Long-Term Visual Outcome of Choroidal Neovascularization in Pathologic Myopia: Natural History and Laser Treatment
Long-Term Visual Outcome of Choroidal Neovascularization in Pathologic Myopia: Natural History and Laser Treatment
复制标题
病理性近视脉络膜新生血管形成的长期视力结果：自然史和激光治疗
DOI：
10.1177/112067219700700401
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发表时间：
1997
影响因子：
1.7
通讯作者：
G. Coscas
中科院分区：
文献类型：
--
作者：
M. Secrétan;D. Kuhn;G. Soubrane;G. Coscas
这项回顾性研究旨在帮助澄清在转诊人群中进行和不进行激光治疗的近视性脉络膜新生血管（CNV）的长期随访（5-10年）期间的视力预后。患者和方法。回顾性选择一组50只连续未治疗眼和一组50只连续治疗眼。入选标准为：荧光素血管造影证明CNV不涉及中心凹中心，视力（VA）> 20/200，年龄小于60岁，症状发作≤ 6个月，随访至少5年。根据具有相同初始VA的亚组，分析随访期间未治疗眼和治疗眼的平均VA降低。结果两组100眼CNV均位于中心凹中心（< 200 μm），仅11%位于中心凹外（> 200 μm）。在自然病程组中，5年后所有CNV均累及中央凹中心，平均VA为20/160。在治疗组中，在5年随访结束时和一次或多次激光治疗后，64%的眼睛有干燥疤痕，平均视力为20/74。然而，复发率非常高（72%），在随访结束时，36%的治疗眼发生了中心凹下复发，VA平均下降至20/154。治疗组和非治疗组的VA平均降低之间的差异在第2年具有统计学显著性。在5年（100只眼）时，仅初始VA优于≥ 20/40的眼睛的差异持续存在（P<0.05）。在8年（76只眼）和10年（24只眼）时，这种差异不再显著。评论这项研究证实，CNV伴随退行性近视具有极差的预后。然而，两组的最终VA分析表明，初始VA高的眼睛从治疗中获得更多。
This retrospective study was designed to help clarify the visual prognosis during long-term follow-up (5-10 years) of myopic choroidal neovascularization (CNV) with and without laser treatment in a referral population. Patients and Methods. A group of 50 consecutive non-treated eyes and a group of 50 consecutive treated eyes were selected retrospectively. Inclusion criteria were: fluorescein angiographic documentation of CNV not involving the center of the fovea, visual acuity (VA) > 20/200, age less than 60, onset of symptoms ≤ 6 months and at least five years of follow-up. The mean decrease in VA in non-treated and treated eyes during the follow-up was analysed on the basis of subgroups with the same initial VA. Results Considering both groups (100 eyes) at presentation, 89% of CNV spared the center of the fovea but were located in the foveolar area (< 200 μm) and only 11% were extrafoveal (> 200 μm). In the natural history group, after five years all CNV involved the center of the fovea and mean VA was 20/160. In the treated group, at the end of the five year follow-up and after one or more laser session, 64% of eyes had a dry scar and mean VA was 20/74. Nevertheless there was a very high rate of recurrences (72%) and at the end of follow-up, 36% of treated eyes had a subfoveal recurrence with a mean decrease in VA to 20/154. The difference between the mean decrease in VA of the treated and non-treated groups was statistically significant at two years. At five years (100 eyes), the difference persisted only for eyes with initial VA better than ≥ 20/40 (P<0.05). At eight years (76 eyes) and ten years (24 eyes), this difference was no longer significant. Comments This study confirms that CNV accompanying degenerative myopia has an extremely poor prognosis. Nevertheless analysis of final VA in both groups suggests that eyes with high initial VA gain more from treatment.