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目的：探讨干性型老年黄斑变性（ＡＭＤ）向湿性型转化的眼底变化特征及寻找转化的危险因素。方法：采用眼底彩色照相、吲哚青绿脉络膜血管造影（ＩＣＧＣＡ）和／或眼底荧光血管造影（ＦＦＡ）对１２例干性型向湿性型转化的ＡＭＤ患者进行了随访观察和分析。结果：１２例干性转为湿性的患者中，对侧眼为湿性型改变的有９例，其中对侧湿性型患眼的脉络膜新生血管（ＣＮＶ）位于黄斑无血管区（ＦＡＺ）内的有７例。湿性型病变由软性玻璃膜疣（ｄｒｕｓｅｎ）发展而来的有５例；由融合性ｄｒｕｓｅｎ发展的有４例；由低荧光ｄｒｕｓｅｎ发展的有２例；由色素上皮低色素发展的有１例。４例在发生湿性改变后同时作了ＦＦＡ和ＩＣＧＣＡ的病例显示ＩＣＧＣＡ有利于发现那些ＦＦＡ不能发现的、被大片深层出血或不规则色素上皮脱离所隐匿的ＣＮＶ。结论：对侧眼为湿性型、对侧眼的ＣＮＶ位于ＦＡＺ内及干性型患眼具有软性、融合性或低荧光ｄｒｕｓｅｎ等是干性型眼发生湿性改变的危险因素。ＩＣＧＣＡ比ＦＦＡ能更早期、精确地发现色素上皮脱离或出血所掩盖的ＣＮＶ。
Objective: To investigate the characteristics of fundus changes of dry type AMD and its risk factors for conversion. METHODS: Twelve dry-to-wet AMD patients were followed up and analyzed using fundus color photography, indocyanine green choroidal angiography (ICGCA) and / or fundus fluorescein angiography (FFA). RESULTS: Of the 12 patients who became wet and dry, the contralateral eye was wet-typed in 9 patients. The contralateral wet-type eye had choroidal neovascularization (CNV) located within the macular avascular area (FAZ) 7 cases. There were 5 cases of wet type lesions from drusen, 4 from drusen, 2 from low-drusen, and 1 from pigmented hypopigmentation . Four cases of both FFA and ICGCA after a change in wet showed ICGCA favoring the detection of CNV hidden in large areas of hemorrhagic or irregular pigment epithelium that could not be detected by FFA. CONCLUSIONS: The contralateral eye is a wet type, the contralateral eye CNV is located within the FAZ, and the dry type has soft, fusion or low-fluorescence drusen, which are risk factors for wet changes in the dry eye. ICGCA detects CNVs covered by pigment epithelial detachment or hemorrhage more accurately and earlier than FFA.