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<p>The goal of the study was to assess the presence of an incomplete (iRORA) and complete (cRORA) retinal pigment epithelium (RPE) and outer retinal atrophy in a general population and explore their associations with other parameters. Participants of the population-based Beijing Eye Study with age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) or those without retinal diseases, underwent optical coherence tomography of the macula. Among 5894 eyes, presence of iRORA and cRORA increased from 0/5117 (0%) and 0/5117 (0%) in the normal group and 0/457 (0%) and 0/457 (0%) in early AMD to 5/277 (1.8%;95%CI:0.3,3.3) and 0/277 (0%) in intermediate AMD, 6/6 (100%) and 6/6 (100%) in geographic atrophy, 0/2 (0%) and 2/2 (100%) in exudative AMD, and 10/30 (33.3%;95%CI:17.8,48.8) and 6/30 (25.0%;95%CI:12.0,38.0) in PCV, respectively. Higher iRORA presence was associated (multivariable analysis) with higher AMD stage (OR:54.7;95%CI:6.68,449;<i>P</i> &lt; 0.001), higher PCV presence (OR:1.523 × 10<sup>5</sup>;95%CI:834,2.785 × 10<sup>7</sup>;<i>P</i> &lt; 0.001), and higher presence of reticular pseudodrusen (OR:19.2;95%CI:1.94,190;<i>P</i> &lt; 0.001). Drusen number (OR:0.97;95%CI:0.91,1.03;<i>P</i> = 0.27) and subfoveal choroidal thickness (OR:1.003;95%CI:0.994,1.013;<i>P</i> = 0.49) were not associated. Higher cRORA presence correlated with higher PCV presence (OR:48.6;95%CI:4.58,517;<i>P</i> = 0.001) and higher presence of reticular pseudodrusen (OR:120;95%CI:13.1,1094;<i>P</i> &lt; 0.001). iRORAs and cRORAs were spatially associated with ellipsoid zone and external limiting membrane defects and intraretinal hyperreflective foci (iHRFs) in the outer and inner retinal layers. The findings suggest that iRORAs and cRORAs presences were relatively low in our population-based study, and were associated with higher presence of reticular pseudodrusen but not with drusen number or subfoveal choroidal thickness. The spatial association with ellipsoid zone defects and external limiting membrane defects and iHRF in the outer retinal layer and beyond fits with the notion of an RPE cell migration playing a role in the development of iRORAs and cRORAs.</p>

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Presence and associations of retinal pigment epithelium and outer retinal atrophy: the Beijing eye study

  • 期刊论文

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  • 发表日期：

    2026年6月2日

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  • Jost B. Jonas,
  • Songhomitra Panda-Jonas,
  • Jie Xu,
  • Rahul A. Jonas,
  • Ya Xing Wang

摘要

The goal of the study was to assess the presence of an incomplete (iRORA) and complete (cRORA) retinal pigment epithelium (RPE) and outer retinal atrophy in a general population and explore their associations with other parameters. Participants of the population-based Beijing Eye Study with age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) or those without retinal diseases, underwent optical coherence tomography of the macula. Among 5894 eyes, presence of iRORA and cRORA increased from 0/5117 (0%) and 0/5117 (0%) in the normal group and 0/457 (0%) and 0/457 (0%) in early AMD to 5/277 (1.8%;95%CI:0.3,3.3) and 0/277 (0%) in intermediate AMD, 6/6 (100%) and 6/6 (100%) in geographic atrophy, 0/2 (0%) and 2/2 (100%) in exudative AMD, and 10/30 (33.3%;95%CI:17.8,48.8) and 6/30 (25.0%;95%CI:12.0,38.0) in PCV, respectively. Higher iRORA presence was associated (multivariable analysis) with higher AMD stage (OR:54.7;95%CI:6.68,449;P < 0.001), higher PCV presence (OR:1.523 × 105;95%CI:834,2.785 × 107;P < 0.001), and higher presence of reticular pseudodrusen (OR:19.2;95%CI:1.94,190;P < 0.001). Drusen number (OR:0.97;95%CI:0.91,1.03;P = 0.27) and subfoveal choroidal thickness (OR:1.003;95%CI:0.994,1.013;P = 0.49) were not associated. Higher cRORA presence correlated with higher PCV presence (OR:48.6;95%CI:4.58,517;P = 0.001) and higher presence of reticular pseudodrusen (OR:120;95%CI:13.1,1094;P < 0.001). iRORAs and cRORAs were spatially associated with ellipsoid zone and external limiting membrane defects and intraretinal hyperreflective foci (iHRFs) in the outer and inner retinal layers. The findings suggest that iRORAs and cRORAs presences were relatively low in our population-based study, and were associated with higher presence of reticular pseudodrusen but not with drusen number or subfoveal choroidal thickness. The spatial association with ellipsoid zone defects and external limiting membrane defects and iHRF in the outer retinal layer and beyond fits with the notion of an RPE cell migration playing a role in the development of iRORAs and cRORAs.