期刊
NEW ENGLAND JOURNAL OF MEDICINE
卷 385, 期 6, 页码 539-547出版社
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp2102061
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Age-related macular degeneration is the leading cause of vision loss in older persons in industrialized nations. Micronutrient supplementation and anti-vascular endothelial growth factor pharmacotherapy can reduce the risk of progression. Baseline examination by eye care providers and ancillary testing are essential for diagnosis and treatment.
Age-Related Macular Degeneration Age-related macular degeneration is the leading cause of vision loss in older persons in industrialized nations. Micronutrient supplementation can reduce the risk of progression to advanced AMD. Treatment of neovascular AMD with anti-vascular endothelial growth factor pharmacotherapy reduces vision loss. Key Clinical Points Age-Related Macular Degeneration Age-related macular degeneration (AMD), the leading cause of vision loss in persons older than 60 years of age in industrialized nations, may be asymptomatic in early stages. A baseline examination by an eye care provider establishes the diagnosis of AMD and helps to determine the disease stage. Ancillary testing that includes optical coherence tomography is used in staging disease, guiding treatment, and assessing the response to therapy. Neovascular AMD is treated with anti-vascular endothelial growth factor pharmacotherapy. Treatment should be initiated soon after the diagnosis to prevent severe vision loss. Micronutrient supplementation, as tested in the Age-Related Eye Disease Studies, is recommended to reduce the risk of progression of intermediate-stage AMD to advanced AMD. Patients should be counseled regarding smoking cessation, blood-pressure control (if they have hypertension), and monitoring of their vision with an Amsler grid.
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