Retinal Pigment Epithelium Curvature Can Predict Late Age-Related Macular Degeneration.

IF 5 2区 医学 Q1 OPHTHALMOLOGY
Rene Cheung, Matt Trinh, Lisa Nivison-Smith
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Abstract

Purpose: Outer retinal band integrity strongly predicts late age-related macular degeneration (AMD). However, it is often assessed subjectively as "continuity" using inconsistent definitions. Alternatively, "curvature" of the outer retinal bands is a quantitative metric that strongly correlates with AMD biomarkers and can screen for intermediate AMD. We evaluated the prognostic ability of retinal pigment epithelium (RPE) and ellipsoid zone (EZ) curvature for late AMD against outer retinal band continuity, pigmentary abnormalities, reticular pseudodrusen, and drusen volume.

Methods: Consecutive patients with intermediate AMD who progressed to late AMD (n = 17) or remained stable (n = 42) were recruited. RPE and EZ curvature were quantified as a ratio of their lengths over Bruch's membrane using the sinuosity method of assessing river curvature, where a ratio of ∼1 indicates no outer retinal pathology. RPE, EZ, and Bruch's membrane were manually segmented and their lengths automatically extracted. The primary outcomes were outer retinal sinuosity and the odds ratio of predicting late AMD.

Results: Mean follow-up time for progressors and nonprogressors was 4.4 and 3.6 years. RPE sinuosity was strongly associated with pigmentary abnormalities (P = 0.001) and drusen volume (P = 0.004) but not reticular pseudodrusen (P = 0.28). RPE sinuosity >1.03 was the strongest predictor of late AMD developing within 5 years (15 [2.9-75]) and across the study period (25 [2.3-282]). Drusen volume >0.03 mm3 was the strongest predictor of progression within 2 years (33 [2.5-426]), and RPD could not independently predict progression within any time frame.

Conclusions: RPE curvature is a promising, quantitative outer retinal biomarker that can prognosticate late AMD and potentially enhance prognostic models.

视网膜色素上皮曲率可预测晚期老年性黄斑变性
目的:视网膜外带的完整性可有力地预测晚期老年性黄斑变性(AMD)。然而,人们通常使用不一致的定义主观地评估 "连续性"。另外,视网膜外带的 "曲率 "也是一个定量指标,它与老年黄斑变性生物标志物密切相关,可以筛查中期老年黄斑变性。我们评估了视网膜色素上皮(RPE)和椭圆形区(EZ)曲率与视网膜外带连续性、色素异常、网状假皱纹和色素沉着量对晚期AMD的预后能力:连续招募了进展到晚期 AMD(17 人)或保持稳定(42 人)的中期 AMD 患者。使用评估河流曲率的正弦曲线法,以RPE和EZ与布鲁氏膜的长度之比来量化RPE和EZ的曲率。人工分割 RPE、EZ 和布鲁氏膜,并自动提取其长度。主要结果是外层视网膜窦度和预测晚期AMD的几率:结果:进展期和非进展期患者的平均随访时间分别为 4.4 年和 3.6 年。RPE窦度与色素异常(P = 0.001)和虹膜体积(P = 0.004)密切相关,但与网状假性虹膜(P = 0.28)无关。RPE窦度>1.03是5年内(15[2.9-75])和整个研究期间(25[2.3-282])发生晚期AMD的最强预测因子。眼底出血量 >0.03 mm3 是 2 年内病情发展的最强预测指标(33 [2.5-426]),RPD 不能独立预测任何时间段内的病情发展:RPE曲率是一种很有前景的定量视网膜外层生物标志物,可以预示晚期AMD,并有可能增强预后模型。
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来源期刊
CiteScore
6.90
自引率
4.50%
发文量
339
审稿时长
1 months
期刊介绍: Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.
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