Liu T Y Alvin, Wang Jiangxia, Csaky Karl G
Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Int J Retina Vitreous. 2023 Apr 7;9(1):24. doi: 10.1186/s40942-023-00461-0.
To investigate the relationship between intraretinal hyperreflective foci (HRF) and visual function in intermediate age-related macular degeneration (iAMD).
Retrospective, cross-sectional study. iAMD patients underwent spectral domain optical coherence tomography (SD-OCT) imaging and vision function testing: normal luminance best corrected visual acuity (VA), low luminance VA (LLVA), quantitative contrast sensitivity function (qCSF), low luminance qCSF (LLqCSF), and mesopic microperimetry. Each OCT volume was graded for the presence and number of HRF. Each HRF was graded for: separation from the retinal pigment epithelium (RPE), above drusen, and shadowing. Central drusen volume was calculated by the built-in functionality of the commercial OCT software after manual segmentation of the RPE and Bruch's membrane.
HRF group: 11 eyes; 9 patients; mean age 75.7 years. No-HRF group: 11 eyes; 10 patients; mean age 74.8 years. In linear mixed effect model adjusting for cube-root transformed drusen volume, HRF group showed statistically significant worse VA, LLVA, LLqCSF, and microperimetry. HRF group showed worse cone function, as measured by our pre-defined multicomponent endpoint, incorporating LLVA, LLqCSF and microperimetry (p = 0.018). For eyes with HRF, # of HRF did not correlate with any functional measures; however, % of HRF separated from RPE and # of HRF that created shadowing were statistically associated with low luminance deficit (LLD).
The association between the presence of HRF and worse cone visual function supports the hypothesis that eyes with HRF have more advanced disease.
研究视网膜内高反射灶（HRF）与中度年龄相关性黄斑变性（iAMD）患者视觉功能之间的关系。
回顾性横断面研究。iAMD患者接受了光谱域光学相干断层扫描（SD-OCT）成像和视觉功能测试：正常亮度最佳矫正视力（VA）、低亮度VA（LLVA）、定量对比敏感度函数（qCSF）、低亮度qCSF（LLqCSF）和中亮度微视野检查。对每个OCT容积的HRF存在情况和数量进行分级。对每个HRF进行分级：与视网膜色素上皮（RPE）的距离、在玻璃膜疣上方以及有无遮挡。在手动分割RPE和布鲁赫膜后，通过商用OCT软件的内置功能计算中央玻璃膜疣体积。
HRF组：11只眼；9例患者；平均年龄75.7岁。无HRF组：11只眼；10例患者；平均年龄74.8岁。在线性混合效应模型中，对经立方根变换的玻璃膜疣体积进行校正后，HRF组在VA、LLVA、LLqCSF和微视野检查方面显示出统计学上显著更差的结果。HRF组显示出较差的视锥细胞功能，这是通过我们预先定义的多组分终点来衡量的，该终点纳入了LLVA、LLqCSF和微视野检查（p = 0.018）。对于有HRF的眼睛，HRF的数量与任何功能指标均无相关性；然而，与RPE分离的HRF百分比以及产生遮挡的HRF数量与低亮度缺陷（LLD）在统计学上相关。
HRF的存在与较差的视锥细胞视觉功能之间的关联支持了以下假设，即有HRF的眼睛患有更晚期的疾病。
