Early and intermediate age-related macular degeneration: update and clinical review.
Early and intermediate age-related macular degeneration: update and clinical review.
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DOI：
10.2147/cia.s142685
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发表时间：
2017
影响因子：
3.6
通讯作者：
Ruiz-Moreno JM
中科院分区：
文献类型：
--
作者：
García-Layana A;Cabrera-López F;García-Arumí J;Arias-Barquet L;Ruiz-Moreno JM
视网膜相关性黄斑变性（AMD）是发达国家不可逆的中心视力丧失的主要原因。随着人口老龄化，AMD将成为全球范围内日益重要和流行的疾病。它是一种复杂的疾病，其病因与遗传和环境风险因素有关。在受影响最严重的人群中，AMD导致的生活质量的广泛下降和日常生活援助的逐步需求突出了预防策略的重要作用，特别是建议患者戒烟。此外，保持健康的饮食，控制其他风险因素（如高血压，肥胖和动脉粥样硬化），以及使用营养补充剂（抗氧化剂）是可以接受的。基因检测对于有AMD家族史的患者尤其重要。最近，AMD临床分类的统一标准，定义没有明显的老化变化;正常的老化变化;早期，中期和晚期AMD阶段，在预测AMD进展风险和建立诊断，治疗方法和患者随访的建议方面具有价值。目前的审查重点是早期和中期AMD，并介绍了这些阶段的临床特征和眼科结果的描述，以及患者的诊断和管理算法，这是很容易适用于日常临床实践。
Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in developed countries. With the aging of population, AMD will become globally an increasingly important and prevalent disease worldwide. It is a complex disease whose etiology is associated with both genetic and environmental risk factors. An extensive decline in the quality of life and progressive need of daily living assistance resulting from AMD among those most severely affected highlights the essential role of preventive strategies, particularly advising patients to quit smoking. In addition, maintaining a healthy diet, controlling other risk factors (such as hypertension, obesity, and atherosclerosis), and the use of nutritional supplements (antioxidants) are recommendable. Genetic testing may be especially important in patients with a family history of AMD. Recently, unifying criteria for the clinical classification of AMD, defining no apparent aging changes; normal aging changes; and early, intermediate, and late AMD stages, are of value in predicting AMD risk of progression and in establishing recommendations for the diagnosis, therapeutic approach, and follow-up of patients. The present review is focused on early and intermediate AMD and presents a description of the clinical characteristics and ophthalmological findings for these stages, together with algorithms for the diagnosis and management of patients, which are easily applicable in daily clinical practice.