Fundus autofluorescence and retinal sensitivity in fellow eyes of age-related macular degeneration in Japan
Fundus autofluorescence and retinal sensitivity in fellow eyes of age-related macular degeneration in Japan
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DOI：
10.1371/journal.pone.0213161
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发表时间：
2019-02
期刊：
影响因子：
3.7
通讯作者：
T. Yasukawa;R. Mori;M. Sawa;Ari Shinojima;Chikako Hara;T. Sekiryu;Y. Oshima;M. Saito;Yukinori Sugano;A. Kato;M. Ashikari;Yoshio Hirano;Hitomi Asato;Mayumi Nakamura;K. Matsuno;N. Kuno;Erika Kimura;T. Nishiyama;M. Yuzawa;T. Ishibashi;Y. Ogura;T. Iida;F. Gomi
中科院分区：
文献类型：
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作者：
T. Yasukawa;R. Mori;M. Sawa;Ari Shinojima;Chikako Hara;T. Sekiryu;Y. Oshima;M. Saito;Yukinori Sugano;A. Kato;M. Ashikari;Yoshio Hirano;Hitomi Asato;Mayumi Nakamura;K. Matsuno;N. Kuno;Erika Kimura;T. Nishiyama;M. Yuzawa;T. Ishibashi;Y. Ogura;T. Iida;F. Gomi
目的 异常眼底自发荧光 (FAF) 可能先于白种人患者晚期年龄相关性黄斑变性 (AMD) 的发生。亚洲人和白人患者在 AMD 类型和严重程度、性别和遗传背景方面存在许多差异。我们调查了日本单侧新生血管性 AMD 患者对侧眼异常 FAF 和视网膜敏感性的特征。方法 66 例单侧新生血管性 AMD 和对侧眼 FAF 异常的患者被纳入这项多中心、前瞻性、观察性研究。为期 12 个月定期测量最佳矫正视力、眼底照片、FAF 图像和显微视野检查的视网膜敏感性。根据国际眼底自发荧光分类组，FAF 图像被分为八种模式。将显微视野测量的点叠加到 FAF 图像和眼底照片上，并根据与异常 FAF 的距离和其他发现将其分为“内部”、“接近”和“远处”。研究了基线异常 FAF 的位置与视网膜敏感性之间的关系。结果 在日本患者中，异常 FAF 中以斑片状 (33.3%) 和局灶性增大 (30.3%) 模式为主。中到大玻璃膜疣主要与高荧光和低荧光相关。 6只眼（9.1%）在1年内出现新生血管性AMD，其平均基线视网膜敏感度为12.8 ± 4.7 dB，显着（p<0.002）低于其他眼。其他 60 只眼睛中的 44 只在基线和第 12 个月时可测量微视野检查，平均视网膜敏感度从 13.5 ± 4.4 显着改善至 13.9 ± 4.8 dB (p<0.001)，这可能与生活方式的改变（例如戒烟、抗氧化剂和补充锌）有关。异常FAF内和附近点的平均视网膜敏感度分别为9.9和11.7 dB，显着低于远离异常FAF的点的14.0 dB。结论 在日本患者中，FAF 异常以斑片状和局灶性增加模式为主。异常 FAF 附近/内部的视网膜敏感性较低。 FAF 和微视野检查可用于在新生血管性 AMD 或地图样萎缩发生之前评估黄斑功能。
Purpose Abnormal fundus autofluorescence (FAF) potentially precedes onset of late age-related macular degeneration (AMD) in Caucasian patients. Many differences exist between Asian and Caucasian patients regarding AMD types and severity, gender, and genetic backgrounds. We investigated the characteristics of abnormal FAF and retinal sensitivity in the fellow eyes of Japanese patients with unilateral neovascular AMD. Methods Sixty-six patients with unilateral neovascular AMD and abnormal FAF in the fellow eye were enrolled in this multicenter, prospective, observational study. The best-corrected visual acuity, fundus photographs, FAF images, and retinal sensitivity on microperimetry were measured periodically for 12 months. The FAF images were classified into eight patterns based on the International Fundus Autofluorescence Classification Group. The points measured by microperimetry were superimposed onto the FAF images and fundus photographs and classified as “within,” “close,” and “distant,” based on the distance from the abnormal FAF and other findings. The relationship between the location of the baseline abnormal FAF and retinal sensitivity was investigated. Results In Japanese patients, patchy (33.3%) and focally increased (30.3%) patterns predominated in the abnormal FAF. Intermediate-to-large drusen was associated predominantly with hyperfluorescence and hypofluorescence. Neovascular AMD developed within 1 year in six (9.1%) eyes, the mean baseline retinal sensitivity of which was 12.8 ± 4.7 dB, significantly (p<0.002) lower than the other eyes. In 44 of the other 60 eyes, microperimetry was measurable at baseline and month 12 and the mean retinal sensitivity improved significantly from 13.5 ± 4.4 to 13.9 ± 4.8 dB (p<0.001), possibly associated with lifestyle changes (e.g., smoking cessation, antioxidant and zinc supplementation). The mean retinal sensitivities of points within and close to the abnormal FAF were 9.9 and 11.7 dB, respectively, which were significantly lower than the 14.0 dB of the points distant from the abnormal FAF. Conclusion In Japanese patients, patchy and focally increased patterns predominated in the abnormal FAF. The retinal sensitivity was lower close to/within the abnormal FAF. FAF and microperimetry are useful to assess macular function before development of neovascular AMD or geographic atrophy.