5-YEAR INCIDENCE AND DISAPPEARANCE OF DRUSEN AND RETINAL-PIGMENT EPITHELIAL ABNORMALITIES - WATERMAN STUDY
5-YEAR INCIDENCE AND DISAPPEARANCE OF DRUSEN AND RETINAL-PIGMENT EPITHELIAL ABNORMALITIES - WATERMAN STUDY
复制标题
DOI：
10.1001/archopht.1995.01100030055022
复制
发表时间：
1995-03-01
影响因子：
--
通讯作者：
WEST, SK
中科院分区：
文献类型：
--
作者：
BRESSLER, NM;MUNOZ, B;WEST, SK
目的：获得年龄相关性黄斑变性(AMD)的5年纵向数据，为疾病预后、公共卫生规划和临床试验发展提供帮助。患者和方法：以可靠、标准化的方式独立地对483名30岁以上水手的眼底照片进行分级。结果：50例70岁以上的患者中有1例发生明确的脉络膜新生血管和/或盘状瘢痕形成，特别是15例70岁以上的AMD-3患者中有1例发生明显的脉络膜新生血管和/或盘状瘢痕形成(定义为大的或融合的玻璃体、视网膜色素上皮局灶性色素沉着和/或非地域性的RPE萎缩)。大玻璃体、局灶性色素沉着或AMD-3的出现与年龄有关，在50至59岁的参与者中分别为5%、1%和7%；在60至69岁的参与者中分别为17%、3%和14%；在70岁或以上的参与者中分别为17%、9%和26%。分别在47名参与者中有16名(34%)、19名参与者中有11名(58%)和61名参与者中的17名(28%)出现了大的玻璃疣、色素沉着或AMD-3的消失，这些人在1985年的照片上都有各自的特征。在AMD-3独立分级的47只眼中，38只眼(81%)的AMD-3并列分级。在被确认患有AMD-3的16只眼睛中，有9只眼睛(56%)被确认失踪。结论：对AMD的非新生血管特征(包括大的玻璃体和RPE的异常)的前瞻性研究必须解释这些特征的出现和消失，并支持并行分级可以补充识别AMD特征的出现或消失的独立分级。
Purpose: To obtain 5-year longitudinal data on age-related macular degeneration (AMD) that might be useful for disease prognosis, public health planning, and clinical trial development.Patients and Methods: Baseline (1985) and 5-year follow-up (1990) fundus photographs of 483 watermen over 30 years of age who participated in a cohort study conducted on the eastern shore of Maryland were graded independently in a reliable, standardized fashion. Eyes in which AMD appeared or disappeared also were graded in a side-by-side fashion.Results: Development of definite choroidal neovascularization and/or disciform scarring occurred in one of 50 participants over 70 years of age, specifically one of 15 participants over 70 years of age with AMD-3 (defined as large or confluent drusen, focal hyperpigmentation of the retinal pigment epithelium [RPE], and/or nongeographic atrophy of the RPE). Appearance of large drusen, focal hyperpigmentation, or AMD-3 was age related, occurring in 5%, 1%, and 7%, respectively, of participants aged 50 to 59 years; 17%, 3%, and 14%, respectively, of participants aged 60 to 69 years; acid 17%, 9%, and 26%, respectively, of participants aged 70 years or more. Disappearance of large drusen, hyperpigmentation, or AMD-3 occurred in 16 (34%) of 47 participants, 11 (58%) of 19 participants, and 17 (28%) of 61 participants, respectively, who had each feature photographically present in 1985. Among the 47 eyes identified in which AMD-3 developed by independent gradings, 38 cases of AMD-3 (81%) were confirmed on side-by-side grading. Among the 16 eyes identified as having AMD-3 that disappeared, nine disappearances (56%) were confirmed. Borderline differences in appearance of pigment, drusen size, drusen location, or photographic quality may have accounted for disappearance in seven cases (44%).Conclusions: Prospective studies on the nonneovascular features of AMD (including large drusen and abnormalities of the RPE) must account for the appearance and disappearance of these features and support the idea that side-by-side gradings can complement independent gradings identifying appearance or disappearance of features of AMD.