西地那非治疗黄斑变性：一项两年试验的结果
Treatment of Macular Degeneration with Sildenafil: Results of a Two-Year Trial.
作者信息
Coleman D Jackson, Lee Winston, Chang Stanley, Silverman Ronald H, Lloyd Harriet O, Daly Suzanne, Tsang Stephen H
机构信息
Department of Ophthalmology, Columbia University, New York, New York, USA.
Jonas Children's Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, New York, USA.
出版信息
Ophthalmologica. 2018;240(1):45-54. doi: 10.1159/000486105. Epub 2018 Apr 25.
OBJECTIVE
To evaluate PDE5/6 inhibition with sildenafil to reduce choroidal ischemia and treat age-related macular degeneration.
METHODS
Sildenafil was prescribed to treat participants with macular degenerations or macular dystrophies measured by spectral-domain optical coherence tomography, color fundus photography, enhanced depth imaging, and best-corrected visual acuity.
RESULTS
No change in calcified drusen was noted. Vitelliform-type soft drusen were not substantially changed. A participant with Best vitelliform macular dystrophy had a significant improvement in vision as well as in photoreceptor and ellipsoid layers.
CONCLUSIONS
Our research supports sildenafil as a safe treatment for age-related and vitelliform macular degenerations. Thickened Bruch's membrane reduces the beneficial effect of perfusion increase, but all eyes appear to benefit from PDE6. Notably, maintenance or improvement in the photoreceptor layer may be the most significant result of sildenafil and is consistent with PDE6 inhibition. Thus, sil-denafil treatment of macular degeneration offers significant potential for vision retention and recovery.
目的
评估西地那非抑制磷酸二酯酶5/6以减轻脉络膜缺血及治疗年龄相关性黄斑变性的效果。
方法
采用光谱域光学相干断层扫描、彩色眼底照相、增强深度成像及最佳矫正视力对黄斑变性或黄斑营养不良患者进行测量，并给予西地那非治疗。
结果
钙化性玻璃膜疣未见变化。卵黄样软性玻璃膜疣无明显改变。一名患有Best卵黄样黄斑营养不良的参与者视力以及光感受器和椭圆体层有显著改善。
结论
我们的研究支持西地那非作为年龄相关性和卵黄样黄斑变性的安全治疗方法。增厚的布鲁赫膜会降低灌注增加的有益效果，但所有眼睛似乎都从磷酸二酯酶6抑制中获益。值得注意的是，光感受器层的维持或改善可能是西地那非最显著的结果，且与磷酸二酯酶6抑制一致。因此，西地那非治疗黄斑变性在视力保留和恢复方面具有巨大潜力。
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