Development and Course of Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials.
Development and Course of Scars in the Comparison of Age-Related Macular Degeneration Treatments Trials.
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DOI：
10.1016/j.ophtha.2018.01.004
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发表时间：
2018-07
期刊：
影响因子：
13.7
通讯作者：
Comparison of Age-related Macular Degeneration Treatments Trials
中科院分区：
文献类型：
--
作者：
Daniel E;Pan W;Ying GS;Kim BJ;Grunwald JE;Ferris FL 3rd;Jaffe GJ;Toth CA;Martin DF;Fine SL;Maguire MG;Comparison of Age-related Macular Degeneration Treatments Trials
描述在黄斑变性治疗比较试验（CATT）中5年内瘢痕形成和纤维化瘢痕变化的风险因素。多中心、前瞻性队列研究。CATT中有1061例受试者。对基线和1、2、5年的彩色摄影和荧光素血管造影图像进行评价。采用Kaplan-Meier曲线估计瘢痕形成的发生率。用考克斯回归模型评估危险因素。瘢痕形成、纤维化瘢痕区域和与纤维化瘢痕相关的黄斑萎缩（“萎缩”）。在第1、2和5年，有瘢痕的眼睛的累积比例分别为32%、46%和56%。与风险增加相关的基线因素（调整的风险比（aHR）和95% CI）为经典CNV（aHR 4.49，95% CI 3.34，6.04）与隐匿性、出血> 1个椎间盘面积（2.28，95% CI 3.34，6.04）。1.49，3.47）vs无出血，视网膜厚度>212 μ m（2.58，95% C.I. 1.69，3.94）vs <120 um，视网膜下组织复合体厚度>275 um（2.64，95% CI 1.81，3.84）vs <= 75 um，视网膜下液厚度> 25 um（1.31，95% CI 0.97，1.75）vs无液体，对侧眼视力20/20（1.72，95% CI 1.25，2.36）vs 20/50或更差，RPE升高缺失（1.71，95% CI 1.21，2.41）和视网膜下高反射物质（1.72，95% CI 1.25，2.36）。在第1年出现纤维化瘢痕的68只眼中，在第1年至第5年之间，视力平均额外下降13个字母。第1、2和5年时的平均瘢痕面积分别为1.2、1.2和1.9个DA。在第1、2和5年，这些眼睛中有18%、24%和54%存在萎缩，平均面积分别为1.6、2.0和3.1 DA。术后5年8眼萎缩取代纤维化瘢痕。瘢痕生长与萎缩生长之间无显著相关性。在临床试验和观察期间，两者的生长速率相似。一些形态学特征，包括典型的CNV和大出血，与瘢痕形成有关。两年后新疤痕形成率下降。大多数纤维化瘢痕和伴随的黄斑萎缩随着时间的推移而扩大，降低视力。
To describe risk factors for scar formation and changes to fibrotic scar through five years in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Multicenter, prospective cohort study. 1061 subjects in CATT. Color photographic and fluorescein angiographic images from baseline and 1, 2, and 5 years were evaluated. Incidence of scar formation was estimated with Kaplan-Meier curves. Risk factors were assessed with Cox regression models. Scar formation, fibrotic scar area and macular atrophy associated with fibrotic scar (“atrophy”). Cumulative proportion of eyes with scar was 32%, 46% and 56% at year 1, 2 and 5, respectively. Baseline factors associated with increased risk (adjusted hazards ratio (aHR) and 95% CI) were classic CNV (aHR 4.49, 95% C.I 3.34, 6.04) vs occult, hemorrhage > 1 disc area (2.28, 95% C.I. 1.49, 3.47) vs no hemorrhage, retinal thickness >212 um (2.58, 95% C.I. 1.69, 3.94) vs <120 um, subretinal tissue complex thickness >275 um (2.64, 95% CI.1.81, 3.84) vs <=75um, subretinal fluid thickness >25um (1.31, 95% CI 0.97, 1.75) vs no fluid, visual acuity in fellow eye 20/20 (1.72, 95% CI 1.25, 2.36) vs 20/50 or worse, RPE elevation absence (1.71, 95% C.I 1.21, 2.41) and subretinal hyperreflective material (1.72, 95% CI 1.25, 2.36). Among 68 eyes that developed fibrotic scar at year 1, visual acuity decreased by a mean of additional 13 letters between year 1 and 5. Mean scar area was 1.2, 1.2 and 1.9 DAs at 1, 2 and 5 years, respectively. Atrophy was present in 18%, 24%, and 54% of these eyes at year 1, 2 and 5, mean areas being 1.6, 2.0 and 3.1 DAs, respectively. Atrophy replaced fibrotic scar in 8 eyes at year 5. There was no significant correlation between scar growth and atrophy growth. The rate of growth for both was similar between the clinical trial and observation periods. Several morphological features, including classic CNV and large hemorrhage, are associated with scar formation. Rate of new scar formation declined after two years. Most fibrotic scars and accompanying macular atrophy expanded over time, reducing visual acuity.
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影响因子：
4.6
作者：
Miura M;Makita S;Sugiyama S;Hong YJ;Yasuno Y;Elsner AE;Tamiya S;Tsukahara R;Iwasaki T;Goto H
通讯作者：
Goto H
影响因子：
158.5
作者：
Brown, David M.;Kaiser, Peter K.;Schneider, Susan
通讯作者：
Schneider, Susan
影响因子：
4.2
作者：
GLATT, H;MACHEMER, R
通讯作者：
MACHEMER, R
影响因子：
3.4
作者：
Munk, Marion R.;Ceklic, Lala;Zinkernagel, Martin S.
通讯作者：
Zinkernagel, Martin S.
影响因子：
13.7
作者：
Grunwald, Juan E.;Daniel, Ebenezer;Martin, Daniel F.
通讯作者：
Martin, Daniel F.