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[PMID]:29196768
[Au] Autor:Zarubina AV; Gal-Or O; Huisingh CE; Owsley C; Freund KB
[Ad] Endereço:Department of Ophthalmology, School of Medicine; University of Alabama at Birmingham, Birmingham, Alabama, United States.
[Ti] Título:Macular Atrophy Development and Subretinal Drusenoid Deposits in Anti-Vascular Endothelial Growth Factor Treated Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(14):6038-6045, 2017 Dec 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To explore the association between presence of subretinal drusenoid deposits (SDD) at baseline in eyes with neovascular age-related macular degeneration (nAMD) with the development of macular atrophy (MA) during anti-vascular endothelial growth factor (VEGF) therapy. Methods: There were 74 eyes without pre-existing MA receiving anti-VEGF therapy for nAMD for 2 years or longer analyzed. At least two image modalities that included spectral-domain optical coherence tomography, near-infrared reflectance, fluorescein angiography, and color fundus photos were used to assess for SDD presence, phenotype (dot and ribbon), and location, neovascularization type, and MA. Logistic regression models using generalized estimating equations assessed the association between SDD and the development of MA adjusting for age, neovascularization type, and choroidal thickness. Results: SDD were present in 46 eyes (63%) at baseline. MA developed in 38 eyes (51%) during the mean of 4.7 ± 1.2 years of follow-up. Compared with eyes without SDD, those with SDD at baseline were 3.0 times (95% confidence interval [CI] 1.1-8.5, P = 0.0343) more likely to develop MA. Eyes with SDD present in the inferior macula and inferior extramacular fields at baseline were 3.0 times and 6.5 times more likely to develop MA at follow-up than eyes without SDD in these locations (95% CI 1.0-8.9, P = 0.0461 and 95% CI 1.3-32.4, P = 0.0218, respectively). MA development was not associated with a specific SDD phenotype. Conclusions: MA frequently developed in eyes during anti-VEGF treatment. SDD were independently associated with MA development. The extension of SDD into the inferior fundus, particularly in the inferior extramacular field, conferred higher odds of subsequent MA development.
[Mh] Termos MeSH primário: Macula Lutea/patologia
Ranibizumab/efeitos adversos
Drusas Retinianas/induzido quimicamente
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Inibidores da Angiogênese/administração & dosagem
Inibidores da Angiogênese/efeitos adversos
Feminino
Angiofluoresceinografia
Seguimentos
Fundo de Olho
Seres Humanos
Injeções Intravítreas
Macula Lutea/efeitos dos fármacos
Masculino
Ranibizumab/administração & dosagem
Drusas Retinianas/diagnóstico
Estudos Retrospectivos
Fatores de Tempo
Tomografia de Coerência Óptica
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Acuidade Visual
Degeneração Macular Exsudativa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22378


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[PMID]:28973332
[Au] Autor:Dysli C; Fink R; Wolf S; Zinkernagel MS
[Ad] Endereço:Department of Ophthalmology, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland.
[Ti] Título:Fluorescence Lifetimes of Drusen in Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4856-4862, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: The purpose of this study was to characterize fundus autofluorescence lifetimes of retinal drusen in patients with AMD. Methods: Patients with AMD and retinal drusen and healthy controls of similar age were examined. A fluorescence lifetime imaging ophthalmoscope was used. Retinal autofluorescence was excited using a 473-nm pulsed laser, and fundus autofluorescence lifetimes of the central retina (30°) were measured in two distinct spectral channels (short: 498 to 560 nm [SSC]; long: 560 to 720 nm [LSC]). Mean retinal autofluorescence lifetimes, corresponding fundus autofluorescence intensity images, spectral domain optical coherence tomography, color fundus images, and clinical data were investigated. Patients were analyzed in two distinct groups (soft drusen and reticular pseudodrusen) and compared with control subjects. Results: Sixty-four eyes of 64 patients with AMD and retinal drusen (age: mean ± SD, 78 ± 8.5 years; range, 59 to 94 years) were investigated and compared with a control group of 20 age-matched healthy subjects. Mean retinal autofluorescence lifetimes in patients with AMD was significantly prolonged compared with the healthy control eyes (mean ± SEM: SSC, 486 ± 18 vs. 332 ± 11 ps, P < 0.0001; LSC: 493 ± 9 vs. 382 ± 17 ps, P < 0.0001). Areas of drusen featured a wide range of fluorescence lifetime values. Long lifetimes were identified in areas of atrophy and in areas of intraretinal hyperreflective deposits. Short lifetimes corresponded to deposits within the photoreceptor outer segment band. Conclusions: Mean retinal autofluorescence lifetimes in AMD patients are significantly prolonged. Intraretinal deposits cause prolonged lifetimes, whereas deposits in the area of the outer photoreceptor segments lead to short fluorescence lifetimes.
[Mh] Termos MeSH primário: Degeneração Macular/patologia
Drusas Retinianas/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Angiofluoresceinografia/métodos
Fundo de Olho
Atrofia Geográfica/patologia
Seres Humanos
Masculino
Meia-Idade
Oftalmoscopia/métodos
Tomografia de Coerência Óptica/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22184


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[PMID]:28973322
[Au] Autor:Paavo M; Lee W; Merriam J; Bearelly S; Tsang S; Chang S; Sparrow JR
[Ad] Endereço:Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States.
[Ti] Título:Intraretinal Correlates of Reticular Pseudodrusen Revealed by Autofluorescence and En Face OCT.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4769-4777, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: We sought to determine whether information revealed from the reflectance, autofluorescence, and absorption properties of RPE cells situated posterior to reticular pseudodrusen (RPD) could provide insight into the origins and structure of RPD. Methods: RPD were studied qualitatively by near-infrared fundus autofluorescence (NIR-AF), short-wavelength fundus autofluorescence (SW-AF), and infrared reflectance (IR-R) images, and the presentation was compared to horizontal and en face spectral domain optical coherence tomographic (SD-OCT) images. Images were acquired from 23 patients (39 eyes) diagnosed with RPD (mean age 80.7 ± 7.1 [SD]; 16 female; 4 Hispanics, 19 non-Hispanic whites). Results: In SW-AF, NIR-AF, and IR-R images, fundus RPD were recognized as interlacing networks of small scale variations in IR-R and fluorescence (SW-AF, NIR-AF) intensities. Darkened foci of RPD colocalized in SW-AF and NIR-AF images, and in SD-OCT images corresponded to disturbances of the interdigitation (IZ) and ellipsoid (EZ) zones and to more pronounced hyperreflective lesions traversing photoreceptor-attributable bands in SD-OCT images. Qualitative assessment of the outer nuclear layer (ONL) revealed thinning as RPD extended radially from the outer to inner retina. In en face OCT, hyperreflective areas in the EZ band correlated topographically with hyporeflective foci at the level of the RPE. Conclusions: The hyperreflective lesions corresponding to RPD in SD-OCT scans are likely indicative of degenerating photoreceptor cells. The darkened foci at positions of RPD in NIR-AF and en face OCT images indicate changes in the RPE monolayer with the reduced NIR-AF and en face OCT signal suggesting a reduction in melanin that could be accounted for by RPE thinning.
[Mh] Termos MeSH primário: Angiofluoresceinografia/métodos
Degeneração Macular/diagnóstico por imagem
Drusas Retinianas/diagnóstico por imagem
Epitélio Pigmentado da Retina/diagnóstico por imagem
Tomografia de Coerência Óptica/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Fundo de Olho
Seres Humanos
Masculino
Meia-Idade
Imagem Óptica/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22338


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[PMID]:28859202
[Au] Autor:Kersten E; Geerlings MJ; den Hollander AI; de Jong EK; Fauser S; Peto T; Hoyng CB
[Ad] Endereço:Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
[Ti] Título:Phenotype Characteristics of Patients With Age-Related Macular Degeneration Carrying a Rare Variant in the Complement Factor H Gene.
[So] Source:JAMA Ophthalmol;135(10):1037-1044, 2017 Oct 01.
[Is] ISSN:2168-6173
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Rare variants in the complement factor H (CFH) gene and their association with age-related macular degeneration (AMD) have been described. However, there is limited literature on the phenotypes accompanying these rare variants. Phenotypical characteristics could help ophthalmologists select patients for additional genetic testing. Objective: To describe the phenotypical characteristics of patients with AMD carrying a rare variant in the CFH gene. Design, Setting, and Participants: In this cross-sectional study, we searched the genetic database of the department of ophthalmology at the Radboudumc (tertiary ophthalmologic referral center) and the European Genetic Database for patients with AMD with a rare genetic variant in the CFH gene. Patient recruitment took place from March 30, 2006, to February 18, 2013, and data were analyzed from November 30, 2015, to May 8, 2017. Phenotypical features on fundus photographs of both eyes of patients were graded by 2 independent reading center graders masked for carrier status. Main Outcomes and Measures: Differences in phenotypical characteristics between rare variant carriers and noncarriers were analyzed using univariable generalized estimated equations logistic regression models accounting for intereye correlation. Results: Analyses included 100 eyes of 51 patients with AMD carrying a CFH variant (mean [SD] age, 66.7 [12.1] years; 64.7% female) and 204 eyes of 102 age-matched noncarriers (mean [SD] age, 67.1 [11.8] years; 54.9% female). Carrying a rare pathogenic CFH variant was associated with larger drusen area (odds ratio range, 6.98 [95% CI, 2.04-23.89] to 18.50 [95% CI, 2.19-155.99]; P = .002), presence of drusen with crystalline appearance (odds ratio, 3.24; 95% CI, 1.24-8.50; P = .02), and drusen nasal to the optic disc (odds ratio range, 4.03 [95% CI, 1.70-9.56] to 7.42 [95% CI, 0.65-84.84]; P = .003). Conclusions and Relevance: Identification of rare CFH variant carriers may be important for upcoming complement-inhibiting therapies. Patients with an extensive drusen area, drusen with crystalline appearance, and drusen nasal to the optic disc are more likely to have a rare variant in the CFH gene. However, it is not likely that carriers can be discriminated from noncarriers based solely on phenotypical characteristics from color fundus images. Therefore, ophthalmologists should consider genetic testing in patients with these phenotypic characteristics in combination with other patient characteristics, such as early onset, cuticular drusen on fluorescein angiography, and family history of AMD.
[Mh] Termos MeSH primário: Degeneração Macular/genética
Fenótipo
Polimorfismo de Nucleotídeo Único
Drusas Retinianas/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Fator H do Complemento/genética
Estudos Transversais
Bases de Dados Factuais
Feminino
Angiofluoresceinografia
Testes Genéticos
Técnicas de Genotipagem
Seres Humanos
Degeneração Macular/diagnóstico
Masculino
Meia-Idade
Drusas Retinianas/patologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (complement factor H, human); 80295-65-4 (Complement Factor H)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1001/jamaophthalmol.2017.3195


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[PMID]:28846119
[Au] Autor:Vemala R; Sivaprasad S; Barbur JL
[Ad] Endereço:King's College Hospital, Denmark Hill, London, United Kingdom.
[Ti] Título:Detection of Early Loss of Color Vision in Age-Related Macular Degeneration - With Emphasis on Drusen and Reticular Pseudodrusen.
[So] Source:Invest Ophthalmol Vis Sci;58(6):BIO247-BIO254, 2017 May 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To evaluate chromatic sensitivity in patients with age-related macular degeneration (AMD) characterized by drusen and reticular pseudodrusen. To investigate whether the severity of color vision loss can distinguish between various stages of AMD and hence be used as an index of progression toward advanced AMD. Methods: Chromatic sensitivity was measured by using the Color Assessment and Diagnosis (CAD) test in asymptomatic individuals with early and intermediate AMD and compared to normative data. All study participants had logMAR visual acuity of 0.3 or better. The CAD thresholds measured in eyes with and without reticular pseudodrusen were also compared and related to central macular thickness (CMT). Student's t-test P values < 0.05 were considered significant. Results: All early- and intermediate-AMD eyes (n = 90) had chromatic sensitivity loss in either RG (red/green) or YB (yellow/blue), or both (P < 0.0001) as compared to age-matched normal subjects. The eyes exhibited a range of CAD thresholds affecting both color mechanisms, but YB color thresholds were in general higher than RG thresholds (P < 0.001). Intermediate-AMD patients exhibited large intersubject variability. In general, eyes with reticular pseudodrusen and eyes with CMT < 200 µm had significantly higher CAD thresholds. Conclusions: The anatomic integrity of cone photoreceptors remains relatively unaffected in early and intermediate stages of AMD. The processing of cone signals in the retina can, however, be heavily disrupted with subsequent loss of both YB and RG chromatic sensitivity. The greatest losses were observed in eyes with reticular pseudodrusen.
[Mh] Termos MeSH primário: Defeitos da Visão Cromática/diagnóstico
Degeneração Macular/diagnóstico
Drusas Retinianas/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Testes de Percepção de Cores
Feminino
Angiofluoresceinografia
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Tomografia de Coerência Óptica
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21771


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[PMID]:28785769
[Au] Autor:Curcio CA; Zanzottera EC; Ach T; Balaratnasingam C; Freund KB
[Ad] Endereço:Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama, United States.
[Ti] Título:Activated Retinal Pigment Epithelium, an Optical Coherence Tomography Biomarker for Progression in Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(6):BIO211-BIO226, 2017 May 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To summarize and contextualize recent histology and clinical imaging publications on retinal pigment epithelium (RPE) fate in advanced age-related macular degeneration (AMD); to support RPE activation and migration as important precursors to atrophy, manifest as intraretinal hyperreflective foci in spectral-domain optical coherence tomography (SDOCT). Methods: The Project MACULA online resource for AMD histopathology was surveyed systematically to form a catalog of 15 phenotypes of RPE and RPE-derived cells and layer thicknesses in advanced disease. Phenotypes were also sought in correlations with clinical longitudinal eye-tracked SDOCT and with ex vivo imaging-histopathology correlations in geographic atrophy (GA) and pigment epithelium detachments (PED). Results: The morphology catalog suggested two main pathways of RPE fate: basolateral shedding of intracellular organelles (apparent apoptosis in situ) and activation with anterior migration. Acquired vitelliform lesions may represent a third pathway. Migrated cells are packed with RPE organelles and confirmed as hyperreflective on SDOCT. RPE layer thickening due to cellular dysmorphia and thick basal laminar deposit is observed near the border of GA. Drusenoid PED show a life cycle of slow growth and rapid collapse preceded by RPE layer disruption and anterior migration. Conclusions: RPE activation and migration comprise an important precursor to atrophy that can be observed at the cellular level in vivo via validated SDOCT. Collapse of large drusen and drusenoid PED appears to occur when RPE death and migration prevent continued production of druse components. Data implicate excessive diffusion distance from choriocapillaris in RPE death as well as support a potential benefit in targeting drusen in GA.
[Mh] Termos MeSH primário: Biomarcadores
Atrofia Geográfica/diagnóstico
Epitélio Pigmentado da Retina/patologia
[Mh] Termos MeSH secundário: Idoso
Movimento Celular
Neovascularização de Coroide/patologia
Progressão da Doença
Feminino
Angiofluoresceinografia
Seres Humanos
Masculino
Descolamento Retiniano/patologia
Drusas Retinianas/patologia
Tomografia de Coerência Óptica
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21872


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[PMID]:28728186
[Au] Autor:Carnevali A; Querques G
[Ti] Título:Choroidal Neovascularization and Geographic Atrophy are Potential Complications of Early Onset Large Colloid Drusen.
[So] Source:Ophthalmic Surg Lasers Imaging Retina;48(7):586-590, 2017 Jul 01.
[Is] ISSN:2325-8179
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The authors report a case of large colloid drusen (LCD) complicated by choroidal neovascularization (CNV) and geographic atrophy (GA). A 54-year-old man was referred to the authors' department with diagnosis of early onset retinal drusen. Multimodal imaging led to a diagnosis of LCD complicated by GA in the right eye and CNV in the left eye. The patient received a single injection of intravitreal aflibercept (Eylea; Regeneron, Tarrytown, NY) in the left eye. Six months later, best-corrected visual acuity improved to 20/25, and spectral-domain optical coherence tomography still showed absence of subretinal and intraretinal fluid. GA and CNV are possible complications of LCD, and contrary to previous beliefs, it should therefore not be considered as a benign condition. Intravitreal aflibercept could be considered as a useful treatment in cases complicated by CNV. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:586-590.].
[Mh] Termos MeSH primário: Neovascularização de Coroide/etiologia
Atrofia Geográfica/etiologia
Drusas Retinianas/complicações
[Mh] Termos MeSH secundário: Neovascularização de Coroide/diagnóstico
Neovascularização de Coroide/tratamento farmacológico
Angiofluoresceinografia/métodos
Seguimentos
Fundo de Olho
Atrofia Geográfica/complicações
Atrofia Geográfica/tratamento farmacológico
Seres Humanos
Injeções Intravítreas
Masculino
Meia-Idade
Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Proteínas Recombinantes de Fusão/administração & dosagem
Drusas Retinianas/diagnóstico
Drusas Retinianas/tratamento farmacológico
Fatores de Tempo
Tomografia de Coerência Óptica/métodos
Acuidade Visual
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.3928/23258160-20170630-11


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[PMID]:28715590
[Au] Autor:Ferrara D; Silver RE; Louzada RN; Novais EA; Collins GK; Seddon JM
[Ad] Endereço:Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, United States.
[Ti] Título:Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration.
[So] Source:Invest Ophthalmol Vis Sci;58(9):3519-3529, 2017 Jul 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: Age-related macular degeneration (AMD) is a progressive disease with multifactorial etiology. There is a need to identify clinical features that are harbingers of advanced disease. We evaluated morphologic features of the retina and choroid on optical coherence tomography (OCT) to determine if they predict progression to advanced disease. Methods: Progressors transitioned from early or intermediate AMD to advanced disease (n = 40 eyes), and were matched on baseline AMD grade and follow-up interval to nonprogressors who did not develop advanced AMD (n = 40 eyes). Features of the neurosensory retina, photoreceptors, retinal pigment epithelium (RPE), and choroid were evaluated. Logistic regression was used to evaluate univariate associations between features and progression to overall advanced AMD, geographic atrophy (GA), and neovascular disease (NV). Multivariate associations based on stepwise regression models were also assessed. Results: Ellipsoid zone disruption was associated with progression to overall advanced AMD and NV (odds ratios [ORs]: 17.9 and 30.6; P < 0.001), with a similar trend observed for GA. Drusenoid RPE detachment, RPE thickening, and retinal pigmentary hyperreflective material were significantly associated with higher risk of progression to advanced AMD (ORs: 5.0-8.5) and NV (ORs: 10.8-17.2). Pigmentary hyperreflective material was associated with progression to GA (OR: 7.5, P = 0.009). Total retinal thickness, pigmentary hyperreflective material, nascent GA features, and choroidal vessel abnormalities were independently associated with progression to advanced AMD in a multivariate stepwise model. Conclusions: Abnormalities in the photoreceptors, retinal thickness, RPE, and choroid were associated with higher risk of developing advanced AMD. These findings provide insights into disease progression, and may be helpful to identify earlier endpoints for clinical studies.
[Mh] Termos MeSH primário: Corioide/diagnóstico por imagem
Neovascularização de Coroide/diagnóstico
Atrofia Geográfica/diagnóstico
Retina/diagnóstico por imagem
Drusas Retinianas/diagnóstico
Tomografia de Coerência Óptica
Degeneração Macular Exsudativa/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Inibidores da Angiogênese/uso terapêutico
Neovascularização de Coroide/tratamento farmacológico
Progressão da Doença
Feminino
Angiofluoresceinografia
Seguimentos
Atrofia Geográfica/tratamento farmacológico
Seres Humanos
Injeções Intravítreas
Masculino
Estudos Prospectivos
Ranibizumab/uso terapêutico
Drusas Retinianas/tratamento farmacológico
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Degeneração Macular Exsudativa/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21696


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[PMID]:28658477
[Au] Autor:Bogunovic H; Montuoro A; Baratsits M; Karantonis MG; Waldstein SM; Schlanitz F; Schmidt-Erfurth U
[Ad] Endereço:Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
[Ti] Título:Machine Learning of the Progression of Intermediate Age-Related Macular Degeneration Based on OCT Imaging.
[So] Source:Invest Ophthalmol Vis Sci;58(6):BIO141-BIO150, 2017 May 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To develop a data-driven interpretable predictive model of incoming drusen regression as a sign of disease activity and identify optical coherence tomography (OCT) biomarkers associated with its risk in intermediate age-related macular degeneration (AMD). Methods: Patients with AMD were observed every 3 months, using Spectralis OCT imaging, for a minimum duration of 12 months and up to a period of 60 months. Segmentation of drusen and the overlying layers was obtained using a graph-theoretic method, and the hyperreflective foci were segmented using a voxel classification method. Automated image analysis steps were then applied to identify and characterize individual drusen at baseline, and their development was monitored at every follow-up visit. Finally, a machine learning method based on a sparse Cox proportional hazard regression was developed to estimate a risk score and predict the incoming regression of individual drusen. Results: The predictive model was trained and evaluated on a longitudinal dataset of 61 eyes from 38 patients using cross-validation. The mean follow-up time was 37.8 ± 13.8 months. A total of 944 drusen were identified at baseline, out of which 249 (26%) regressed during follow-up. The prediction performance was evaluated as area under the curve (AUC) for different time periods. Prediction within the first 2 years achieved an AUC of 0.75. Conclusions: The predictive model proposed in this study represents a promising step toward image-guided prediction of AMD progression. Machine learning is expected to accelerate and contribute to the development of new therapeutics that delay the progression of AMD.
[Mh] Termos MeSH primário: Aprendizado de Máquina
Degeneração Macular/diagnóstico
Tomografia de Coerência Óptica/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Biomarcadores/análise
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Prospectivos
Drusas Retinianas/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21789


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[PMID]:28624323
[Au] Autor:Borrelli E; Abdelfattah NS; Uji A; Nittala MG; Boyer DS; Sadda SR
[Ad] Endereço:Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
[Ti] Título:Postreceptor Neuronal Loss in Intermediate Age-related Macular Degeneration.
[So] Source:Am J Ophthalmol;181:1-11, 2017 Sep.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the relationship between ganglion cell complex (GCC) thickness and photoreceptor alterations in eyes with intermediate age-related macular degeneration (AMD). DESIGN: Retrospective case-control study. METHODS: We collected data from 68 eyes with intermediate AMD from 68 patients with spectral-domain optical coherence tomography (SDOCT) imaging. A control group of 50 eyes from 50 healthy subjects was included for comparison. Our main outcome measures for comparison between groups were (1) the average and minimum GCC thickness and (2) the "normalized" reflectivity of the ellipsoid zone (EZ) en face image. RESULTS: The average and minimum GCC thicknesses were thinner in AMD patients (69.54 ± 9.30 µm and 63.22 ± 14.11 µm, respectively) than in healthy controls (78.57 ± 6.28 µm and 76.28 ± 6.85 µm, P < .0001 and P < .0001, respectively). Agreement was found to be excellent in the "normalized" EZ reflectivity assessment (intraclass correlation coefficient = 0.986, coefficient of variation = 1.11). The EZ "normalized" reflectivity was 0.67 ± 0.11 in controls and 0.61 ± 0.09 in the AMD group (P = .006). In univariate analysis, EZ "normalized" reflectivity was found to have a significant direct relationship with average (P < .0001) and minimum (P < .0001) GCC thickness in AMD patients, but not in controls (P = .852 and P = .892, respectively). CONCLUSIONS: Eyes with intermediate AMD exhibit GCC thinning, as well as a reduced EZ "normalized" reflectivity, and these parameters are correlated. This study supports the concept of postreceptor retinal neuronal loss as a contributor to retinal thinning in intermediate AMD.
[Mh] Termos MeSH primário: Fibras Nervosas/patologia
Drusas Retinianas/diagnóstico
Células Ganglionares da Retina/patologia
Segmento Interno das Células Fotorreceptoras da Retina/patologia
Segmento Externo das Células Fotorreceptoras da Retina/patologia
Degeneração Macular Exsudativa/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Estudos Transversais
Feminino
Angiofluoresceinografia
Seres Humanos
Masculino
Estudos Retrospectivos
Tomografia de Coerência Óptica
Acuidade Visual
Degeneração Macular Exsudativa/classificação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE



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