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彩色照片和眼底自身荧光图像评估地理性萎缩图像:年龄相关性眼病研究2报告编号11

Domalpally A, Danis R, Agrón E, et al.

期刊名称:Ophthalmology

卷期:2016年第123卷第11期

摘要

目的:旨在比较彩色照片和眼底自发荧光(FAF)图像显示的地理性萎缩(GA)面积和GA面积变化。设计:年龄相关性眼病研究2AREDS2)是一项前瞻性多中心随机临床试验,这项试验在5年期间每年使用彩色照片评估了干性年龄相关性黄斑变性(AMD)的进展。获取研究期间的任何年度就诊时加入FAF辅助研究的参与者的FAF图像。研究对象:AREDS2 FAF辅助研究包括8070份相关彩色图像及2202例能随访到的受试者的FSF记录。方法:在中央读数中心独立评估相应的颜色和FAF图像,用于GA区域测量,病变生长和黄斑中心受累。主要预后指标:彩色和FAF图像上显示的GA,面积,生长速率和黄斑中心受累。结果:2048次就诊时发现低荧光(25.4%)。两种方式之间GA的一致性为0.79kappa23%的低自发荧光就诊者的彩色照片上没有表现GA GA存在百分比的一致性从基线时的43%到第5年的81%,随着时间的推移而改善。两种方式之间的GA面积平均差异为0.5mm2),FAF面积较大。 彩色照片个FAF图像的GA生长速率分别为1.45mm2),1.43mm2)。彩色照片组51%和FAF图像组56%的受试者有黄斑中心受累。结论:使用FAF图像可早期发现地理性萎缩,但在这项研究中,两种类型不相上下。 彩色照片和FAF图像上的GA区域进展可比,但黄斑中心受累的评估可能不同,可能是因为黄斑色素沉着阻断了自发荧光。

PURPOSE:To compare measurements of area of geographic atrophy (GA) and change in GA area from color photographs and fundus autofluorescence (FAF) images.DESIGN:The Age-Related Eye Disease Study 2 (AREDS2) was a prospective multicenter randomized clinical trial evaluating progression of dry age-related macular degeneration (AMD) using color photographs at annual visits over a 5-year study period. The FAF images were acquired in a subset of participants who joined the FAF ancillary study at any of the annual visits over the study period.PARTICIPANTS:The AREDS2 FAF ancillary study included 8070 corresponding color and FAF visits of 2202 participants with variable follow-up.METHODS:Corresponding color and FAF images were independently evaluated at a central reading center for GA area measurement, lesion growth, and involvement of the macula center.MAIN OUTCOME MEASURES:Presence, area, growth rate of GA, and involvement of center of macula from color and FAF images.RESULTS:Hypoautofluorescence was visible in 2048 visits (25.4%). Agreement for the presence of GA between the 2 modalities had a kappa of 0.79, with 23% of visits with hypoautofluorescence not presenting with GA on color photographs. Percentage agreement for GA presence ranged from 43% at baseline to 81% at year 5 with improving agreement over time. The mean difference in GA area between the 2 modalities was 0.5 mm(2), with larger areas on FAF. Growth rate of GA was 1.45 mm(2) from color photographs and 1.43 mm(2) from FAF images. The center of the macula was involved in 51% of color photographs and 56% with FAF images.CONCLUSIONS:Geographic atrophy may be detected earlier by the use of FAF images, but over the course of the study, the 2 modalities become comparable. Progression of GA area is comparable between color photographs and FAF images, but evaluating involvement of the center of the macula may differ, probably because of macular pigmentation blocking autofluorescence.


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