Clinical study on diagnosis and treatment of age related macular degeneration

脉络膜新生血管（CNV）的检测是诊断老年性黄斑变性（AMD）的重要手段。对伴有典型和/或隐匿性脉络膜新生血管的AMD病例进行了回顾。在目前的变量中，界限清楚的高荧光和晚期ICG渗漏CNV与视力丧失的风险最高相关。相比之下，无ICG渗漏的CNV不代表风险显著增加。快速注射方法的一个小团的染料使检测脉络膜静脉延迟填充，这是不清楚，很容易看到使用普通的注射方法，是有用的详细检查脉络膜循环，包括CNV。我们审查了渗出性AMD随访超过6个月。术后视力下降6行以上者15眼（15.5%），未行光凝者13眼（14.8%）。由于对个别病例的分析，它们包括激光对中央凹的损伤和CNV的错误诊断。对吲哚菁绿色血管造影上出现的热点高荧光斑块的光凝治疗应重新评价。回顾性分析ICG染料增强半导体激光治疗AMD合并黄斑中心凹下CNV的有效性和局限性。ICG增强光凝术的解剖成功率更高，但功能结局与氩或氪激光光凝术相同。由于中心凹下CNV的视力预后也较差，因此应引入光动力学治疗。采用第二代光敏材料（ATX-S10）进行了基础实验，取得了较好的效果。

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).