Grunwald J E, Hariprasad S M, DuPont J, Maguire M G, Fine S L, Brucker A J, Maguire A M, Ho A C
Department of Ophthalmology, Scheie Eye Institute, School of Medicine, University of Pennsylvania, Philadelphia 19104, USA.
Invest Ophthalmol Vis Sci. 1998 Feb;39(2):385-90.
To compare measurements of the foveolar choroidal blood circulation in subjects with nonexudative, age-related macular degeneration (AMD) with those of control subjects.
Laser Doppler flowmetry was used to assess relative choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBFlow) in the center of the fovea. Measurements were obtained in 20 eyes of 20 subjects with 10 or more large drusen, visual acuity of 20/32 or better, and no evidence of choroidal neovascularization. Findings obtained in these subjects were compared with those of 10 eyes of 10 age- and blood pressure-matched control subjects with no large drusen. Foveolar choroidal blood flow measurements were obtained by asking the study participants to fixate on a probing laser beam.
No significant differences in average age, blood pressure, or intraocular pressure were observed between subjects with AMD and control subjects. In subjects with AMD, average ChBVol was 0.24 +/- 0.08 (+/- 1 SD) arbitrary units (AU); this value was 33% lower than that of control subjects (0.36 +/- 0.11 AU; two-tailed, independent Student's t-test, P = 0.005). Average ChBVel, conversely, was not significantly different from normal (0.44 +/- 0.07 AU) in subjects with AMD (0.44 +/- 0.10 AU). Average ChBFlow in subjects with AMD (8.7 +/- 3.1 AU) was 37% lower than that of control subjects (13.7 +/- 3.5 AU) (P = 0.0005). Average blood flow pulsatility was 6% higher in subjects with AMD (0.71 +/- 0.15) than in control subjects (0.66 +/- 0.14), but this difference was not statistically significant (P = 0.42).
Average ChBFlow in the nonexudative stages of AMD is lower than that of age-matched controls, and the effect is caused mainly by a decrease in ChBVol. Further studies are needed to elucidate whether decreased ChBFlow plays a role in the development of choroidal neovascularization, and whether ChBFlow measurements may help identify subjects with AMD at risk for developing choroidal neovascularization.
比较非渗出性年龄相关性黄斑变性（AMD）患者与对照者的黄斑小凹脉络膜血液循环测量值。
使用激光多普勒血流仪评估黄斑中心凹的相对脉络膜血流速度（ChBVel）、容积（ChBVol）和流量（ChBFlow）。对20例有10个或更多大玻璃膜疣、视力为20/32或更好且无脉络膜新生血管证据的受试者的20只眼睛进行测量。将这些受试者的测量结果与10例年龄和血压匹配且无大玻璃膜疣的对照受试者的10只眼睛的测量结果进行比较。通过要求研究参与者注视探测激光束来获得黄斑小凹脉络膜血流测量值。
AMD患者与对照者在平均年龄、血压或眼压方面未观察到显著差异。在AMD患者中，平均ChBVol为0.24±0.08（±1标准差）任意单位（AU）；该值比对照者（0.36±0.11 AU）低33%（双侧独立学生t检验，P = 0.005）。相反，AMD患者的平均ChBVel与正常者（0.44±0.07 AU）无显著差异（0.44±0.10 AU）。AMD患者的平均ChBFlow（8.7±3.1 AU）比对照者（13.7±3.5 AU）低37%（P = 0.0005）。AMD患者的平均血流搏动性（0.71±0.15）比对照者（0.66±0.14）高6%，但这种差异无统计学意义（P = 0.42）。
AMD非渗出期的平均ChBFlow低于年龄匹配的对照者，且这种影响主要由ChBVol降低引起。需要进一步研究以阐明ChBFlow降低是否在脉络膜新生血管形成中起作用，以及ChBFlow测量是否有助于识别有发生脉络膜新生血管风险的AMD患者。
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