中度年龄相关性黄斑变性的微观视力和光学相干断层扫描结构风险因素。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina Pub Date : 2024-08-01 DOI:10.1016/j.oret.2024.02.016

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引用次数: 0

摘要

目的：确定增加中度年龄相关性黄斑变性（iAMD）患者疾病进展风险的光学相干断层扫描（OCT）结构生物标志物与显微透视视网膜灵敏度之间的关系设计：前瞻性横断面观察研究参与者：23 名 iAMD 患者：23 名 iAMD 患者的 45 只眼睛方法：患者接受 OCT 和微观视力测定。根据视网膜内高反射灶（HRF）、类髓鞘病变内低反射（HRDL）、视网膜下类髓鞘沉积（SDD）、双层征（DLS）和髓鞘体积等风险因素对 OCT 扫描进行评估。用覆盖黄斑的 33 点网格分析了微透视视网膜灵敏度。用一种新方法确定视网膜的哪个部分与每个微透视点相对应，构建了一个沃罗诺伊图，将黄斑划分为由比其他任何点都更接近每个点的区域组成的单元。将 Voronoi 图叠加到 OCT 上，就能确定 OCT 风险因素的点对点位置。采用单变量和多变量线性混合效应模型进行分析：单个测量点的微透视视网膜灵敏度与 OCT 风险因素之间的关联结果：本研究纳入了 1479 个视网膜灵敏度点和相应的 OCT 结构区。采用单变量线性混合效应模型进行分析时，视网膜灵敏度随 OCT 风险因素 HRF、HRDL、DLS 和色素沉着量的存在而明显下降（所有 P <0.001）。多变量模型显示，存在 HRF（P < 0.001）、DLS（P = 0.025）和更大的色素沉着量（P < 0.001）时，视网膜灵敏度会显著降低。

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Microperimetry and Structural Risk Factors on OCT in Intermediate Age-Related Macular Degeneration

Purpose

To determine the relationship between structural biomarkers on OCT that increase the risk of disease progression and microperimetric retinal sensitivity in patients with intermediate age-related macular degeneration (iAMD).

Design

Prospective cross-sectional, observational study.

Participants

Forty-five eyes of 23 patients with iAMD.

Methods

Patients underwent OCT and microperimetry. OCT scans were evaluated for the risk factors intraretinal hyperreflective foci (HRF), hyporeflectivity within drusenoid lesions (HRDL), subretinal drusenoid deposits, double-layer sign (DLS), and drusen volume. Microperimetric retinal sensitivity was analyzed with a 33-point grid covering the macula. With a novel method of determining what part of the retina corresponded to each microperimetry point, a Voronoi diagram was constructed, dividing the macula in cells consisting of the region nearer to each point than any other. The Voronoi diagram was superimposed on the OCT, making it possible to determine the point-to-point location of the OCT risk factors. Univariable and multivariable linear mixed-effect models were used for analysis.

Main Outcome Measures

Association between microperimetric retinal sensitivity and OCT risk factors at individual measuring points.

Results

One thousand four hundred seventy-nine points of retinal sensitivity and corresponding structural area on OCT were included in this study. Retinal sensitivity was significantly decreased with presence of the OCT risk factors HRF, HRDL, DLS, and drusen volume (all P < 0.001) when analyzed with the univariable linear mixed-effect model. The multivariable model showed a significant decrease of retinal sensitivity with presence of HRF (P < 0.001), DLS (P = 0.025), and greater drusen volume (P < 0.001).

Conclusions

Presence of HRF, DLS, and greater drusen volume, all of which increase the risk of disease progression, is significantly and independently associated with decreased microperimetric retinal sensitivity in patients with iAMD.