Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.
Invest Ophthalmol Vis Sci. 2022 Oct 3;63(11):4. doi: 10.1167/iovs.63.11.4.
The purpose of this study was to investigate the impact of double-layer sign (DLS) on geographic atrophy (GA) progression in eyes with foveal-sparing GA and age-related macular degeneration (AMD).
This is a retrospective, consecutive case series of eyes with foveal-sparing GA secondary to AMD with more than 6 months of follow-up. The size of the foveal-sparing area was measured on the fundus autofluorescence images at the first and last visits. Each eye was evaluated for the presence or absence of DLS inside the foveal-sparing area. We graded eyes based on the presence of DLS within the foveal-sparing area and compared the progression of GA between two groups (DLS (+) versus DLS (-)).
We identified 25 eyes with foveal-sparing GA with at least 2 follow-up visits (average interval = 22.7 ± 11.8 months between visits). The mean foveal sparing area was 1.74 ± 0.87 mm2 (range = 0.42-4.14 mm2) at baseline and 1.26 ± 0.75 mm2 (range = 0.25-2.92 mm2) at the last visit. Seventeen eyes (65.3%) were graded as DLS (+) within the foveal-sparing area. Square root progression of GA toward the fovea was significantly faster in the DLS (-) eyes (0.149 ± 0.078 mm/year) compared to the DLS (+) group (0.088 ± 0.052 mm/year; P = 0.04).
The DLS (-) group showed significantly faster centripetal GA progression than the DLS (+) group. Our data suggest that the presence of DLS in the spared foveal area could be a protective factor against foveal progression of GA in eyes with AMD.
本研究旨在探讨双层征（DLS）对伴有黄斑区 spared 的年龄相关性黄斑变性（AMD）性地图状萎缩（GA）进展的影响。
这是一项回顾性、连续病例系列研究，纳入了伴有黄斑区 spared 的 AMD 性 GA 随访时间超过 6 个月的患者。在首次和末次就诊时，通过眼底自发荧光图像测量黄斑区 spared 区域的大小。评估每个眼睛的黄斑区 spared 区域内是否存在 DLS。我们根据黄斑区 spared 区域内是否存在 DLS 对眼睛进行分级，并比较两组（DLS（+）与 DLS（-））之间的 GA 进展情况。
我们共纳入了 25 只具有至少 2 次随访的伴有黄斑区 spared 的 GA 眼（两次就诊的平均间隔为 22.7±11.8 个月）。基线时，黄斑区 spared 区域的平均面积为 1.74±0.87mm2（范围为 0.42-4.14mm2），末次随访时为 1.26±0.75mm2（范围为 0.25-2.92mm2）。在黄斑区 spared 区域内，17 只眼睛（65.3%）被评为 DLS（+）。与 DLS（+）组相比，DLS（-）组的 GA 向黄斑中心的平方根进展速度明显更快（0.149±0.078mm/年比 0.088±0.052mm/年；P=0.04）。
与 DLS（+）组相比，DLS（-）组的 GA 向中心进展速度明显更快。我们的数据表明，AMD 患者黄斑区 spared 区域存在 DLS 可能是防止 GA 向黄斑中心进展的保护因素。
