研究人员开发高龄黄斑变性风险评估模型

根据在线发布的报告称，新的风险评估模型可能有助于预测先进年龄相关的黄斑变性的发展眼科的档案,其中一个jama /档案期刊。

年龄相关黄斑变性(amd.）根据文章的背景信息，是美国和西方世界失明的主要原因。“作为设计更好的预防措施和更早的进展治疗方案加速和新的基因关联被确定，增加了目前已知的风险因素，有一个可靠的风险评估模型的愿望已经成为相当大的兴趣和潜在价值，”作者写道。他们解释说，该模型应该识别出早期AMD患者，他们发展为晚期AMD的风险最大，并且应该能够预测何时发展可能发生。

Michael L. Klein, M.D., from the Casey Eye Institute, Oregon Health & Science University, Portland, and colleagues sought to design a risk assessment model for development of advanced AMD that included phenotypic (related to observable physical characteristics), demographic, environmental and genetic risk factors. They used longitudinal data from the Age-Related Eye Disease Study, including participants' DNA samples, ocular and medical histories and examinations. The researchers identified two endpoints: development of advanced AMD in either eye by participants who did not have this condition at baseline, and advanced AMD in a second eye by participants who, at baseline, had it in one eye. Patients were followed for an average of 9.3 years.

最终模型中包含的变量包括简单量表得分(临床总得分)风险因素(双眼)，两种基因型，非常大的drusen(视网膜上与AMD相关的沉积物)，吸烟，家族史，一只眼睛的晚期AMD和年龄。完整的模型表现良好，能够区分个体的晚期AMD风险。在最终模型的2,602名参与者中，基线时没有晚期AMD, 24% (n = 635)在随访中出现了晚期AMD。在基线水平的晚期AMD患者中，82%的人是地形性萎缩(视网膜细胞逐渐退化，称为“干性AMD”)型，56%的人是新生血管型(新血管形成和渗漏，称为“湿性AMD”)，另一只眼出现了晚期AMD。

结果“可以通过帮助确定后续检查的频率，中央视力的家庭监测以及启动的可取性来实现临床实践中的潜在价值，以及启动的可取性预防措施including beneficial lifestyle changes such as dietary alterations and nutritional supplement use," the authors note. "The short-term end points (e.g., 2 years) may be helpful in planning clinical trials." They add that the model performed well on measures of discrimination, calibration and overall performance. "We believe our current model is of substantial value in assessing AMD risk, and we expect that future advances will further improve its accuracy," they write.

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