Boopathiraj Nithya, Wagner Isabella V, Dorairaj Syril K, Miller Darby D, Stewart Michael W
Department of Ophthalmology, Mayo Clinic, Jacksonville, FL.
Mayo Clinic Alix School of Medicine, Mayo Clinic, Jacksonville, FL.
Mayo Clin Proc Innov Qual Outcomes. 2024 Jun 26;8(4):364-374. doi: 10.1016/j.mayocpiqo.2024.05.003. eCollection 2024 Aug.
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the Western world, with a higher prevalence among Europeans and North Americans than that in Africans, Hispanics, and Asians. Advanced AMD is categorized as atrophic (dry) or exudative (wet/neovascular age-related macular degeneration [nAMD]). Dry AMD is characterized by progressive geographic atrophy of the retinal pigment epithelium and outer retinal layers, whereas nAMD is characterized by new vessels that invade the subretinal and/or subretinal pigment epithelium spaces. Existing treatments delay the onset of advanced AMD and reverses vision loss for a couple of years before atrophy usually decreases central visual acuity. We searched PubMed and Medline databases from January 1, 1980, to December 1, 2023, using the following search terms: . Relevant articles in English (or English translations) were retrieved and reviewed. Bibliographies of the identified manuscripts were also reviewed to identify relevant studies. Age-related macular degeneration most commonly affects people older than 55 years. Visual prognosis varies, with advanced lesions (nAMD and geographic atrophy) leading to rapid, progressive loss of central vision and contrast sensitivity. Although AMD is not a life-threatening disease, reduced vision profoundly compromises quality of life and necessitates living assistance for many patients. Over the past 2 decades, advances in prevention (vitamin supplementation) and therapy (antivascular endothelial growth factor and complement inhibitor drugs) have reduced vision loss and blindness. Further research is needed to decrease the incidence of blindness in patients with advanced disease.
年龄相关性黄斑变性（AMD）是西方世界不可逆失明的主要原因，欧洲人和北美人的患病率高于非洲人、西班牙裔人和亚洲人。晚期AMD分为萎缩性（干性）或渗出性（湿性/新生血管性年龄相关性黄斑变性[nAMD]）。干性AMD的特征是视网膜色素上皮和视网膜外层进行性地图样萎缩，而nAMD的特征是新生血管侵入视网膜下和/或视网膜色素上皮下间隙。现有治疗方法可延缓晚期AMD的发病，并在萎缩通常降低中心视力之前的几年内逆转视力丧失。我们使用以下检索词在1980年1月1日至2023年12月1日期间搜索了PubMed和Medline数据库。检索并审查了英文（或英文译文）的相关文章。还审查了已识别手稿的参考文献以识别相关研究。年龄相关性黄斑变性最常影响55岁以上的人群。视觉预后各不相同，晚期病变（nAMD和地图样萎缩）会导致中心视力和对比敏感度迅速、进行性丧失。虽然AMD不是危及生命的疾病，但视力下降严重影响生活质量，许多患者需要生活帮助。在过去20年中，预防（维生素补充）和治疗（抗血管内皮生长因子和补体抑制剂药物）方面的进展减少了视力丧失和失明。需要进一步研究以降低晚期疾病患者的失明发生率。
