CHORIOCAPILLARIS FLOW DEFICITS AS A RISK FACTOR FOR PROGRESSION OF AGE-RELATED MACULAR DEGENERATION
CHORIOCAPILLARIS FLOW DEFICITS AS A RISK FACTOR FOR PROGRESSION OF AGE-RELATED MACULAR DEGENERATION
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DOI：
10.1097/iae.0000000000002990
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发表时间：
2021-04-01
影响因子：
3.3
通讯作者：
Sadda, Srinivas R.
中科院分区：
文献类型：
--
作者：
Corvi, Federico;Tiosano, Liran;Sadda, Srinivas R.
目的：评价脉络膜毛细血管（CC）血流缺损和结构性光学相干断层扫描生物标志物与中度年龄相关性黄斑变性（iAMD）进展为完全视网膜色素上皮和外视网膜萎缩之间的相关性。方法：回顾性分析连续iAMD患者，至少随访12个月。通过logistic回归分析，估计基线和随访月时视网膜内高反射病灶、低反射玻璃疣核心、视网膜下玻璃疣样沉积物、中心3 mm圆内玻璃疣体积≥ 0.03 mm（3）、对侧眼AMD晚期和CC血流缺损的比值比。结果：112眼iAMD患者均获得随访。进展的眼睛更可能显示视网膜内高反射灶、低反射玻璃疣核心和玻璃疣体积>= 0.03 mm（3）。CC流量赤字也显着更大的眼睛，发展完全视网膜色素上皮和外部视网膜萎缩。视网膜内高反射病灶、低反射玻璃疣核心、玻璃疣体积≥ 0.03 mm（3）和较高CC血流缺损与完全视网膜色素上皮和外部视网膜萎缩的发展显著且独立相关。结论：CC血流缺损在进展为完全视网膜色素上皮和外视网膜萎缩的iAMD眼中显著更大，并且在考虑结构光学相干断层扫描生物标志物时仍然是独立的风险因素。CC血流缺损可能有助于加强iAMD患者的风险分层和诊断。
Purpose: To evaluate the association between choriocapillaris (CC) flow deficits and structural optical coherence tomography biomarkers and the progression of intermediate age-related macular degeneration (iAMD) to complete retinal pigment epithelial and outer retinal atrophy. Methods: Retrospective analysis of consecutive patients with iAMD with a minimum follow-up of 12 months. Odds ratios of intraretinal hyperreflective foci, hyporeflective drusen cores, subretinal drusenoid deposits, the presence of drusen volume >= 0.03 mm(3) within a central 3-mm circle, fellow eye with late stage of AMD, and CC flow deficits at baseline and months of follow-up were estimated from logistic regression. Results: A total of 112 eyes with iAMD were included. Eyes that progressed were significantly more likely to show intraretinal hyperreflective foci, hyporeflective drusen cores, and drusen volume >= 0.03 mm(3). The CC flow deficit was also significantly greater in eyes that developed complete retinal pigment epithelial and outer retinal atrophy. Intraretinal hyperreflective foci, hyporeflective drusen cores, drusen volume >= 0.03 mm(3), and higher CC flow deficits were significantly and independently associated with the development of complete retinal pigment epithelial and outer retinal atrophy. Conclusion: The CC flow deficit was significantly greater in iAMD eyes that progressed to complete retinal pigment epithelial and outer retinal atrophy and remained an independent risk factor when structural optical coherence tomography biomarkers were considered. CC flow deficits may be useful for enhancing risk stratification and prognostication of patients with iAMD.