Background Comparison of Typical Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Japanese Patients
Background Comparison of Typical Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy in Japanese Patients
复制标题
DOI：
10.1016/j.ophtha.2009.06.013
复制
发表时间：
2009-12-01
期刊：
影响因子：
13.7
通讯作者：
Yanagi, Yasuo
中科院分区：
文献类型：
--
作者：
Ueta, Takashi;Obata, Ryo;Yanagi, Yasuo
目的：比较日本人群中渗出性年龄相关性黄斑变性(AMD)最主要的两种亚型：典型AMD和息肉状脉络膜血管病变(PCV)的背景因素。设计：横断面比较。参与者：连续的典型AMD患者(n=89)和PCV患者(n=138)进行初步调查。在第二次调查中，参与者的数量扩大到包括148名典型的AMD患者和170名PCV患者。所有纳入本研究的患者均在东京大学医院黄斑门诊接受了随访。方法：主要通过访谈获得性别、年龄、体重指数、吸烟、饮酒、高血压、糖尿病、高脂血症、缺血性心脏病、中风、强光暴露、中心性浆液性脉络膜视网膜病变(CSC)、白内障手术、青光眼和类固醇使用史的背景资料。采访者被掩盖了AMD的亚型诊断。采用单因素和多因素Logistic回归分析来确定典型AMD和PCV在背景因素上的差异。在二次调查中，进一步证实了CSC和PCV病史的相关性，并调查了眼底镜下萎缩的视网膜色素上皮(RIDE)和局灶性光凝瘢痕可提示CSC病史。主要观察指标：典型AMD或PCV患者背景因素的频率和平均值。结果：两组患者的背景相似，但他们的DM和CSC病史不同。糖尿病病史在典型的AMD中更常见(24.7%比13.0%在第一次调查中；P=0.027)，而CSC病史在PCV中更常见(3.4%比14.7%在第二次调查中；P=0.0005)。眼底镜下可见视网膜色素上皮束萎缩或局限性光凝性瘢痕(0.7%vs.7.6%；P=0.002)。结论：典型黄斑变性和视网膜色素变性的背景因素相似，但不完全相同。糖尿病病史和CSC病史分别在典型的AMD和PCV中更为常见。
Objective: To compare background factors of the 2 most dominant subtypes of exudative age-related macular degeneration (AMD) in the Japanese population: typical AMD and polypoidal choroidal vasculopathy (PCV).Design: Cross-sectional comparison.Participants: Consecutive patients with typical AMD (n = 89) and PCV (n = 138) for the primary survey. For the secondary survey, the number of participants was extended to include 148 typical AMD and 170 PCV patients. All the patients included in the present study had been followed up at The University of Tokyo Hospital outpatient macular clinic.Methods: Background data on gender; age; body mass index; smoking; alcohol consumption; and histories of hypertension, diabetes mellitus (DM), hyperlipidemia, ischemic heart disease, stroke, intensive light exposure, central serous chorioretinopathy (CSC), cataract surgery, glaucoma, and steroid use were obtained mainly through interview. The interviewers were masked to the subtype diagnosis of AMD. Univariate and multivariate logistic regression analyses were performed to identify differences in the background factors between typical AMD and PCV. In the secondary survey, the association of a history of CSC and PCV was confirmed further, and funduscopic findings of an atrophic retinal pigment epithelial (RIDE) tract and focal photocoagulation scars that could indicate a history of CSC were investigated.Main Outcome Measures: Frequency and mean of background factors inpatients with typical AMD or PCV.Results: The 2 groups showed similar backgrounds with the exception of their histories of DM and CSC. A history of DM was more frequent in typical AMD (24.7% vs. 13.0% in the primary survey; P = 0.027), whereas a history of CSC was more prevalent in PCV (3.4% vs. 14.7% in the secondary survey; P = 0.0005). Funduscopic findings of an atrophic RPE tract or focal photocoagulation scars were found more frequently in PCV (0.7% vs. 7.6%; P = 0.002).Conclusions: Background factors of typical AMD and PCV are similar but not identical. A history of DM and CSC are more frequent in typical AMD and PCV, respectively.