The diagnosis and treatment of age-related macular degeneration (AMD) is an international hotspot of eye research. Successful clinical applications of antiVEGF drugs promoted both basic research and clinical practice of AMD. A number of countries and professional societies have established clinical guidelines for AMD management, including the epidemiology, risk factors, diagnosis, classification, and treatment process. These AMD guidelines are mostly based on recently published results of clinical trials, provided good model of evidence based medicine. It is urgent and necessary to have our own guideline which is suitable for Chinese patients. Reviewing and learning existed guidelines will help us to improve the clinical practice of AMD in China.
Objective To evaluate different methods in determ ining the postoperative changes of anatomical structures in macular diseases． Methods Thirty-one eyes of 31 cases of macular diseases, were studied among them there were 15 eyes with idiopathic macular hole (IMH),and the others included 8 eyes with macular epiretinal membranes(ERMs), 4 eyes with age relate d macular degeneration(AMD) and 4 eyes with idiopathic submacular neovasculariza tions(SRNV)． All cases were examined with retinoscope or retinogra phy, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT ) pre-and postoperatively． Results Funduscopy showed that all of the 15 IMHs were closed after operation, but OCT showed th at among them 2 affected eyes still had partial retinal detachment at the macular hole edge in one quadrant and the sensory layer in macular area became thinner in 1 affected eye． FFA revealed damage of retinal pigment epithelium (RPE) in 5 cases． As for the ERMs and SRNV, funduscopy could n ot identify wether they were completely removed or not after operation． FFA ind icated that SRNV and SRNV were completely removed and the damage of RPE．OCT discovere d that the ERMs and SRNV were completely removed and the sensory layer became th inner in 3 eyes． Conclusion The combination of funduscopy , FFA and OCT can get the whole view of macular diseases and their postopera tive anatomical evaluation． (Chin J Ocul Fundus Dis, 2001,17:33-36)
Age-related macular degeneration (AMD), a set of age-related macular disease, is induced by a variety of factors. New intervention Methods help us to understand the AMD pathogenesis further; however, we only have limited knowledge of these novel Methods . To improve diagnosis and treatment practices of AMD, it is a priority to propose a standardized clinical procedure of AMD management in China. The Chinese Ocular Fundus Association has just proposed a Chinese AMD clinical pathway based on expertsprime;opinions and evidence based medicine. This clinical guideline is implementable for different stages and subtypes of AMD patients, and hopefully will be updated frequently with more clinical practice. Implementing this AMD pathway in China will improve the quality of clinical practice and research of AMD in China.
PURPOSE:To search for the occult choroidal neovascularization(CNV)of age-related macular degeneration (AMD)with macular hemorrhage using indocyanine green angiography(ICGA). METHODS:FFA and ICGA were performed in a series of 22 cases(24 eyes)of AMD with macular hemorrhage,and the findings of both angiograms were compared each other. RESULTS :ICGA was found to be superior than FFA in evaluating the occult CNV of AMD with hemorrhage owing to the following outstanding findings in this series,i.e,in judging the presence,position,number and range of the occult CNV. CONCLUSION:ICGA is an important technique in diagnosing the subretinal occult CNV in AMD with macular hemorrhage,and useful in selecting therapeutic measures including photocoagulation and surgical treatment. （Chin J Ocul Fundus Dis,1997,13: 146-149）
Objective To investigate the possible relationship between choroidal neovascularization (CNV) and macular choroidal watershed zones (CWZ) in patients with age-related macular degeneration (AMD). Methods Fifty-seven selected indocyanine green video angiograms (ICGA) of 57 patients (57 eyes) with AMD were evaluated, and 35 ones of the healthy fellow eyes of 35 patients with unilateral non-AMD fundus diseases were selected as age-matched control. The video angiograms were evaluated for investigating the relationship between CNV and macular CWZ. Results In 57 eyes with AMD, 35 (61.4%) had macular CWZ, while in 35 control patients only 3 (8.57% ) had. The difference was significant (Plt;0.05). In 43 eyes with exudative AMD and CNV, 32 (74.4%) had macular CWZ, including 29 eyes (90.6%) with CNV caused by macular CWZ. Conclusion Macular CWZ could be a predilection site of CNV in exudative AMD. (Chin J Ocul Fundus Dis，2003，19：76-78)
Objective To analyse the indocyanine green angiographic findings in contralateral eyes of patients with unilateral exudative age-related macular degeneration(AMD). Methods Fundus photograph,fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were performed in a series of 70 patients with unilateral AMD and drusens and pigmentary changes in the macular region in contralateral eyes.The findings of fluoroangiograms were observed and analysed. Results ICGA revealed the characteristics of the contralateral eyes as follows:(1)Drusen could be hypofluorescent,hyperfluorescent or normal fluorescent;(2)14 eyes revealed plaque-like late hyperfluorescent;(3)13 eyes revealed choroidal filling defect;(4)18 eyes revealed pindot-like clusters of late hyperfluorescence. Conclusion ICGA is useful in evaluating the lesions and circulation disturbance of the contralateral eye,and may help to find the risk factors of developing future exudative changes. (Chin J Ocul Fundus Dis, 1999, 15: 216-218)
Objective To verify the applicable significance of confocal scanning laser retinal tomography in agerelated macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD, and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P＜0.01); Z profile signal width, maximum height，and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P＜0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P＜0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD. (Chin J Ocul Fundus Dis, 2002, 18: 262-265)