视网膜下脂质小滴是具有中间年龄相关性黄斑变性的眼睛中黄斑新生血管化的早期生物标志物。
SUBRETINAL LIPID GLOBULES AN EARLY BIOMARKER OF MACULAR NEOVASCULARIZATION IN EYES WITH INTERMEDIATE AGE-RELATED MACULAR DEGENERATION.
机构信息
Ophthalmology Unit, Department NESMOS, S. Andrea Hospital, University of Rome "La Sapienza", Rome, Italy.
UOS Retina, IRCCS-Fondazione Bietti, Rome, Italy.
出版信息
Retina. 2023 Jun 1;43(6):913-922. doi: 10.1097/IAE.0000000000003760.
PURPOSE
To explore the association between subretinal lipid globules (SLGs) detected in eyes with intermediate age-related macular degeneration with the presence of nonexudative macular neovascularization.
METHODS
This was a retrospective analysis of 113 consecutive patients with bilateral intermediate age-related macular degeneration (226 eyes) followed for a least 6 months. All eyes underwent multimodal imaging with fundus autofluorescence, spectral-domain optical coherence tomography, and optical coherence tomography angiography. Subretinal lipid globules were identified on spectral-domain optical coherence tomography as round hyporeflective lesions measuring 31 to 157 µ m located between the ellipsoid zone and the retinal pigment epithelium/Bruch membrane complex. Nonexudative macular neovascularization was detected with optical coherence tomography angiography. The features of NE-MNV lesions detected in eyes with SLGs were compared with those in eyes without SLGs.
RESULTS
Subretinal lipid globules were identified in 15 eyes of which 14 eyes (93.3%) demonstrated NE-MNV on optical coherence tomography angiography. In the remaining 98 eyes without SLGs, 18 (18.4%) displayed NE-AMD on optical coherence tomography angiography. The macular neovascularization area was larger in the SLG subgroup (+0.38 vs. +0.21 mm 2 , P = 0.008) and showed faster horizontal growth (+727 µ m, CI 95% 250.4, 1,205.4) than MNV in eyes without SLGs (+64.9 µ m, CI 95%, 24.3, 154) on optical coherence tomography B-scans. After a mean of 11.6 months, the conversion rate to exudative MNV was similar between eyes with SLGs and those without SLGs [8/26 (38.5%) versus 3/13 (27.3%), P = 0.56)].
CONCLUSION
The detection of SLGs in eyes with intermediate age-related macular degeneration was strongly correlated with the presence of NE-MNV. Although these MNV lesions were larger and grew faster than NE-MNV detected in eyes lacking SLGs, the rates of conversion to exudative MNV appeared similar.
目的
探讨在具有中间年龄相关性黄斑变性的眼中检测到的视网膜下脂质球（SLG）与非渗出性黄斑新生血管（MNV）的存在之间的关联。
方法
这是对 113 例连续双侧中间年龄相关性黄斑变性（226 只眼）患者进行的回顾性分析，随访时间至少为 6 个月。所有眼睛均进行了多模态成像，包括眼底自发荧光、谱域光学相干断层扫描和光相干断层扫描血管造影。在谱域光学相干断层扫描上，将直径为 31 至 157μm 的位于椭圆体带和视网膜色素上皮/布鲁赫膜复合体之间的圆形低反射性病变识别为视网膜下脂质球。通过光相干断层扫描血管造影检测非渗出性黄斑新生血管。比较了 SLG 眼中检测到的 NE-MNV 病变的特征与无 SLG 眼中的特征。
结果
在 15 只眼中发现了视网膜下脂质球，其中 14 只眼（93.3%）在光相干断层扫描血管造影上显示为 NE-MNV。在其余 98 只无 SLG 的眼中，18 只（18.4%）在光相干断层扫描血管造影上显示为 NE-AMD。与无 SLG 的眼中的 MNV 相比，SLG 亚组的黄斑新生血管面积更大（+0.38 比+0.21mm²，P=0.008），并且在光相干断层扫描 B 扫描上的水平生长速度更快（+727μm，CI95% 250.4，1,205.4）（+64.9μm，CI95% 24.3，154）。平均 11.6 个月后，SLG 眼中与无 SLG 眼中向渗出性 MNV 的转化率相似[8/26（38.5%）与 3/13（27.3%），P=0.56]。
结论
在中间年龄相关性黄斑变性的眼中检测到 SLG 与 NE-MNV 的存在密切相关。尽管这些 MNV 病变比在缺乏 SLG 的眼中检测到的 NE-MNV 更大且生长速度更快，但向渗出性 MNV 的转化率似乎相似。
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