期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 17, 页码 -出版社
MDPI
DOI: 10.3390/jcm11175110
关键词
age-related macular degeneration; Amish eye study; complete retinal pigment epithelial and outer retina atrophy; geographic atrophy; optical coherence tomography
资金
- National Eye Institute, Bethesda, Maryland [RO1 EY023164]
- Department of Ophthalmology at the Perelman School of Medicine, Univ. of Pennsylvania, Philadelphia, Pennsylvania
- John P. Hussman Institute of Human Genomics at the University of Miami Miller School of Medicine, Miami, Florida
- Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
- F.M. Kirby Foundation
- Research to Prevent Blindness
This population-based study in elderly Amish individuals found that high central drusen volume and intraretinal hyperreflective foci are risk factors for progression to late age-related macular degeneration (AMD).
Objective: To evaluate the optical coherence tomography (OCT)-based risk factors for progression to late age-related macular degeneration (AMD) in a population-based study of elderly Amish. Methods: A total of 1332 eyes of 666 consecutive subjects who completed a 2-year follow-up visit were included in this multicenter, prospective, longitudinal, observational study. Imaging features were correlated with 2-year incidence of late AMD development. Odds ratios for imaging features were estimated from logistic regression. Baseline OCT images were reviewed for the presence of drusen volume >= 0.03 mm(3) in the central 3 mm ring, intraretinal hyperreflective foci (IHRF), hyporeflective drusen cores (hDC), subretinal drusenoid deposits (SDD), and drusenoid pigment epithelium detachment (PED). Subfoveal choroidal thickness, drusen area, and drusen volume within 3 and 5 mm circles centered on the fovea were also assessed. Results: Twenty-one (1.5%) of 1332 eyes progressed to late AMD by 2 years. The mean age of the study subjects was 65 +/- 10.17 (+/- SD) years and 410 subjects were female. Univariate logistic regression showed that drusen area and volume in both 3 mm and 5 mm circles, subfoveal choroidal thickness, drusen volume >= 0.03 mm(3) in the 3 mm ring, SDD, IHRF, and hDC were all associated with an increased risk for development of late AMD. The multivariate regression model identified that drusen volume in the 3 mm ring (OR: 2.59, p = 0.049) and presence of IHRF (OR: 57.06, p < 0.001) remained as independent and significant risk factors for progression to late AMD. Conclusions: This population-based study confirms previous findings from clinic-based studies that high central drusen volume and IHRF are associated with an increased risk of progression to late AMD. These findings may be of value in risk-stratifying patients in clinical practice or identifying subjects for early intervention clinical trials.
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