Hirabayashi Kazutaka, Yu Hannah J, Wakatsuki Yu, Marion Kenneth M, Wykoff Charles C, Sadda Srinivas R
Doheny Eye Institute, Los Angeles, California.
Retina Consultants of Texas, Retina Consultants of America, Houston, Texas.
Ophthalmol Retina. 2023 Mar;7(3):253-260. doi: 10.1016/j.oret.2022.09.007. Epub 2022 Oct 6.
To determine the frequency of multiple OCT biomarkers of intermediate age-related macular degeneration (iAMD) and their relationship with the development of complete retinal pigment epithelium and outer retinal atrophy (cRORA) after 2 years.
Retrospective cohort study.
This retrospective analysis included 330 eyes of 330 consecutive patients with iAMD in ≥ 1 eye who had 24 months of follow-up data.
Spectralis OCT volume scans (49 B-scans over 6 × 6 mm, automatic real time = 6, fovea-centered) at baseline were evaluated for the previously described iAMD biomarkers, including a high-central drusen volume (DV; ≥ 0.03 mm), intraretinal hyper-reflective foci (IHRF), subretinal drusenoid deposits (SDDs), hypo-reflective drusen cores (hDCs), and a thin or thick (multilayered) double-layer sign (DLS). The age-related macular degeneration (AMD) status in the fellow eye was also assessed and classified as normal or early AMD, iAMD, exudative macular neovascularization, or cRORA.
Incidence of cRORA, odds ratio for demographics, and OCT features.
At month 24, 16.36% (54/330) of the iAMD eyes developed cRORA. Several baseline features, including high-central DV, IHRF, SDD, hDC, thin DLS, and cRORA in the fellow eye, were associated with a significantly greater risk for development of cRORA at 2 years. The odds ratio, 95% confidence interval, P value, and baseline frequencies of these biomarkers were DV (6.510, 2.467-17.176, P < 0.001, 49.1%), IHRF (12.763, 4.763-34.202, P < 0.001, 38.8%), SDD (2.307, 1.003-5.304, P = 0.049, 34.2%), hDC (3.012, 1.152-7.873, P = 0.024, 13.0%), thin DLS (4.517, 1.555-13.126, P = 0.006, 11.8%), and cRORA in the fellow eye (7.184, 1.938-26.623, P = 0.003, 8.2%).
In addition to the 4 previously reported factors that are present in a significant proportion of iAMD (DV, IHRF, hDC, and SDD), a thin DLS and cRORA in the fellow eye were associated with an increased risk of progression to cRORA over 2 years. These biomarkers may aid in prognostication, risk stratification, and selection of patients for clinical trials.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
确定中度年龄相关性黄斑变性（iAMD）多种光学相干断层扫描（OCT）生物标志物的出现频率及其与2年后完全视网膜色素上皮和外层视网膜萎缩（cRORA）发生的关系。
回顾性队列研究。
这项回顾性分析纳入了330例连续的iAMD患者的330只眼，这些患者至少有一只眼有24个月的随访数据。
对基线时的Spectralis OCT容积扫描（6×6mm范围内49次B扫描，自动实时=6，以黄斑中心凹为中心）进行评估，以检测先前描述的iAMD生物标志物，包括高中心性玻璃膜疣体积（DV；≥0.03mm）、视网膜内高反射灶（IHRF）、视网膜下玻璃膜疣样沉积物（SDD）、低反射玻璃膜疣核心（hDC）以及薄或厚（多层）双层征（DLS）。还评估了对侧眼的年龄相关性黄斑变性（AMD）状态，并将其分类为正常或早期AMD、iAMD、渗出性黄斑新生血管或cRORA。
cRORA的发生率、人口统计学特征的比值比以及OCT特征。
在第24个月时，16.36%（54/330）的iAMD眼发生了cRORA。几个基线特征，包括高中心性DV、IHRF、SDD、hDC、薄DLS以及对侧眼的cRORA，与2年后发生cRORA的风险显著增加相关。这些生物标志物的比值比、95%置信区间、P值和基线频率分别为DV（6.510，2.467 - 17.176，P < 0.001，49.1%）、IHRF（12.763，4.763 - 34.202，P < 0.001，38.8%）、SDD（2.307，1.003 - 5.304，P = 0.049，34.2%）、hDC（3.012，1.152 - 7.873，P = 0.024，13.0%）、薄DLS（4.517，1.555 - 13.126，P = 0.006，11.8%）以及对侧眼的cRORA（7.184，1.938 - 26.623，P = 0.003，8.2%）。
除了先前报道的在相当比例的iAMD中存在的4个因素（DV、IHRF、hDC和SDD）外，薄DLS和对侧眼的cRORA与2年内进展为cRORA的风险增加相关。这些生物标志物可能有助于预后评估、风险分层以及为临床试验选择患者。
专有或商业披露信息可在参考文献之后找到。
