Schneider U, Kuck H, Inhoffen W, Kreissig I
Universitäts-Augenklinik, Abteilung III Netzhaut und Glaskörperchirurgie, Tübingen.
Klin Monbl Augenheilkd. 1996 Aug-Sep;209(2-3):8-13.
The indication of laser therapy of subretinal neovascularization is based on the visual acuity and the localization and extension of subretinal membranes. However, laser therapy based on these guide-lines, repeatedly leads to disappointing results as functional effects of neovascularizations on the central visual field and fixation are not considered. With fundus-controlled scanning laser microperimetry we examined light sensitivity and fixation in areas of subretinal neovascularization of 33 patients suffering from beginning (n = 8), advanced (n = 17) or hemorrhagic (n = 8) neovascularization in age-related macular degeneration. 14 out of 17 patients with signs of advanced and all patients with hemorrhagic neovascularization had absolute scotoma in the affected area. In each of the patients suffering from beginning neovascularization we found relative scotomas and preserved central fixation, even in subfoveal membrane localization. The role of scanning laser microperimetry in the indication of laser therapy in age-related macular degeneration is discussed.
视网膜下新生血管形成的激光治疗指征基于视力以及视网膜下膜的定位和范围。然而,基于这些指导原则的激光治疗反复导致令人失望的结果,因为未考虑新生血管形成对中心视野和注视的功能影响。我们使用眼底控制的扫描激光微视野检查法,对33例年龄相关性黄斑变性患者视网膜下新生血管形成区域的光敏感度和注视情况进行了检查,这些患者分别处于新生血管形成的初期(n = 8)、进展期(n = 17)或出血期(n = 8)。17例有进展期体征的患者中有14例以及所有出血性新生血管形成的患者在患区出现绝对暗点。在每例处于新生血管形成初期的患者中,即使在黄斑中心凹下膜定位的情况下,我们也发现了相对暗点且中心注视得以保留。本文讨论了扫描激光微视野检查法在年龄相关性黄斑变性激光治疗指征中的作用。