年龄相关性黄斑变性的脉络膜厚度评价（英文）

Evaluation of choroidal thickness in cases with age-related macular degeneration

目的:通过光学相干断层扫描(optical coherence tomography,OCT;RTVue 100-2;V 5.1,Optovue,Fremont,CA,USA)测量比较非新生血管性与新生血管性年龄相关性黄斑变性(age-related macular degeneration,AMD)黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT),并分析脉络膜厚度(choroidal thickness,CT)对AMD新血管形成的影响。方法:本研究为回顾性、横断面研究。以单侧眼患有新生血管性AMD且对侧眼患有非新生血管性AMD的24例患者(48眼)作为研究组,选取年龄与眼轴长度相匹配的40例健康眼作为对照组。非新生血管性AMD亚组研究对象是黄斑区有玻璃疣和/或色素变化眼,而新生血管性AMD亚组研究对象是由于脉络膜新生血管而致视网膜下或视网膜内有渗出液和/或脂性渗出眼。运用OCT垂直测量外侧高反射线(视网膜色素上皮层)到脉络膜巩膜交界面间的距离。选取7个不同点进行脉络膜厚度测量,测量区域为距黄斑中心凹颞侧和鼻侧1500μm范围,测量间距为500μm。测量结果在亚组间进行统计学对比研究。结果:研究组患者平均年龄为72.4±8.97(60～82)岁,对照组受试者平均年龄为71.2±8.8(58～81)岁。新生血管性AMD组中平均SFCT明显大于非新生血管性AMD组的厚度(P<0.05)。非新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异无统计学意义(P>0.05);而新生血管性AMD组中,平均SFCT与平均鼻、颞侧脉络膜厚度比较,差异有统计学意义(P<0.05)。结论:运用OCT对脉络膜厚度进行测量,有助于理解AMD的病理生理机制。然而,仍需要大型前瞻性研究来探求新生血管性AMD中SFCT增厚的原因。

AIM：To compare subfoveal choroidal thickness（ SFCT）between cases with non-neovascular age-related macular degeneration（ AMD） and neovascular AMD by optical coherence tomography（ OCT） and to evaluate the contribution of choroidal thickness（ CT） measurements to the understanding of pathogenesis of neovascularization in AMD.METHODS： Fourty-eigth eyes of 24 patients who had neovascular AMD in one eye and non-neovascular AMD in the other eye were included in this retrospective,crosssectional study as study group. Forty eyes of healthy,age and axial length matched individuals were selected as the control group. Eyes with drusen and /or pigmentary changes were included in the non- neovascular AMD subgroup. Eyes with subretinal or intraretinal fluid and /orlipid exudation due to the choroidal neovascularization were included in the neovascular AMD subgroup. OCT measurements were performed with RTVue 100-2（ V 5.1,Optovue,Fremont,CA,USA） perpendicularly from the outer part of the hyperreflective line（ retinal pigment epithelial layer） to the line corresponding to the choroidoscleral junction. Choroidal thickness was measured at 7different points,500μ m intervals up to 1500μ m temporal and nasal to the fovea in the study group and compared statistically between subgroups.RESULTS： The mean age of patients was 72.4±8.97（ 60-82） y. The mean age of healthy individuals was 71.2± 8.8（ 58-81） y. Mean SFCT of neovascular AMD group were significantly thicker than non- neovascular AM D group（ P〈0.05）. In non-neovascular AMD group,there was no statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness（ P〈0. 05）.In neovascular AMD group, there was a statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness（ P〈0.05）.CONCLUSION： Choroidal thickness measurements with OCT device can make a contribution to the understanding the phatophysiology of AMD and large prospective studies should be conducted to understand why SFCT was thicker in neovascular AMD.