Abstract：
To investigate the correlation between morphological lesions and functional indicators in eyes with neovascular age-related macular degeneration (nAMD).
This was a prospective observational study of treatment-naïve nAMD eyes. Various morphological lesions and impaired retinal structures were manually measured at baseline and month-3 in three-dimensional optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images, including the volumes (mm3) of macular neovascularization (MNV), avascular subretinal hyperreflective material (avascular SHRM), subretinal fluid (SRF), intraretinal fluid (IRF), serous pigment epithelial detachment (sPED) and the impaired area (mm2) of ellipsoid zone (EZ), external limiting membrane (ELM) and outer nuclear layer (ONL).
Sixty-three eyes were included. The volume of avascular SHRM showed persistent positive associations with the area of EZ damage, both at baseline, month-3, and change values (all P < 0.001). Poor BCVA (month-3) was associated with larger volumes of baseline IRF (β = 0.377, P < 0.001), avascular SHRM (β = 0.306, P = 0.032), and ELM impairment area (β = 0.301, P = 0.036) in multivariate model. EZ and ELM impairment were primarily associated with baseline avascular SHRM (β = 0.374, p = 0.003; β = 0.388, P < 0.001, respectively), while ONL impairment primarily associated with MNV (β = 0.475, P < 0.001).
The utilization of three-dimensional measurements elucidates the intrinsic connections among various lesions and functional outcomes. In particular, avascular SHRM plays an important role in prognosis of nAMD.
This was a prospective observational study of treatment-naïve nAMD eyes. Various morphological lesions and impaired retinal structures were manually measured at baseline and month-3 in three-dimensional optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images, including the volumes (mm3) of macular neovascularization (MNV), avascular subretinal hyperreflective material (avascular SHRM), subretinal fluid (SRF), intraretinal fluid (IRF), serous pigment epithelial detachment (sPED) and the impaired area (mm2) of ellipsoid zone (EZ), external limiting membrane (ELM) and outer nuclear layer (ONL).
Sixty-three eyes were included. The volume of avascular SHRM showed persistent positive associations with the area of EZ damage, both at baseline, month-3, and change values (all P < 0.001). Poor BCVA (month-3) was associated with larger volumes of baseline IRF (β = 0.377, P < 0.001), avascular SHRM (β = 0.306, P = 0.032), and ELM impairment area (β = 0.301, P = 0.036) in multivariate model. EZ and ELM impairment were primarily associated with baseline avascular SHRM (β = 0.374, p = 0.003; β = 0.388, P < 0.001, respectively), while ONL impairment primarily associated with MNV (β = 0.475, P < 0.001).
The utilization of three-dimensional measurements elucidates the intrinsic connections among various lesions and functional outcomes. In particular, avascular SHRM plays an important role in prognosis of nAMD.
摘要：
目的：探讨新生血管性年龄相关性黄斑变性（nAMD）眼形态学病变与功能指标的相关性。
方法：这是一项对未治疗nAMD眼的前瞻性观察性研究。在基线和第3个月，在三维光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）图像中手动测量各种形态病变和受损的视网膜结构，包括黄斑新生血管(MNV)的体积(mm3)，无血管视网膜下高反射材料（无血管SHRM），视网膜下液（SRF），卷内液体(IRF),浆液性色素上皮脱离（sPED）和椭圆形区（EZ）的受损面积（mm2），外界膜(ELM)和外核层(ONL)。
结果：纳入63只眼。无血管SHRM的体积与EZ损伤面积呈持续正相关，两者都在基线，第3个月和变化值（所有P<0.001）。BCVA差（第3个月）与较大量的基线IRF相关（β=0.377，P<0.001），无血管SHRM（β=0.306，P=0.032），多变量模型中ELM损伤面积(β=0.301,P=0.036)。EZ和ELM损害主要与基线无血管SHRM相关(β=0.374,p=0.003;β=0.388,P<0.001),而ONL损害主要与MNV相关(β=0.475,P<0.001)。
结论：三维测量的应用阐明了各种病变和功能结局之间的内在联系。特别是,无血管SHRM在nAMD的预后中起重要作用。
方法：这是一项对未治疗nAMD眼的前瞻性观察性研究。在基线和第3个月，在三维光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）图像中手动测量各种形态病变和受损的视网膜结构，包括黄斑新生血管(MNV)的体积(mm3)，无血管视网膜下高反射材料（无血管SHRM），视网膜下液（SRF），卷内液体(IRF),浆液性色素上皮脱离（sPED）和椭圆形区（EZ）的受损面积（mm2），外界膜(ELM)和外核层(ONL)。
结果：纳入63只眼。无血管SHRM的体积与EZ损伤面积呈持续正相关，两者都在基线，第3个月和变化值（所有P<0.001）。BCVA差（第3个月）与较大量的基线IRF相关（β=0.377，P<0.001），无血管SHRM（β=0.306，P=0.032），多变量模型中ELM损伤面积(β=0.301,P=0.036)。EZ和ELM损害主要与基线无血管SHRM相关(β=0.374,p=0.003;β=0.388,P<0.001),而ONL损害主要与MNV相关(β=0.475,P<0.001)。
结论：三维测量的应用阐明了各种病变和功能结局之间的内在联系。特别是,无血管SHRM在nAMD的预后中起重要作用。
