地图样萎缩和脉络膜新生血管并存的黄斑变性研究进展

Research progress of macular degenerationin combination of geographic atrophyand choroidal neovascularization

地图样萎缩(GA)及脉络膜新生血管形成(CNV)是晚期年龄相关性黄斑变性(AMD)的特征性改变,被认为是2种不同的病理变化,严重影响患者的视力。但临床实际中发现,患者单眼可以同时存在GA和CNV改变,其中GA出现往往早于CNV。在眼底检查和影像学检查中,其可能表现为玻璃膜疣或视网膜下玻璃膜疣样沉积物,此外没有特征性的变化或遗传标记物可诊断合并GA/CNV。抗血管内皮生长因子(anti-VEGF)对于CNV的治疗已经得到广泛认可,但有研究表明anti-VEGF治疗后会增加GA的发生率,导致GA/CNV出现。本文就单眼合并GA/CNV的流行病学、临床表现及治疗等方面进行综述,以期为其诊断治疗提供理论依据。

Geographic atrophy(GA)and choroidal neovascularization(CNV)are the major factors contributing to age-related macular degeneration(AMD),which is considered to be two different pathological changes,severely affects the patient's vision.However,in clinical practice,it has been found that both GA and CNV changes can occur in one eye of patients,and GA often appears earlier than CNV.It verrucous warts or subretinal verrucous deposits may present during fundus examination and imaging examination,and no characteristic changes or genetic markers could be diagnosed as GA/CNV.Anti-vascular endothelial growth factor(anti-VEGF)has been widely recognized for the treatment of CNV,but some studies have shown that anti-VEGF treatment can increase the incidence of GA,leading to the occurrence of GA/CNV.In this article,the epidemiology,clinical manifestations and treatment of monocular GA/CNV were reviewed in order to provide theoretical basis for its diagnosis and treatment.