Pauleikhoff D, Knebel C, Peuser M, Schrenk M, Wessing A
Universitätsaugenklinik Essen.
Klin Monbl Augenheilkd. 1996 Nov;209(5):309-14. doi: 10.1055/s-2008-1035324.
The treatment of late age-related Macular Degeneration (AMD) according to the results of prospective clinical studies is indicated in classical choroidal neovascularisations (NV), which can be delineated from the center of the fovea. To evaluate the effectiveness of this therapy, the knowledge of the frequency of treatable lesions in the spectrum of late AMD is important.
The frequency of different manifestations of late AMD and of lesions treatable with photocoagulation according to the results of prospective clinical studies was recorded in a consecutive series of 2503 fluorescein angiogramms in patients with symptomatic late AMD.
Classical choroidal NV could be detected in 35.4% of the patients. In 5.5% of the patients these NV were extra- or juxtafoveolar and therefore laser treatment could be recommended. 10.2% of the patients demonstrated small (< 1 PD) subfoveal classical NV and 20.4% of the patients showed large (> 1 PD) subfoveal NV or membranes associated with large subfoveal, subretinal hemorrhages. Occult choroidal NV could be seen in 41.8% of the patients. These occult NV were larger 1 PD in 21.9% of the patients and small (< 1 PD) in 19.9% of the patients. Pigment epithial detachments (PED) could be seen in 14.6% of the patients (9.9 vascular PED, 3.7% avascular PED, 1.0% rip of the retinal pigment epithelium). Disciform scars were present in 7.2% of the angiogramms.
The spectrum of late AMD can be differentiated in several clinical features. In this consecutive series of 2503 symptomatic AMD patients only appr. 6%% of the patients could be treated with laser treatment according to the results of prospective clinical studies. Because in addition the success of this treatment is very limited, the development of new therapeutic options is one of the major tasks in ophthalmology.
根据前瞻性临床研究结果，晚期年龄相关性黄斑变性（AMD）的治疗适用于可从黄斑中心凹界定的典型脉络膜新生血管（NV）。为评估该疗法的有效性，了解晚期AMD范围内可治疗病变的频率很重要。
根据前瞻性临床研究结果，对2503例有症状的晚期AMD患者的连续系列荧光素血管造影记录晚期AMD的不同表现以及可通过光凝治疗的病变频率。
35.4%的患者可检测到典型脉络膜NV。5.5%的患者这些NV位于黄斑中心凹外或紧邻黄斑中心凹，因此可推荐激光治疗。10.2%的患者表现为小（<1视盘直径）的黄斑中心凹下典型NV，20.4%的患者表现为大（>1视盘直径）的黄斑中心凹下NV或与大的黄斑中心凹下、视网膜下出血相关的膜。41.8%的患者可见隐匿性脉络膜NV。这些隐匿性NV在21.9%的患者中大于1视盘直径，在19.9%的患者中小于1视盘直径。14.6%的患者可见色素上皮脱离（PED）（9.9%为血管性PED，3.7%为无血管性PED，1.0%为视网膜色素上皮撕裂）。7.2%的血管造影显示有盘状瘢痕。
晚期AMD的范围可在几种临床特征中区分。在这2503例有症状的AMD患者的连续系列中，根据前瞻性临床研究结果，仅约6%的患者可接受激光治疗。此外，由于该治疗的成功率非常有限，开发新的治疗选择是眼科的主要任务之一。
