Prädiktive Nahinfrarot-SLO-Merkmale für Risse des retinalen Pigmentepithels bei altersabhängiger Makuladegeneration

 

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Zusammenfassung

Hintergrund: Ziel dieser Studie war es, prädiktive Merkmale für das Auftreten von Rissen des retinalen Pigmentepithels (RPE) bei altersabhängiger Makuladegeneration (AMD) in Gegenwart von RPE-Abhebungen mittels konfokaler Scanning Laser Ophthalmoskopie (cSLO)-basierter Bildgebung zu identifizieren.

Material und Methoden: Fünfzehn Augen von 15 Patienten (mittleres Alter 77 Jahre, SD ± 6), bei denen sich im Verlauf aus retinalen Pigmentepithelabhebungen ein RPE-Riss entwickelte, wurden retrospektiv hinsichtlich Veränderungen in Nahinfrarot-Reflexions-(NIR-)Aufnahmen ausgewertet.

Ergebnisse: In 13 von 15 Fällen (87 %) zeigte sich ein umschriebenes, irreguläres erhöhtes Signal im Bereich der PED durchschnittlich 58 Tage (SD ± 40) vor Diagnose des RPE-Risses. Bei 62 % der Patienten traten diese Veränderungen am gegenüberliegenden PED-Rand der späteren Risslokalisation auf.

Schlussfolgerung: Hyperreflektive Signale in der NIR-Bildgebung können auf einen inzipienten Riss des RPE in Gegenwart einer RPE-Abhebung hinweisen. Dieses mittels eines nicht invasiven Bildgebungsverfahrens neu identifizierte, potenziell prädiktive Merkmal soll nun in größeren Kohorten bei Patienten mit AMD-assoziierten Pigmentepithelabhebungen prospektiv validiert werden und könnte für Therapieentscheidungen hilfreich sein.

Abstract

Purpose: The aim of this study was to identify potential predictive markers in confocal scanning laser ophthalmoscopy (cSLO)-based imaging for tears of the retinal pigment epithelium (RPE) in the presence of pigment epithelial detachments (PED) due to age-related macular degeneration (AMD).

Methods: Fifteen eyes of 15 patients (mean age 77 years, SD ± 6) with RPE tears and pre-existing PEDs were retrospectively analysed for the presence of increased signals on near-infrared imaging (NIR) using confocal scanning laser ophthalmoscopy (cSLO).

Results: In 87 % of the cases increased reflectance signals on NIR in the area of the PED were noted prior to the development of an RPE tear. On average, these signals were recorded 58 days (SD ± 40) before the rip was diagnosed. In 62 % of the patients these signals were localised opposite to the rip location at the rim of the PED.

Conclusion: Increased reflectance signals on NIR imaging may serve as a predictive marker for RPE tears in patients with PED in AMD. These signals recordable with a non-invasive imaging method should be prospectively validated in a larger cohort of patients with PEDs. It may be useful in the management of patients exhibiting this manifestation of exudative AMD.

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