Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Retina. 2023 May 1;43(5):755-761. doi: 10.1097/IAE.0000000000003733.
To establish whether extensive macular atrophy with pseudodrusen (EMAP) can be distinguished from the diffuse-trickling phenotype of geographic atrophy (DTGA) secondary to age-related macular degeneration on the basis of its features on blue-light autofluorescence.
The authors reviewed our prospectively maintained database to enroll patients with a diagnosis of EMAP, DTGA, and non-DTGA with a minimum follow-up of 1 year. Atrophic areas and growth rates were measured on blue-light autofluorescence images, using the Heidelberg Region Finder tool. Circularity and roundness were chosen as atrophy shape descriptors, extracted using ImageJ, and compared between disease groups.
A total of 28 EMAP, 27 DTGA, and 30 non-DTGA eyes were included in the analysis. The median follow-up time was around 3.5 years. Extensive macular atrophy with pseudodrusen was characterized by an irregular and elongated shape (low circularity and low roundness) and associated with a fast atrophy growth rate (3.6 mm 2 /year), compared with non-DTGA. However, these parameters were not significantly different between EMAP and DTGA.
Our study found that EMAP and DTGA cannot be effectively differentiated on fundus autofluorescence. In both diseases, the macular atrophic area has a major vertical axis, fringed borders, and fast progression.
基于蓝光照相自发荧光的特征，探讨广泛性大 斑 层 萎 缩 伴假性 结 节（EMAP）是否可以与年龄相关性黄斑变性继发的弥漫性滴状萎缩（DTGA）相区分。
作者回顾性地查阅了我们的数据库，纳入了 EMAP、DTGA 和非 DTGA 患者，这些患者的诊断至少有 1 年的随访。使用海德堡区域定位仪（Heidelberg Region Finder tool），在蓝光照相自发荧光图像上测量萎缩区域和生长速率。使用 ImageJ 提取了圆形度和圆度这两个萎缩形状描述符，并在疾病组之间进行比较。
共纳入 28 只 EMAP 眼、27 只 DTGA 眼和 30 只非 DTGA 眼进行分析。中位随访时间约为 3.5 年。与非 DTGA 相比，EMAP 的特征为不规则且狭长的萎缩形状（低圆形度和低圆度），并伴有快速的萎缩生长速率（3.6mm²/年）。然而，这些参数在 EMAP 和 DTGA 之间没有显著差异。
我们的研究发现，在眼底自发荧光图像上，EMAP 和 DTGA 无法有效区分。在这两种疾病中，黄斑萎缩区域都有一个主要的垂直轴、边缘呈锯齿状，且进展迅速。
