Modelling the natural history of geographic atrophy in patients with age-related macular degeneration
Modelling the natural history of geographic atrophy in patients with age-related macular degeneration
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DOI：
10.1080/09286580591005723
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发表时间：
2005-12-01
影响因子：
1.8
通讯作者：
Holz, FG
中科院分区：
文献类型：
--
作者：
Dreyhaupt, J;Mansmann, U;Holz, FG
目的：模拟年龄相关性黄斑变性（AMD）患者地图样萎缩（GA）的自然病程。方法：采用多中心、纵向、前瞻性、观察性FAM研究，收集GA的自然病程数据。用自体荧光扫描激光检眼镜测量GA的大小。遗传算法的自然过程是由两个不同的混合效应模型（MEM）。这两种模型进行比较的模型假设的正确性，拟合优度和预测行为。结果：线性模型预测效果较好，非线性模型更符合模型假设。非线性模型更好地拟合GA的小区域和大区域的数据，而线性模型似乎更适合内侧区域。需要更多的数据来更详细地研究这两种模式的相互作用。结论：GA的自然病程在个体之间差异很大。然而，迄今为止尚未确定解释这种变异性的可靠因素。MEM可用于描述“个体间”和“个体内”影响，而无需精确了解影响因素。使用MEM评估GA自然史的数据，可以得到参数估计值，这些参数估计值可用于设计干预性试验，用于可能减少或阻止AMD患者GA进展的治疗模式。
Purpose: To model the natural course of geographic atrophy (GA) in patients with age-related macular degeneration (AMD). Methods: Data on the natural course of GA were collected in the multi-center, longitudinal, prospective observational FAM study. The size of GA was measured by autofluorescence scanning laser ophthalmoscopy. The natural course of GA is modelled by two different mixed effect models (MEM). Both models are compared with respect to the correctness of the model assumptions, goodness of fit, and predictive behavior. Results: The linear model results in better prediction, the non-linear model is more in agreement with the model assumptions. The non-linear model fits the data for small and large areas of GA better, while the linear model seems to be more adequate for the medial areas. More data will be needed to study the interplay of both models in more detail. Conclusions: The natural course of GA varies extremely between individuals. However, reliable factors for the explanation of this variability have so far not been established. MEM are useful for describing "Inter-individual" as well as "Intra-individual" influences without the need for precise knowledge of the influencing factors. Using MEM to evaluate data on the natural history of GA allows one to derive parameter estimates, which could be used to design interventional trials for modes of therapy with a potential to reduce or stop the progression of GA in patients with AMD.