年龄相关性黄斑变性患者眼中网状假性玻璃膜疣面积的纵向评估
Longitudinal Assessment of Area of Reticular Pseudodrusen in Eyes with Age-Related Macular Degeneration.
作者信息
Velaga Swetha Bindu, Alagorie Ahmed Roshdy, Nittala Muneeswar Gupta, Moore Noel C, Song Yeunjoo E, Haines Jonathan, Pericak-Vance Margaret A, Stambolian Dwight, Hu Zhihong, He Ye, Sadda Srinivas R
机构信息
Doheny Eye Institute, University of California-Los Angeles, Los Angeles, California.
Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
出版信息
Ophthalmol Sci. 2025 Jul 7;5(6):100881. doi: 10.1016/j.xops.2025.100881. eCollection 2025 Nov-Dec.
PURPOSE
To evaluate the change in the area of reticular pseudodrusen (RPD) and choroidal thickness over 2 years in eyes with age-related macular degeneration (AMD).
DESIGN
Longitudinal cohort study.
SUBJECTS
The study reviewed 1332 eyes from 666 subjects with baseline and 2-year follow-up data, of which 108 eyes were graded to have RPD. Among these, 35 eyes from 22 participants (mean age: 72.8 ± 8.9 years; range: 50-84; 37% female) were eligible for this analysis because they had early or intermediate AMD with RPD at baseline, absence of geographic atrophy at 2 years, and images that were gradable for the presence of RPD.
METHODS
Infrared reflectance (IR), blue-light fundus autofluorescence, and spectral-domain OCT were obtained for all subjects at baseline and at 2 years. Using the instrument software, a certified grader delineated the RPD area (mm) on the IR image using the free hand tool. Choroidal thickness was measured for both baseline and month 24 using a previously described deep learning algorithm to compute a choroidal volume.
MAIN OUTCOME MEASURES
Changes in RPD area (mm) and mean volumetric choroidal thickness (μm) between baseline and 2 years.
RESULTS
The RPD area increased significantly ( < 0.001) by month 24 compared with baseline with a mean increase of 6.23 ± 4.64 mm. The mean volumetric choroidal thickness was not significantly different from baseline 182.2 ± 94.36 (134.20-227.90) to month 24 178.2 ± 41.10 (109-258).
CONCLUSIONS
In this longitudinal natural history analysis, we observed an increase in RPD area of >6 mm over 2 years in the absence of a significant change in choroidal thickness. Although AMD eyes with presence of RPD typically have a thinner choroid, the increase in extent of these lesions does not appear to be associated with further thinning of the choroid.
FINANCIAL DISCLOSURES
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的
评估年龄相关性黄斑变性（AMD）患者2年内视网膜下网状假性玻璃膜疣（RPD）面积和脉络膜厚度的变化。
设计
纵向队列研究。
研究对象
本研究回顾了666名受试者的1332只眼睛的基线数据和2年随访数据，其中108只眼睛被分级为有RPD。其中，22名参与者的35只眼睛（平均年龄：72.8±8.9岁；范围：50 - 84岁；37%为女性）符合本分析条件，因为他们在基线时患有伴有RPD的早期或中期AMD，2年时无地图样萎缩，且有可用于RPD分级的图像。
方法
在基线和2年时，对所有受试者进行红外反射（IR）、蓝光眼底自发荧光和光谱域光学相干断层扫描（OCT）检查。使用仪器软件，一名经过认证的分级人员使用徒手工具在IR图像上描绘RPD面积（mm）。使用先前描述的深度学习算法计算脉络膜体积，测量基线和第24个月时的脉络膜厚度。
主要观察指标
基线和2年之间RPD面积（mm）和平均脉络膜体积厚度（μm）的变化。
结果
与基线相比，到第24个月时RPD面积显著增加（<0.001），平均增加6.23±4.64 mm。平均脉络膜体积厚度从基线时的182.2±94.36（134.20 - 227.90）到第24个月时的178.2±41.10（109 - 258），与基线无显著差异。
结论
在这项纵向自然史分析中，我们观察到在脉络膜厚度无显著变化的情况下，2年内RPD面积增加超过6 mm。虽然存在RPD的AMD眼睛通常脉络膜较薄，但这些病变范围的增加似乎与脉络膜进一步变薄无关。
财务披露
专有或商业披露信息可在本文末尾的脚注和披露部分中找到。
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