Sandberg M A, Gaudio A R, Miller S, Weiner A
Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114.
Invest Ophthalmol Vis Sci. 1994 May;35(6):2734-40.
To determine whether the extent of disease in age-related macular degeneration (AMD) varies with iris pigmentation.
The authors assessed visual function and macular appearance in the fellow eye or both eyes of 132 white patients with unilateral neovascular AMD. All patients had a visual acuity of 20/60 or better in the fellow eye. Eighty-nine of the patients were coded as having light irides (blue, green, or hazel) and 43 were coded as having dark irides (brown); the two groups of patients had comparable mean ages.
By the Mann-Whitney test for differences in mean rank, fellow eyes with light irides showed a marginally worse visual acuity (P = .156) but significantly more visual field impairment by letter recognition perimetry (P = .011) and the macular threshold test of the Humphrey Field Analyzer (P = .043), and more retinal pigment epithelial atrophy (P = .017) and focal areas of hyperpigmentation (P = .002) than fellow eyes with dark irides. For eyes with a choroidal neovascular membrane (CNVM), those with light irides had significantly lower visual acuities (P = .006) and larger scars (P = .006) than eyes with dark irides. In addition, extent of disease in the eye with a CNVM was positively correlated with extent of disease in the fellow eye for most comparisons.
These observations suggest that light iris pigmentation is associated with more extensive retinal disease in patients with unilateral neovascular AMD. Furthermore, in such patients, those with worse disease in the eye with a CNVM may tend to have more extensive atrophic disease in the fellow eye.
确定年龄相关性黄斑变性（AMD）的疾病程度是否随虹膜色素沉着而变化。
作者评估了132名单侧新生血管性AMD的白人患者对侧眼或双眼的视觉功能和黄斑外观。所有患者对侧眼的视力均为20/60或更好。其中89例患者被编码为浅虹膜（蓝色、绿色或淡褐色），43例被编码为深虹膜（棕色）；两组患者的平均年龄相当。
通过Mann-Whitney秩均值差异检验，浅虹膜对侧眼的视力略差（P = 0.156），但通过字母识别视野计（P = 0.011）和Humphrey视野分析仪的黄斑阈值测试（P = 0.043）显示视野损害明显更严重，视网膜色素上皮萎缩（P = 0.017）和色素沉着灶（P = 0.002）也比深虹膜对侧眼更多。对于有脉络膜新生血管膜（CNVM）的眼睛，浅虹膜者的视力明显更低（P = 0.006），瘢痕更大（P = 0.006）。此外，在大多数比较中，有CNVM的眼睛的疾病程度与对侧眼的疾病程度呈正相关。
这些观察结果表明，浅虹膜色素沉着与单侧新生血管性AMD患者更广泛的视网膜疾病有关。此外，在这类患者中，有CNVM的眼睛疾病较重者，其对侧眼可能倾向于有更广泛的萎缩性疾病。
