Oosterhuis J A
Universitäts-Augenklinik, Leiden.
Fortschr Ophthalmol. 1990;87 Suppl:S52-61.
Age-related macular degeneration (AMD) is the main cause of visual loss in the Western world. In 80-90% it is the result of the exudative type of AMD with subretinal neovascularization (SRN). As soon as SRN is suspected, fluorescein angiography must be performed without delay. When the neovascular membrane is well-defined, sparing the subfoveolar area--a situation observed in only a small portion of the patients--then green argon or red krypton laser treatment is indicated, the only therapy currently available. The 3-year success rate is about 50% owing to the recurrence of SRN, an as yet unsolved problem. The prognosis also depends on the intensity of the lesions of non-exudative macular degeneration. Statistical evaluation shows that in most patients the main effect of photocoagulation is only to postpone the loss of central vision.
年龄相关性黄斑变性(AMD)是西方世界视力丧失的主要原因。在80%-90%的病例中,它是渗出型AMD伴视网膜下新生血管(SRN)的结果。一旦怀疑有SRN,必须立即进行荧光素血管造影。当新生血管膜边界清晰,不累及黄斑中心凹下区域(这种情况仅在一小部分患者中观察到)时,则可采用绿色氩激光或红色氪激光治疗,这是目前唯一可用的治疗方法。由于SRN复发这一尚未解决的问题,3年成功率约为50%。预后还取决于非渗出性黄斑变性病变的严重程度。统计评估表明,在大多数患者中,光凝的主要作用只是推迟中心视力丧失。