Gurudas Sarega, Marques Inês, Girmens Jean-François, Lechanteur Yara, Parravano Maria Cristina, Berger Lieselotte, Agostini Hansjürgen, Barrão Sandra, Tsiroukis Evangelos, Monés Jordi, Sararols Laura, Silva Rufino, Scholl Hendrik, Lommatzsch Albrecht, Stanzel Boris, Vujosevic Stela, Sivaprasad Sobha
National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Centre for Clinical Trials, AIBILI / Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
Eye (Lond). 2025 Jul 19. doi: 10.1038/s41433-025-03895-y.
BACKGROUND/OBJECTIVES: To study the associations of VA and intermediate age-related macular degeneration (iAMD) subclassifications.
SUBJECTS/METHODS: This is the analysis of baseline data of a multicentre study on patients with iAMD in at least one eye. The subclassifications of iAMD were classified as: (i) iAMD with no evidence of incomplete retinal pigment epithelial and outer retinal atrophy (iRORA) or subretinal drusenoid deposits (SDD); (ii) iAMD with SDD with no iRORA; (iii) iAMD with iRORA with no SDD and (iv) iAMD with iRORA and SDD.
983 eyes from 805 patients with iAMD were analysed. The mean age was 75.8 years (SD 7.9), with 35.0% (282) male. Eyes with iRORA with SDD had lower VA relative to eyes with no iRORA and no SDD (OR = 0.98 [95% CI 0.96, 0.998]; P = 0.03). The VA in the better seeing eye was significantly higher than in the worse seeing eye. Increased age (sex adjusted OR, 1.07, 95% CI 1.05-1.09; P < 0.001) and female gender (age adjusted OR, 0.75, 95% CI 0.56-1.01; P = 0.057) were associated with SDD. Eyes with nAMD in the fellow eye had reduced odds of iRORA in the study eye (adjusted OR = 0.60, 95% CI 0.40-0.91; P = 0.015). Eyes with GA had increased odds of iRORA in the study eye (adjusted OR = 3.30, 95% CI 2.00-5.45; P < 0.001).
Baseline age, presence of SDD and/or iRORA and fellow eye status need to be considered in future clinical trials evaluating preventive or treatment options for iAMD.
背景/目的：研究视力（VA）与中度年龄相关性黄斑变性（iAMD）亚分类之间的关联。
受试者/方法：这是一项针对至少一只眼睛患有iAMD患者的多中心研究基线数据的分析。iAMD的亚分类被分为：（i）无视网膜色素上皮和外层视网膜萎缩不完全（iRORA）或视网膜下类玻璃膜疣沉积物（SDD）证据的iAMD；（ii）有SDD但无iRORA的iAMD；（iii）有iRORA但无SDD的iAMD；以及（iv）有iRORA和SDD的iAMD。
对805例iAMD患者的983只眼睛进行了分析。平均年龄为75.8岁（标准差7.9），男性占35.0%（282例）。与无iRORA和无SDD的眼睛相比，有iRORA和SDD的眼睛VA较低（比值比[OR]=0.98[95%置信区间0.96,0.998]；P=0.03）。视力较好眼睛的VA显著高于视力较差的眼睛。年龄增加（性别调整后的OR，1.07，95%置信区间1.05 - 1.09；P<0.001）和女性（年龄调整后的OR，0.75，95%置信区间0.56 - 1.01；P=0.057）与SDD相关。对侧眼患有新生血管性年龄相关性黄斑变性（nAMD）的眼睛，研究眼出现iRORA的几率降低（调整后的OR=0.60，95%置信区间0.40 - 0.91；P=0.015）。患有地图样萎缩（GA）的眼睛，研究眼出现iRORA的几率增加（调整后的OR=3.30，95%置信区间2.00 - 5.45；P<0.001）。
在未来评估iAMD预防或治疗方案的临床试验中，需要考虑基线年龄、SDD和/或iRORA的存在以及对侧眼状况。
