Choroidal Blood Flow and Progression of Age-Related Macular Degeneration in the Fellow Eye in Patients with Unilateral Choroidal Neovascularization
Choroidal Blood Flow and Progression of Age-Related Macular Degeneration in the Fellow Eye in Patients with Unilateral Choroidal Neovascularization
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DOI：
10.1167/iovs.09-4968
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发表时间：
2010-08-01
影响因子：
4.4
通讯作者：
Schmetterer, Leopold
中科院分区：
文献类型：
--
作者：
Boltz, Agnes;Luksch, Alexandra;Schmetterer, Leopold
目的.心血管危险因素如吸烟、高血压和动脉粥样硬化似乎在脉络膜新生血管（CNV）的发展中起重要作用。最近的研究也提供了证据，表明AMD患者的脉络膜和视网膜血流减少。基于这些结果，本研究假设AMD患者脉络膜血流量降低与CNV风险增加相关。41例单侧脉络膜新生血管性AMD患者被纳入这项观察性纵向研究。患者的对侧眼作为研究眼。分别用激光多普勒血流仪和激光干涉仪测量中心凹下脉络膜血流（FLOW）和眼底搏动幅度（FPA）。多变量COX回归模型用于检验低脉络膜灌注参数与CNV.EPTS.发展相关的假设。在随访至研究结束的37例患者中，17例发生CNV，20例未发生。单因素Cox回归分析显示，低流量、收缩压、眼压和FPA是CNV发生的危险因素。此外，研究眼的AMD越严重，对侧眼发生CNV的风险越高。多因素考克斯回归分析显示，只有FLOW（P = 0.0071）、FPA（P = 0.0068）和分期（P = 0.031）对CNV的进展有统计学意义。目前的研究表明，较低的脉络膜灌注是单侧CNV患者对侧眼CNV发展的危险因素。（Invest Ophthalmol维斯科学。2010; 51：4220-4225）DOI：10.1167/iovs.09-4968
PURPOSE. Cardiovascular risk factors such as smoking, hypertension, and atherosclerosis seem to play an important role in the development of choroidal neovascularization (CNV). Recent studies have also provided evidence suggesting that choroidal and retinal blood flow is decreased in patients with AMD. On the basis of these results, the hypothesis for this study was that lower choroidal blood flow is associated with an increased risk of CNV in patients with AMD.METHODS. Forty-one patients with unilateral choroidal neovascular AMD were included in this observational longitudinal study. The fellow eyes of the patients served as study eyes. Subfoveal choroidal blood flow (FLOW) and fundus pulsation amplitude (FPA) were assessed with laser Doppler flowmetry and laser interferometry, respectively. A multivariate COX-regression model was used to test the hypothesis that low choroidal perfusion parameters are associated with the development of CNV.RESULTS. Of the 37 patients that were followed up until the end of the study, 17 developed CNV and 20 did not. The univariate COX-regression analysis shows that lower FLOW, systolic blood pressure, intraocular pressure, and FPA are risk factors for development of CNV. Moreover, the more advanced the AMD in the study eye, the higher the risk for CNV to develop in the fellow eye. Multivariate COX regression analysis indicated that only FLOW (P = 0.0071), FPA (P = 0.0068), and staging (P = 0.031) had statistically significant influences on the progression to CNV.CONCLUSIONS. The present study indicates that lower choroidal perfusion is a risk factor for the development of CNV in the fellow eye of patients with unilateral CNV. (Invest Ophthalmol Vis Sci. 2010; 51: 4220-4225) DOI:10.1167/iovs.09-4968