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IMPROVING THE AGE-RELATED MACULAR DEGENERATION CONSTRUCT A New Classification System

机译:改善与年龄相关的黄斑变性构建一个新的分类系统

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Previous models of disease in age-related macular degeneration (AMD) were incomplete in that they did not encompass subretinal drusenoid deposits (pseudodrusen), subtypes of neovascularization, and polypoidal choroidal vasculopathy. In addition, Type 3 neovascularization starts in the retina and may not necessarily involve the choroid. As such, the term choroidal neovascularization is not appropriate for these eyes. The new aspects in the AMD construct are to include specific lipoprotein extracellular accumulations, namely drusen and subretinal drusenoid deposits, as early AMD. The deposition of specific types of deposit seems to be highly correlated with choroidal thickness and topographical location in the macula. Late AMD includes macular neovascularization or atrophy. The particular type of extracellular deposit is predictive of the future course of the patient. For example, eyes with subretinal drusenoid deposits have a propensity to develop outer retinal atrophy, complete outer retinal and retinal pigment epithelial atrophy, or Type 3 neovascularization as specific forms of late AMD. Given Type 3 neovascularization may never involve the choroid, the term macular neovascularization is suggested for the entire spectrum of neovascular disease in AMD. In contrast to older classification systems, the proposed system encompasses the relevant presentations of disease and more precisely predicts the future course of the patient. In doing so, the concept was developed that there may be genetic risk alleles, which are not necessarily the same alleles that influence disease expression.
机译:以前相关黄斑变性(AMD)的先前疾病模型不完整,因为它们没有包含副血管滴鼻菌沉积物(假霉素),新血管形成亚型和息肉脉络膜血管病变。此外,3型新血管形成在视网膜中开始,并且不一定涉及脉络膜。因此,术语脉络膜新生血管形成不适合这些眼睛。 AMD构建体中的新方面包括特异性脂蛋白细胞外累积,即Drusen和Suboretinal Drusenoid沉积物,作为早期的AMD。特定类型的沉积物的沉积似乎与黄斑中的脉络膜厚度和地形位置高度相关。晚期包括黄斑新生血管或萎缩。特定类型的细胞外沉积物是预测患者未来过程的预测。例如,具有副滴胞型沉积物的眼睛具有开发外视网膜萎缩,完全外视网膜和视网膜颜料上皮萎缩的倾向,或作为晚期AMD的特定形式的3种新生血管形成。给定的3型新生血管形成可能永远不会涉及脉络膜,在AMD中的整个新生血管疾病方面提出了术语黄斑新生血管。与较旧的分类系统相比,所提出的系统包括相关的疾病演示,更准确地预测患者的未来过程。在这样做时,该概念是开发的,可能存在遗传风险等位基因,这不一定是影响疾病表达的等位基因。

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