Soubrane G, Coscas G, Français C, Koenig F
Clinique Ophthalmologique Universitaire de Créteil, Universite de Paris XII.
Ophthalmology. 1990 May;97(5):649-57. doi: 10.1016/s0161-6420(90)32530-7.
Little information is available on the natural history and no data have been published on laser treatment for occult neovascularization in age-related macular degeneration. The visual and angiographic outcomes were analyzed in 156 patients (82 untreated eyes; 81 treated eyes) with occult neovascularization who were followed for 1 to 8 years. Early laser treatment decreased visual acuity to less than 20/200 in 31 of the treated eyes (38%) compared with 20 of the untreated eyes (25%). Three years after the onset of symptoms, 24 treated eyes (29%) and 31 eyes untreated eyes (38%) retained 20/50 visual acuity or better, whereas their respective initial visual acuities were not statistically different. Severe loss of vision (6 or more lines of visual acuity) occurred in 43 treated eyes (53%) and in 33 untreated eyes (40%) at the end of follow-up (range, 12-84 months). A slow and gradual increase of the disciform lesion was demonstrated on fluorescein angiography in 60 untreated eyes, with subfoveal involvement noted in 39 eyes at the end of follow-up. In the treated group, subfoveal involvement occurred in 53 eyes, after a relatively short time (mean, 4 months). Only 28 of the 81 treated eyes had successful anatomic results. These findings suggested that laser treatment of occult neovascularization immediately after the onset of symptoms should not be recommended.
关于年龄相关性黄斑变性隐匿性新生血管的自然病史，目前所知甚少，且尚无关于激光治疗的相关数据发表。对156例隐匿性新生血管患者（82只未治疗眼；81只治疗眼）进行了1至8年的随访，并分析了其视力和血管造影结果。与20只未治疗眼（25%）相比，早期激光治疗使31只治疗眼（38%）的视力下降至20/200以下。症状出现三年后，24只治疗眼（29%）和31只未治疗眼（38%）的视力保持在20/50或更好，而它们各自的初始视力无统计学差异。随访结束时（随访时间为12 - 84个月），43只治疗眼（53%）和33只未治疗眼（40%）出现了严重视力丧失（视力下降6行或更多）。60只未治疗眼在荧光素血管造影中显示盘状病变缓慢逐渐增加，随访结束时39只眼出现黄斑中心凹受累。在治疗组中，黄斑中心凹受累发生在53只眼中，时间相对较短（平均4个月）。81只治疗眼中只有28只获得了成功的解剖学结果。这些发现表明，不建议在症状出现后立即对隐匿性新生血管进行激光治疗。
