Progression of choriocapillaris flow deficits in clinically stable intermediate age-related macular degeneration
Progression of choriocapillaris flow deficits in clinically stable intermediate age-related macular degeneration
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DOI：
10.1038/s41433-020-01298-9
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发表时间：
2021-01-07
期刊：
影响因子：
3.9
通讯作者：
Sadda, Srinivas R.
中科院分区：
文献类型：
--
作者：
Tiosano, Liran;Corradetti, Giulia;Sadda, Srinivas R.
目的观察34例稳定期老年性黄斑变性（AMD）患者的脉络膜毛细血管（CC）血流缺损（FD）情况。两种模式均使用6 x 6 mm中心凹扫描，研究眼扫描两次，以便随后取平均值。输出正面OCTA CC板（RPE带以下31-41 μ m）并补偿信号衰减。在二值化和CC FD计算之前，对两个补偿的CC正面图像进行配准和平均。在基线和12个月时对整个6 x 6黄斑区的CC FD进行定量。采用SS-OCT容积scans.Results对34只眼中存在的高危特征，即视网膜内高反射灶（HRF）、视网膜下玻璃疣样沉积物（SDD）和低反射核心玻璃疣进行评估，其中25例患者的25只眼在12个月时在检查和OCT上保持稳定为中期AMD，而没有发展为晚期AMD。基线时有11只眼具有高风险特征，而随访结束时有14只眼具有高风险特征（p = 0.094）。基线时整个6 x 6黄斑区的平均+/- SD FD%为19.32 +/- 4.64%，研究结束时显着增加至28.62 +/- 4.71%（p = 0.001）。结论相对稳定的中度AMD患者脉络膜毛细血管血流损害在一年内明显恶化。这可能表明CC功能障碍的潜在进展发生在OCT上出现结构变化之前，并导致进展为晚期AMD。
Purpose To evaluate the choriocapillaris (CC) flow deficit (FD) in eyes with stable intermediate age-related macular degeneration (AMD) eyes over 12 months of follow-up.Methods Thirty four patients with intermediate AMD were prospectively enrolled and evaluated by swept-source optical coherence tomography (SS-OCT) and OCT-angiography (OCTA) using the PLEX-Elite 9000. A 6 x 6 mm foveal-centered scan was used for both modalities and the study eyes were scanned twice to allow subsequent averaging. En face OCTA CC slabs (31-41 mu m below the RPE-band) were exported and compensated for signal attenuation. Two compensated CC en-face images were registered and averaged prior to binarization and CC FD computation. The CC FD of the entire 6 x 6 macular region was quantified at baseline and at 12-months. The presence of high-risk features, namely intraretinal hyper-reflective foci (HRF), subretinal drusenoid deposits (SDD), and hyporeflective-core-drusen, were evaluated using SS-OCT volume scans.Results Among the 34 eyes, 25 eyes from 25 patients were noted on exam and OCT to remain stable as intermediate AMD at 12-months without the development of late AMD. Eleven eyes had high-risk features at baseline compared to 14 eyes at the end of the follow-up (p = 0.094). The mean +/- SD FD% across the whole 6 x 6 macular region at baseline was 19.32 +/- 4.64% and significantly increased to 28.62 +/- 4.71% at the end of the study (p = 0.001). The CC FD progressed significantly both in non-HR and HR-eyes.Conclusions Choriocapillaris flow impairment significantly deteriorated over one year in relatively stable intermediate AMD. This might suggest that underlying progression of CC dysfunction occurs before structural changes appears on OCT and lead to the progression to late-stage AMD.