Reticular Pseudodrusen and Their Association with Age-Related Macular Degeneration
Reticular Pseudodrusen and Their Association with Age-Related Macular Degeneration
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DOI：
10.1016/j.ophtha.2015.10.029
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发表时间：
2016-03-01
期刊：
影响因子：
13.7
通讯作者：
Guymer, Robyn H.
中科院分区：
文献类型：
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作者：
Finger, Robert P.;Chong, Elaine;Guymer, Robyn H.
目的：在大样本中确定网状假性玻璃疣（RPD）的患病率及其与年龄相关性黄斑变性（AMD）和AMD危险因素的关系。设计：在澳大利亚维多利亚的墨尔本进行的基于社区的队列研究。参与者：2003年至2007年随访时，共有21130名年龄在48至86岁之间的参与者可用于眼科评估。在基线和随访时获得生活方式、饮食和人体测量数据。在随访时，数字黄斑彩色照片被分为早期，中期和晚期AMD以及RPD的存在。数据进行了分析，使用多项逻辑回归控制年龄，性别，吸烟，出生国，和diet.Main结果措施：检测RPD的基础上彩色眼底photosynthesis.Results：RPD的患病率为0.41%（87 21 130参与者），51%有双边RPD。与大玻璃疣患者相比，RPD患者年龄更大（> 125 μ m; 76 +/- 4 vs. 68 +/- 9岁; P < 0.001）。年龄增加、女性、吸烟者、局灶性色素异常和大玻璃疣（> 125 mm）与RPD的患病率较高相关。地图状萎缩（GA）的存在与RPD的最高几率相关（比值比[OR]，153; 95%置信区间[CI]，53-442），其次为脉络膜新生血管（CNV; OR，90; 95%CI，26-310）、中期AMD（OR，33; 95%CI，14-77）和早期AMD（OR，12; 95%CI，5-31）。ARMS 2单核苷酸多态性（SNP）rs 10490924、HTRA 1 SNP rs 11200638和rs3793917以及CFH SNP rs393955、rs 1061170和rs 2274700与RPD患病率增加相关（均P < 0.05）。网状假性玻璃疣与AMD高度并发，并且与已知的AMD风险因素如年龄、性别、吸烟、和遗传风险因素。网状假性玻璃疣与GA的相关性比与CNV的相关性更强。虽然RPD不是AMD特有的，但它们可能是进展为晚期AMD的强风险因素，类似于局灶性色素异常和大玻璃疣。(C)2016年美国眼科学会。
Purpose: To determine the prevalence of reticular pseudodrusen (RPD) and its association with age-related macular degeneration (AMD) and AMD risk factors in a large sample.Design: Community-based cohort study in Melbourne, Victoria, Australia.Participants: A total of 21 130 participants 48 to 86 years of age available for ophthalmic assessment at follow-up from 2003 through 2007.Methods: Lifestyle, diet, and anthropometric measurements were obtained at baseline and follow-up. At follow-up, digital macular color photographs were graded for early, intermediate, and late AMD as well as the presence of RPD. Data were analyzed using multinomial logistic regression controlling for age, gender, smoking, country of birth, and diet.Main Outcome Measures: Detection of RPD based on color fundus photographs.Results: Prevalence of RPD was 0.41% (87 of 21 130 participants), with 51% having bilateral RPD. Patients with RPD were older compared with patients with large drusen (> 125 mu m; 76 +/- 4 vs. 68 +/- 9 years; P < 0.001). Increasing age, female gender, being a current smoker, as well as focal pigmentary abnormalities and large drusen (> 125 mm) were associated with a higher prevalence of RPD. Presence of geographic atrophy (GA) was associated with the highest odds of having RPD (odds ratio [OR], 153; 95% confidence interval [CI], 53-442), followed by choroidal neovascularization (CNV; OR, 90; 95% CI, 26-310), intermediate AMD (OR, 33; 95% CI, 14-77), and early AMD (OR, 12; 95% CI, 5-31) compared with those with no AMD. The ARMS2 single nucleotide polymorphism (SNP) rs10490924, HTRA1 SNPs rs11200638 and rs3793917, and CFH SNPs rs393955, rs1061170, and rs2274700 were associated with increased prevalence of RPD (all P < 0.05).Conclusions: Reticular pseudodrusen are highly concurrent with AMD and have similar associations with known AMD risk factors such as age, gender, smoking, and genetic risk factors. Reticular pseudodrusen are associated more strongly with GA than with CNV. Although RPD are not specific to AMD, they are likely to be a strong risk factor for progression to late-stage AMD, similar to focal pigmentary abnormalities and large drusen. (C) 2016 by the American Academy of Ophthalmology.