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玻璃疣的鉴别:玻璃疣和与年龄相关性黄斑变性、遗传性眼病、其它病理性过程相关的玻璃疣状表现

Khanoo OA, Khan RS, et al.

期刊名称:Progress in Retinal and Eye Research

卷期:2016年第53卷

摘要

玻璃疣被最近的研究发现与年龄相关性黄斑变性有关,其中一些类型被认为是机体老化的正常结果,但仍有一部分在遗传性和系统性损害中发现。玻璃疣通常位于视网膜色素层外部,色素层的某些物质的积累可能会导致玻璃疣状改变,被称为假性玻璃疣。这篇综述首次清楚提出了关于玻璃疣的生物发生和亚临床症状的概述。临床中可探测到其沉积物的亚型可能存在重叠,通常在老年病人或年龄相关性黄斑变性中发现,然后结合显像模式对其会有更加清楚的认识:大概包括硬性和软性玻璃疣,表皮性玻璃疣,网状假性玻璃疣和“幽灵疣”。不同于能引起玻璃疣或玻璃疣状改变的年龄相关性黄斑变性,对于这类眼病的讨论如下:包括由单基因调控或其遗传特性暂不清楚。一些系统性因素引起的玻璃疣状沉积也应在率范围中。通过这篇综述,陈列了以上所述的各种类型引发的玻璃疣的高分辨率图像,尤其是一些少见的类型,这对区别假性玻璃疣具有重要意义。在本文最后一节,对目前一些公认的说法加以突出,并对此方向的未来研究热点做出了简要评述。

Drusen are discu KN, Mahrssed frequently in the context of their association with age-related macular degeneration (AMD). Some types may, however, be regarded as a normal consequence of ageing; others may be observed in young age groups. They also occur in a number of inherited disorders and some systemic conditions. Whilst drusen are classically located external (sclerad) to the retinal pigment epithelium, accumulations of material internal (vitread to) this layer can display a drusen-like appearance, having been variously termed pseudodrusen or subretinal drusenoid deposits. This review first briefly presents an overview of drusen biogenesis and subclinical deposit. The (frequently overlapping) subtypes of clinically detectable deposit, seen usually in the context of ageing or AMD, are then described in more detail, together with appearance on imaging modalities: these include hard and soft drusen, cuticular drusen, reticular pseudodrusen and "ghost drusen". Eye disorders other than AMD which may exhibit drusen or drusen-like features are subsequently discussed: these include monogenic conditions as well as conditions with undefined inheritance, the latter including some types of early onset drusen such as large colloid drusen. A number of systemic conditions in which drusen-like deposits may be seen are also considered. Throughout this review, high resolution images are presented for most of the conditions discussed, particularly the rarer ones, providing a useful reference library for images of the range of conditions associated with drusen-like appearances. In the final section, some common themes are highlighted, as well as a brief discussion of some future avenues for research.


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