脉络膜信号超传递在光学相干断层扫描成像中的表现：与年龄相关性黄斑变性中地图样萎缩的发展相关。

Choroidal signal hypertransmission on optical coherence tomography imaging: Association with development of geographic atrophy in age-related macular degeneration.

机构信息

Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.

Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Clin Exp Ophthalmol. 2024 May-Jun;52(4):431-439. doi: 10.1111/ceo.14356. Epub 2024 Jan 29.

DOI:10.1111/ceo.14356

PMID:38286571

Abstract

BACKGROUND

To examine the association between large choroidal signal hypertransmission ≥250 μm (LHyperT) on optical coherence tomography (OCT) with the risk of developing geographic atrophy (GA) and compare this risk with those associated with nascent geographic atrophy (nGA).

METHODS

Two hundred and eighty eyes from 140 participants with bilateral large drusen and without late age-related macular degeneration (AMD) or nGA at baseline underwent OCT imaging and colour fundus photography (CFP) at 6-monthly intervals up to 5 years. OCT scans were graded for the presence of LHyperT and nGA, and CFPs were graded for the presence of GA.

RESULTS

The five-year incidence of LHyperT and nGA were 37% and 27% respectively (p = 0.003), and the two-year probability of their progression to GA were 17% and 40%, respectively (p = 0.002). LHyperT and nGA explained 81% and 91% of the variance in the time to develop GA, respectively (p = 0.032), and they were both associated with a significantly higher rate of GA development compared to eyes without these lesions (adjusted hazard ratio = 110.8 and 183.2, respectively; p < 0.001 for both).

CONCLUSIONS

LHyperT and nGA were both high-risk features for GA development, but the latter showed a higher rate of GA progression and explained a significantly greater proportion of the variance in the time to develop GA. As such, nGA may be a more robust surrogate endpoint than LHyperT for the conventional clinical endpoint of CFP-defined GA for intervention trials in the early stages of AMD.

摘要

背景

本研究旨在探讨光学相干断层扫描（OCT）上大脉络膜信号高透过（LHyperT）≥250μm与地理萎缩（GA）发生风险的关系，并将这种风险与新生型 GA（nGA）相关风险进行比较。

方法

本研究纳入了 140 名双侧大玻璃膜疣且基线时无晚期年龄相关性黄斑变性（AMD）或 nGA 的患者的 280 只眼，这些患者每 6 个月接受一次 OCT 成像和眼底彩色照相（CFP）检查，随访时间长达 5 年。OCT 扫描评估 LHyperT 和 nGA 的存在，CFP 评估 GA 的存在。

结果

5 年内 LHyperT 和 nGA 的发生率分别为 37%和 27%（p=0.003），其进展为 GA 的 2 年概率分别为 17%和 40%（p=0.002）。LHyperT 和 nGA 分别解释了 GA 发生时间的 81%和 91%的变异性（p=0.032），与无这些病变的眼睛相比，两者均与 GA 发生风险显著增加相关（调整后的危害比分别为 110.8 和 183.2；两者均 p<0.001）。