Department of Ophthalmology, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, United States.
Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Invest Ophthalmol Vis Sci. 2024 Nov 4;65(13):39. doi: 10.1167/iovs.65.13.39.
To compare the choroidal vasculature in eyes with early- and intermediate-stage age-related macular degeneration (dAMD) and healthy using a novel three-dimensional algorithm.
Patients with dAMD and healthy controls underwent clinical examinations and swept-source optical coherence tomography scans (PlexElite-9000 device) centered on the fovea. Scans with quality scores >6 were included. Eyes with any signs of neovascular AMD or geographic atrophy were excluded. The choroidal layer was segmented using ResUNet model and volumetric smoothing. Phansalkar thresholding was used to binarize the choroidal vasculature. The three-dimensional maps were divided into five sectors. The three largest vessels in each sector were measured to determine the mean choroidal vessel diameter (MChVD) and inter-vessel distance (IVD). Volumetric choroidal thickness (ChT) and vascularity index (CVI) were also calculated.
This retrospective cross-sectional study analyzed 60 eyes from 45 dAMD patients (27 early-stage, 33 intermediate-stage) and 26 eyes from 16 healthy controls. The average MChVD was increased in dAMD eyes compared to healthy eyes (239.559 ± 47.058 µm vs. 197.873 ± 49.047 µm, P < 0.001). The average MChVD in each sector increased significantly in eyes with dAMD (P < 0.05). The average IVD was increased significantly in dAMD eyes compared to healthy eyes (234.128 ± 69.537 µm vs. 179.914 ± 49.995 µm, P < 0.001). The average IVD in each sector was significantly increased in eyes with dAMD (P < 0.05). Average ChT and CVI in dAMD were reduced compared to healthy eyes (P < 0.05).
Eyes with dAMD demonstrated increased MChVD and IVD and decreased ChT and CVI, possibly related to smaller-vessel atrophy and larger-vessel dilation.
使用一种新的三维算法比较早期和中期年龄相关性黄斑变性（AMD）及健康对照眼的脉络膜血管。
患有 dAMD 和健康对照者接受临床检查和基于黄斑的扫频源光学相干断层扫描（PlexElite-9000 设备）。纳入质量评分>6 的扫描。排除任何新生血管性 AMD 或地图样萎缩的迹象。使用 ResUNet 模型和容积平滑对脉络膜层进行分割。Phansalkar 阈值用于对脉络膜血管进行二值化。将三维图谱分为五个区域。测量每个区域的三条最大血管，以确定平均脉络膜血管直径（MChVD）和血管间距离（IVD）。还计算了脉络膜容积厚度（ChT）和血管指数（CVI）。
本回顾性横断面研究分析了 45 例 dAMD 患者（27 例早期，33 例中期）的 60 只眼和 16 例健康对照者的 26 只眼。与健康眼相比，dAMD 眼的平均 MChVD 增加（239.559±47.058 µm 比 197.873±49.047 µm，P<0.001）。dAMD 眼各区域的平均 MChVD 均显著增加（P<0.05）。与健康眼相比，dAMD 眼的平均 IVD 显著增加（234.128±69.537 µm 比 179.914±49.995 µm，P<0.001）。dAMD 眼各区域的平均 IVD 均显著增加（P<0.05）。与健康眼相比，dAMD 眼的平均 ChT 和 CVI 降低（P<0.05）。
dAMD 眼表现为 MChVD 和 IVD 增加，ChT 和 CVI 降低，可能与小血管萎缩和大血管扩张有关。
