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
{"title":"老年性黄斑变性（AMD）早期的超透射缺陷","authors":"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","doi":"10.1016/j.jnma.2024.07.078","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>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).</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 445"},"PeriodicalIF":2.5000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hyper transmission Defects in Early Stages of Age-Related Macular Degeneration (AMD)\",\"authors\":\"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\",\"doi\":\"10.1016/j.jnma.2024.07.078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>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).</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":17369,\"journal\":{\"name\":\"Journal of the National Medical Association\",\"volume\":\"116 4\",\"pages\":\"Page 445\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the National Medical Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0027968424001597\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Medical Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0027968424001597","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Hyper transmission Defects in Early Stages of Age-Related Macular Degeneration (AMD)
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.
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.
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