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老年性黃斑部病變眼底表現之分類
Classification of Fundus Features of Age-Related Macular Degeneration
摘要
老年性黃斑部病變(age-related macular degeneration, ARMD)為造成老年人口視力障礙之重要原因，然而一直沒有一個廣泛為大家所接受之分類標準。本文採用Bressler等人所提出之分類系統(Arch Ophthalmol 1989；107:847-852)，對過去5年來於台大醫院診斷為老年性黃斑部病變且接受過螢光眼底攝影之病人進行分類。本分類系統將老年性黃斑部病變分為四級。 本研究結果顯示： (1)第1級佔14.2%，第2級佔10.9%，第3級佔27.0%，第4級佔18.3%。 (2)隨著年齡增加，較嚴重級次之眼睛所佔比率有增加的趨勢。 (3)某些特徵，如大型隱結、軟性隱結或融合性隱結之出現，和同一時間另一眼出現滲出性黃斑部病變在統計上具備有意義之相關。 綜合本研究之經驗，向Bressler等人所提出之分類分級系統對於老年性黃斑部病變之分類，不失為一個具有臨床上實用性的好方法。
關鍵字
無資料並列摘要
Age-related macular degeneration (ARMD) is one of the major causes of irreversible severe visual loss among elder adults. However, there is no universally accepted definition of macular degeneration. We decided to choose the one described by Bressler et al. in 1989. (Arch Ophthalmol 1989; 107:847-852). We reviewed the fundus photograph and fluorescein angiography of ARMD patients who had undergone fluorescein angiography examination at National Taiwan University Hospital from Jul. 1989 to Jun. 1994 and graded them according to the grading system of Bressler et al. Our results revealed- 1. Grade 1:14.2%, Grade 2:10.9%, Grade 3:27.0%, Grade 4:18.3%. 2. The proportion of higher grade ARMD increased with age. 3. Some drusen characteristics such as large drusen, soft drusen or confluent drusen are related to the presence of exudative maculopathy in the fellow eye. In summary, we found this grading system is practicable and useful. It will be of much help for research and investigation in the prevalence, etiology, prevention and treatment of ARMD.