目的:研究对比敏感度(CS)与脉络膜毛细血管灌注和其他结构光学相干断层扫描(OCT)生物标志物在干性年龄相关性黄斑变性(AMD)。
方法:横截面,观察性研究。
方法:一百只AMD眼睛(早22只,来自74名患者的52个中间和26个晚期)和来自37名年龄相似的受试者的45个对照眼。
方法:所有参与者都进行了视敏度(VA)评估,定量对比敏感度函数(qCSF)测试,黄斑OCT,和6x6-mm扫频源OCT血管造影(OCTA)扫描在同一天。OCT体积分析了视网膜下的玻璃疣样沉积物和低反射玻璃疣核,并测量外核层(ONL)的厚度。OCTA扫描用于计算玻璃疣体积,内脉络膜流量不足百分比(IC-FD%),并测量脉络膜超透射缺陷(HTD)的面积。在用Phansalkar方法进行补偿和二值化后,从16μm厚的脉络膜厚板上测量IC-FD%。使用广义线性混合效应模型来评估功能变量和结构变量之间的关联。
方法:为了探索qCSF测量的CS之间的关联,ICFD%和各种AMD成像生物标志物。
结果:与对照相比,AMD在所有阶段表现出显著降低的qCSF指标眼。单变量分析揭示了各种成像生物标志物之间的显著关联,两组qCSF指标和VA均降低。多因素分析证实,中心5mm较高的IC-FD%与AMD眼中所有qCSF指标的降低显着相关(β=-0.74至-0.25,均p<0.05),但与VA无关(p>0.05)。中心3mm的ONL厚度与VA(β=2.85,p<0.001)和几个qCSF指标(β=0.01-0.90,所有p<0.05)相关,尤其是AMD的眼睛。Further,在AMD各期的低中频(β=-0.30~-0.29,p<0.001)下,较大的HTD面积与VA降低(β=-0.89,p<0.001)和CS降低相关.
结论:中心5mm的IC-FD%与qCSF测量的CS之间的显着关联加强了以下假设:黄斑脉络膜毛细血管灌注减少有助于AMD的视觉功能变化,这在CS中比在VA中更明显。
OBJECTIVE: To investigate the relationships between contrast sensitivity (CS),
choriocapillaris perfusion, and other structural OCT biomarkers in dry age-related macular degeneration (AMD).
METHODS: Cross-sectional, observational study.
METHODS: One hundred AMD eyes (22 early, 52 intermediate, and 26 late) from 74 patients and 45 control eyes from 37 age-similar subjects.
METHODS: All participants had visual acuity (VA) assessment, quantitative CS function (qCSF) testing, macular OCT, and 6 × 6-mm swept-source OCT angiography scans on the same day. OCT volumes were analyzed for subretinal drusenoid deposits and hyporeflective drusen cores, and to measure thickness of the outer nuclear layer. OCT angiography scans were utilized to calculate drusen volume and inner choroid flow deficit percentage (IC-FD%), and to measure the area of choroidal hypertransmission defects (HTDs). Inner choroid flow deficit percentage was measured from a 16-μm thick
choriocapillaris slab after compensation and binarization with Phansalkar\'s method. Generalized linear mixed-effects models were used to evaluate the associations between functional and structural variables.
METHODS: To explore the associations between qCSF-measured CS, IC-FD%, and various AMD imaging biomarkers.
RESULTS: Age-related macular degeneration exhibited significantly reduced qCSF metrics eyes across all stages compared with controls. Univariate analysis revealed significant associations between various imaging biomarkers, reduced qCSF metrics, and VA in both groups. Multivariate analysis confirmed that higher IC-FD% in the central 5 mm was significantly associated with decreases in all qCSF metrics in AMD eyes (β = -0.74 to -0.25, all P < 0.05), but not with VA (P > 0.05). Outer nuclear layer thickness in the central 3 mm correlated with both VA (β = 2.85, P < 0.001) and several qCSF metrics (β = 0.01-0.90, all P < 0.05), especially in AMD eyes. Further, larger HTD areas were associated with decreased VA (β = -0.89, P < 0.001) and reduced CS at low-intermediate frequencies across AMD stages (β = -0.30 to -0.29, P < 0.001).
CONCLUSIONS: The significant association between IC-FD% in the central 5 mm and qCSF-measured CS reinforces the hypothesis that decreased macular
choriocapillaris perfusion contributes to visual function changes in AMD, which are more pronounced in CS than in VA.
BACKGROUND: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.