Pozzo Giuffrida Francesco, Nassisi Marco, de Sanctis Lorenzo, Milella Paolo, Malerba Alessia, Mapelli Chiara, Dell'Arti Laura, Casaluci Marco, Romano Francesco, Invernizzi Alessandro, Staurenghi Giovanni, Viola Francesco
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Ophthalmological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy ; and.
Retina. 2024 Dec 1;44(12):2049-2056. doi: 10.1097/IAE.0000000000004251. Epub 2024 Nov 12.
To determine the 10-year morphologic outcomes and identify potential risk factors of exudative age-related macular degeneration (AMD) in the fellow eyes (FEs) in patients with naive exudative AMD.
Data from 100 patients were retrospectively reviewed. Baseline macular neovascularization (MNV) type in the exudative AMD eye and presence of drusen, intraretinal hyperreflective foci, nonfoveal incomplete retinal pigment epithelium and outer retinal atrophy, central retinal thickness, and subfoveal choroidal thickness in the FEs were analyzed as biomarkers for progression in the second eye.
Fifty-four patients developed exudative AMD in the FE at the end of the follow-up. Subjects with Type 2 and Type 3 macular neovascularization in the exudative AMD eye had a higher risk of exudative AMD in the FE (hazard ratio [HR] = 3.365; P = 0.039 and HR = 3.801; P = 0.037). Fellow eyes with drusen (large HR = 6.938, P = 0.001; cuticular HR = 6.937, P < 0.0001; subretinal drusenoid deposits HR = 13.678, P < 0.0001) and intraretinal hyperreflective foci (HR = 1.853, P = 0.041) were also at higher risk. Seven patients were legally blind by the end of the follow-up.
The rate of exudative AMD in the FE was 54% 10 years after the diagnosis in the exudative eye. The FE of patients with Type 2 and Type 3 macular neovascularization was at high risk of early progression. Drusen and intraretinal hyperreflective foci were also significant risk factors for macular neovascularization development.
确定初发性渗出性年龄相关性黄斑变性（AMD）患者对侧眼（FE）的10年形态学转归，并识别潜在危险因素。
回顾性分析100例患者的数据。分析渗出性AMD眼的基线黄斑新生血管（MNV）类型以及FE中的玻璃膜疣、视网膜内高反射灶、非黄斑区视网膜色素上皮不完全性和外层视网膜萎缩、中心视网膜厚度及黄斑下脉络膜厚度，将其作为第二只眼病情进展的生物标志物。
随访结束时，54例患者的FE发生了渗出性AMD。渗出性AMD眼中为2型和3型黄斑新生血管的患者，其FE发生渗出性AMD的风险更高（风险比[HR]=3.365；P=0.039，HR=3.801；P=0.037）。有玻璃膜疣（大玻璃膜疣HR=6.938，P=0.001；微小玻璃膜疣HR=6.937，P<0.0001；视网膜下玻璃膜疣样沉积物HR=13.678，P<0.0001）和视网膜内高反射灶（HR=1.853，P=0.041）的FE也具有更高风险。随访结束时，7例患者法定失明。
渗出性眼诊断10年后，FE中渗出性AMD的发生率为54%。2型和3型黄斑新生血管患者的FE早期进展风险高。玻璃膜疣和视网膜内高反射灶也是黄斑新生血管形成的重要危险因素。
