Clinical study on diagnosis and treatment of age related macular degeneration

年龄相关性黄斑变性诊治的临床研究

• 批准号: 09671812
• 负责人: MIKI Tokuhiko
• 金额: $ 1.92万
• 依托单位: OSAKA CITY UNIVERSITY MEDICAL SCHOOL
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671812/
• 关键词: Age-related macular degeneration; Indocyanine green angiography; Image subtractionmethod; Choroidal circulation; choroidal neovascularization; Laser treatment; dye enhanced photocoagulation; photodynamic therapy; レーザ治療; 自然経過; ICG螢光造影; 視力予後; 新生

What is the most important in the diagnosis of the age related macular degeneration (AMD) is the detection of the choroidal neovascularization (CNV). AMD cases with classic and/or occult choroidal neovascularization were reviewed. Well demarcated hyperfluorescence with late ICG leakage CNV was associated with the highest risk for visual acuity loss among the present variables. In contrast, CNV having no ICG leakage represented no significantly increased risk. The rapid injection method of a small bolous of dye enabled detection of the choroidal veins with delayed filling, which was not clearly and easily visible using the ordinary injection method, and is useful for detailed examination of choroidal circulation including CNV.We reviewed exudative AMD which were followed up more than six months. Decrease in visual acuity by 6 lines or more developed in 15 eyes (15.5%) which received photocoagulation and in 13 eyes (14.8%) which did not. Due to analysis of individual cases, they included damage to the fovea by laser and incorrect diagnosis of CNV. Photocoagulation of a hot spot with hyperfluorescent plaque on indocyanine green angiography should be revaluation. The effectiveness and limitation of ICG dye enhanced diode laser photocoagulation in treating subfoveal CNV associated with AMD were investigated retrospectively. ICG enhanced photocoagulation achieved a higher anatomical success rate but equal functional outcomes to those with argon or krypton laser photocoagulation. Because visual prognosis of subfoveal CNV was also poor, the photodynamic treatment should be introduced. The basic experiment was finished in the good result using second generation photosensitivity material (ATX-S10).

在老年性黄斑变性（AMD）的诊断中，脉络膜新生血管（CNV）的检测是最重要的。我们回顾了典型和/或隐匿脉络膜新生血管的AMD病例。在目前的变量中，界限清晰的高荧光伴晚期ICG渗漏性CNV与视力丧失的最高风险相关。相比之下，没有ICG泄漏的CNV没有显著增加风险。小泡快速注射染色剂的方法可以检测到延迟充盈的脉络膜静脉，这是普通注射方法不清晰和容易看到的，有助于详细检查脉络膜循环，包括CNV。我们回顾了渗出性AMD，随访超过6个月。接受光凝治疗的15眼（15.5%）视力下降6线以上，未接受光凝治疗的13眼（14.8%）视力下降6线以上。由于个案分析，它们包括激光损伤中央窝和CNV的错误诊断。在吲哚菁绿血管造影上发现的带有高荧光斑块的热点应重新评估。回顾性分析了ICG染料增强二极管激光光凝治疗视网膜中央凹下CNV合并AMD的有效性和局限性。ICG增强光凝术与氩激光或氪激光光凝术相比，具有更高的解剖成功率和相同的功能效果。由于中央凹下CNV的视力预后也较差，应引入光动力治疗。利用第二代光敏材料（ATX-S10）完成了基础实验，取得了良好的效果。

项目成果

尾花 明、郷渡有子、三木徳彦、西口和輝: "高度視力低下をきたした滲出型加齢性黄斑変性症例の検討"臨床眼科. 53(5). 873-878 (1999)

Akira Obana、Yuko Goto、Norihiko Miki、Kazuteru Nishiguchi：“伴有严重视力丧失的湿性年龄相关性黄斑变性病例的研究”临床眼科 53(5) (1999)。

Obana A, Gohto Y, Nishiguchi K, Miki T, et al.: "A retrospective pilot study of indocyanine green enhanced diode laser photocoagulation for subfoveal choroidal neovascularizarion associated with age-related macular degeneration"Jpn J Ophthalmol. (投稿予定).

Obana A、Gohto Y、Nishiguchi K、Miki T 等人：“吲哚菁绿增强二极管激光光凝治疗与年龄相关性黄斑变性相关的黄斑中心凹下脉络膜新生血管的回顾性初步研究”Jpn J Ophthalmol。

尾花 明他: "高度の視力低下を来した滲出型加齢性黄斑変性症例の検討" 臨床眼科. 受理,掲載予定. (1999)

Akira Obana 等人：“患有严重视力丧失的湿性年龄相关性黄斑变性病例的研究”，已接受，计划出版（1999 年）。

三木徳彦他: "ICG螢光造影による加齢性黄斑変性の脈絡膜新生血管分類とその視力予後" 臨床眼科. (受理,掲載予定). (1998)

Norihiko Miki 等人：“通过 ICG 荧光检查对年龄相关性黄斑变性的脉络膜新生血管进行分类及其视觉预后”《临床眼科》（已接受，计划出版）。

Obana A, Gohto Y, Miki T, Nishiguchi K: "Review of cases of exudative age-related macular degeneration with severe visual loss"Jpn J Clin Ophthalmo. 53. 873-878 (1999)

Obana A、Gohto Y、Miki T、Nishiguchi K：“渗出性年龄相关性黄斑变性伴严重视力丧失的病例回顾”Jpn J Clin Olookingmo。