Lozano-Rechy D, Duker J S, Jalkh A E
Clinical Research Unit, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts.
Am J Ophthalmol. 1993 Aug 15;116(2):140-7. doi: 10.1016/s0002-9394(14)71277-2.
We reviewed the relationship between lipid exudation and subretinal neovascular membranes associated with age-related macular degeneration. The records of 500 consecutive patients with subretinal neovascular membranes caused by age-related macular degeneration were examined. Seventy-five patients (15%) (85 eyes) manifested lipid exudation in conjunction with subretinal neovascularization. Twelve patients (2.4%) (13 eyes) had a massive lipid exudative response with extensive serous retinal detachment (resembling Coats' disease). Of the 85 eyes with subretinal neovascular membranes and lipid exudation, 71 (84%) had a subretinal neovascular membrane that was classified as ill defined. Improvement of vision with or without treatment was seen in only 14 of these 85 eyes (16.4%). After comparing these 85 eyes to 94 eyes from 76 patients with age-related macular degeneration and subretinal neovascular membranes but no lipid exudation, we found that a subretinal neovascular membrane associated with lipid exudation was more likely to be ill defined (71 eyes [84%] vs 35 eyes [37%]; P = .0001), was more frequently associated with retinal pigment epithelial detachment (30 eyes [35%] vs 15 eyes [16%]; P = .0029), and was more likely not to have stabilization of visual acuity (14 eyes [16%] vs 31 eyes [33%]; P = .025).
我们回顾了脂质渗出与年龄相关性黄斑变性相关的视网膜下新生血管膜之间的关系。检查了500例连续的年龄相关性黄斑变性所致视网膜下新生血管膜患者的记录。75例患者（15%）（85只眼）表现出脂质渗出并伴有视网膜下新生血管形成。12例患者（2.4%）（13只眼）出现大量脂质渗出反应并伴有广泛的浆液性视网膜脱离（类似Coats病）。在85只伴有视网膜下新生血管膜和脂质渗出的眼中，71只（84%）的视网膜下新生血管膜被分类为边界不清。在这85只眼中，仅14只（16.4%）无论是否接受治疗视力有改善。将这85只眼与76例年龄相关性黄斑变性且有视网膜下新生血管膜但无脂质渗出患者的94只眼进行比较后，我们发现与脂质渗出相关的视网膜下新生血管膜更可能边界不清（71只眼[84%]对35只眼[37%]；P = 0.0001），更频繁地伴有视网膜色素上皮脱离（30只眼[35%]对15只眼[16%]；P = 0.0029），且更可能没有视力稳定（14只眼[16%]对31只眼[33%]；P = 0.025）。
