Vinding T
University Eye Clinic, Rigshospitalet, Copenhagen, Denmark.
Acta Ophthalmol (Copenh). 1990 Aug;68(4):410-4. doi: 10.1111/j.1755-3768.1990.tb01668.x.
Macular changes in 60 to 80-year-old people i.e. drusen (DR), pigmentary changes (PC) and exudative changes (EXC) are assessed by fundoscopy in a random and age stratified population with 924 of the participants examined in both maculae (1848 eyes). DR, PC and EXC were found in 18.4%, 12.9% and 2.1% of all eyes with a rising frequency associated with increasing age. A separation was made between changes implying a visual acuity of 6/9 or less as criteria of age-related macular degeneration (AMD) and age related macular changes without visual impairment (AMCW). The occurrence of DR, PC and EXC from eyes with AMD showed an age related rise which was also found for DR, contrary to PC and EXC deriving from eyes with AMCW. The basic forms of AMD, atrophic and exudative, were represented in 78.6% and 21.4% of individuals or 80.9% and 19.1% of eyes with AMD. The predominant findings in AMD eyes were DR + PC in combination represented in 60.7% of atrophic and 66.8% of exudative AMD eyes, while in atrophic AMCW eyes DR as only finding was leading with 59.2%. It is concluded that in eyes with atrophic macular changes, DR, respectively PC as only finding involves no visual deterioration in 80.6%, respectively 72.6%, while DR + PC in combination, as well as the appearance of EXC, are found to be the most likely expression of AMD as long as a visual impairment of 6/9 or worse is included in the definition of AMD.
在一个随机且按年龄分层的60至80岁人群中，通过检眼镜检查评估黄斑变化，即玻璃膜疣（DR）、色素变化（PC）和渗出性变化（EXC），924名参与者的双眼均接受了检查（共1848只眼）。在所有眼中，DR、PC和EXC的发现率分别为18.4%、12.9%和2.1%，且频率随年龄增长而上升。根据年龄相关性黄斑变性（AMD）的标准，即视力为6/9或更低，以及无视力损害的年龄相关性黄斑变化（AMCW），对这些变化进行了区分。AMD眼中DR、PC和EXC的发生率呈现与年龄相关的上升趋势，DR也是如此，这与AMCW眼中的PC和EXC情况相反。AMD的基本形式，萎缩性和渗出性，在AMD个体中分别占78.6%和21.4%，或在AMD眼中分别占80.9%和19.1%。AMD眼中的主要发现是DR + PC联合出现，在萎缩性AMD眼中占60.7%，在渗出性AMD眼中占66.8%，而在萎缩性AMCW眼中，仅DR作为发现结果占主导地位（59.2%）。得出的结论是，在萎缩性黄斑变化的眼中，仅发现DR或PC分别在80.6%和72.6%的情况下不会导致视力下降，而只要将视力损害为6/9或更差纳入AMD的定义中，DR + PC联合出现以及EXC的出现被认为是AMD最可能的表现形式。
