Ophthalmology. 1998 Aug;105(8):1364-72. doi: 10.1016/s0161-6420(98)98014-9.
This study aimed to describe characteristics of choroidal neovascularization (CNV) that developed in high-risk eyes of patients with age-related macular degeneration (AMD) enrolled in the Choroidal Neovascularization Prevention Trial (CNVPT).
Consecutive case series among patients enrolled in a multicenter, randomized controlled trial.
Eighteen eyes of 18 patients who developed exudative AMD were studied from among 156 patients with large drusen enrolled in the Bilateral Drusen Study and 120 patients having one eye with exudative AMD and the other eye with large drusen enrolled in the Fellow Eye Study. The CNVPT Fellow Eye Study provided 12 eyes (10, treatment group; 2, control group), and the CNVPT Bilateral Drusen Study contributed 6 eyes (4, treatment group; 2, control group).
The CNVPT Reading Center assessment and grading of patients with CNV and other exudative complications was reviewed.
Onset of CNV, laser intensity for treated eyes, classification of lesion components, size of lesion, location of lesion, foveal involvement, and change in visual acuity were measured.
Eighteen eyes showed onset of CNV between 2 and 21 months after enrollment. In comparison with the CNVPT Laser Standard Intensity, variations in laser treatment intensity (6 eyes graded less than standard intensity and 8 eyes graded standard intensity) were not associated with CNV events. Seventeen of 18 eyes showed occult CNV in whole or in part, and only 1 eye manifested purely classic CNV. The median size range was 2 to 3.5 disc areas. Among the 14 treated eyes that developed exudative lesions, 7 showed subfoveal involvement and 13 had CNV associated with the region of treatment. At the time of the CNV event, 9 of 18 eyes showed greater than a 2-line loss of vision from baseline while the remaining eyes were stable.
Preliminary data show that visually significant exudative manifestations of AMD may develop in patients with high-risk drusen who undergo macular laser photocoagulation. The CNV lesions typically are occult, often subfoveal, and associated with the region of treatment. Longer follow-up is warranted.
本研究旨在描述参与脉络膜新生血管预防试验（CNVPT）的年龄相关性黄斑变性（AMD）患者高危眼中发生的脉络膜新生血管（CNV）的特征。
对一项多中心随机对照试验中的患者进行连续病例系列研究。
在双侧玻璃膜疣研究中纳入的156例有大玻璃膜疣的患者以及在对侧眼研究中纳入的120例一只眼患有渗出性AMD且另一只眼有大玻璃膜疣的患者中，研究了18例发生渗出性AMD患者的18只眼。CNVPT对侧眼研究提供了12只眼（10只，治疗组；2只，对照组），CNVPT双侧玻璃膜疣研究贡献了6只眼（4只，治疗组；2只，对照组）。
回顾了CNVPT阅读中心对CNV及其他渗出性并发症患者的评估和分级。
测量CNV的发病情况、治疗眼的激光强度、病变成分分类、病变大小、病变位置、黄斑受累情况以及视力变化。
18只眼在入组后2至21个月出现CNV。与CNVPT激光标准强度相比，激光治疗强度的变化（6只眼分级低于标准强度，8只眼分级为标准强度）与CNV事件无关。18只眼中有17只全部或部分表现为隐匿性CNV，只有1只眼表现为单纯典型性CNV。中位大小范围为2至3.5个视盘面积。在14只发生渗出性病变的治疗眼中，7只显示黄斑中心凹受累，13只CNV与治疗区域相关。在CNV事件发生时，18只眼中有9只与基线相比视力下降超过2行，其余眼视力稳定。
初步数据表明，接受黄斑激光光凝治疗的高危玻璃膜疣患者可能会出现具有视觉意义的AMD渗出性表现。CNV病变通常是隐匿性的，常累及黄斑中心凹，并与治疗区域相关。需要进行更长时间的随访。
