Development of atrophy of the retinal pigment epithelium around disciform scars
Development of atrophy of the retinal pigment epithelium around disciform scars
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DOI：
10.1136/bjo.2005.083022
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发表时间：
2006-04-01
影响因子：
4.1
通讯作者：
Sarks, S
中科院分区：
文献类型：
--
作者：
Sarks, J;Tang, K;Sarks, S
背景/目的：老年性黄斑变性(AMD)继发于盘状瘢痕的眼被认为是视力稳定的。本研究的目的是报告瘢痕周围视网膜色素上皮(RPE)萎缩的后续发展，并讨论其可能的基础。方法：观察18例20只眼在脉络膜新生血管(CNV)周围发生萎缩的情况。使用Topcon Imagenet 2000系统描述了一种测量萎缩随时间扩展的方法。结果：在临床上，CNV最初被一环苍白包围，随后发展为RPE的萎缩带。在CNV静止后的前3年发展最快，但随后继续缓慢扩张，扩大到疤痕大小的3倍以上。组织病理学标本显示大的脉络膜血管直接进入瘢痕，瘢痕周围和下方的小脉络膜血管减少。结论：盘状瘢痕周围可能有一条扩张的RPE萎缩带，推测这是脉络膜循环重塑的结果。在计划、管理和评估治疗结果时，可能需要考虑由此产生的暗点的持续扩大。
Background/aims: Eyes with burnt out disciform scars secondary to age related macular degeneration (AMD) are regarded as visually stable. The aim of this study is to report the subsequent development of atrophy of the retinal pigment epithelium (RPE) around the scars and discuss the possible basis.Methods: 20 eyes from 18 patients were observed to develop atrophy around choroidal neovascularisation (CNV). A method of measuring expansion of the atrophy over time is described using the Topcon Imagenet 2000 system. An additional 10 clinicopathological examples were reviewed.Results: Clinically CNV became surrounded initially by a ring of pallor that progressed to an expanding band of atrophy of the RPE. It developed most rapidly in the first 3 years after CNV became quiescent but then continued to expand slowly to more than three times the size of the scar. Histopathological specimens showed large choroidal vessels entering the scars directly and a reduced number of small choroidal vessels beneath and around the scarConclusions: Disciform scars may become surrounded by an expanding band of atrophy of the RPE, postulated to result from remodelling of the choroidal circulation. The ongoing enlargement of the resulting scotoma may need to be considered when planning management and assessing treatment outcomes.