NATURAL COURSE OF AGE-RELATED RETENTIONAL AVASCULAR PIGMENT EPITHELIAL DETACHMENT: Support For The Lipid Barrier Hypothesis.

IF 2.3 2区医学 Q2 OPHTHALMOLOGY Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2024-11-01 DOI:10.1097/IAE.0000000000004210

Yongyue Su, Feng Wen, Yuhong Gan, Yunkao Zeng, Xuenan Zhuang, Guiqin He, Yining Zhang, Ruijun Yang, Xiongze Zhang

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Abstract

Purpose: Retentional pigment epithelial detachment (PED) associated with age-related scattered hypofluorescent spots on late-phase indocyanine green angiography (ASHS-LIA) is hypothesized to be caused by Bruch membrane's lipid barrier. This study aimed to report the natural course of retentional PED and evaluate the relationship between retentional PED evolution and ASHS-LIA.

Methods: Patients with treatment-naïve retentional PED were enrolled and observed every 3 months for at least 12 months. Treatment was not performed except for secondary macular neovascularization.

Results: In 55 studied eyes with a median follow-up of 18.0 (range: 12-36) months, 87.3% (48/55) of the retentional PEDs persisted, 7.3% (4/55) resolved, and 5.5% (3/55) progressed to polypoidal choroidal vasculopathy. The mean PED area significantly increased during the follow-up ( P < 0.001) and with the ASHS-LIA grade at each follow-up point (all P <0.05), especially during the first 6 months before approaching the edge of confluent ASHS-LIA. Persistent PEDs were mostly stable (52.1%) or enlarged (45.8%) but reduced in only 1 case (2.1%) because of retinal pigment epithelium microrip at the edge of PED. The persistent PEDs were all within the ASHS-LIA region, especially the macular confluence region. The resolved PEDs all had grade 1 ASHS-LIA and resolved after gradual expansion of PED beyond the confluent ASHS-LIA region. Pigment epithelial detachments that progressed to macular neovascularization all had confluent grade 2 or 3 ASHS-LIA. Retinal pigment epithelium microrips or apertures within PED did not affect the progression of the PED.

Conclusion: The natural course of retentional PED is closely related to the features of ASHS-LIA and supports its lipid-barrier hypothesis.

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与年龄相关的保留性血管色素上皮脱落的自然过程：支持脂质屏障假说

目的：潴留性色素上皮脱落（PED）与晚期吲哚青绿血管造影（ASHS-LIA）中与年龄相关的散在低荧光斑点有关，据推测是由布鲁氏膜的脂质屏障引起的。本研究旨在报告保留性 PED 的自然病程，并评估保留性 PED 演变与 ASHS-LIA 之间的关系：方法：研究人员招募了未经治疗的滞留性 PED 患者，每 3 个月观察一次，至少观察 12 个月。除了继发性黄斑新生血管外，其他患者均未接受治疗：中位随访时间为 18.0 个月（12-36 个月）的 55 例患者中，87.3%（48/55）的留存性 PED 持续存在，7.3%（4/55）的留存性 PED 消失，5.5%（3/55）的留存性 PED 进展为多形性脉络膜血管病。随访期间，PED 的平均面积明显增加（P滞留性 PED 的自然病程与 ASHS-LIA 的特征密切相关，支持其脂质屏障假说。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.