年齡相關性黃斑部病變致病機轉與流行病學

Pathogenesis and Epidemiology of Age-related Maculopathy

年齡相關性黃斑部病變（age-related maculopathy, ARM）是一種隨著年齡增長而在視網膜中心部位產生病理性的變化，造成中心視力減損。這是已開發國家老年人口失明的首要原因。早期ARM，視力不一定會受影響，而晚期ARM，包括了乾性和溼性兩種臨床表現，皆會造成嚴重的視力減損。它的致病轉機，在不同時期，雖有各種不同理論被提出，但迄今並無一致的結論。許多大規模的流行病學研究報告，在美國和美國以外的地區被提出，提供了年齡相關性黃斑部病變之盛行率和發生率以及危險因子等相關訊息，而年齡又是最重要的危險因子。進一步的探討致病轉機，藉流行病學研究找出可避免的危險因子，尋找可能的治療方式，仍是當今預防老年人因此病失明的重要課題。

Age-related maculopathy(ARM) is a degenerative disorder of central macula which results in severe visual loss while age increases. It is the leading cause of legal blindness in elderly population in well developed countries. In early ARM, vision is not necessarily affected. But in late ARM, visual acuity is severely impaired, no matter dry or wet AMD. Although many possible mechanisms for development of ARM have been proposed, there are still no conclusions about pathogenesis of ARM. Several large scale epidemiological studies of ARM in and outside the United States provided valuable information about the prevalence, incidence and possible risk factors of ARM. Age is the most significant risk factor. Further investigations for pathogenesis possible modifiable risks factor and treatment modalities by epidemiological studies are essential for preventing blindness in elderly.