Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Gyeonggi-do, Republic of Korea.
Ophthalmol Retina. 2024 Sep;8(9):863-871. doi: 10.1016/j.oret.2024.04.003. Epub 2024 Apr 9.
In this study, we identify risk factors that predict the progression of acquired vitelliform lesions (AVLs) over time.
Retrospective cohort study.
One hundred sixty-three eyes of 132 patients with a diagnosis of intermediate age-related macular degeneration (iAMD) with AVL.
This retrospective study evaluated consecutive eyes with AMD from a retina clinic population and included 1181 patients and 2362 eyes. After excluding cases with associated geographic atrophy, macular neovascularization (MNV), vitreomacular traction, and those with <2 years of follow-up data, the final analysis cohort consisted of 163 eyes (132 patients) with ≥1 AVL. The first available visit in which an AVL was evident was considered the baseline visit, and follow-up data were collected from a visit 2 years (± 3 months) later. Progression outcomes at the follow-up visit were classified into 6 categories: resorbed, collapsed, MNV, stable, increasing, and decreasing. Subsequently, we analyzed the baseline characteristics for each category and calculated odds ratios (ORs) to predict these various outcomes.
The study focused on identifying predictive factors influencing the evolution of AVL in iAMD eyes.
In total, 163 eyes with AVL had follow-up data at 2 years. The collapsed group demonstrated a significantly greater baseline AVL height and width compared with other groups (P < 0.001). With regard to qualitative parameters, subretinal drusenoid deposits (SDDs) and intraretinal hyperreflective foci (IHRF) at the eye level, AVL located over drusen, and IHRF and external limiting membrane disruption over AVL were significantly more prevalent in the collapsed group compared with other groups (P < 0.05 for all comparisons). Odds ratios for progressing to atrophy after 2 years of follow-up, compared with the resorbed group, were significant for SDD (OR, 2.82; P = 0.048) and AVL height (OR, 1.016; P = 0.006).
The presence of SDDs and greater AVL height significantly increases the risk of developing atrophy at the location of AVL after 2 years of follow-up. These findings may be of value in risk prognostication and defining patient populations for inclusion in future early intervention trials aimed at preventing progression to atrophy.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
本研究旨在确定随时间推移预测获得性玻璃膜疣（AVL）进展的风险因素。
回顾性队列研究。
132 例经诊断为中间型年龄相关性黄斑变性（iAMD）伴 AVL 的患者的 163 只眼。
这项回顾性研究评估了来自视网膜诊所人群的连续 AMD 眼，并纳入了 1181 例患者和 2362 只眼。在排除伴有地图状萎缩、黄斑新生血管（MNV）、玻璃体黄斑牵引以及随访数据＜2 年的病例后，最终分析队列包括 163 只眼（132 例），这些眼中均有≥1 个 AVL。首次出现 AVL 的可评估就诊被视为基线就诊，随访数据来自 2 年后（±3 个月）的就诊。在随访就诊时，将进展结果分为 6 类：吸收、塌陷、MNV、稳定、增加和减少。随后，我们分析了各分类的基线特征，并计算了预测这些不同结局的优势比（OR）。
本研究重点在于确定影响 iAMD 眼中 AVL 演变的预测因素。
共有 163 只眼的 AVL 有 2 年的随访数据。与其他组相比，塌陷组的基线 AVL 高度和宽度显著更大（P＜0.001）。就定性参数而言，与其他组相比，在眼水平的视网膜下类脂沉积（SDD）和视网膜内高反射灶（IHRF）、位于玻璃膜疣上的 AVL 以及 AVL 上方的 IHRF 和外节膜破坏更常见于塌陷组（所有比较 P＜0.05）。与吸收组相比，2 年后进展为萎缩的 SDD（比值比，2.82；P=0.048）和 AVL 高度（比值比，1.016；P=0.006）的优势比显著更高。
存在 SDD 和更大的 AVL 高度显著增加了 2 年后 AVL 部位发生萎缩的风险。这些发现可能对风险预测和确定未来旨在预防萎缩进展的早期干预试验中纳入的患者人群具有价值。
本文末尾的脚注和披露中可能包含专有或商业披露信息。
