Holz F G, Wolfensberger T J, Piguet B, Gross-Jendroska M, Wells J A, Minassian D C, Chisholm I H, Bird A C
Department of Clinical and Preventive Ophthalmology, Moorfields Eye Hospital, London, United Kingdom.
Ophthalmology. 1994 Sep;101(9):1522-8. doi: 10.1016/s0161-6420(94)31139-0.
In patients with unilateral visual loss related to age-related macular disease, the risk of visual loss in the second eye is documented as being between 7% and 10% per year. The risk is uncertain in those with good vision with each eye and bilateral macular drusen.
In a prospective study, 126 patients with bilateral drusen were reviewed annually for up to 3 years. Serial fundus photographs and fluorescein angiograms were analyzed independently by two readers in a masked fashion using a standardized grading scheme, including size, number, density, and fluorescence angiographic behavior of drusen.
New lesions occurred in one or both eyes of 17 (13.5%) of the 126 patients. The cumulative incidence of exudative or nonexudative lesions was 8.55% at 1 year, at 2 years 16.37%, and 23.52% at 3 years for patients older than 65 years of age. Significant risk factors included the degree of confluence of drusen within 1600 microns of the center of the fovea (P = 0.023), focal hyperpigmentation (P = 0.004), slow choroidal filling (P = 0.023), and focal extrafoveal areas of atrophy of the retinal pigment epithelium (P = 0.042).
The results give an estimate for the incidence of complicating lesions in patients with bilateral drusen and identify those features indicating higher than average risk of visual loss.
在与年龄相关性黄斑病变相关的单侧视力丧失患者中，有记录显示，另一只眼睛每年的视力丧失风险在7%至10%之间。对于双眼视力良好且有双侧黄斑玻璃膜疣的患者，该风险尚不确定。
在一项前瞻性研究中，对126例双侧玻璃膜疣患者进行了为期3年的年度复查。两名阅片者采用标准化分级方案，以盲法独立分析系列眼底照片和荧光素血管造影，包括玻璃膜疣的大小、数量、密度和荧光血管造影表现。
126例患者中有17例（13.5%）一只或两只眼睛出现了新病变。65岁以上患者渗出性或非渗出性病变的累积发生率在1年时为8.55%，2年时为16.37%，3年时为23.52%。显著的风险因素包括黄斑中心凹1600微米范围内玻璃膜疣的融合程度（P = 0.023）、局灶性色素沉着（P = 0.004）、脉络膜充盈缓慢（P = 0.023）以及视网膜色素上皮的局灶性黄斑外萎缩区域（P = 0.042）。
该结果给出了双侧玻璃膜疣患者并发病变的发生率估计，并确定了那些表明视力丧失风险高于平均水平的特征。
