Clinical Characteristics of Reticular Pseudodrusen in the Fellow Eye of Patients with Unilateral Neovascular Age-Related Macular Degeneration
Clinical Characteristics of Reticular Pseudodrusen in the Fellow Eye of Patients with Unilateral Neovascular Age-Related Macular Degeneration
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DOI：
10.1016/j.ophtha.2014.03.015
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发表时间：
2014-09-01
期刊：
影响因子：
13.7
通讯作者：
Chakravarthy, Usha
中科院分区：
文献类型：
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作者：
Hogg, Ruth E.;Silva, Rufino;Chakravarthy, Usha
目的：描述网状假性玻璃疣，个体特征，和视网膜function.Design之间的关联：队列研究参与者：我们招募了105例患者（年龄范围，52-93岁）谁有先进的新生血管年龄相关性黄斑变性（AMD）在只有1只眼睛从3个临床centers.Methods：最低随访12个月。选择用于研究的眼睛是没有晚期疾病的对侧眼睛。视力的临床指标是远视力、近视力和Smith-Kettlewell低亮度视力测试（SKILL）的结果。眼底成像包括彩色摄影、无红色成像、蓝色自体荧光成像、荧光素血管造影、吲哚菁绿色血管造影和使用标准化方案的光学相干断层扫描。这些用于检测随访期间研究眼中新生血管性AMD的进展。使用多模式方法对所有成像输出进行网状假性玻璃疣（RPD）存在或不存在的分级。脉络膜厚度测量中心凹中心和其他2个等距的位置，从中央凹（1500 μ m）鼻侧和颞侧。视网膜厚度和体积的指标是从制造商提供的自动分割读数中获得的。主要结果指标：RPD的存在、远视力、近视力、SKILL评分、脉络膜厚度、视网膜厚度和视网膜体积。结果：43名参与者（41%）通过1种或多种成像方法发现了网状假性玻璃疣。有网状玻璃疣的患者的SKILL评分（平均评分+/-标准差[SD，38 +/- 12]）显著低于无网状玻璃疣的患者（平均评分+/- SD，33 +/- 9）（P - 0.034）。网状玻璃疣患者的视网膜旁厚度、视网膜旁体积和所有脉络膜厚度参数均显著低于无网状玻璃疣患者。校正年龄和性别后，RPD的存在与新生血管性AMD的发生相关（比值比，5.5; 95%置信区间，1.1-28.8; P = 0.042）。所有参与者在地图状萎缩的发展过程中随访有明显的RPD在baseline.Conclusions：视网膜和脉络膜的解剖特征，视觉功能，和风险因素的显着差异存在于单侧新生血管性AMD患者与RPD相比，没有，因此，这些患者应密切监测，因为发展双边疾病的风险。(C)2014年由美国眼科学会。
Purpose: To describe associations between reticular pseudodrusen, individual characteristics, and retinal function.Design: Cohort study.Participants: We recruited 105 patients (age range, 52-93 years) who had advanced neovascular age-related macular degeneration (AMD) in only 1 eye from 3 clinical centers in Europe.Methods: Minimum follow-up was 12 months. The eye selected for study was the fellow eye without advanced disease. Clinical measures of vision were distance visual acuity, near visual acuity, and results of the Smith-Kettlewell low-luminance acuity test (SKILL). Fundus imaging included color photography, red-free imaging, blue autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and optical coherence tomography using standardized protocols. These were used to detect progression to neovascular AMD in the study eye during follow-up. All imaging outputs were graded for the presence or absence of reticular pseudodrusen (RPD) using a multimodal approach. Choroidal thickness was measured at the foveal center and at 2 other equidistant locations from the fovea (1500 mu m) nasally and temporally. Metrics on retinal thickness and volume were obtained from the manufacturer-supplied automated segmentation readouts.Main Outcome Measures: Presence of RPD, distance visual acuity, near visual acuity, SKILL score, choroidal thickness, retinal thickness, and retinal volume.Results: Reticular pseudodrusen was found in 43 participants (41%) on 1 or more imaging method. The SKILL score was significantly worse in those with reticular drusen (mean score +/- standard deviation [SD, 38 +/- 12) versus those without (mean score +/- SD, 33 +/- 9) (P - 0.034). Parafoveal retinal thickness, parafoveal retinal volume, and all of the choroidal thickness parameters measured were significantly lower in those with reticular drusen than in those without. The presence of RPD was associated with development of neovascular AMD when corrected for age and sex (odds ratio, 5.5; 95% confidence interval, 1.1-28.8; P = 0.042). All participants in whom geographic atrophy developed during follow-up had visible RPD at baseline.Conclusions: Significant differences in retinal and choroidal anatomic features, visual function, and risk factor profile exist in unilateral neovascular AMD patients with RPD compared with those without; therefore, such patients should be monitored carefully because of the risk of developing bilateral disease. (C) 2014 by the American Academy of Ophthalmology.