Soubrane G, Coscas G, Larcheveque F
Clinique ophtalmologique universitaire de Créteil, Université de Paris XII, Créteil, France.
J Fr Ophtalmol. 1988;11(11):711-20.
The leakage from the new vessels, responsible for the exudative form of age-related macular degeneration (ARMD), produces retinal detachment, haemorrhages, exudates and intraretinal cystoid macular edema (CME). In a retrospective study of 100 eyes, we assessed the prognostic value of cystoid macular degeneration of the inner retina. It was nos specifically linked to: 1 - the duration of the neovascular involvement; 2 - the extent of the neovascular membrane; 3 - the location of the new vessels; 4 - the type of the new vessels; definite (48 eyes) or occult (19 eyes), or advanced and fibrous lesions (21 eyes). However, cystoid macular edema was initially associated to legal blindness in 46% of eyes. Active SNV associated with CME were retrofoveal in 83% of the eyes. But biomicroscopical evidence of CME requires fluorescein angiography to identify the new vessels still amenable to laser photocoagulation. After a follow-up period ranging from 30 days to 6 years (mean 15 months), 69% of eyes were legally blind although 41 eyes were treated with laser photocoagulation (focal or perifoveolar). Thus, functional prognosis in ARMD is not uniquely and directly correlated with the presence of cystoid macular edema in ARMD.
新生血管渗漏是年龄相关性黄斑变性(ARMD)渗出型的病因,可导致视网膜脱离、出血、渗出及视网膜内黄斑囊样水肿(CME)。在一项对100只眼的回顾性研究中,我们评估了视网膜内层黄斑变性的预后价值。它与以下因素无特异性关联:1 - 新生血管累及的持续时间;2 - 新生血管膜的范围;3 - 新生血管的位置;4 - 新生血管的类型;明确的(48只眼)或隐匿的(19只眼),或晚期及纤维性病变(21只眼)。然而,黄斑囊样水肿最初在46%的眼中与法定盲相关。与CME相关的活动性视网膜下新生血管(SNV)在83%的眼中位于黄斑后凹。但CME的生物显微镜证据需要荧光素血管造影来识别仍适合激光光凝治疗的新生血管。在30天至6年(平均15个月)的随访期后,尽管41只眼接受了激光光凝治疗(局灶性或黄斑中心凹周围),但69%的眼仍为法定盲。因此,ARMD的功能预后并非唯一且直接与ARMD中黄斑囊样水肿的存在相关。