老年黄斑变性的研究进展

回顾了近年来老年黄斑变性的病因、发病机制、治疗及预防方面的研究新进展。有关危险因素新的流行病学调查结果为防治提供了理论依据，杆细胞易感生学说提出了新的发病机制，新的治疗方法如光动力治疗、局限性黄斑转位术、经瞳孔温热治疗及基因治疗都有一定的效果，但同时也存在许多问题，需要继续探讨。     

老年黄斑变性的治疗研究进展

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、早期诊断及治疗,国内外展开了大量的研究。本文将总结近年来国内外对老年黄斑变性的新的治疗手段和方法。     

老年黄斑变性的局部视网膜电图研究

目的:观察老年黄斑变性(AMD)对视网膜黄斑部电活动影响特征,并对局部视网膜电图(LERG)的敏感性作出评价。方法:对80例AMD患者99只眼进行了黄斑区三个范围局部视网膜电图(LERG)测定,并与患者的视力及相应检测范围病损面积进行了对比研究。结果:黄斑区2.5°、5°、7.5°范围内,干性AMD组LERG平均振幅降低,但与正常对照组间无显著性差异(P>0.05),湿性AMD组LERG平均振幅显著降低(P<0.01)。湿性AMD LERG b波振幅与病人视力呈正相关性,与相应范围病灶面积呈负相关。干性AMD玻璃膜疣数量对LERG尚无影响。结论:不同类型AMD对于黄斑功能损害程度不同,湿性型损害大于干性型;中心凹功能损害大于旁中心凹。LERG在AMD的黄斑功能测定方面是较敏感的电生理方法。眼科学报 1996;12:93—97。     

老年性黄斑变性发病机制的新概念

目的：复习和综合有关年龄相关性黄斑变性(AMD)的发病机制的信息。     

年龄相关性黄斑变性发病机制的研究进展

年龄相关性黄斑变性(age related macular degeneration,AMD)是引起中老年严重视力丧失最主要的原因。尽管进行了大量的基础和临床研究,其发病机制仍不清楚,大多数学者认为这是一种多因素疾病。我们概述了国内外有关AMD最新研究结果,为进一步探索AMD潜在的发生机制提供依据和方向。     

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     

老年黄斑变性患者呼吸链酶复合物活性测定

老年黄斑变性(age—related macular degenera-tion，AMD)发病机制不清。新近研究表明老年变性疾病的发生与机体氧化磷酸化功能衰退有关，表现为呼吸链酶复合物活性降低，组织能量代谢异常。我们通过测定AMD患者部分呼吸链酶复合物活性，对AMD患者机体氧化磷酸化功能进行分析，探讨AMD发病机制。     

B型超声检查对渗出型老年性黄斑变性的诊断价值

目的:探讨渗出型老年性黄斑变性(Age-related macular degeneration,AMD)的B型超声影象特征。方法:采用NIDEKUS-3300型超声诊断仪,对31例(54只眼)渗出型AMD进行了观察。结果:视网膜色素上皮脱离时,眼内后极部出现膜状弧形回声,光带与眼球壁之间,可见一个梭形透声区;渗出或出血未完全吸收阶段,呈混合性回声;渗出或出血逐渐吸收并为瘢痕组织所替代时,可见实体性小隆起物,强回声,形状似凸透镜或三角形,凸起端指向球后,玻璃体腔面平坦。结论:B型超声在渗出型AMD的诊断、治疗随访观察中具有实用价值。眼科学报1999;15:233-235。     

抗氧化营养素与老年性黄斑变性的防治

老年性黄斑变性(Age-related macular degeneration,AMD)是老年人视力损伤和致盲的主要原因。视网膜的高耗氧性,高长链多不饱和脂肪酸含量,作为氧自由基的靶点和暴露于可见光的特性使其易产生氧化应激。大量研究均显示抗氧化营养素有助于老年性黄斑变性的防治,本文就其最新研究进展进行综述。眼科学报2007;23:193-198.     

正常眼和老年黄斑变性眼的局部视网膜电图

以全视野亮背景及４５′视角的红色闪光作刺激，采用带中孔的角膜接触镜电极，记录了局部视网膜电图。测得２２只正常眼的黄斑中心对盲点区的局部ＥＲＧ振幅之比值为３．５４±１．３５，而３１只老年黄斑变性眼的比值是１．３９±０．５４，两者差异显著（Ｐ＜０．０１），两组全视野明适应ＥＲＧ间无意义，表明此法建立的局部ＥＲＧ记录技术对早期老年黄斑变性病人具有一定诊断价值。     

Hormone Therapy as a Protective Factor for Age-Related Macular Degeneration

ABSTRACT

Purpose

The purpose of this study was to determine if the use of menopausal hormone therapy (HT) is related to the development of neovascular (NV) age-related macular degeneration (AMD), geographic atrophy (GA) and/or early/intermediate AMD.     

The Role of Eye Movements During Reading in Patients with Age-Related Macular Degeneration (AMD)

AMD patients often have particular difficulty reading, even when the text is magnified to compensate for reduced visual acuity. This study explores whether reading performance can be explained by eye movement factors. Forty patients with advanced AMD were tested with a high-speed video eye tracker to evaluate fixation stability and saccadic eye movements. Reading speed was measured for standardized texts viewed at the critical print size. Visual acuity and contrast sensitivity were unrelated to reading speed, but fixation stability, proportion of regressive saccades and size of forward saccades were all significantly associated with reading performance, accounting for 74% of the variance. The implications of these findings for low-vision training programmes are discussed.     

Retinal Vascular Caliber and Age-related Macular Degeneration in an Indian Population from Singapore

Purpose: To examine the association between retinal vascular caliber and early age-related macular degeneration (AMD) in an Indian population.

Methods: A total of 3112 Indian participants aged ≥40 years from the population-based Singapore Indian Eye Study who had data available on retinal vascular caliber measurements and AMD status were included. Retinal arteriolar and venular calibers were measured from digital photographs using computer-assisted software according to a standardized protocol. Images of the macular region were graded according to the modified Wisconsin age-related maculopathy grading system. Right eyes were selected for analyses. Binary logistic regression models were used to assess the association, adjusting for age, sex, systolic blood pressure, total cholesterol, random blood glucose, body mass index, and the companion retinal vascular caliber.

Results: A total of 107 participants (3.4%) were diagnosed with early AMD. Neither arteriolar nor venular caliber was related to AMD. For early AMD, the age-, sex-, and companion retinal vascular caliber-adjusted odds ratio (OR) per standard deviation (SD) decrease in arteriolar caliber was 0.95 (95% CI 0.84–1.31; p?=?0.671), and per SD increase in venular caliber was OR: 0.96 (95% CI: 0.77–1.20); p?=?0.714. No trend was found after categorizing retinal vascular calibers into quartiles. Multivariate adjustment and stratified analyses did not alter these results.

Conclusion: Retinal vascular calibers were not related to early AMD among Indian participants. These findings differ from those of several previous studies performed in Caucasian and Asian populations.     

老年黄斑变性线粒体DNA缺失的初步研究

目的:研究与衰老和氧化磷酸化功能缺陷有关的细胞线粒体DNA(mtDNA)突变,从基因水平探讨老年黄斑变性(ARMD)的发病机理。方法:应用聚合酶链反应(PCR)对20例老年黄斑变性(ARMD)病人之血细胞线粒体DNA(mtDNA)缺失进行了初步研究。结果:有6例湿性ARMD扩增出2条异常DNA片段,提示在mtDNA位点7901～13650之间存在有2种mtDNA缺失,其缺失片段大小分别为5.0kb和5.2kb。另有5例湿性ARMD扩增出1条1.2kb的异常片段,提示在mtDNA位点8531～13400之间还存在1种长度为3.67kb的缺失片段,10例对照均未扩增出异常mtDNA片段。结论:提示在湿性ARMD病人血细胞mtDNA存在有包括与年龄相关的长度为5.0kb在内的多重缺失,mtDNA突变与ARMD发病机制的关系还需进一步深入研究。眼科学报 1997;13:52     

Genomewide Association Study of Retinal Traits in the Amish Reveals Loci Influencing Drusen Development and Link to Age-Related Macular Degeneration

PurposeThe purpose of this study was to identify genetic risk loci for retinal traits, including drusen, in an Amish study population and compare these risk loci to known risk loci of age-related macular degeneration (AMD).MethodsParticipants were recruited from Amish communities in Ohio, Indiana, and Pennsylvania. Each participant underwent a basic health history, ophthalmologic examination, and genotyping. A genomewide association analysis (GWAS) was conducted for the presence and quantity of each of three retinal traits: geographic atrophy, drusen area, and drusen volume. The findings were compared to results from a prior large GWAS of predominantly European-ancestry individuals. Further, a genetic risk score for AMD was used to predict the presence and quantity of the retinal traits.ResultsAfter quality control, 1074 participants were included in analyses. Six single nucleotide polymorphisms (SNPs) met criteria for genomewide significance and 48 were suggestively associated across three retinal traits. The significant SNPs were not highly correlated with known risk SNPs for AMD. A genetic risk score for AMD provided significant predictive value of the retinal traits.ConclusionsWe identified potential novel genetic risk loci for AMD in a midwestern Amish study population. Additionally, we determined that there is a clear link between the genetic risk of AMD and drusen. Further study, including longitudinal data collection, may improve our ability to define this connection and improve understanding of the biological risk factors underlying drusen development.     

Harmonizing the Classification of Age-related Macular Degeneration in the Three-Continent AMD Consortium

Purpose: To describe methods to harmonize the classification of age-related macular degeneration (AMD) phenotypes across four population-based cohort studies: the Beaver Dam Eye Study (BDES), the Blue Mountains Eye Study (BMES), the Los Angeles Latino Eye Study (LALES), and the Rotterdam Study (RS).

Methods: AMD grading protocols, definitions of categories, and grading forms from each study were compared to determine whether there were systematic differences in AMD severity definitions and lesion categorization among the three grading centers. Each center graded the same set of 60 images using their respective systems to determine presence and severity of AMD lesions. A common 5-step AMD severity scale and definitions of lesion measurement cutpoints and early and late AMD were developed from this exercise.

Results: Applying this severity scale changed the age-sex adjusted prevalence of early AMD from 18.7% to 20.3% in BDES, from 4.7% to 14.4% in BMES, from 14.1% to 15.8% in LALES, and from 7.5% to 17.1% in RS. Age-sex adjusted prevalences of late AMD remained unchanged. Comparison of each center’s grades of the 60 images converted to the consortium scale showed that exact agreement of AMD severity among centers varied from 61.0–81.4%, and one-step agreement varied from 84.7–98.3%.

Conclusion: Harmonization of AMD classification reduced categorical differences in phenotypic definitions across the studies, resulted in a new 5-step AMD severity scale, and enhanced similarity of AMD prevalence among the four cohorts. Despite harmonization it may still be difficult to remove systematic differences in grading, if present.     

早期老年性黄斑变性的暗视ERG检测

用暗视视网膜电图（ERG）检测了眼底有drusen的早期老年性黄斑变性（AMD）患者42例（56眼）和正常对照组50例（50眼）。结果与正常对照组相比，发现早期AMD有a波峰时和幅值异常。红光ERG的a波谷数减少（P＜0．005），而兰光ERG改变不显著（P＞0．05）。同时还发现，红光ERG的改变与视力、病变部位、类型有关．提示：暗视ERG可作为AMD早期的检测手段之一。