新生性地理萎缩作为3型黄斑新生血管形成的预测指标

Nascent Geographic Atrophy as a Predictor of Type 3 Macular Neovascularization Development.

作者信息

Sacconi Riccardo, Sarraf David, Sadda SriniVas R, Freund K Bailey, Servillo Andrea, Fogel Levin Meira Miri, Costanzo Eliana, Corradetti Giulia, Cabral Diogo, Zur Dinah, Trivizki Omer, Parravano Mariacristina, Bandello Francesco, Loewenstein Anat, Querques Giuseppe

机构信息

School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of head and neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California; Greater Los Angeles VA Healthcare Center, Los Angeles, California, United States.

出版信息

Ophthalmol Retina. 2023 Jul;7(7):586-592. doi: 10.1016/j.oret.2023.01.019. Epub 2023 Feb 2.

DOI:10.1016/j.oret.2023.01.019

PMID:36736896

Abstract

PURPOSE

To investigate the association of nascent geographic atrophy (GA) preceding the development of exudative type 3 macular neovascularization (MNV) in patients with age-related macular degeneration (AMD).

DESIGN

Retrospective longitudinal study.

PARTICIPANTS

Patients with AMD diagnosed with treatment-naive exudative type 3 MNV in 1 or both eyes were evaluated. Inclusion criteria included serial tracked structural OCT examinations for ≥ 2 years before the detection of exudative type 3 MNV.

METHODS

Clinical characteristics and retinal imaging, including structural OCT at baseline and at each follow-up examination, were analyzed. Eyes showing the presence of nascent GA during the follow-up were selected for analysis of prevalence, and clinical characteristics at the site of subsequent type 3 MNV development.

MAIN OUTCOME MEASURES

Description of the prevalence and clinical characteristics of nascent GA at the site of subsequent type 3 MNV development.

RESULTS

Overall, 97 eyes affected by type 3 MNV meeting inclusion criteria were analyzed. Of 97 eyes (71 patients), 22 eyes of 21 patients (mean age 82 ± 9 years) showed nascent GA preceding exudative type 3 MNV. The observed prevalence of nascent GA preceding exudative type 3 MNV was 22.7% (95% confidence interval, 14.4%-31.0%). Exudative type 3 MNV developed a mean of 9 ± 6 months after detection of nascent GA. The presence of reticular pseudodrusen in the study eye did not significantly influence the timing of exudative type 3 MNV development after the observation of nascent GA (P > 0.1 in all analyses). Reduced best-corrected visual acuity was recorded at the exudative type 3 stage in comparison with the nascent GA stage (P = 0.003).

CONCLUSIONS

As nascent GA may precede the development of exudative type 3 MNV, the detection of nascent GA in eyes with AMD may warrant closer surveillance to identify early exudative type 3 MNV warranting treatment.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

摘要

目的

研究年龄相关性黄斑变性（AMD）患者在渗出性3型黄斑新生血管（MNV）发生之前新生地理性萎缩（GA）的相关性。

设计

回顾性纵向研究。

参与者

对诊断为单眼或双眼初治渗出性3型MNV的AMD患者进行评估。纳入标准包括在检测到渗出性3型MNV之前≥2年的系列跟踪结构OCT检查。

方法

分析临床特征和视网膜成像，包括基线和每次随访检查时的结构OCT。选择随访期间出现新生GA的眼睛进行患病率分析，以及后续3型MNV发生部位的临床特征分析。

主要观察指标

描述后续3型MNV发生部位新生GA的患病率和临床特征。

结果

总体上，分析了符合纳入标准的97只受3型MNV影响的眼睛。在97只眼睛（71例患者）中，21例患者（平均年龄82±9岁）的22只眼睛在渗出性3型MNV之前出现了新生GA。渗出性3型MNV发生前新生GA的观察患病率为22.7%（95%置信区间，14.4%-31.0%）。渗出性3型MNV在检测到新生GA后平均9±6个月发生。研究眼中网状假性玻璃膜疣的存在对观察到新生GA后渗出性3型MNV发生的时间没有显著影响（所有分析中P>0.1）。与新生GA阶段相比，渗出性3型阶段记录到最佳矫正视力下降（P=0.003）。