■纵向评估非渗出性年龄相关性黄斑变性(AMD)中高风险结构生物标志物对自然疾病进展的影响空间分辨的介位和暗位眼底控制的视野检查。
■多模态视网膜成像数据和眼底控制的视野刺激点在长达4年的时间内,根据每次年度访问的地标对应关系进行半自动配准。亚RPE玻璃疣的存在,视网膜下树状软骨沉积,色素上皮脱离(PEDs),超反射焦点(HRF),卵黄样病变,折射沉积物,在每次刺激位置和就诊时,对不完全RPE和外侧视网膜萎缩(iRORA)以及完全RPE和外侧视网膜萎缩(cRORA)进行分级。提取局部视网膜层厚度。混合效应模型用于结构-功能相关性。
■49例非渗出性AMD患者的54只眼(平均年龄,70.7±9.1岁)和27只健康对照者的27只眼睛(平均年龄,包括63.4±8.9年)。在学习过程中,PED的存在具有最高的功能影响,平均估计损失-1.30dB(P<0.001)的介孔和-1.23dB(P<0.001)的暗孔测试,其次是-0.89dB的HRF(介孔,P=0.001)和-0.87dB(暗色,P=0.005)。视网膜下关节软骨样沉积与更强的视力障碍相关(中视,-0.38dB;P=0.128;暗色,-0.37dB;P=0.172)与子RPE玻璃疣(-0.22dB,P=0.0004;-0.18dB,P=0.006)。随着C-RORA的发展,暗视视网膜敏感性进一步显着降低(-2.15dB;P=0.02)。RPE玻璃疣复合物的增厚和外核层的变薄对空间分辨的视网膜敏感性产生了负面影响。
■PED和HRF的存在对进行性逐点敏感性损失的预后影响最大。与视锥介导的局部视网膜敏感性丧失相比,具有视网膜萎缩发展的早期迹象的优势杆表明光感受器保留是未来介入性AMD试验的潜在治疗目标。
UNASSIGNED: To longitudinally assess the impact of high-risk structural biomarkers for natural disease progression in non-exudative age-related macular degeneration (AMD) on spatially resolved mesopic and scotopic fundus-controlled perimetry testing.
UNASSIGNED: Multimodal retinal imaging data and fundus-controlled perimetry stimuli points were semiautomatically registered according to landmark correspondences at each annual visit over a period of up to 4 years. The presence of sub-RPE drusen, subretinal drusenoid deposits, pigment epithelium detachments (PEDs), hyper-reflective foci (HRF), vitelliform lesions, refractile deposits, and incomplete RPE and outer retinal atrophy (iRORA) and complete RPE and outer retinal atrophy (cRORA) were graded at each stimulus position and visit. Localized retinal layer thicknesses were extracted. Mixed-effect models were used for structure-function correlation.
UNASSIGNED: Fifty-four eyes of 49 patients with non-exudative AMD (mean age, 70.7 ± 9.1 years) and 27 eyes of 27 healthy controls (mean age, 63.4 ± 8.9 years) were included. During study course, presence of PED had the highest functional impact with a mean estimated loss of -1.30 dB (P < 0.001) for mesopic and -1.23 dB (P < 0.001) for scotopic testing, followed by HRF with -0.89 dB (mesopic, P = 0.001) and -0.87 dB (scotopic, P = 0.005). Subretinal drusenoid deposits were associated with a stronger visual impairment (mesopic, -0.38 dB; P = 0.128; scotopic, -0.37 dB; P = 0.172) compared with sub-RPE drusen (-0.22 dB, P = 0.0004; -0.18 dB, P = 0.006). With development of c-RORA, scotopic retinal sensitivity further significantly decreased (-2.15 dB; P = 0.02). Thickening of the RPE-drusen-complex and thinning of the outer nuclear layer negatively impacted spatially resolved retinal sensitivity.
UNASSIGNED: The presence of PED and HRF had the greatest prognostic impact on progressive point-wise sensitivity losses. Higher predominant rod than cone-mediated localized retinal sensitivity losses with early signs of retinal atrophy development indicate photoreceptor preservation as a potential therapeutic target for future interventional AMD trials.