The association between drusen extent and foveolar choroidal blood flow in age-related macular degeneration.
The association between drusen extent and foveolar choroidal blood flow in age-related macular degeneration.
复制标题
DOI：
10.1097/iae.0b013e3182150483
复制
发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Grunwald JE
中科院分区：
文献类型：
--
作者：
Berenberg TL;Metelitsina TI;Madow B;Dai Y;Ying GS;Dupont JC;Grunwald L;Brucker AJ;Grunwald JE
探讨非渗出性黄斑变性（AMD）病变程度与小凹脉络膜血流的关系。使用计算机程序确定总结节面积、平均结节面积和总结节数，该程序用于量化157例（239只眼）非渗出性AMD患者眼底照片中人工勾画的结节范围。采用激光多普勒血流仪测定中央窝中心脉络膜相对血流速度（ChBVel）、体积（ChBVol）和血流（ChBFlow）。我们发现总风洞面积与ChBVol或ChBFlow呈显著的反比关系。总靶面积每增加1 mm2， ChBVol减少0.0061任意单位（AU, p=0.03）， ChBFlow减少0.23任意单位（p=0.049）。平均用药面积与ChBVol和ChBFlow呈显著负相关。平均直径每增加0.01 mm2， ChBVol降低0.0149 AU (p=0.001)， ChBFlow降低0.4951 AU （p=0.003）。年龄调整削弱了其显著性，尽管平均用药面积相对于ChBFlow （p=0.017）和ChBVol （p=0.004）仍然很强。在本研究中使用的计算机辅助量化显示了高度的年级内和年级间的一致性。在非渗出性AMD患者中，水肿程度增加与ChBVol和ChBFlow降低之间存在关联。这提示了缺血的存在，可能是高危患者易发展为晚期疾病的原因。
To investigate the relationship between drusen extent and foveolar choroidal blood flow in non-exudative AMD. Total drusen area, average druse area, and total drusen number were determined using a computer program developed to quantify the extent of manually outlined drusen from fundus photographs of 157 patients (239 eyes) with non-exudative AMD. Laser Doppler flowmetry was used to assess relative choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBFlow) in the center of the fovea. We found a significant inverse relationship between total drusen area and ChBVol or ChBFlow. For every 1 mm2 increase in total drusen area, ChBVol decreased by 0.0061 arbitrary units (AU; p=0.03) and ChBFlow decreased by 0.23 AU (p=0.049). Average druse area was also significantly inversely related to ChBVol and ChBFlow. For every 0.01 mm2 increase in average druse area, the ChBVol decreased by 0.0149 AU (p=0.001) and the ChBFlow decreased by 0.4951 AU (p=0.003). Adjustment for age weakened the significance, though it remained strong for average druse area versus ChBFlow (p=0.017) and ChBVol (p=0.004). The computer-aided quantification of drusen used in this study showed high intra- and inter-grader agreement. In patients with non-exudative AMD, there is an association between increased drusen extent and decreased ChBVol and ChBFlow. This suggests the presence of ischemia and possibly the reason why patients with high risk drusen are prone to advanced disease.