State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
Microvasc Res. 2024 Sep;155:104716. doi: 10.1016/j.mvr.2024.104716. Epub 2024 Jul 14.
To investigate the correlation between morphological lesions and functional indicators in eyes with neovascular age-related macular degeneration (nAMD).
This was a prospective observational study of treatment-naïve nAMD eyes. Various morphological lesions and impaired retinal structures were manually measured at baseline and month-3 in three-dimensional optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images, including the volumes (mm) of macular neovascularization (MNV), avascular subretinal hyperreflective material (avascular SHRM), subretinal fluid (SRF), intraretinal fluid (IRF), serous pigment epithelial detachment (sPED) and the impaired area (mm) of ellipsoid zone (EZ), external limiting membrane (ELM) and outer nuclear layer (ONL).
Sixty-three eyes were included. The volume of avascular SHRM showed persistent positive associations with the area of EZ damage, both at baseline, month-3, and change values (all P < 0.001). Poor BCVA (month-3) was associated with larger volumes of baseline IRF (β = 0.377, P < 0.001), avascular SHRM (β = 0.306, P = 0.032), and ELM impairment area (β = 0.301, P = 0.036) in multivariate model. EZ and ELM impairment were primarily associated with baseline avascular SHRM (β = 0.374, p = 0.003; β = 0.388, P < 0.001, respectively), while ONL impairment primarily associated with MNV (β = 0.475, P < 0.001).
The utilization of three-dimensional measurements elucidates the intrinsic connections among various lesions and functional outcomes. In particular, avascular SHRM plays an important role in prognosis of nAMD.
研究新生血管性年龄相关性黄斑变性（nAMD）患者眼部形态病变与功能指标的相关性。
这是一项针对未经治疗的 nAMD 患者的前瞻性观察研究。在三维光学相干断层扫描（OCT）和光相干断层扫描血管造影（OCTA）图像中，手动测量基线和第 3 个月各种形态病变和受损视网膜结构，包括黄斑新生血管（MNV）、无血管视网膜下高反射物质（avascular SHRM）、视网膜下液（SRF）、视网膜内液（IRF）、浆液性色素上皮脱离（sPED）和椭圆体带（EZ）、外部界膜（ELM）和外核层（ONL）的损伤面积（mm）。
纳入 63 只眼。无血管 SHRM 体积与 EZ 损伤面积在基线、第 3 个月及变化值均呈持续正相关（均 P<0.001）。较差的 BCVA（第 3 个月）与基线 IRF 体积较大（β=0.377，P<0.001）、无血管 SHRM 体积较大（β=0.306，P=0.032）和 ELM 损伤面积较大（β=0.301，P=0.036）相关。在多元模型中，EZ 和 ELM 损伤主要与基线无血管 SHRM 相关（β=0.374，P=0.003；β=0.388，P<0.001），而 ONL 损伤主要与 MNV 相关（β=0.475，P<0.001）。
三维测量的应用阐明了各种病变与功能结果之间的内在联系。特别是，无血管 SHRM 在 nAMD 的预后中起着重要作用。
