AGE-RELATED MACULAR DEGENERATION PREVENTION TRIAL

老年性黄斑变性(AMD)是导致失明的主要原因 在美国和几个西方国家的成年人中。 大约90%的失明可归因于新生血管形态 1例为AMD，其余为色素上皮脱离 和地理萎缩。黄斑光凝研究表明 激光治疗在减少眼睛视力丧失方面是有效的 患有新生血管性AMD。然而，大多数损伤对激光是不可接受的。 接受治疗，即使接受治疗，视力也会下降到平均水平 从20/250到20/320。目前还没有其他有效的治疗方法来治疗这种疾病。 AMD的各种形式。 预防由高级形式的AMD造成的视力损失 对公共卫生有深远的影响。如果干预率只有30% 有效预防眼球内脉络膜新生血管 在高危人群中，AMD的法定盲目率可以降低 一半。黄斑中出现大的玻璃体可以很好地预测 新能源汽车的发展。低强度激光治疗导致高风险 玻璃体在大多数眼睛里消失了。受控、试点、临床试验 激光治疗对CNV的发展和视力丧失的影响 正在对两组患者进行治疗：双侧大玻璃体患者 单侧CNV和第二(对)眼大的 红酒。初步报告提供了CNV发病率增加的证据 治疗同伴眼，至少治疗后第一年。为 两项小型临床试验显示，双眼玻璃体疱疹患者的眼睛 治疗3年后CNV下降和视力改善的证据 一项大型试验显示，接受治疗的眼睛和未治疗的眼睛几乎没有区别 整整18个月。 很大一部分人口可能受益，也可能受到伤害 激光治疗要求对治疗进行彻底的评估。我们 提出预防老年性黄斑变性的并发症 评估激光治疗的安全性和有效性的试验(CAPT) 预防双侧玻璃体挫伤患者的视力丧失。更改中 视力将是主要的结果变量。次要结果 措施将是CNV的发生率，色素上皮脱离和 地理萎缩、对比度阈值改变和临界改变 用于读取的磅大小。此外，参与的患者将是 根据他们在一般素质和视觉特异质上的得分来描述 生命评估的结果。

Age-related macular degeneration (AMD) is the leading cause of blindness among adults in the United States and several Western countries. Approximately 90% of the blindness is attributable to the neovascular form of AMD and the remainder is attributable to pigment epithelial detachment and geographic atrophy. The Macular Photocoagulation Study has shown that laser treatment is effective in reducing the extent of vision loss in eyes with neovascular AMD. However, most lesions are not amenable to laser treatment and even with treatment visual acuity deteriorates to an average of 20/250 to 20/320. There are no other proven treatments for the advance forms of AMD. Prevention of vision loss from the advanced forms of AMD would have profound public health implications. If an intervention were only 30% effective in preventing choroidal neovascularization (CNV) within the high-risk population, the rate of legal blindness from AMD could be cut in half. The presence of large drusen in the macula is a strong predictor of the development of CNV. Low intensity laser treatment causes high-risk drusen to disappear in most eyes. Controlled, pilot, clinical trials on the effect of laser treatment on development of CNV and loss of vision are underway on two groups of patients: patients with bilateral large drusen and patients with unilateral CNV and the second (fellow) eye with large drusen. Initial reports provide evidence of an increased rate of CNV in treatment fellow eyes, at lest for the first year after treatment. For eyes of patients with bilateral drusen, two small clinical trials show evidence of decreased CNV and better vision in treated eyes at 3 years and one large trial shows little difference between treated and untreated eyes through 18 months. The large segment of the population that might benefit, or be harmed, by laser treatment mandates a thorough evaluation of the treatment. We propose the Complications of Age-related Macular Degeneration Prevention Trial (CAPT) to assess the safety and effectiveness of laser treatment in preventing loss of vision among patients with bilateral drusen. Change in visual acuity will be the primary outcome variable. Secondary outcome measures will be the incidence of CNV, pigment epithelial detachment and geographic atrophy, change in contrast threshold, and change in critical point size for reading. In addition, the participating patients will be described with by their scores on both general and vision specific quality of life assessments.