Polito Antonio, Isola Miriam, Lanzetta Paolo, Gregori Dario, Bandello Francesco
Department of Ophthalmology, University of Udine, Udine, Italy.
Ann Acad Med Singap. 2006 Mar;35(3):145-50.
The purpose of this review is to combine the results of existing literature on the natural history of occult choroidal neovascularisation (CNV) associated with age-related macular degeneration (AMD).
Published reports evaluating eyes with occult CNV in AMD patients were selected for meta-analysis based on a computerised MEDLINE search. Pooled estimates of the proportions of eyes with a vision loss greater than 2 to 3 (moderate vision loss) or 6 lines (severe vision loss) at 1 year and 2 to 3 years, respectively, or developing a classic component on fluorescein angiography at 1 year were measured.
There is no significant heterogeneity among published rates of visual loss and development of classic CNV. The overall pooled estimates (95% confidence limits) of the proportions of eyes with at least moderate or severe vision loss, respectively, were 59% (53% to 64.5%) and 34% (25% to 43%) at 1 year and 70% (64% to 76%) and 47% (40% to 54%) at 2 to 3 years; the overall pooled estimate of the percentage of eyes developing classic CNV at 1 year was 46% (39% to 54%).
A substantial number of patients with occult CNV from AMD will develop at least moderate visual loss at 1 year and severe visual loss within 3 years. However, visual acuity may remain stable in up to 30% of patients. These results may help us to understand the exact role of new therapies and in planning future trials.
本综述的目的是综合现有关于年龄相关性黄斑变性（AMD）相关隐匿性脉络膜新生血管（CNV）自然病程的文献结果。
基于计算机化的MEDLINE检索，选择已发表的评估AMD患者隐匿性CNV眼睛的报告进行荟萃分析。分别测量1年和2至3年时视力下降大于2至3行（中度视力下降）或6行（重度视力下降）的眼睛比例，或1年时荧光素血管造影出现典型成分的眼睛比例的合并估计值。
已发表的视力丧失率和典型CNV发生率之间无显著异质性。1年时至少中度或重度视力下降的眼睛比例的总体合并估计值（95%置信区间）分别为59%（53%至64.5%）和34%（25%至43%），2至3年时为70%（64%至76%）和47%（40%至54%）；1年时出现典型CNV的眼睛百分比的总体合并估计值为46%（39%至54%）。
大量AMD相关隐匿性CNV患者在1年时将出现至少中度视力下降，3年内出现重度视力下降。然而，高达30%的患者视力可能保持稳定。这些结果可能有助于我们了解新疗法的确切作用并规划未来试验。
