Association between Foveal Photoreceptor Integrity and Visual Outcome in Neovascular Age-related Macular Degeneration
Association between Foveal Photoreceptor Integrity and Visual Outcome in Neovascular Age-related Macular Degeneration
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DOI：
10.1016/j.ajo.2009.01.017
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发表时间：
2009-07-01
影响因子：
4.2
通讯作者：
Yoshimura, Nagahisa
中科院分区：
文献类型：
--
作者：
Hayashi, Hisako;Yamashiro, Kenji;Yoshimura, Nagahisa
目的：评估成功治疗新生血管性年龄相关性黄斑变性 (AMD) 眼睛后视觉结果与中心凹感光器完整性之间的相关性。设计：回顾性图表审查。方法：我们回顾性研究了 51 名新生血管性 AMD 患者的 51 只眼睛的病历，这些患者均接受光动力疗法 (PDT) 成功治疗。所有眼睛在初次治疗后均进行了超过 24 个月的随访。使用谱域光学相干断层扫描，评估内节和外节 (IS/OS) 感光器连接的状态，作为中心凹感光器层完整性的标志。 结果：在最后一次就诊时，没有眼睛显示出渗出性变化。分别有 8 只 (15.7%) 和 25 只 (29.4%) 眼在中央凹下方检测到完整或不连续的 IS/OS 线，而 28 只 (54.9%) 眼没有 IS/OS 线。中央凹下方具有连续或不连续 IS/OS 线的眼睛比没有 IS/OS 线的眼睛具有更好的最终视力 (VA)（分别为 P < .001）。在 51 只眼睛中，36 只出现息肉样脉络膜血管病变 (PCV)，而 15 只被诊断为典型 AMD，无 PCV。 PCV 眼睛的视力结果明显更好 (P = .026)。大多数患有典型 AMD 的眼睛 (13/15; 86.7%) 在最后一次就诊时没有 IS/OS 线，而 36 只患有 PCV 的眼睛中只有 13 只 (36.1%) 在中央凹下方没有 IS/OS 线。结论：中央凹下方光感受器层的完整性与成功 PDT 后新生血管性 AMD 的最终 VA 相关。 （美国眼科杂志 2009 年；148:83-89。(C) 2009 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To evaluate the correlation between visual outcome and foveal photoreceptor integrity after successful treatment of eyes with neovascular age,related macular degeneration (AMD).DESIGN: Retrospective chart review.METHODS: We retrospectively studied the medical records of 51 eyes of 51 patients with neovascular AMD who were treated successfully with photodynamic therapy (PDT). All eyes were followed-up for more than 24 months after the initial treatment. Using spectral-domain optical coherence tomography, the status of the inner segment and outer segment (IS/OS) photoreceptor junction was assessed as a hallmark of the integrity of the foveal photoreceptor layer.RESULTS: At the final visit, no eyes showed an exudative change. A complete or discontinuous IS/OS line was detected beneath the fovea in 8 (15.7%) and 25 (29.4%) eyes, respectively, whereas 28 (54.9%) had no IS/OS line. Eyes with a continuous or discontinuous IS/OS line beneath the fovea had better final visual acuity (VA) than did eyes without an IS/OS line (P < .001, respectively). Of the 51 eyes, 36 showed polypoidal choroidal vasculopathy (PCV), whereas 15 were diagnosed as having typical AMD without PCV. Visual outcome was significantly better in eyes with PCV (P = .026). Most eyes (13/15; 86.7%) with typical AMD had no IS/OS line at the final visit, whereas only 13 (36.1%) of the 36 eyes with PCV had no IS/OS line beneath the fovea.CONCLUSIONS: Integrity of the photoreceptor layer beneath the fovea is associated with the final VA in neovascular AMD after successful PDT. (Am J Ophthalmol 2009;148:83-89. (C) 2009 by Elsevier Inc. All rights reserved.)