风湿热和长期使用苄星青霉素是巴西队列中广泛黄斑萎缩伴假黄斑的可能风险因素。

IF 1.9 Q2 OPHTHALMOLOGY
Carlos Augusto Moreira-Neto, Rafaella Atherino Schmidt Andujar, John Chii Tyng Chao, Huber Vasconcelos, Fábio Eduardo Eberhardt Alves, Gabriela Doná Rodrigues, Bruno Hirt, Jayme Arana, Eduardo Cunha Souza, André Maia, Juliana Maria Ferraz Sallum, Carlos Augusto Moreira
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引用次数: 0

摘要

背景:尽管伴有假性黄斑萎缩(EMAP)的广泛性黄斑萎缩病例大量增加,但这种疾病的基本特征仍不为人所知。巴西患者过去常有风湿热(RF)和/或苄星青霉素(BP)治疗史,这可能与该病有关。我们分析了RF和BP与巴西患者EMAP的相关性:观察性、回顾性、病例对照研究:方法:在巴西三家私人眼科诊所的数据库中搜索具有 EMAP 类似症状的患者。询问每位患者是否曾有射频和/或长期使用BP的病史。患者接受了最佳矫正视力(BCVA)测量、彩色眼底成像、眼底自动荧光(FAF)成像、光学相干断层扫描(OCT)成像和视网膜电图(ERG)检查。对以下特征进行了分析:视网膜下类核素沉积(SDD)、色素斑、视网膜色素上皮/基底膜(RPE/BM)分离、外层视网膜或 RPE 萎缩,以及铺路石样外观的识别。脉络膜厚度使用增强型深度成像 OCT 测量。中心萎缩区通过超宽视野 FAF 人工测量:共纳入了 77 名 EMAP 患者(女性,66.2%;平均年龄 58.6 岁)的 154 只眼睛;90.9% 的患者被诊断为 RF;94.8% 的患者接受过 BP 治疗,治疗开始的平均年龄为 7.3 岁(平均持续时间 11.8 年)。治疗时间对萎缩面积有显著影响(P = 0.027),治疗时间每增加 1 年,萎缩面积平均减少 6.91 平方毫米。诊断为 RF 时的年龄对 SDD 有显著影响(P = 0.026)。RF(晚期疾病)诊断时间每增加 1 年,中心 SDD 出现的几率就会降低 24%。在 OCT 上,65.5% 的眼睛有 SDD,70% 以上的眼睛有 RPE/BM 分裂和外层视网膜或 RPE 萎缩。EMAP患者的脉络膜厚度明显增厚(P 结语:EMAP患者的脉络膜厚度明显增厚(P 结语:EMAP患者的脉络膜厚度明显增厚):这些研究结果表明,在巴西患者中,RF 和 EMAP 之间存在关联。应询问 EMAP 患者是否有射频病史。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rheumatic fever and long-term use of benzathine penicillin as possible risk factors for extensive macular atrophy with pseudodrusen in a Brazilian cohort.

Background: Although there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients.

Design: Observational, retrospective, case-control study.

Methods: The databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF.

Results: A total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm2 in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes.

Conclusion: These findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF.

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来源期刊
CiteScore
3.50
自引率
4.30%
发文量
81
审稿时长
19 weeks
期刊介绍: International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities
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