Optical coherence tomography-based observation of the natural history of drusenoid lesion in eyes with dry age-related macular degeneration.
Optical coherence tomography-based observation of the natural history of drusenoid lesion in eyes with dry age-related macular degeneration.
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DOI：
10.1016/j.ophtha.2013.05.029
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发表时间：
2013-12
期刊：
影响因子：
13.7
通讯作者：
Sadda SR
中科院分区：
文献类型：
--
作者：
Ouyang Y;Heussen FM;Hariri A;Keane PA;Sadda SR
使用光谱域光学相干断层扫描（SD-OCT）研究预测非血管性年龄相关性黄斑变性（NNVAMD）眼睛中类鼓膜病变（类鼓膜和类鼓膜色素上皮脱离）萎缩发展的危险因素。队列研究。来自29名NNVAMD患者的41只眼睛。研究回顾了在至少6个月的时间内接受SD-OCT成像的NNVAMD患者。进一步分析6个月或最后一次随访时伴有新萎缩的类槌状瘤样病变。在整个研究期间详细描述了病变变化。计算新的局部萎缩发病的优势比（OR）和风险。结节样病变特征及纵向变化特征包括最大病变高度、病变直径、病变内反射率、上覆视网膜内高反射特征（HRF）的存在及程度。中央凹下脉络膜厚度和每个病变下的脉络膜厚度。基线时发现543个个体结节样病变，随访期间发现28个病变。平均随访时间21.3±8.6（范围6-44）个月。3.2%（18/571）的结节样病变在首次就诊的18.3±9.5（范围：5-28）个月内进展为萎缩。具有异质内反射率的类德鲁斯瘤病变与6个月时新发萎缩（OR=5.614, 95%可信区间(CI) = 1.777 ~ 24.673）和最后随访时新发萎缩（OR=7.005， CI=2.300 ~ 21.337）显著相关。HRF存在的病变也是6个月时新萎缩发生的重要预测因素（OR=30.161， CI=4.766-190.860）和最后随访（OR=11.211， CI=2.513-50.019）。基线最大高度大于80微米或脉膜厚度小于135微米的病变与最后随访的新萎缩发病呈正相关（or =7.886， CI=2.105 ~ 29.538, or =3.796， CI=1.154 ~ 12.481）。在这项研究中，HRF的存在覆盖了结节样病变，这些病变的异质性内反射，被发现一致地预测了随后几个月局部萎缩的发生。这些发现为NNVAMD患者解剖变化的自然历史提供了进一步的见解。
To use spectral domain optical coherence tomography (SD-OCT) to investigate risk factors predictive for development of atrophy of drusenoid lesions (drusen and drusenoid pigment epithelium detachment) in eyes with non-neovascular age-related macular degeneration (NNVAMD). Cohort study. Forty-one eyes from 29 patients with NNVAMD. Patients with NNVAMD who underwent registered SD-OCT imaging over a minimum period of six months, were reviewed. Drusenoid lesions that accompanied by new atrophy onset at 6 month or last follow up were further analyzed. Detailed lesion change was described throughout the study period. Odds ratios (OR) and risk for new local atrophy onset were calculated. Drusenoid lesion features and longitudinal changes in features including maximum lesion height, lesion diameter, lesion internal reflectivity, presence and extent of overlying intraretinal hyperreflective features (HRF). Subfoveal choroidal thickness and choroidal thickness measured below each lesion. 543 individual drusenoid lesions were identified at baseline, while 28 lesions developed during follow-up. The mean follow-up time was 21.3 ± 8.6 (range, 6-44) months. 3.2% (18/571) of drusenoid lesions progressed to atrophy within 18.3±9.5 (range: 5-28) months of initial visit. Drusenoid lesions with heterogenous internal reflectivity were significantly associated with new atrophy onset at 6 month (OR=5.614, 95% confidence interval (CI) =1.277-24.673) and new atrophy onset at last follow up (OR=7.005, CI=2.300-21.337). Lesions with presence of HRF also were significant predictors for new atrophy onset at 6 month (OR=30.161, CI=4.766-190.860) and at last follow up (OR=11.211, CI=2.513-50.019). Lesions with a baseline maximum height over 80 microns or choroidal thickness less than 135 microns showed positive association with the new atrophy onset at last follow up (OR=7.886, CI=2.105-29.538 and OR=3.796, CI=1.154-12.481, respectively). In this study, the presence of HRF overlying drusenoid lesions, a heterogeneous internal reflectivity of these lesions, was found consistently to be predictive of local atrophy onset in the ensuing months. These findings provide further insight into the natural history of anatomical change occurring in patients with NNVAMD.