Hyper transmission Defects in Early Stages of Age-Related Macular Degeneration (AMD)

IF 2.5 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the National Medical Association Pub Date : 2024-08-01 DOI:10.1016/j.jnma.2024.07.078

William A. Johnston B.S., Deepayan Kar Ph.D, Lukas Goerdt M.D., Kenneth R. Sloan Ph.D, Mark E. Clark MEng, Thomas A. Swain MPH, Ph.D, Gerald McGwin M.S., Ph.D, Cynthia Owsley Ph.D, MSPH, Christine A. Curcio Ph.D

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引用次数: 0

Abstract

Purpose

AMD degrades reading vision in aged persons worldwide. Hyper-transmission defects (HTDs) on optical coherence tomography (OCT), a structural clinical imaging biomarker for AMD progression, represents loss of shadowing by degenerating retinal pigment epithelium (RPE). We sought HTDs in individuals with normal eyes, early AMD (eAMD), and intermediate AMD (iAMD).

Methods

One eye of each participant in the baseline visit of the Alabama Study on Early Age-Related Macular Degeneration 2 (ALSTAR2) was analyzed. AMD presence and severity was determined using standardized color fundus photography. Participants underwent volume OCT angiography imaging. HTDs were defined in en face scans by hyper-intensity of signal in the choroid, confirmed on B-scans by the presence of RPE disruption, and measured by fitting circles.

Results

In 460 eyes of 460 participants (normal N=236, eAMD N=134, iAMD N=90), HTDs were detected in 134. Prevalence of any HTD (minimum diameter ≥62 μm) was higher in eyes with iAMD (86.7%, N=78) and eAMD (35.1%, N=47) compared to normal eyes (3.8%, N=9). Prevalence of HTD ≥250 μm was higher in eyes with iAMD (13.3%, N=12) and eAMD (5.2%, N=7) compared to normal eyes (0.4%, N=1).

Conclusions

More and larger HTDs are found in later stages of AMD. Degeneration of the RPE layer leads to HTDs and can be quickly identified on face OCTA scans. Persistent HTDs are markers for geography atrophy, an AMD end-stage (PMID 36958537). The prognostic significance of HTD identified at early stages of AMD will be clarified by imaging of the same participants at 3-year follow-up.

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老年性黄斑变性（AMD）早期的超透射缺陷

目的 AMD 使全世界老年人的阅读视力下降。光学相干断层扫描（OCT）上的超透射缺陷（HTDs）是 AMD 进展的结构性临床成像生物标志物，它代表了退化的视网膜色素上皮（RPE）所造成的阴影损失。我们在正常眼、早期老年性黄斑变性（eAMD）和中期老年性黄斑变性（iAMD）患者中寻找 HTD。采用标准化彩色眼底照相法确定是否存在黄斑变性以及黄斑变性的严重程度。参与者接受了容积 OCT 血管造影成像。在正面扫描中，HTD 的定义是脉络膜信号强度过高，在 B 扫描中通过 RPE 破坏的存在进行确认，并通过拟合圆进行测量。结果在 460 名参与者的 460 只眼睛中（正常 N=236，eAMD N=134，iAMD N=90），134 只眼睛检测到 HTD。与正常眼（3.8%，9 人）相比，任何 HTD（最小直径≥62 μm）在 iAMD 眼（86.7%，78 人）和 eAMD 眼（35.1%，47 人）中的发生率更高。与正常眼（0.4%，N=1）相比，iAMD 眼（13.3%，N=12）和 eAMD 眼（5.2%，N=7）中 HTD≥250 μm 的发生率更高。RPE层的变性会导致HTD，并可通过面部OCTA扫描快速识别。持续的HTD是地理萎缩的标志，而地理萎缩是AMD的终末阶段（PMID 36958537）。在 AMD 早期阶段发现的 HTD 的预后意义将通过对相同参与者进行 3 年随访时的成像来明确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the National Medical Association 医学-医学：内科

CiteScore

4.80

自引率

3.00%

发文量

139

审稿时长

98 days

期刊介绍： Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.