Vilares-Morgado Rodrigo, Silva Ivo, Cunha Ana Maria, Carneiro Ângela, Falcão-Reis Fernando, Falcão Manuel
Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal.
Ophthalmologica. 2022;245(6):528-537. doi: 10.1159/000525978. Epub 2022 Jul 19.
The objective of this study wasto assess the prevalence of complete retinal pigment epithelium (RPE) and outer retinal atrophy (cRORA) in patients with unilateral exudative age-related macular degeneration (AMD) of the fellow eye and establish if the presence of non-exudative macular neovascularization (NE-MNV) influences the prevalence of RPE and outer retinal atrophy in eyes with AMD.
This is an observational cross-sectional study of 68 patients with unilateral exudative AMD. Demographic and clinical data were collected, and multimodal retinal imaging was performed in all patients. Two groups of patients were defined according to the presence (NE-MNV) or absence (no NE-MNV) of NE-MNV in the study eye. We compared the prevalence of tomographic cRORA and fundus autofluorescence (FAF) geographic atrophy (GA) and differences in cRORA greatest linear diameter (GLD) and GA area between groups.
Globally, cRORA was present in 11 eyes (16.2%), FAF GA was present in 10 eyes (14.7%), and NE-MNV was present in 10 eyes (14.7%) of patients with unilateral exudative AMD of the fellow eye. The overall cRORA GLD was 1,950.64 ± 1,428.31 μm, and the mean area of GA was 9.25 ± 7.50 mm2. Regarding comparisons between groups, cRORA was present in 9 eyes (15.5%) without NE-MNV and in 2 eyes (20%) with NE-MNV (p = 0.66). Tomographic signs of atrophy were more frequent in eyes with NE-MNV (50% vs. 24.1% in eyes without NE-MNV; p = 0.008). No significant differences were found in cRORA GLD (p = 0.30) between groups. Eyes with NE-MNV and eyes without NE-MNV had a similar prevalence of FAF GA (2 eyes out of 10 and 8 eyes out of 58, respectively; p = 0.64). Eyes with NE-MNV had a smaller mean area of GA (2.07 ± 0.24 mm2 vs. 11.05 ± 7.34 mm2; p = 0.01).
In our study, the presence of NE-MNV was not associated with the prevalence of cRORA and/or FAF GA. Nonetheless, eyes with NE-MNV presented smaller areas of GA, which suggests that this type of neovascularization may prevent the progression of RPE and outer retinal atrophy. Longitudinal studies are required to confirm these preliminary results.
本研究的目的是评估对侧眼为单侧渗出性年龄相关性黄斑变性（AMD）患者中完全视网膜色素上皮（RPE）和外层视网膜萎缩（cRORA）的患病率，并确定非渗出性黄斑新生血管（NE-MNV）的存在是否会影响AMD患者眼中RPE和外层视网膜萎缩的患病率。
这是一项对68例单侧渗出性AMD患者进行的观察性横断面研究。收集了人口统计学和临床数据，并对所有患者进行了多模态视网膜成像。根据研究眼中NE-MNV的存在（NE-MNV）或不存在（无NE-MNV）将患者分为两组。我们比较了断层扫描cRORA和眼底自发荧光（FAF）地图样萎缩（GA）的患病率，以及两组之间cRORA最大线性直径（GLD）和GA面积的差异。
总体而言，在对侧眼为单侧渗出性AMD的患者中，11只眼（16.2%）存在cRORA，10只眼（14.7%）存在FAF GA，10只眼（14.7%）存在NE-MNV。cRORA的总体GLD为1950.64±1428.31μm，GA的平均面积为9.25±7.50mm²。关于组间比较，无NE-MNV的9只眼（15.5%）存在cRORA，有NE-MNV的2只眼（20%）存在cRORA（p=0.66）。NE-MNV眼中萎缩的断层扫描征象更常见（50%对无NE-MNV眼的24.1%；p=0.008）。两组之间cRORA GLD无显著差异（p=0.30）。有NE-MNV的眼和无NE-MNV的眼FAF GA的患病率相似（分别为10只眼中的2只和58只眼中的8只；p=0.64）。有NE-MNV的眼GA平均面积较小（2.07±0.24mm²对11.05±7.34mm²；p=0.01）。
在我们的研究中，NE-MNV的存在与cRORA和/或FAF GA的患病率无关。尽管如此，有NE-MNV的眼GA面积较小，这表明这种类型的新生血管可能会阻止RPE和外层视网膜萎缩的进展。需要进行纵向研究来证实这些初步结果。
