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脉络膜视网膜下的类脂沉积与心血管疾病的相关性。

Association of subretinal drusenoid deposits and cardiovascular disease.

机构信息

Ophthalmology Department, Hadassah Medical Center, Jerusalem, Israel.

Data Research Unit, Hadassah Research Fund, Hadassah Medical Center, Jerusalem, Israel.

出版信息

Sci Rep. 2024 Oct 26;14(1):25569. doi: 10.1038/s41598-024-76342-9.

DOI:10.1038/s41598-024-76342-9
PMID:39462007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11513000/
Abstract

The presence of subretinal drusenoid deposits (SDDs) in patients with age-related macular degeneration (AMD) appears to be correlated with cardiovascular disease (CVD) and may serve as a useful tool for predicting certain forms of CVD. Here, we tested this hypothesis by examining whether patients with AMD with SDDs are more likely to have a cardiovascular-related condition and/or undergo a cardiovascular procedure. This is a retrospective cohort study. We included a total of 597 patients with AMD either with SDDs (n = 332) or without SDDs (n = 265). All patients underwent spectral-domain optical coherence tomography (SD-OCT). The SD-OCT scans were annotated by masked, experienced graders. We also extracted data from the patients' electronic medical records (EMRs), including patient demographics, cardiovascular diagnoses, and CVD-related procedures based on ICD-9 codes. AMD patients with SDDs were more likely to be diagnosed with CVD or undergo a cardiovascular procedure compared to AMD patients without SDDs, particularly percutaneous transluminal coronary angioplasty (PTCA; OR 2.73, 95% CI [1.21, 6.13], p = 0.02). Multivariate analysis confirmed the association between the presence of SDDs and a background of PTCA in the presence of other covariates. These data suggest that the presence of SDDs in patients with AMD correlates with certain severe cardiovascular conditions; SDDs and CVD may share common pathogenic pathways.

摘要

在年龄相关性黄斑变性 (AMD) 患者中存在视网膜下类脂沉积(SDD)似乎与心血管疾病(CVD)相关,并且可能作为预测某些类型 CVD 的有用工具。在这里,我们通过检查是否存在 SDD 的 AMD 患者更有可能患有与心血管相关的病症和/或接受心血管程序来检验这一假设。这是一项回顾性队列研究。我们共纳入了 597 名 AMD 患者,其中 332 名患者存在 SDD,265 名患者不存在 SDD。所有患者均接受了频域光相干断层扫描(SD-OCT)检查。SD-OCT 扫描由经过培训的、经验丰富的阅片员进行注释。我们还从患者的电子病历(EMR)中提取了数据,包括患者的人口统计学数据、心血管诊断和基于 ICD-9 代码的 CVD 相关程序。与不存在 SDD 的 AMD 患者相比,存在 SDD 的 AMD 患者更有可能被诊断为 CVD 或接受心血管程序,尤其是经皮腔内冠状动脉血管成形术(PTCA;OR 2.73,95%CI[1.21,6.13],p=0.02)。多变量分析证实了在存在其他混杂因素的情况下,SDD 的存在与 PTCA 背景之间的关联。这些数据表明,AMD 患者中 SDD 的存在与某些严重的心血管疾病相关;SDD 和 CVD 可能具有共同的发病途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/68a5754bcc3b/41598_2024_76342_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/74b1b63d5ccb/41598_2024_76342_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/e85951f15cf7/41598_2024_76342_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/68a5754bcc3b/41598_2024_76342_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/74b1b63d5ccb/41598_2024_76342_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/e85951f15cf7/41598_2024_76342_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c00/11513000/68a5754bcc3b/41598_2024_76342_Fig3_HTML.jpg

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本文引用的文献

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Diagnostics (Basel). 2022 Dec 26;13(1):68. doi: 10.3390/diagnostics13010068.
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Risk Factors for Progression of Age-Related Macular Degeneration: Population-Based Amish Eye Study.年龄相关性黄斑变性进展的危险因素:基于人群的阿米什人眼部研究。
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Subretinal drusenoid deposits: An update.视网膜下类玻璃膜疣沉积物:最新进展
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Retinal vessel diameters and function in cardiovascular risk and disease.视网膜血管直径与心血管风险和疾病。
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SUBRETINAL DRUSENOID DEPOSITS AND SOFT DRUSEN: Are They Markers for Distinct Retinal Diseases?视网膜下硬性脂滴沉积和软性脂滴:它们是不同视网膜疾病的标志物吗?
Retina. 2022 Jul 1;42(7):1311-1318. doi: 10.1097/IAE.0000000000003460.
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Hyporeflective Cores within Drusen: Association with Progression of Age-Related Macular Degeneration and Impact on Visual Sensitivity.玻璃膜疣内低反射核心:与年龄相关性黄斑变性进展的相关性及其对视敏度的影响。
Ophthalmol Retina. 2022 Apr;6(4):284-290. doi: 10.1016/j.oret.2021.11.004. Epub 2021 Dec 3.
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OCT Biomarkers in Neovascular Age-Related Macular Degeneration: A Narrative Review.新生血管性年龄相关性黄斑变性中的光学相干断层扫描生物标志物:一项叙述性综述。
J Ophthalmol. 2021 Jul 17;2021:9994098. doi: 10.1155/2021/9994098. eCollection 2021.
8
SUBRETINAL DRUSENOID DEPOSIT IN AGE-RELATED MACULAR DEGENERATION: Histologic Insights Into Initiation, Progression to Atrophy, and Imaging.年龄相关性黄斑变性的视网膜下硬性脂褐质沉积:发病机制、向萎缩进展及影像学研究的组织学观察。
Retina. 2020 Apr;40(4):618-631. doi: 10.1097/IAE.0000000000002657.
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A Random Forest classifier-based approach in the detection of abnormalities in the retina.基于随机森林分类器的视网膜异常检测方法。
Med Biol Eng Comput. 2019 Jan;57(1):193-203. doi: 10.1007/s11517-018-1878-0. Epub 2018 Aug 4.
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