Krytkowska Elżbieta, Olejnik-Wojciechowska Joanna, Grabowicz Aleksandra, Safranow Krzysztof, Machalińska Anna
First Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland.
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland.
J Clin Med. 2023 Dec 16;12(24):7728. doi: 10.3390/jcm12247728.
Multimodal retinal imaging enables the detection of subretinal drusenoid deposits (SDD) with significantly greater accuracy compared to fundus photography. The study aimed to analyze a relationship between the presence of SDD, the clinical picture of AMD, and disease progression in a 3 year follow-up. A total of 602 eyes of 339 patients with a diagnosis of AMD, of which 121 (55%) had SDD confirmed in multimodal retinal imaging, were enrolled in the study. SDD was related to a more advanced stage of AMD ( = 0.008), especially with the presence of geographic atrophy (OR = 4.11, 95% CI 2.02-8.38, < 0.001). Eyes with SDD presented significantly lower choroidal and retinal thickness (ATC: 210.5 μm, CRT: 277 μm, respectively) and volume (AVC: 0.17 mm, CRV: 8.29 mm, < 0.001, respectively) compared to SDD-negative eyes (ATC: 203 μm, CRT: 277 μm; AVC: 7.08 mm, 8.54 mm, < 0.001). Accordingly, the prevalence of pachychoroids and pachyvessels was significantly lower in the SDD present group than in eyes without SDD ( = 0.004; = 0.04, respectively). Neither demographic factors, lipid profile, genetic predisposition, systemic vascular disease comorbidities, nor parameters of retinal vessels were affected by the presence of SDD. We found no effect of SDD presence on AMD progression ( = 0.12). The presence of SDD appeared to be related to local rather than systemic factors.
与眼底照相相比，多模态视网膜成像能够以显著更高的准确性检测视网膜下类玻璃膜疣沉积物（SDD）。该研究旨在分析SDD的存在、年龄相关性黄斑变性（AMD）的临床表现与3年随访期内疾病进展之间的关系。共有339例诊断为AMD的患者的602只眼纳入研究，其中121只眼（55%）在多模态视网膜成像中确诊有SDD。SDD与AMD的更晚期阶段相关（P = 0.008），尤其是与地图样萎缩的存在相关（比值比 = 4.11，95%置信区间2.02 - 8.38，P < 0.001）。与无SDD的眼相比，有SDD的眼脉络膜和视网膜厚度（分别为：脉络膜厚度210.5μm，视网膜厚度277μm）和体积（分别为：脉络膜体积0.17mm³，视网膜体积8.29mm³，P均< 0.001）显著更低（无SDD的眼：脉络膜厚度203μm，视网膜厚度277μm；脉络膜体积7.08mm³，视网膜体积8.54mm³，P < 0.001）。因此，有SDD组的厚脉络膜和厚血管的患病率显著低于无SDD的眼（分别为P = 0.004；P = 0.04）。人口统计学因素、血脂谱、遗传易感性、全身血管疾病合并症以及视网膜血管参数均不受SDD存在的影响。我们发现SDD的存在对AMD进展无影响（P = 0.12）。SDD的存在似乎与局部而非全身因素有关。
