预测与保护：评估老年性黄斑变性的双层征象。
IF 2.6
3区 医学
Q2 OPHTHALMOLOGY
Ophthalmology and Therapy
Pub Date : 2024-10-01
Epub Date: 2024-08-16
DOI:10.1007/s40123-024-01012-y
引用次数: 0
摘要
介绍：晚期老年性黄斑变性（AMD）是视力丧失的主要原因。因此，人们对可预测或预防晚期黄斑变性发病的前兆病变很感兴趣。其中一种病变是视网膜色素上皮（RPE）和布鲁氏膜（BM）的浅层分离，有多种说法，包括双层征（DLS）：本文旨在研究和澄清有关 RPE 和 BM 浅层分离的不同术语。我们还回顾了与 DLS 相关的结果的现有证据：首先，DLS 是否可预测渗出性新生血管性黄斑变性；其次，DLS 是否对地理萎缩具有潜在的保护作用：结果：描述 RPE 和 BM 浅层分离的各种术语反映出 DLS 可表现出不同的特征。有血管的 DLS 似乎可防止萎缩，但也可能发展为渗出，而无血管的 DLS 则与萎缩风险增加有关。光学相干断层扫描（OCT）血管造影术（OCTA）是识别和区分各种形式 DLS 的主要方法。如果没有 OCTA 或实际上无法进行 OCTA，则可使用 OCT 将 DLS 简化分类为厚型或薄型，从而大致确定血管化的可能性。通过将深度学习算法应用于 OCT 扫描，自动检测 DLS 的研究正在进行中：结论：DLS一词仍然适用于描述RPE和BM的浅层分离。这一特征的检测和分类为晚期 AMD 的进展风险提供了有价值的信息。然而，DLS 的外观及其在预测 AMD 进展方面的价值可能因患者而异。通过进一步研究，可以确认个体化风险，为适当的治疗提供依据。本文章由计算机程序翻译，如有差异，请以英文原文为准。
Predict and Protect: Evaluating the Double-Layer Sign in Age-Related Macular Degeneration.
Introduction: Advanced age-related macular degeneration (AMD) is a major cause of vision loss. Therefore, there is interest in precursor lesions that may predict or prevent the onset of advanced AMD. One such lesion is a shallow separation of the retinal pigment epithelium (RPE) and Bruch's membrane (BM), which is described by various terms, including double-layer sign (DLS).
Methods: In this article, we aim to examine and clarify the different terms referring to shallow separation of the RPE and BM. We also review current evidence on the outcomes associated with DLS: firstly, whether DLS is predictive of exudative neovascular AMD; and secondly, whether DLS has potential protective properties against geographic atrophy.
Results: The range of terms used to describe a shallow separation of the RPE and BM reflects that DLS can present with different characteristics. While vascularised DLS appears to protect against atrophy but can progress to exudation, non-vascularised DLS is associated with an increased risk of atrophy. Optical coherence tomography (OCT) angiography (OCTA) is the principal method for identifying and differentiating various forms of DLS. If OCTA is unavailable or not practically possible, simplified classification of DLS as thick or thin, using OCT, enables the likelihood of vascularisation to be approximated. Research is ongoing to automate DLS detection by applying deep-learning algorithms to OCT scans.
Conclusions: The term DLS remains applicable for describing shallow separation of the RPE and BM. Detection and classification of this feature provides valuable information regarding the risk of progression to advanced AMD. However, the appearance of DLS and its value in predicting AMD progression can vary between patients. With further research, individualised risks can be confirmed to inform appropriate treatment.
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来源期刊
Ophthalmology and Therapy
OPHTHALMOLOGY-
CiteScore
4.20
自引率
3.00%
发文量
157
审稿时长
6 weeks
期刊介绍：
Aims and Scope
Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals.
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