Wisconsin Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
Wisconsin Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
Ophthalmol Retina. 2023 Feb;7(2):111-117. doi: 10.1016/j.oret.2022.08.001. Epub 2022 Aug 6.
To identify the prevalence of extramacular drusen and their role in the progression of age-related macular degeneration (AMD).
Retrospective analysis of a prospective cohort study.
The study was conducted in 4168 eyes (2998 participants) with intermediate AMD in one or both eyes enrolled in the Age-Related Eye Disease Study 2 (AREDS2), a 5-year multicenter study of nutritional supplements.
Baseline 3-field 30-degree color photographs were evaluated for drusen characteristics outside the macular grid, including size, area, and location. The characteristics of extramacular drusen were compared with those of drusen within the macula.
Progression rates to late AMD.
Although extramacular drusen were observed in 3624 (86.9%) eyes, they represented a small area (< 0.5 mm) in 50.3% of eyes, with only 17.5% exhibiting an area of > 1 disc area. Eyes with extramacular drusen exhibited larger macular drusen size and area than eyes without extramacular drusen (P < 0.001). Extramacular drusen were not associated with progression to late AMD. The hazard ratio adjusted for baseline age, sex, smoking, AMD severity level, and reticular pseudodrusen for 4043 eyes at risk of developing late AMD over 5 years was 1.17 (95% confidence interval [CI], 0.88-1.54; P = 0.27) for geographic atrophy and 0.96 (95% CI, 0.76-1.2; P = 0.7) for neovascular AMD.
Extramacular drusen are commonly observed in eyes with AMD and are more frequent with an increasing drusen burden within the macula. In eyes with intermediate AMD, extramacular drusen do not confer additional risk to previously identified risk factors in progression to late AMD.
确定玻璃膜疣的患病率及其在年龄相关性黄斑变性（AMD）进展中的作用。
前瞻性队列研究的回顾性分析。
该研究纳入了年龄相关性眼病研究 2 期（AREDS2）中的 4168 只眼（2998 名参与者），这些眼均患有一只或双眼的中间型 AMD，这是一项为期 5 年的多中心营养补充剂研究。
对 3 视野 30 度彩色照片进行评估，以确定黄斑网格外的玻璃膜疣特征，包括大小、面积和位置。比较了玻璃膜疣外玻璃膜疣的特征与黄斑内玻璃膜疣的特征。
向晚期 AMD 的进展速度。
尽管 3624 只眼（86.9%）观察到玻璃膜疣，但 50.3%的眼玻璃膜疣面积较小（<0.5mm），只有 17.5%的眼玻璃膜疣面积>1 个视盘面积。与无玻璃膜疣的眼睛相比，有玻璃膜疣的眼睛的黄斑玻璃膜疣大小和面积更大（P<0.001）。玻璃膜疣与向晚期 AMD 的进展无关。在 4043 只有发展为晚期 AMD 风险的眼中，经过 5 年的调整，基于基线年龄、性别、吸烟状况、AMD 严重程度水平和网状假性玻璃膜疣的危险比为 1.17（95%置信区间[CI]，0.88-1.54；P=0.27），用于地理萎缩；0.96（95%CI，0.76-1.2；P=0.7）用于新生血管性 AMD。
AMD 眼中常见玻璃膜疣，随着黄斑内玻璃膜疣负担的增加，玻璃膜疣更为常见。在中间型 AMD 眼中，玻璃膜疣不会增加先前确定的晚期 AMD 进展风险因素的风险。
