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同时的GA和CNV/MNV:发病率,特征和治疗方法
Keiko Kataoka1, Richard Gale2, Xiaoxin Li3
1Kyorin University School of Medicine, Tokyo, Japan.
概括
地理缩 (GA) 和胆管新血管化 (CNV) /黄斑新血管化 (MNV) 经常在与晚年相关的黄斑退化 (AMD) 中共存在. 这些情况具有共同的风险因素,并且应该使用多式联络成像来共同评估,以有效管理.
科学领域:
- 眼科医生 眼科 眼科
- 医学研究 医学研究
- 临床实践 临床实践
背景情况:
- 从历史上看,地理缩 (GA) 和胆道新血管化 (CNV) /黄斑新血管化 (MNV) 在晚年黄斑退化 (AMD) 中被视为不同的实体.
- 最近的文献表明,GA和CNV/MNV共存的报告病例数量越来越多.
- 了解它们的相互作用对于临床实践中全面的长期管理策略至关重要.
研究的目的:
- 审查有关同时发生GA和CNV/MNV的发病率,风险因素和临床特征的文献.
- 为诊断,评估和同时存在的GA和CNV/MNV的管理制定共识性建议.
- 要突出晚期AMD的连续性,包括GA和CNV/MNV.
主要方法:
- 综合文献综述,重点关注同步的GA和CNV/MNV.
- 对发病率,遗传和临床风险因素的分析.
- 评估像OCT和OCT-A.这样的诊断成像模式.
- 对治疗影响的审查,特别是抗VEGF疗法.
主要成果:
- 在GA眼中CNV/MNV的发病率为每年7.4%;在CNV/MNV之后的MA发生在24.4%-37%的病例中.
- 亚临床CNV/MNV通过OCT-A检测到11%-16%的GA眼睛.
- GA和CNV/MNV具有共同的遗传 (HTRA1,补充因子) 和临床风险因子,表明AMD的连续性.
- 对CNV/MNV的抗VEGF治疗不会影响MA的进展;1型CNV/MNV与MA的进展速度较慢有关.
结论:
- GA和CNV/MNV共存的概率很高,需要同时考虑它们.
- 多模式成像,特别是OCT和OCT-A,对于同时评估这两种情况至关重要.
- 未来的临床研究应该集中在评估GA和CNV/MNV一起.
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