The development of choroidal neovascularization in eyes with the geographic atrophy form of age-related macular degeneration
The development of choroidal neovascularization in eyes with the geographic atrophy form of age-related macular degeneration
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DOI：
10.1016/s0161-6420(99)00509-6
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发表时间：
1999-05-01
期刊：
影响因子：
13.7
通讯作者：
Applegate, CA
中科院分区：
文献类型：
--
作者：
Sunness, JS;Gonzalez-Baron, J;Applegate, CA
目的：目的：探讨年龄相关性黄斑变性（AMD）所致地图样萎缩（GA）患者的脉络膜新生血管（CNV）发生率及其特征。设计：前瞻性自然病程研究，队列分析。参与者：152例GA患者，至少1只眼经荧光素血管造影检查无CNV，每年随访一次。结果：13只GA眼发生CNV。对于基线时双侧GA且无CNV的患者，2年时有2%发生CNV，4年时有11%发生CNV。对于对侧眼CNV的患者，GA组2年时CNV的发生率为18%，4年时为34%。发生CNV的眼比仅GA组的眼视力丧失更多。在对侧眼CNV组中，那些在基线时具有较少中央萎缩（和更好的敏锐度）的患有GA的研究眼更有可能发展CNV。CNV在9只眼睛中在GA的外周边缘发展，在两只眼睛中在备用中心凹区域发展，并且在一只眼睛中在中心和边缘发展。没有一只眼在萎缩区域发生CNV。CNV的出现在某些情况下是短暂的，并最终表现为GA的扩大区域。另外12只患眼有角膜新生血管，但无明确的CNV证据; 3只被认为是可疑的CNV，其余的被认为是可能在老年患者中看到的角膜新生血管。结论：患GA的患眼，其对侧眼有CNV，是在GA患眼中发生CNV的显著风险。患有双侧GA且无CNV证据的患者发生CNV的风险相对较低。CNV可能是短暂的，可能无法检测到。与CNV无关的视网膜内病变在老年人群中相对常见。
Objective: To determine the rate of developing choroidal neovascularization (CNV) in eyes with geographic atrophy (GA) from age-related macular degeneration (AMD) and the characteristics of the CNV in these eyes.Design: Prospective natural history study with cohort analysis,Participants: One hundred fifty-two patients with GA and no CNV by fluorescein angiography in at least 1 eye, with annual follow-up.Main Outcome Measures: The development of CNV,Results: Thirteen eyes with GA developed CNV. For patients with bilateral GA and no CNV at baseline, 2% developed CNV by 2 years and 11% by 4 years. For patients with CNV in the fellow eye, 18% developed CNV in the study eye with GA by 2 years and 34% by 4 years, The eyes that developed CNV experienced more acuity loss than did the eyes with only GA. Within the fellow eye CNV group, those study eyes with GA that had less central atrophy (and better acuity) at baseline were more likely to develop CNV, The CNV developed at a peripheral border of GA in nine eyes, in the spared foveal region in two eyes, and in both center and border in one eye. No eye developed CNV in the area of atrophy itself. The appearance of CNV was evanescent in some cases and had a final appearance of an enlarged area of GA. Twelve other eyes had hemorrhages without definite evidence of CNV; three were thought to be suspicious for CNV and the remainder were thought to be hemorrhages that may be seen in elderly patients,Conclusion: An eye with GA whose fellow eye has CNV is at significant risk for the development of CNV in the GA eye. A patient with bilateral GA and no evidence of CNV is at relatively low risk for developing CNV, The CNV may be evanescent and may not be detected. Intraretinal hemorrhages unrelated to CNV are relatively common in this older population.