Clinical study on diagnosis and treatment of age related macular degeneration

老年性黄斑变性(AMD)的诊断最重要的是脉络膜新生血管(CNV)的检测。复习了AMD合并典型和/或隐匿性脉络膜新生血管的病例。在目前的变量中，边界清楚的强荧光和晚期ICG渗漏的CNV与视力丧失的风险最高相关。相反，无ICG渗漏的CNV患者的风险没有显著增加。快速注射小剂量染料的方法可以检测到脉络膜静脉的延迟充盈，这是普通注射方法不能清楚和容易看到的，对包括CNV在内的脉络膜循环的详细检查是有用的。接受光凝治疗的15只眼(15.5%)和未接受光凝治疗的13只眼(14.8%)视力下降6行或以上。由于个别病例的分析，包括激光对中心凹的损伤和CNV的误诊。对吲哚青绿血管造影术中有高荧光斑块的热点进行光凝治疗应重新评估。回顾分析ICG染料增强型半导体激光治疗黄斑中心凹下CNV合并AMD的疗效和局限性。ICG增强光凝术获得了更高的解剖成功率，但功能结果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，应引入光动力疗法。使用第二代光敏材料(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).