Natural history of incomplete retinal pigment epithelial and outer retinal atrophy in age-related macular degeneration
Natural history of incomplete retinal pigment epithelial and outer retinal atrophy in age-related macular degeneration
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DOI：
10.1016/j.jcjo.2021.01.005
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发表时间：
2021-09-15
影响因子：
4.2
通讯作者：
Sarraf, David
中科院分区：
文献类型：
--
作者：
Corradetti, Giulia;Corvi, Federico;Sarraf, David
目的：采用光学相干断层扫描（OCT）分析，评估非新生血管性中度年龄相关性黄斑变性（iAMD）患者不完全视网膜色素上皮和外层视网膜萎缩（iRORA）向完全视网膜色素上皮和外层视网膜萎缩（cRORA）转化的时间进程和风险因素。设计：回顾性生存研究。参与者：跟踪结构Spectralis OCT（海德堡工程，海德堡，德国）的体积数据集从2视网膜专家在加州大学洛杉矶分校进行了回顾性筛选，以确定连续参与者与非-方法：在选择的第一阶段，筛选321只连续的iAMD眼睛的iRORA发作。在前24个月内发生iRORA的眼睛再随访24个月，以评估向cRORA的转化率。Kaplan-Meier生存曲线的制定，以说明转换从iRORA到cRORA.Results：在321基线参与者与iAMD，87事件iRORA病变（50只眼，42名参与者）被纳入转换分析。81处iRORA病变（93.1%）在24个月内（中位14个月）转化为cRORA。多变量二元逻辑回归分析表明，基线时视网膜内高反射灶和中心凹外iRORA位置与更快进展为cRORA的速率相关（模型R-2 = 0.816，p < 0.05）。这些发现可能对设计早期干预试验进行危险分层和预测有价值，但需要通过前瞻性分析进行验证。
Objective: To assess the time course and risk factors for conversion of incomplete retinal pigment epithelium and outer retina atrophy (iRORA) to complete retinal pigment epithelium and outer retina atrophy (cRORA) in eyes with non-neovascular intermediate age-related macular degeneration (iAMD), using optical coherence tomography (OCT) analysis.Design: Retrospective survival study.Participants: Tracked structural Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany) volume datasets from 2 retinal specialists at the University of California-Los Angeles were retrospectively screened to identify consecutive participants with non-neovascular iAMD without signs of atrophy or macular neovascularization in either eye at baseline.Methods: In the first stage of selection, 321 consecutive iAMD eyes were screened for onset of iRORA. Eyes that developed iRORA within the first 24 months were followed for an additional 24 months to assess the rate of conversion to cRORA. A Kaplan-Meier survival curve was formulated to illustrate the conversion from iRORA to cRORA.Results: Among 321 baseline participants with iAMD, 87 incident iRORA lesions (50 eyes, 42 participants) were included in the conversion analysis. Eighty-one iRORA lesions (93.1%) converted to cRORA within 24 months (median 14 months). Multivariate binary logistic regression analysis indicated that intraretinal hyperreflective foci and extrafoveal iRORA location at baseline were associated with a faster rate of progression to cRORA (model R-2 = 0.816, p < 0.05).Conclusions: The majority of incident iRORA lesions progress to cRORA within a 24-month period. These findings may be of value in the design of early intervention trials for risk stratification and prognostication but need to be validated with a prospective analysis.