Effect of change in drusen evolution on photoreceptor inner segment/outer segment junction.
Effect of change in drusen evolution on photoreceptor inner segment/outer segment junction.
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DOI：
10.1097/iae.0b013e318242b949
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Freeman WR
中科院分区：
文献类型：
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作者：
Hartmann KI;Gomez ML;Bartsch DU;Schuster AK;Freeman WR
目的：应用光谱域光学相干断层扫描（SD-OCT）评价年龄相关性黄斑变性（AMD）玻璃疣大小改变后感光细胞内段/外段（IS/OS）连接的完整性。使用Spectralis SD-OCT（Heidelberg Engineering）对14只患有临床干性AMD的眼睛中的2624个玻璃疣进行玻璃疣体积光栅扫描，这些眼睛在23-28个月（平均26.3个月）之间进行了纵向随访，未进行干预。所有患眼均具有ETDRS视力。共分析了2624例玻璃疣中的416例。玻璃疣消退83例（20%），大小不变212例（51%），进展121例（29%）。玻璃疣平均大小为63.7 ± 25.7 μ m。玻璃疣形态的横断面分析显示玻璃疣大小与IS/OS连接/感光细胞完整性受损之间存在相关性（r=-0.48，p<0.001）。随着时间推移消退的玻璃疣中，IS/OS连接完整。即使是造成严重破坏的玻璃疣，74%的玻璃疣显示IS/OS恢复（p<0.001）。玻璃疣的进展显示IS/OS连接的结构破坏。在玻璃疣消退后，IS/OS连接能够随着玻璃疣消退而恢复，或者由于IS/OS连接线的初始玻璃疣压缩而被人为压缩并且最初不可见。因此，玻璃疣的演变可能在影响光感受器IS/OS-连接的完整性中起重要作用。
To evaluate the integrity of photoreceptor inner segment/outer segment (IS/OS) junction after change of drusen size in age-related macular degeneration (AMD) using spectral domain optical coherence tomography (SD-OCT). Drusen volume raster scans were performed with the Spectralis SD-OCT (Heidelberg Engineering) through 2624 drusen in 14 eyes with clinically dry AMD who had been longitudinally followed between 23–28 months without intervention (mean 26.3 months). All eyes had ETDRS visual acuity. A total of 416 out of 2624 drusen were analyzed. Of 416 drusen, 83 (20%) were found to have regressed spontaneously (group A), 212 (51%) showed no change in size (group B) and 121 (29%) progressed (group C), Mean drusen size of all drusen was 63.7 ± 25.7 microns. Cross-sectional analysis of drusen morphology showed a correlation between drusen size and disrupted IS/OS junction/photoreceptor integrity (r=−0.48, p<0.001). Of the drusen that regressed over time there was intact IS/OS junction integrity. Even drusen that caused a major disruption showed IS/OS restoration in 74% of the drusen (p<0.001). Progression of drusen shows structural disruption of the IS/OS-junction. After drusen regression the IS/OS-junction is either able to restore as drusen regress or was artifactitiously compressed and not initially visible due to the initial drusen compression of the IS/OS junctional line. Therefore drusen evolution may play an important role in affecting the photoreceptor IS/OS-junction integrity.