老年黄斑变性的流行病学和检查方法研究进展

老年黄斑变性是一种严重威胁老年人视功能的眼底疾病,针对其危险因素及早期诊断,国内外展开了大量的研究.本文将对近年来老年黄斑变性的流行病学及早期诊断手段的研究进展进行综述.     

年龄相关性黄斑变性的病因学研究进展

年龄相关性黄斑变性已经成为老年人群的一个重要的公共卫生问题,但是其具体的病因学发病机制至今尚不清楚。本综述概述了国内外有关年龄相关性黄斑变性最新研究结果,为进一步探索年龄相关性黄斑变性潜在的发生机制提供依据和方向。     

生命质量及其在年龄相关性黄斑变性研究中的应用进展

生活质量评价是全面评价疾病及治疗对患者造成的生理、心理和社会生活等方面的影响,对于全面认识年龄相关性黄斑变性具有极其重要的意义。年龄相关性黄斑变性是慢性影响50岁以上人群视功能障碍的主要原因,不仅严重影响老年人群的视功能,同时影响老年人群的社会功能、情感及情绪。我们就目前国内外开展相关研究作一简要综述。     

康柏西普玻璃体腔注射治疗渗出型老年性黄斑变性的疗效

目的：观察玻璃体腔内注射康柏西普治疗渗出型老年黄斑变性的临床疗效。
　　方法：前瞻性研究。渗出型老年黄斑变性患者112例112眼,随机分为研究组和对照组,各56例56眼,研究组患者采用玻璃体腔内注射康柏西普治疗,对照组采用保守治疗,观察治疗前后两组患者裸眼视力及黄斑中心凹视网膜厚度。
　　结果：研究组患者治疗后视力明显提高,且治疗后6mo 提高最明显。研究组患者治疗后黄斑中心凹视网膜厚度均减低,且治疗后6mo 减低最明显。
　　结论：玻璃体腔内注射康柏西普能有效提高渗出型老年黄斑变性患者视力,降低黄斑中心凹厚度。     

藏族和汉族的老年黄斑变性

本文对50-90岁的藏族和汉族老年人进行了致盲眼病-老年黄斑变性的流行病学调查。藏、汉族的老年黄斑变性患病率分别为15.59%和6.41%。并比较了两民族间老年黄斑变性的患病率差异,及与本病发生可能有关的危险因素,表明对老年黄斑变性的预防和发病研究是至关重要的。     

湖南省老年黄斑变性流行病学调查

老年黄斑变性是威胁老年人视力的一种严重眼病,1905年Oeller 称为黄斑盘状变性,1926年Juninus 和Kuhut 称为老年黄斑盘状变性。本病在西方国家的发病率高,是致盲的主     

老年黄斑变性合并白内障患者行超声乳化术疗效分析

目的 探讨老年黄斑变性合并白内障患者行超声乳化手术联合人工晶状体植入的临床效果及安全性、可行性.方法 对40例52只眼老年黄斑变性合并白内障患者,行超声乳化联合人丁晶状体植入术,其中干性老年黄斑变性者45只眼,湿性老年黄斑变性者7只眼.收集其资料进行回顾性分析,观察患者术后视力改善情况及有无并发症发生.结果 术后3月时,90.38%患者视力不同程度提高,视力无明显提高甚至下降者5只眼,均为湿性黄斑变性患者.最佳矫正视力0.3-0.6者12只眼(其中达0.6者8只眼),0.1-0.3者35只眼,<0.1者5只眼.4例术中后囊破裂,3例术后角膜雾状水肿.术后1年,7只眼湿性黄斑变性均有不同程度的加重,干性黄斑变性患者未发现眼底新生血管之类改变.结论 超声乳化联合人工晶状体植入术可明显提高老年黄斑变性合并白内障患者术后视力,但对于湿性黄斑变性患者手术应慎重.     

老年黄斑变性外周血中视网膜抗体的研究

目的 探索老年黄斑变性（ＡＭＤ）的免疫发病机理。方法 运用ＳＤＳ－ＰＡＧＥ电泳、免疫印迹技术检测老年黄斑变性患者外周血中视网膜抗体；运用免疫组化法组织定位。结果 老年黄斑变性患者外周血中存在显著高于正常对照组的视网膜抗体，其相应抗原相对分子质量为２７０００～３５０００，４３０００～５００００，５６０００～６７０００，８００００～９００００，抗原定位在视网膜光感受器外节和神经元的胞核。结论 自身免疫反应是老年黄斑变性发生、发展的一个重要因素。     

眼内扫描激光视野计用于检测老年黄斑变性

目的：测定眼内扫描激光视野计用于检测老年黄斑变性（ARMD）视功能损害的敏感性和特异性。方法：通过眼内扫描激光视野计测定了患者是否存在视野损害，并在双盲情况下，根据眼底照相的表现评估老年黄斑变性的严重程度。一项前瞻性的双盲实验比较了眼内视野计和眼底照相的结果。91位老年黄斑变性患者和24位非老年黄斑变性患者通过眼科检查后人选了该实验。院内有关审查组批准了此研究。视野暗点是我们测定的主要结果。     

《临床眼科杂志》第10卷(2002年)文题索引

临床研究老年黄斑变性共焦扫描激光多普勒视网膜血流分析陈松等 (3 )…Vitreon眼内短期填充的并发症分析吕林等 (8)……………………彩色多普勒成像技术对老年黄斑变性眼血流动力学的研究………欧阳小平等 (11)…………………………………………………老年黄斑变性的多焦 ERG检     

The burden of age-related macular degeneration: a value-based analysis

PURPOSE OF REVIEW: The quality-of-life loss and the financial consequences associated with age-related macular degeneration are assessed. RECENT FINDINGS: The quality-of-life loss associated with macular degeneration is markedly underestimated by the general public, nonophthalmic physicians, and ophthalmologists who treat patients with this condition. Mild age-related macular degeneration causes a 17% decrement in the quality of life of the average patient, similar to that encountered with moderate cardiac angina or symptomatic human immunodeficiency virus syndrome. Moderate age-related macular degeneration causes a 40% decrease in the average patient's quality of life, similar to that associated with severe cardiac angina or renal dialysis. Very severe age-related macular degeneration causes a large 63% decrease in the average patient's quality of life, similar to that encountered with end-stage prostatic cancer or a catastrophic stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The return on investment is high for both treatment with current age-related macular degeneration therapies and the research costs invested in the development of age-related macular degeneration treatment modalities. SUMMARY: Age-related macular degeneration is a major public health problem that has a devastating effect upon patients and marked adverse financial consequences for the economy.     

Severe loss of vision after removal of cataract caused by intravitreal triamcinolone in combination with photodynamic therapy for exudative age-related macular degeneration

Intravitreal triamcinolone has been suggested as an adjunctive to photodynamic therapy in the treatment of exudative macular degeneration. One of the side-effects of intravitreal triamcinolone is the development of cataract, and it is known that cataract extraction can exacerbate macular degeneration. A case is presented where combined intravitreal triamcinolone and photodynamic therapy stopped the progression of the exudative macular degeneration. Subsequent progression of cataract required cataract extraction, which resulted in a very rapid progression of the exudative macular degeneration and loss of vision.     

Position of the Retinological Society, the German Ophthalmological Society and the Professional Association of Ophthalmologists in Germany on the current therapeutic possibilities for neovascular age-related macular degeneration

The basic conditions in the management of exudative age-related macular degeneration have changed considerably since the last statement of the German professional associations in 2006. While Pegaptanib was approved in Germany already in 2006 Ranibizumab was approved for the treatment of exudative macular degeneration in Germany in February 2007. More over the quality assurance regulations for the photodynamic treatment of choroidal neovascularizations with Verteporfin were modified including the treatment of occult lesions and implementing a simplified classification of extra- and subfoveal lesions. Consequently modification of the recommendations for the non-surgical treatment of exudative age-related macular degeneration appeared inevitable.     

Nutritional supplement use and age-related macular degeneration

Age-related macular degeneration is one of the leading causes of visual loss among people aged 65 years or older. The causes and factors associated with the progression of age-related macular degeneration are unknown presently. Basic research and epidemiologic data support the hypotheses that higher levels of antioxidant vitamins and minerals may protect the eye from the development of age-related macular degeneration. For this reason and also because of the lack of effective treatment for most cases of age-related macular degeneration, nutritional supplements with antioxidants have emerged as possible therapy for age-related macular degeneration. Nutritional supplements are not proven therapy for age-related macular degeneration. The potential beneficial effects and adverse side effects of the nutritional supplements have not yet been fully evaluated in carefully conducted clinical trials. Several randomized placebo-controlled clinical trials are presently underway. Results of these studies will provide important data to clarify the potential beneficial and adverse effects of such treatment. Until these results are available, it would be premature to make recommendations in favor of vitamin or mineral supplements.     

年龄相关性黄斑变性诊断与治疗规范：2022年英国皇家眼科医学会指南解读

年龄相关性黄斑变性(AMD),又称老年性黄斑变性,为黄斑区结构的衰老性改变,主要由视网膜色素上皮细胞和视网膜退行性病变引起,患者会出现不可逆性中心视力下降、视物变形。英国皇家眼科医学会发布了最新的AMD指南,对AMD的定义、分类、诊断和治疗等做了详细介绍。本文将对该指南进行全面解读,旨在为广大医务工作者进一步提高AMD的诊断和治疗水平提供参考,以期更好地服务于广大眼病患者。     

Quality of life and health economic assessments of age-related macular degeneration

In this article, we review measures of patient-reported outcomes that can show whether a treatment for age-related macular degeneration also provides patient-perceived benefits. In addition, we look at health economic measurements currently being used to develop cost-effectiveness models for age-related macular degeneration.     

Treatment of neovascular age-related macular degeneration: past, present and future directions

PURPOSE OF REVIEW: The treatment options of choroidal neovascularization due to age-related macular degeneration have expanded. Prior to ocular photodynamic therapy the only available treatment was laser photocoagulation. Clinicians and patients were not particularly enthusiastic despite its ability to stabilize vision. The purpose of the review is to review the past and current concepts of neovascular age-related macular degeneration therapy and to provide a short overview of upcoming treatments. RECENT FINDINGS: Photodynamic therapy provided us with the first realistic means to address subfoveal choroidal neovascularization lesions from age-related macular degeneration. Antivascular endothelial growth factors now allow better visual outcomes than mere stabilization of vision and other promising treatments are undergoing study at this time. SUMMARY: Age-related macular degeneration therapy has undergone a significant revolution in recent years. Understanding the historical perspective of treatment provides a better appreciation of current therapies. Still there is no cure for this disease and more promising treatments are currently under investigation.     

Treatment of subfoveal choroidal neovascular membranes with systemic interferon-alpha 2a.

Systemic interferon-alpha has recently been reported to be useful in the treatment of choroidal neovascular membranes (CNVM) in age-related macular degeneration. To further investigate its effect we treated eight patients with subfoveal choroidal neovascular membranes of various aetiologies including idiopathic, age-related macular degeneration and myopic chorioretinal degeneration. Only one of the eight patients responded with an angiographically demonstrated decrease in the size of the CNVM; this was in a patient from the idiopathic group. Considerable side-effects were reported with marked lethargy and malaise limiting compliance with some patients. Although this is an initial report with limited patient numbers and follow-up, it does suggest a role for interferon-alpha in patients with idiopathic neovascular membranes where the retina is otherwise normal, but raises some doubt as to its efficacy in the treatment of age-related macular degeneration.     

Treatment of subfoveal choroidal neovascular membranes with systemic interferonl α 2a

Systemic interferon-α has recently been reported to be useful in the treatment of choroidal neovascular membranes (CNVM) in age-related macular degeneration. To further investigate its effect we treated eight patients with subfoveal choroidal neovascular membranes of various aetiologies including idiopathic, age-related macular degeneration and myopic chorioretinal degeneration. Only one of the eight patients responded with an angiographically demonstrated decrease in the size of the CNVM; this was in a patient from the idiopathic group. Considerable side-effects were reported with marked lethargy and malaise limiting compliance with some patients. Although this is an initial report with limited patient numbers and follow-up, it does suggest a role for interferon-α in patients with idiopathic neovascular membranes where the retina is otherwise normal, but raises some doubt as to its efficacy in the treatment of age-related macular degeneration.     

Age-related macular degeneration and its management

Age-related macular degeneration is a major cause of vision loss in older individuals. The clinical picture and pathogenesis of age-related macular degeneration is reviewed. Present treatment modalities for subretinal vascularization in exudative-type macular degeneration and their limitations are discussed. The role of low-vision aids in providing magnification for reading vision is described. The role of intraocular lens implantation is discussed, as well as the newly developed intraocular lens which, with the addition of a plus-lens, functions as a Galilean telescope to provide magnification for near vision.