Toulouie Sara, Chang Sean, Pan Julia, Snyder Kiersten, Yiu Glenn
Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA.
California Northstate University, College of Medicine, Elk Grove, CA, USA.
J Ophthalmol. 2022 Jul 31;2022:8210599. doi: 10.1155/2022/8210599. eCollection 2022.
Evaluate the relationship between retinal vascular caliber and age-related macular degeneration (AMD) severity or progression.
A retrospective secondary analysis of 1172 fundus photographs and clinical data from the prospective Age-Related Eye Disease Study (AREDS). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) were measured using the Parr-Hubbard-Knudtson formula. Univariate and multivariate regressions were used to determine the association of CRAE, CRVE, and AVR with age, sex, smoking status, presence of cilioretinal artery, and AMD severity at baseline and 5 years using the 9-step AMD severity score.
Only CRAE and CRVE were higher in men ( < 0.001), current smokers ( < 0.001), and the eyes with a cilioretinal artery (=0.009 - 0.043). AMD severity was greater in older patients (=0.001), current smokers (=0.012), the eyes without a cilioretinal artery (=0.001), and lower AVR (=0.034) on multivariate regression but was not influenced by CRAE or CRVE (=0.240 - 0.500). Choroidal neovascularization (CNV) presence was associated with older age (=0.003) and absence of a cilioretinal artery (=0.009), while central geographic atrophy (CGA) was associated with narrower CRAE (=0.002) and possibly AVR (=0.046). None of the retinal vessel parameters were predictive of AMD severity score or new onset of CNV or CGA at 5 years.
A lower arteriole-to-venule ratio may be associated with AMD severity, with narrower arterioles seen in the eyes with geographic atrophy, suggesting a role of the retinal vasculature in AMD pathophysiology. This trial is registered with ClinicalTrials.gov Identifier: NCT00000145.
评估视网膜血管管径与年龄相关性黄斑变性（AMD）严重程度或进展之间的关系。
对来自前瞻性年龄相关性眼病研究（AREDS）的1172张眼底照片和临床数据进行回顾性二次分析。使用帕尔-哈伯德-克努德森公式测量视网膜中央动脉等效直径（CRAE）、视网膜中央静脉等效直径（CRVE）和动静脉比（AVR）。采用单变量和多变量回归分析，使用9级AMD严重程度评分来确定CRAE、CRVE和AVR与年龄、性别、吸烟状况、睫状视网膜动脉的存在以及基线和5年时AMD严重程度之间的关联。
男性（<0.001）、当前吸烟者（<0.001）以及有睫状视网膜动脉的眼睛（=0.009 - 0.043）的CRAE和CRVE仅较高。多变量回归分析显示，老年患者（=0.001）、当前吸烟者（=0.012）、没有睫状视网膜动脉的眼睛（=0.001）以及较低的AVR（=0.034）的AMD严重程度更高，但不受CRAE或CRVE的影响（=0.240 - 0.500）。脉络膜新生血管（CNV）的存在与年龄较大（=0.003）和没有睫状视网膜动脉（=0.009）相关，而中心性地图样萎缩（CGA）与较窄的CRAE（=0.002）以及可能的AVR（=0.046）相关。在5年时，没有视网膜血管参数能够预测AMD严重程度评分或CNV或CGA的新发情况。
较低的动静脉比可能与AMD严重程度相关，在地图样萎缩的眼睛中可见较窄的小动脉，提示视网膜血管系统在AMD病理生理学中发挥作用。本试验已在ClinicalTrials.gov注册，标识符：NCT00000145。
