A simplified severity scale for age-related macular degeneration: AREDS Report No. 18.
A simplified severity scale for age-related macular degeneration: AREDS Report No. 18.
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DOI：
10.1001/archopht.123.11.1570
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发表时间：
2005-11
影响因子：
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通讯作者：
F. Ferris;M. Davis;T. Clemons;Li-Yin Lee;E. Chew;A. Lindblad;R. Milton;S. Bressler;R. Klein-R.-Klei
中科院分区：
文献类型：
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作者：
F. Ferris;M. Davis;T. Clemons;Li-Yin Lee;E. Chew;A. Lindblad;R. Milton;S. Bressler;R. Klein-R.-Klei
目的建立一个用于确定晚期年龄相关性黄斑变性（AMD）危险性的简化临床量表。方法根据AMD相关眼病研究中眼底照片的分级，为个体眼睛制定详细的量表，然后在每只眼睛中存在或不存在2种容易识别的视网膜异常、玻璃疣和色素异常的交叉表中评估进展为晚期AMD的速率。大玻璃疣和任何色素变化特别预测发展为晚期AMD。结果：为患者开发的评分系统为每只眼睛分配了1个风险因素，即存在1个或多个大玻璃疣（≥ 125 μ m，椎间盘边缘大静脉的宽度），以及1个风险因素，即存在任何色素异常。将双眼的风险因素相加，得到5级量表（0-4），其中至少一只眼睛发生晚期AMD的大约5年风险以这种容易记住的顺序增加：0个因素，0.5%; 1个因素，3%; 2个因素，12%; 3个因素，25%;和4个因素，50%。对于没有大玻璃疣的人，双眼中存在中间玻璃疣被计为1个风险因素。结论：这种简化的量表为晚期AMD的发展提供了方便的风险类别，可以通过临床检查或要求较低的摄影程序来确定，而不是在AMD相关眼病研究中使用。
OBJECTIVE To develop a simplified clinical scale defining risk categories for development of advanced age-related macular degeneration (AMD). METHODS Following development of a detailed scale for individual eyes based on gradings of fundus photographs in the Age-Related Eye Disease Study, rates of progression to advanced AMD were assessed in cross-tabulations of presence or absence in each eye of 2 easily identified retinal abnormalities, drusen and pigment abnormalities. Large drusen and any pigment changes were particularly predictive of developing advanced AMD. RESULTS The scoring system developed for patients assigns to each eye 1 risk factor for the presence of 1 or more large (> or = 125 microm, width of a large vein at disc margin) drusen and 1 risk factor for the presence of any pigment abnormality. Risk factors are summed across both eyes, yielding a 5-step scale (0-4) on which the approximate 5-year risk of developing advanced AMD in at least one eye increases in this easily remembered sequence: 0 factors, 0.5%; 1 factor, 3%; 2 factors, 12%; 3 factors, 25%; and 4 factors, 50%. For persons with no large drusen, presence of intermediate drusen in both eyes is counted as 1 risk factor. CONCLUSION This simplified scale provides convenient risk categories for development of advanced AMD that can be determined by clinical examination or by less demanding photographic procedures than used in the Age-Related Eye Disease Study.