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近视性脉络膜新生血管形成:一项10年随访研究

Myopic choroidal neovascularization: a 10-year follow-up.

作者信息

Yoshida Takeshi, Ohno-Matsui Kyoko, Yasuzumi Kenjiro, Kojima Ariko, Shimada Noriaki, Futagami Soh, Tokoro Takashi, Mochizuki Manabu

机构信息

Department of Ophthalmology and Visual Science, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

出版信息

Ophthalmology. 2003 Jul;110(7):1297-305. doi: 10.1016/S0161-6420(03)00461-5.

Abstract

PURPOSE

To clarify the long-term visual outcome of choroidal neovascularization (CNV) in eyes with high myopia in Asian patients.

DESIGN

We reviewed the medical records of 25 consecutive patients (27 eyes) with myopic CNV who were followed up for at least 10 years after the onset of CNV. Visual acuity was examined 10 years after CNV onset.

INTERVENTION

Demographic and clinical data were obtained from the patients' medical records.

MAIN OUTCOME MEASURES

Visual acuity readings during the 10 years after CNV onset.

RESULTS

At the onset of CNV, 19 eyes (70.4%) had a visual acuity better than 20/200, and six eyes (22.2%) had a visual acuity better than 20/40. Three years after the onset of CNV, 15 eyes (55.5%) retained a visual acuity of better than 20/200. At 5 and 10 years after the onset, however, visual acuity dropped to 20/200 or less in 24 eyes (88.9%) and in 26 eyes (96.3%), respectively. The logarithm of the minimum angle of resolution (logMAR) visual acuity was significantly worse at 5 and 10 years after onset as compared with that at CNV onset. Chorioretinal atrophy developed around the regressed CNV in 26 eyes (96.3%) at 5 and 10 years after the onset of CNV.

CONCLUSIONS

Long-term visual outcome of myopic CNV is extremely poor. The visual acuity of almost all of the patients dropped to 20/200 or less within 5 to 10 years after the onset of CNV, secondary to the development of chorioretinal atrophy around the regressed CNV. These findings indicate that active treatments should be recommended to prevent long-term visual impairment in Asian patients with myopic CNV.

摘要

目的

阐明亚洲高度近视患者脉络膜新生血管(CNV)的长期视力预后。

设计

我们回顾了25例连续的近视性CNV患者(27只眼)的病历,这些患者在CNV发病后至少随访了10年。在CNV发病10年后检查视力。

干预

从患者病历中获取人口统计学和临床数据。

主要观察指标

CNV发病后10年内的视力读数。

结果

在CNV发病时,19只眼(70.4%)的视力优于20/200,6只眼(22.2%)的视力优于20/40。CNV发病3年后,15只眼(55.5%)的视力仍优于20/200。然而,在发病5年和10年后,分别有24只眼(88.9%)和26只眼(96.3%)的视力降至20/200或更低。与CNV发病时相比,发病5年和10年后的最小分辨角对数(logMAR)视力明显更差。在CNV发病5年和10年后,26只眼(96.3%)在消退的CNV周围出现了脉络膜视网膜萎缩。

结论

近视性CNV的长期视力预后极差。几乎所有患者的视力在CNV发病后5至10年内降至20/200或更低,这是由于消退的CNV周围脉络膜视网膜萎缩的发展所致。这些发现表明,对于亚洲近视性CNV患者,应推荐积极治疗以预防长期视力损害。

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