Clinical Characteristics and Progression of Pachychoroid and Conventional Geographic Atrophy

IF 3.2 Q1 OPHTHALMOLOGY Ophthalmology science Pub Date : 2024-04-10 DOI:10.1016/j.xops.2024.100528

Yukiko Sato MD , Naoko Ueda-Arakawa MD, PhD , Ayako Takahashi MD, PhD , Masahiro Miyake MD, PhD , Yuki Mori MD, PhD , Yasunori Miyara MD , Chikako Hara MD, PhD , Yoko Kitajima MD , Ruka Maruko MD, PhD , Moeko Kawai MD , Hajime Takahashi MD, PhD , Hideki Koizumi MD, PhD , Maiko Maruyama-Inoue MD, PhD , Yasuo Yanagi MD, PhD , Tomohiro Iida MD, PhD , Kanji Takahashi MD, PhD , Taiji Sakamoto MD, PhD , Akitaka Tsujikawa MD, PhD

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Abstract

Purpose

To elucidate the clinical characteristics and progression rates of pachychoroid and conventional geographic atrophy (GA).

Design

Retrospective, multicenter, observational study.

Participants

A total of 173 eyes from 173 patients (38 eyes with pachychoroid GA and 135 with conventional GA) from 6 university hospitals in Japan were included. All patients were Japanese, aged ≥50 years and with fundus autofluorescence images having analyzable image quality. A total of 101 eyes (22 with pachychoroid GA and 79 with conventional GA) were included in the follow-up group.

Methods

The studied eyes were classified as having pachychoroid or conventional GA; the former was diagnosed if the eye had features of pachychoroid and no drusen. The GA area was semiautomatically measured on fundus autofluorescence images, and the GA progression rate was calculated for the follow-up group. Multivariable linear regression analysis was used to determine whether the rate of GA progression was associated with GA subtype.

Main Outcome Measures

Clinical characteristics and progression rates of pachychoroid and conventional GA.

Results

The pachychoroid GA group was significantly younger (70.3 vs. 78.7 years; P < 0.001), more male-dominant (89.5 vs. 55.6%; P < 0.001), and had better best-corrected visual acuity (0.15 vs. 0.40 in logarithm of the minimum angle of resolution; P = 0.002), thicker choroid (312.4 vs. 161.6 μm; P < 0.001), higher rate of unifocal GA type (94.7 vs. 49.6%; P < 0.001), and smaller GA area (0.59 vs. 3.76 mm²^; P < 0.001) than the conventional GA group. In the follow-up group, the mean GA progression rate (square-root transformation) was significantly lower in the pachychoroid GA group than in the conventional GA group (0.11 vs. 0.27 mm/year; P < 0.001).

Conclusions

Demographic and ocular characteristics differed between GA subtypes. The progression rate of pachychoroid GA, adjusted for age and baseline GA area, was significantly lower than that of conventional GA. Japanese patients with conventional GA showed characteristics and progression rates similar to those in White populations. Some characteristics of GA in Japanese population differ from those in Waucasian populations, which may be due to the inclusion of pachychoroid GA.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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蛛网膜下腔和传统性地理萎缩的临床特征和发展过程

目的阐明蛛网膜下腔和传统性地理萎缩（GA）的临床特征和进展率。参与者共纳入了来自日本 6 所大学医院的 173 名患者的 173 只眼睛（38 只眼睛患有蛛网膜下腔 GA，135 只眼睛患有传统性 GA）。所有患者均为日本人，年龄≥50 岁，眼底自动荧光图像具有可分析的图像质量。随访组共包括 101 只眼睛（22 只为蛛网膜性 GA，79 只为传统 GA）。方法将研究对象的眼睛分为蛛网膜性 GA 和传统 GA；如果眼睛具有蛛网膜特征且无梭形细胞，则诊断为前者。根据眼底自动荧光图像对GA面积进行半自动测量，并计算随访组的GA进展率。采用多变量线性回归分析确定GA进展率是否与GA亚型相关。主要结果测量蛛网膜GA和传统GA的临床特征和进展率。结果蛛网膜GA组明显更年轻（70.3 vs. 78.7岁；P <0.001），男性占多数（89.5 vs. 55.6%; P <0.001），最佳矫正视力更好（最小分辨角对数为 0.15 vs. 0.40; P = 0.002），脉络膜更厚（312.4 μm vs. 161.6 μm; P = 0.003），视网膜更薄（1.5 μm vs. 1.5 μm; P = 0.004）。P=0.002）、脉络膜更厚（312.4 μm 对 161.6 μm；P=0.001）、单焦点 GA 率更高（94.7% 对 49.6%；P=0.001）、GA 面积更小（0.59 mm2 对 3.76 mm2；P=0.001）。在随访组中，柏氏GA组的平均GA进展率（平方根变换）明显低于传统GA组（0.11 vs. 0.27 mm/年；P < 0.001）。经年龄和基线GA面积调整后，虹膜睫状体GA的进展率明显低于传统GA。日本传统 GA 患者的特征和进展率与白人相似。日本人群中GA的某些特征与白种人不同，这可能是由于包含了咽峡部GA。

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