Loewenstein Anat
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Faculty of Medicine, Tel Aviv University, Israel.
Retina. 2007 Sep;27(7):873-8. doi: 10.1097/IAE.0b013e318050d2ec.
The main cause for visual loss in age-related macular degeneration (AMD) is the development of choroidal neovascularization (CNV), which has been shown to occur in 18% of patients over 5 years. Even though satisfactory treatments for CNV are available, in the majority of cases no improvement in visual acuity occurs and in those it does it is mostly limited. Early detection has the potential of significantly improving the final visual outcome of patients who develop subfoveal CNV.
This review is a summary of the importance of early detection in the management of AMD, in view of the current available treatment methods. It is a review of the results of early detection of AMD using the Preferential Hyperacuity Perimeter (PHP).
Awareness for symptoms, use of the Amsler grid and monitoring by an ophthalmologist are not satisfactory means for early detection of AMD. The PHP has good sensitivity and specificity in detecting CNV patient early and differentiate them from intermediate AMD.
In an era of excellent treatments available for CNV treatment, early detection of CNV by novel technology modalities such as the PHP at a frequency that allows early detection (approximately 4 times a year) is crucial in the armamentarium of AMD patient management.
年龄相关性黄斑变性(AMD)导致视力丧失的主要原因是脉络膜新生血管(CNV)的形成,已证实5年内18%的患者会出现这种情况。尽管有针对CNV的满意治疗方法,但在大多数病例中,视力并无改善,即便有改善也大多有限。早期检测有可能显著改善发生中心凹下CNV患者的最终视力结局。
鉴于当前可用的治疗方法,本综述总结了早期检测在AMD管理中的重要性。它回顾了使用优先超敏锐度视野计(PHP)对AMD进行早期检测的结果。
对症状的认知、使用阿姆斯勒方格表以及由眼科医生进行监测,都不是早期检测AMD的令人满意的方法。PHP在早期检测CNV患者并将其与中度AMD患者区分开来方面具有良好的敏感性和特异性。
在有针对CNV治疗的优秀治疗方法的时代,通过新技术手段如PHP以允许早期检测的频率(约每年4次)对CNV进行早期检测,在AMD患者管理手段中至关重要。