Instituto de Oftalmobiologia Aplicada (IOBA), Campus Miguel Delibes, University of Valladolid, Pº de Belén nº 17, Valladolid 47011, Spain.
BMC Ophthalmol. 2014 Jun 25;14:82. doi: 10.1186/1471-2415-14-82.
Fibrotic disciform scars represent the end-stage of wet age-related macular degeneration (AMD) and ophthalmologists tend not to treat them. However, reactivation can occur resulting in further worsening of patients. The aim of this study is to describe the clinical outcomes of 10 patients with disciform scars from age-related macular degeneration (AMD) that have subsequently reactivated.
Indocyanine green angiography (ICG) was used to identify the active areas and these "hot spots" (HS) that were subsequently treated with focal laser photocoagulation.
In 10 out of 11 patients with potential reactivation of an AMD scar, a treatable HS was found on the ICG at the border of the disciform scar. The identified HS was treated with focal laser photocoagulation. Post treatment these areas became inactive. However in 2 cases, reactivation occurred requiring retreatment a few months later.
AMD patients who are noted to have disciform scars that are increasing in size and signs of activation such as lipid exudation and subretinal haemorrhage should undergo ICG imaging to look for HS. These patients could benefit from focal laser to stabilize the disease and avoid complications and further peripheral visual loss. It is suspected that these patients may have the polypoidal subtype of AMD.
纤维性盘状瘢痕代表湿性年龄相关性黄斑变性（AMD）的终末期，眼科医生通常不治疗它们。然而，它们可能会重新激活，导致患者病情进一步恶化。本研究旨在描述 10 例盘状瘢痕性 AMD 患者的临床转归，这些患者的瘢痕随后重新激活。
采用吲哚菁绿血管造影（ICG）识别活跃区域和盘状瘢痕边缘的“热点”（HS），随后对这些 HS 进行局部激光光凝治疗。
在 11 例有 AMD 瘢痕潜在再激活的患者中，10 例患者的 ICG 上发现了可治疗的 HS。对识别出的 HS 进行局部激光光凝治疗后，这些区域变得不活跃。然而，在 2 例患者中，几个月后再次出现了再激活，需要再次治疗。
对于瘢痕不断增大且有脂类渗出和视网膜下出血等活动迹象的 AMD 患者，应进行 ICG 成像以寻找 HS。这些患者可能受益于局部激光治疗以稳定病情，避免并发症和进一步的周边视力丧失。怀疑这些患者可能患有息肉样 AMD 亚型。
