年龄相关性黄斑变性的黄斑眼底特征的对称性。
Symmetry of Macular Fundus Features in Age-Related Macular Degeneration.
机构信息
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, Israel.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
出版信息
Ophthalmol Retina. 2023 Aug;7(8):672-682. doi: 10.1016/j.oret.2023.03.016. Epub 2023 Mar 30.
PURPOSE
The symmetry of major macular fundus features in both eyes of the same patient with age-related macular degeneration (AMD) was investigated using swept-source(SS)-OCT.
DESIGN
Retrospective review of a prospective study.
PARTICIPANTS
Patients with AMD.
METHODS
Grading was performed on the first SS-OCT images obtained on the patients. Two graders diagnosed the presence of drusen, geographic atrophy (GA), and exudative AMD (eAMD) in each eye. Medical records were reviewed to assess prior exudation. To assess symmetry, 1 eye of each patient was randomly selected as the index eye and compared with the fellow eye. The kappa statistic (κ) was used to assess the symmetry of diagnosis. The intraclass correlation coefficient (ICC) was used to assess the symmetry of drusen area and volume.
MAIN OUTCOME MEASURES
Interocular symmetry of the AMD stages: drusen, GA, and eAMD.
RESULTS
A total of 1310 patients with AMD were included. The average age was 78 years (range, 50-102; 60% women). Of the 1310 subjects, 54% (701) presented with symmetric disease: 20% with bilateral drusen, 11% with bilateral GA, and 22% with bilateral eAMD. Only 0.5% of the subjects had both GA and eAMD in both eyes. Of the randomly selected index eyes, 825 (47%) were right eyes. Overall, limited interocular agreement was observed between the index and fellow eyes (54%; κ = 0.29). Kappa coefficients were poor (< 0.4) for index eyes diagnosed with drusen (κ = 0.27), eAMD (κ = 0.17), and mixed disease (κ = 0.03). There was moderate agreement between the index and fellow eyes for GA (κ = 0.50). Of the 265 patients with bilateral drusen, the symmetry of drusen area measurements had moderate ICC values of 0.70, 0.71, and 0.70 in the 3- and 5-mm diameter foveal-centered circles and in the total scan area, respectively. The ICC values for the drusen volumes were 0.65, 0.66, and 0.64, respectively.
CONCLUSIONS
Interocular symmetry was poor for eyes with drusen, eAMD, and mixed disease, but moderate for GA. Although the diagnosis of drusen was not very symmetric between eyes, when present in both eyes, the drusen area and volume measurements were moderately symmetric.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
目的
使用扫频源（SS）-OCT 研究年龄相关性黄斑变性（AMD）患者双眼主要黄斑眼底特征的对称性。
设计
前瞻性研究的回顾性分析。
参与者
AMD 患者。
方法
对患者的首次 SS-OCT 图像进行分级。两名分级员诊断每只眼的玻璃膜疣、地图状萎缩（GA）和渗出性 AMD（eAMD）的存在。回顾病历以评估先前的渗出情况。为了评估对称性，随机选择每个患者的 1 只眼作为指数眼，并与对侧眼进行比较。使用kappa 统计量（κ）评估诊断的对称性。使用组内相关系数（ICC）评估玻璃膜疣面积和体积的对称性。
主要观察指标
AMD 各期（玻璃膜疣、GA 和 eAMD）的眼间对称性。
结果
共纳入 1310 例 AMD 患者。平均年龄为 78 岁（范围，50-102；60%为女性）。在 1310 名受试者中，54%（701 例）表现为双侧疾病对称：20%双侧玻璃膜疣，11%双侧 GA，22%双侧 eAMD。仅有 0.5%的患者双眼均同时存在 GA 和 eAMD。在随机选择的指数眼中，825 只（47%）为右眼。总体而言，指数眼与对侧眼之间的眼间一致性有限（54%；κ=0.29）。指数眼诊断为玻璃膜疣（κ=0.27）、eAMD（κ=0.17）和混合性疾病（κ=0.03）的kappa 系数较差（<0.4）。GA 的指数眼与对侧眼之间的一致性为中度（κ=0.50）。在 265 例双侧玻璃膜疣患者中，3 毫米和 5 毫米直径的中央凹中心注视圆以及总扫描区域的玻璃膜疣面积测量的 ICC 值分别为 0.70、0.71 和 0.70。玻璃膜疣体积的 ICC 值分别为 0.65、0.66 和 0.64。
结论
玻璃膜疣、eAMD 和混合性疾病眼间对称性较差，但 GA 眼间对称性为中度。虽然双眼玻璃膜疣的诊断不是非常对称，但当双眼均存在玻璃膜疣时，其面积和体积测量具有中度对称性。
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