老年黄斑变性预防与治疗推荐.ppt

Verteporfin Lesions caused by the presence of CNV affect vision to different degrees depending on their position. If part or all of the lesion is under the center of the foveal avascular zone, the lesion is defined as subfoveal; lesions within 200 μm of the foveal center but not underneath it are defined as juxtafoveal; and extrafoveal lesions are those where lesions are at least 200 μm from the foveal center.1 Patients with extrafoveal and juxtafoveal lesions have a poor prognosis and studies show that after 3 years, the majority of untreated extrafoveal lesions become subfoveal.2 Well-demarcated extrafoveal and juxtafoveal lesions, however, have been successfully treated with laser photocoagulation for several years. Maintenance of vision has been achieved for an extended interval but CNV recurred in 50% of cases within 2 years.1 Most patients with neovascular AMD have CNV under the foveal center. Subfoveal lesions also are associated with a poor visual prognosis.2 Laser photocoagulation of these cases has been shown to be beneficial only for selected, small, well-demarcated lesions with classic CNV. Furthermore, treatment can be associated with immediate loss of vision.3 References 1. Macular Photocoagulation Study Group. Arch Ophthalmol 1991, 109:1220-31 2. Bressler, N. Surv Ophthalmol 1988, 32:375-413 3. Macular Photocoagulation Study Group. Arch Ophthalmol 1991, 109:1232-41 Diagnosis Verteporfin Verteporfin Introduction References 1. O’Shea, J.G. Postgrad Med J 1998, 74:203-7 Age-related macular degeneration (AMD) is the leading cause of severe and irreversible vision loss in elderly people throughout the western world.1 It is a disease that progressively damages the sensitive center of the retina – the fovea – and hence the center of the visual field. So far, AMD has been largely untreatable, but the development of new approaches, such as verteporfin therapy, provides hope for preserving the vision of people with some forms of AMD. As the number of people