (34.83%) compared with controls (36.25%) (p < 0.05). Chorioretinal vasculature is impaired in intermediate AMD patients and vascular parameters could be attractive new prognostic biomarkers. Future therapeutic approaches may target this vascular dysfunction and delay disease progression.
年龄相关性黄斑变性（AMD）是一种多因素疾病，其完整的发病机制仍不清楚。局部血流动力学可能在其表现和进展中起关键作用。为了评估脉络膜和视网膜血管参数，共分析了134只眼睛，其中100只患有中度AMD，34只为年龄匹配的健康对照。104例患者的131只眼睛符合完整图像评估标准，3只眼睛因图像质量不足被排除：第1组：中度AMD（n = 97）和第2组：健康对照（n = 34）。使用Spectralis（海德堡工程公司）获取具有增强深度成像（EDI）的光谱域光学相干断层扫描（SD-OCT）和光学相干断层扫描血管造影（OCT-A）。对脉络膜和视网膜毛细血管丛进行评估，并使用图像二值化来获得定量数据。平均年龄为77.67岁，女性占67.2%。与第2组相比，第1组的黄斑中心凹下脉络膜总面积和管腔面积显著减少（分别为0.88mm²和0.40mm²，对比1.24mm²和0.55mm²）（p < 0.05）。关于脉络膜毛细血管血流密度，AMD眼睛的值（34.83%）低于对照组（36.25%）（p < 0.05）。中度AMD患者的脉络膜视网膜血管受损，血管参数可能是有吸引力的新的预后生物标志物。未来的治疗方法可能针对这种血管功能障碍并延缓疾病进展。
