目的:比较二维黄斑色素光密度(2D-MPOD)和空间匹配客观视野对不同严重程度的年龄相关性黄斑变性(AMD)的诊断能力,具有标准视野和最佳矫正视力(BCVA)。
方法:客观场分析仪(OFA)提供了客观视野,海德堡光谱光学相干断层扫描(OCT)测量了AMD患者的2D-MPOD,两者在0.99±0.16年内完成了两次。从每个2D-MPOD图像,我们提取了20个区域/黄斑,匹配20OFA刺激/黄斑。对于每个地区,我们从2D-MPOD像素值计算了7项测量值,并将这些测量值与OFA敏感性和延迟相关联.我们量化了2D-MPOD变化,2D-MPOD和OFA区分AMD分期的能力,以及使用接收器操作员特征图下面积百分比(%AUROC)的矩阵视野法和BCVA的判别力。
结果:在29名受试者的58眼中(71.6±6.3年,22名女性),我们发现年龄相关性眼病研究(AREDS)-3和AREDS-4严重度的2D-MPOD和OFA敏感性之间存在显著相关性。延迟与AREDS-2显著相关。对于区域4,相关性扩展到所有怪癖。与Bland-Altman图相关的回归显示,在研究期间,2D-MPOD发生了显着变化。尤其是可变性措施。MPOD/区域中位数在80.0±6.3%的%AUROC下将AREDS-1与AREDS-3眼区分开,表现优于OFA,矩阵视野检查,和BCVA。
结论:在晚期AMD中,MPOD改变与中枢功能改变相关,并且在外周延伸有显著相关性。早期AMD的良好诊断能力和研究的显着变化表明2D-MPOD和OFA可能提供有效的生物标志物。
OBJECTIVE: To compare diagnostic power for different severities of age-related macular degeneration (AMD) of two-dimensional macular pigment optical densities (2D-MPOD) and spatially matched objective perimetry, with standard perimetry and best-corrected visual acuity (BCVA).
METHODS: The ObjectiveField Analyser (OFA) provided objective perimetry, and a Heidelberg Spectralis optical coherence tomography (OCT) measured 2D-MPOD in AMD patients, both completed twice over 0.99 ± 0.16 years. From each 2D-MPOD image, we extracted 20 regions/macula, matched to the 20 OFA stimuli/macula. For each region, we calculated 7 measures from the 2D-MPOD pixel values and correlated those with OFA sensitivities and delays. We quantified 2D-MPOD changes, the ability of 2D-MPOD and OFA to discriminate AMD stages, and the discriminatory power of Matrix perimetry and BCVA using percentage area under receiver operator characteristic plots (%AUROC).
RESULTS: In 58 eyes of 29 subjects (71.6 ± 6.3 years, 22 females), we found significant correlations between 2D-MPOD and OFA sensitivities for Age-Related Eye Disease Studies (AREDS)-3 and AREDS-4 severities. Delays showed significant correlations with AREDS-2. For AREDS-4, correlations extended across all eccentricities. Regression associated with the Bland-Altman plots showed significant changes in 2D-MPOD over the study period, especially variability measures. MPOD per-region medians discriminated AREDS-1 from AREDS-3 eyes at a %AUROC of 80.0 ± 6.3%, outperforming OFA, Matrix perimetry, and BCVA.
CONCLUSIONS: MPOD changes correlated with central functional changes and significant correlations extended peripherally in later-stage AMD. Good diagnostic power for earlier-stage AMD and significant change over the study suggest that 2D-MPOD and OFA may provide effective biomarkers.