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Sample records for choroidal neovascularization

  1. Inflammatory choroidal neovascularization

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    Neri Piergiorgio

    2009-01-01

    Full Text Available Purpose and Methods: Choroidal neovascularization (CNV can be a severe sight-threatening sequela, which can be secondary to both infectious and noninfectious uveitis. This review summarizes the different diseases associated with CNV, highlighting new treatment modalities and the possible strategies, which could be applied for the therapy of this occurrence. Results: Since CNV can often originate from posterior pole lesions and can be hard to identify, an accurate examination is mandatory in order to identify the correct diagnosis. In the majority of cases, fluorescein angiography (FA, indocyanine green angiography (ICGA and optical coherence tomography (OCT enable the determination of the clinical characteristics of the CNV. An infectious disease should be looked for to include a suitable therapy when available. The treatment strategy for CNV secondary to noninfectious uveal inflammations should be directed at controlling the inflammatory process. Systemic corticosteroids with or without immunosuppressive agents are indicated even when the CNV occurs with apparently inactive uveitis: Chronic subclinical inflammation can be the basis for the pathogenesis of CNV. Additional therapies aimed directly at the neovascular process, such as the intravitreal anti-Vascular Endothelial Growth Factor (VEGF agents, are recommended particularly when the therapy shows an insufficient response. Conclusion: CNV secondary to uveitis is a severe sequela leading to significant visual impairment. ICGA is mandatory in order to obtain relevant information about the choroidal status. Several therapeutic options have been considered, but no guidelines are provided at the moment. Moreover, the current data are still only based on case reports or small series. For such reasons, further trials are mandatory to validate the preliminary available results.

  2. Choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion

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    Samuray Tuncer

    2013-01-01

    Full Text Available Choroidal nevi are the most common benign pigmented lesions of the fundus. Choroidal neovascularization is a rare complication of choroidal nevi. We report herein a young patient managed successfully with intravitreal bevacizumab injections for juxtapapillary choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion.

  3. Matrix Metalloproteinases Expression in Choroidal Neovascular Membranes

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    Jun Zeng; Deyong Jiang; Xiangping Liu; Xiaohua Zhu; Luosheng Tang

    2004-01-01

    Purpose: To investigate the expression of matrix metalloproteinases (MMPs) in choroidal neovascular membranes with age-related macular degeneration (AMD).Methods: Seventeen choroidal neovascular membranes surgically removed from AMD patients with pars plana vitrectomy and subretinal membranes peeling were investigated.The expression of MMP-2 and MMP-9 was determined with immunohistochemical technique.Results: Immunohistochemistry staining in choroidal neovascular membranes for MMP2 and MMP-9 was observed in 17 specimens. There was no detective of MMP-2 and MMP-9 in normal retinas.Conclusions: MMP-2 and MMP-9 were found in choroidal neovascular membranes, may degrade the Bruch membrane and be associated with the perforation of new vessels into Bruch membrane, involving a basic pathogenic process of AMD.

  4. In Vitro Model of Human Choroidal Neovascular

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Choroidal capillary endothelia cell (CEC) plays a critical role in the development of choroidal neovascularization which is one of the major causes of blindness. An effective method for CEC cultivation was proposed.The isolation of human choroidal CECs using micro dissection followed by the use of superparamagnetic beads (Dynabeads) coated with the CD 31, which selectively binds to the endothelial cell surface. Cells bound to beads were isolated using a magnetic particle concentrator. The CECs were planted into type Ⅳ collagen coated 24 well plates. The results show that the primary cultured CEC is induced to tube formation in collagen Ⅳ coated environment, which can be presented as an in vitro model of choroidal neovascularization.

  5. Choroidal neovascular membrane associated with choroidal osteoma (CO treated with trans-pupillary thermo therapy.

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    Sharma Sumita

    2004-01-01

    Full Text Available Choroidal neovascular membrane, a known complication of choroidal osteoma causing visual loss when located subfoveally, can be successfully treated with transpupillary thermo therapy.

  6. Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization

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    Ellabban AA

    2012-05-01

    Full Text Available Abdallah A Ellabban, Akitaka Tsujikawa, Ken Ogino, Sotaro Ooto, Kenji Yamashiro, Akio Oishi, Nagahisa YoshimuraDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanPurpose: To study changes in choroidal thickness with ranibizumab treatment for choroidal neovascularization (CNV.Design: Prospective case series.Methods: This prospective study consisted of 60 CNV-affected eyes of 60 patients treated with intravitreal injections of ranibizumab using an on-demand protocol after an initial loading phase. The eyes studied included 20 with age-related macular degeneration (AMD, 20 with polypoidal choroidal vasculopathy (PCV, and 20 with myopic CNV. In the eyes with AMD and PCV, choroidal thickness at the fovea was measured with optical coherence tomography using enhanced depth imaging. In eyes with myopic CNV, the choroidal thickness was measured using standard optical coherence tomography without the enhanced depth imaging technique.Results: With ranibizumab treatment, central retinal thickness decreased significantly (P < 0.001 and visual acuity improved significantly (P < 0.001. However, central choroidal thickness (167.2 ± 108.3 µm showed no significant change at 1 month after the loading phase (165.2 ± 107.8 µm, P = 0.120 or at final examination (164.8 ± 107.7 µm, P = 0.115. At baseline, central retinal thickness in eyes with AMD was significantly greater that those with PCV (P = 0.005 or high myopia (P = 0.029. However, central choroidal thickness in eyes with myopic CNV was significantly thinner than in eyes with AMD (P < 0.001 or PCV (P < 0.001. In each type of disease, there was no significant change in central choroidal thickness with ranibizumab treatment.Conclusion: The effect of ranibizumab on the choroidal thickness is minimal, if any.Keywords: choroidal thickness, ranibizumab, optical coherence tomography

  7. CCR3 and choroidal neovascularization.

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    Yiwen Li

    Full Text Available Age-related macular degeneration (AMD is the leading cause of irreversible blindness in the elderly in industrialized countries. The "wet" AMD, characterized by the development of choroidal neovacularization (CNV, could result in rapid and severe loss of central vision. The critical role of vascular endothelial growth factor A (VEGF-A in CNV development has been established and VEGF-A neutralization has become the standard care for wet AMD. Recently, CCR3 was reported to play an important role in CNV development and that CCR3 targeting was reported to be superior to VEGF-A targeting in CNV suppression. We investigated the role of CCR3 in CNV development using the Matrigel induced CNV and found that in both rats and mice, CNV was well-developed in the control eyes as well as in eyes treated with CCR3 antagonist SB328437 or CCR3 neutralizing antibodies. No statistically significant difference in CNV areas was found between the control and SB328437 or CCR3-ab treated eyes. Immunostaining showed no specific expression of CCR3 in or near CNV. In contrast, both VEGF-A neutralizing antibodies and rapamycin significantly suppressed CNV. These results indicate that CCR3 plays no significant role in CNV development and question the therapeutic approach of CCR3 targeting to suppress CNV. On the other hand, our data support the therapeutic strategies of VEGF-A and mTOR (mammalian target of rapamycin targeting for CNV.

  8. Retinal pigment epithelium tear formation following intravitreal ranibizumab injection in choroidal neovascularization secondary to choroidal osteoma.

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    Erol, Muhammet K; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet

    2014-09-01

    Choroidal osteoma is an extremely rare osseous tumor of the choroid where choroidal neovascularization (CNV) is the major cause of visual loss. We report the case of a 28-year-old female with CNV secondary to choroidal osteoma, who developed RPE tear after intravitreal ranibizumab treatment.

  9. Beals–Hecht syndrome and choroidal neovascularization

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    Roberto Gallego-Pinazo

    2010-07-01

    Full Text Available Roberto Gallego-Pinazo1, Ruth López-Lizcano1, José María Millán2,3, J Fernando Arevalo5, J Luis Mullor6, Manuel Díaz-Llopis1,3,41Department of Ophthalmology, 2Department of Genetics, Unit of Experimental Opthalmology, Hospital Universitario La Fe, Valencia, Spain; 3Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Valencia, Spain; 4Faculty of Medicine, University of Valencia, Valencia, Spain; 5Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 6Unit of Experimental Opthalmology, Fundación Parala Investigación del Hospital La Fe, Valencia, SpainPurpose: To describe a case of choroidal neovascularization (CNV in a female diagnosed with Beals–Hecht syndrome.Methods: A retrospective, interventional case is described in a 26-year-old female complaining of metamorphopsia and visual loss in her left eye (counting fingers. The fluorescein angiogram and the optical coherence tomography supported the diagnosis of CNV. Intravitreal ranibizumab was administered.Results: After the third intravitreal ranibizumab, her visual acuity improved to 0.8 and the morphology of the macular area was restored.Conclusions: To our knowledge this is the first report of CNV in Beals–Hecht syndrome treated with ranibizumab. Self-monitoring by periodically performing Amsler grid test is strongly recommended in these patients in order to achieve an early diagnosis of eventual CNV and avoid visual acuity loss.Keywords: Beals–Hecht syndrome, connective tissue disease, choroidal neovascularization, ranibizumab

  10. Keratoconus associated with choroidal neovascularization: a case report

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    Oh Joo

    2010-02-01

    Full Text Available Abstract Introduction Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane. Case presentation A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis® five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes. Conclusion Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions.

  11. Choroidal osteoma with choroidal neovascular membrane: Successful treatment with intravitreal bevacizumab

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    Neeraj Pandey

    2010-09-01

    Full Text Available Neeraj Pandey, Ayachit GuruprasadMM Joshi Eye Institute, Hubli, Karnataka, IndiaAbstract: An otherwise healthy 27-year-old woman presented with complaints of sudden painless blurred vision in the right eye for one week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal, but OD demonstrated an elevated, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid, suggestive of a choroidal neovascular membrane in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well defined area of hyperfluorescence that increased in size and intensity in the later phases, suggestive of active extrafoveal choroidal neovascular membrane. Optical coherence tomography confirmed the extrafoveal choroidal neovascular membrane with subfoveal fluid. She was treated with intravitreal bevacizumab OD. At the two-week visit, vision OD improved to 20/20. Fluorescein angiography and optical coherence tomography revealed a resolved choroidal neovascular membrane. Intravitreal bevacizumab may be an effective alternative in the management of choroidal neovascular membrane secondary to choroidal osteoma.Keywords: osteoma, choroidal neovascular membrane, optical coherence tomography, bevacizumab

  12. Bilateral choroidal osteoma with choroidal neovascular membrane treated with bevacizumab in a child.

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    Agarwal, Manisha; Kantha, Meha; Mayor, Rahul; Venkatesh, Ramesh; Shroff, Cyrus M

    2014-01-01

    Choroidal osteoma is a rare benign tumor. We report a male child diagnosed with bilateral choroidal osteoma, high myopia and secondary choroidal neovascularization (CNV) membrane in one eye. Co-existence of posterior staphyloma made the clinical diagnosis of choroidal osteoma difficult due to the osteoma filling the depression of the posterior staphyloma. Typical findings on fundus fluorescein angiography, optical coherence tomography, B-scan and indocyanine green angiography confirmed the diagnosis. A review of literature was performed. CNV secondary to choroidal osteoma was treated with intravitreal bevacizumab and it responded well. Regular follow-up is essential for recurrence of CNV and decalcification of the osteoma.

  13. Correlation between clinical and histological features in a pig model of choroidal neovascularization

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    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik;

    2006-01-01

    To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features.......To analyse the histological changes in the retina and the choroid in a pig model of choroidal neovascularization (CNV) and to correlate these findings with fundus photographic and fluorescein angiographic features....

  14. Current and emerging treatment options for myopic choroidal neovascularization

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    El Matri L

    2015-04-01

    Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

  15. Prevalence of outer retinal tubulation in eyes with choroidal neovascularization

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    Giachetti Filho, Richard Geraldo; Zacharias,Leandro Cabral; Monteiro,Thaís Vera; Preti, Rony Carlos; Pimentel, Sérgio Gianoti

    2016-01-01

    Background Outer retinal tubulations (ORTs) are branching tubular structures located in the outer nuclear layer of the retina. The goal of this study is to determine the prevalence of ORTs observed in eyes with choroidal neovascularization (CNV) undergoing treatment with anti-angiogenic intravitreous injection (IVI) with anti-VEGF (vascular endothelial growth factor) at the Ophthalmology Department of a tertiary hospital in São Paulo, Brazil. Methods This is a descriptive study based on medic...

  16. Optical Coherence Tomography Angiography for Detecting Choroidal Neovascularization Secondary to Choroidal Osteoma.

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    Szelog, Jason T; Bonini Filho, Marco A; Lally, David R; de Carlo, Talisa E; Duker, Jay S

    2016-01-01

    Choroidal osteoma is an ossifying tumor that is found predominantly in the peripapillary and macular areas. It typically affects otherwise healthy females. Vision loss may occur secondary to the development of choroidal neovascularization (CNV). Fluorescein angiography (FA) remains the gold standard for diagnosing CNV; however, the use of optical coherence tomography angiography (OCTA) as an adjunct to FA is growing. In this report, a 16-year-old female with a large, unilateral peripapillary choroidal osteoma presented with blurred vision. Exam revealed scattered intraretinal hemorrhage, but FA was unable to detect CNV overlying the tumor. OCTA detected abnormal flow in the outer retina corresponding to a type 2 CNV. Following intravitreal anti-vascular endothelial growth factor therapy, the CNV regressed, the hemorrhage resolved, and there was less fluid. OCTA may be helpful in detecting CNV noninvasively in eyes in which FA is equivocal, such as those with choroidal osteoma.

  17. Photodynamic therapy combined with intravitreal bevacizumab in a patient with choroidal neovascularization secondary to choroidal osteoma.

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    Jang, Jung Hyun; Kim, Keong Hwan; Lee, Soo Jung; Park, Jung Min

    2012-12-01

    Choroidal osteoma is a benign ossified tumor that is found predominantly in healthy young women during their second and third decades of life. The lesions are white-to-cream or orange in color, are located in the peripapillary and macular areas, and are unilateral in most patients. The symptoms of choroidal osteoma include decreased visual acuity and metamorphopsia or scotoma corresponding to the location of the osteoma, but some patients have no symptoms. Prognosis of vision varies according to tumor location, retinal pigment epithelial and sensory retinal degeneration, subretinal fluid and hemorrhage, and development of a subretinal neovascular membrane.

  18. OCT Angiography Identification of Choroidal Neovascularization Secondary to Acute Zonal Occult Outer Retinopathy.

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    Levison, Ashleigh L; Baynes, Kimberly; Lowder, Careen Y; Srivastava, Sunil K

    2016-01-01

    A 74-year-old female with acute zonal occult outer retinopathy presented with a new lesion suspicious for choroidal neovascularization (CNV) in her right eye. Optical coherence tomography angiography (OCTA) confirmed the presence of CNV. OCTA is a new imaging technique that may help guide diagnosis and management of choroidal neovascular membranes in uveitic diseases.

  19. A Mouse Model for Laser-induced Choroidal Neovascularization.

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    Shah, Ronil S; Soetikno, Brian T; Lajko, Michelle; Fawzi, Amani A

    2015-12-27

    The mouse laser-induced choroidal neovascularization (CNV) model has been a crucial mainstay model for neovascular age-related macular degeneration (AMD) research. By administering targeted laser injury to the RPE and Bruch's membrane, the procedure induces angiogenesis, modeling the hallmark pathology observed in neovascular AMD. First developed in non-human primates, the laser-induced CNV model has come to be implemented into many other species, the most recent of which being the mouse. Mouse experiments are advantageously more cost-effective, experiments can be executed on a much faster timeline, and they allow the use of various transgenic models. The miniature size of the mouse eye, however, poses a particular challenge when performing the procedure. Manipulation of the eye to visualize the retina requires practice of fine dexterity skills as well as simultaneous hand-eye-foot coordination to operate the laser. However, once mastered, the model can be applied to study many aspects of neovascular AMD such as molecular mechanisms, the effect of genetic manipulations, and drug treatment effects. The laser-induced CNV model, though useful, is not a perfect model of the disease. The wild-type mouse eye is otherwise healthy, and the chorio-retinal environment does not mimic the pathologic changes in human AMD. Furthermore, injury-induced angiogenesis does not reflect the same pathways as angiogenesis occurring in an age-related and chronic disease state as in AMD. Despite its shortcomings, the laser-induced CNV model is one of the best methods currently available to study the debilitating pathology of neovascular AMD. Its implementation has led to a deeper understanding of the pathogenesis of AMD, as well as contributing to the development of many of the AMD therapies currently available.

  20. Thrombospondin-1 Expression in RPE and Choroidal Neovascular Membranes

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    Shikun He; Francesca Incardona; Manlin Jin; Stephen J. Ryan; David R. Hinton

    2006-01-01

    Purpose: To investigate the expression of thrombospondin 1 (TSP-1) in retinal pigment epithelium (RPE) and choroidal neovascular membranes (CNVMs) from patients with age-related macular degeneration (AMD).Methods: Tissue sections from normal human fetal and adult eyes and surgically removed CNVMs were immunostained for TSP-1 localization. Polymerase chain reaction and Western blotting were used to analyze TSP-1 mRNA and protein from human RPE cells, respectively. TSP-1 in the supernatant of cultured RPE cells and eye explants were measured using enzyme-linked immunosorbent assay. MTT assay was used to evaluate the RPE survival after TSP-1 treatment.Results: The strongest immunostaining for TSP-1 was observed in the RPE monolayer around drusen in early AMD. The intensity of TSP-1 staining in normal eye sections was much weaker than that of early AMD and CNVM. TSP-1 mRNA was positive in cultured fetal and adult RPE cells. There was increasing secretion of TSP-1 into the supernatant of cultured RPE and eye explants. The specific band of TSP-1 was identified by Western blot. No significant inhibition of RPE survival was found with the exposure to TSP-1.Conclusions: TSP-1 expression in drusen and CNVM was upregulated and associated with RPE monolayer. TSP-1 may be a natural negative regulator for choroidal neovascularization.

  1. Combination therapy of low-fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane in choroidal osteoma

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    Rodney J Morris

    2011-01-01

    Full Text Available Choroidal osteoma is an unusual form of intraocular calcification seen in otherwise healthy eyes. It is a benign idiopathic osseous tumor of the choroid, typically seen in young females. Choroidal neovascular membrane (CNVM is a complication seen in one-third of these patients and carries a poor visual outcome. We report a case of a 25-year-old hyperthyroid female with choroidal osteoma and subfoveal CNVM in her left eye which was successfully treated using low-fluence photodynamic therapy (PDT with verteporfin followed by a single injection of intravitreal ranibizumab.

  2. Segmentation of choroidal neovascularization in fundus fluorescein angiograms.

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    Abdelmoula, Walid M; Shah, Syed M; Fahmy, Ahmed S

    2013-05-01

    Choroidal neovascularization (CNV) is a common manifestation of age-related macular degeneration (AMD). It is characterized by the growth of abnormal blood vessels in the choroidal layer causing blurring and deterioration of the vision. In late stages, these abnormal vessels can rupture the retinal layers causing complete loss of vision at the affected regions. Determining the CNV size and type in fluorescein angiograms is required for proper treatment and prognosis of the disease. Computer-aided methods for CNV segmentation is needed not only to reduce the burden of manual segmentation but also to reduce inter- and intraobserver variability. In this paper, we present a framework for segmenting CNV lesions based on parametric modeling of the intensity variation in fundus fluorescein angiograms. First, a novel model is proposed to describe the temporal intensity variation at each pixel in image sequences acquired by fluorescein angiography. The set of model parameters at each pixel are used to segment the image into regions of homogeneous parameters. Preliminary results on datasets from 21 patients with Wet-AMD show the potential of the method to segment CNV lesions in close agreement with the manual segmentation.

  3. Long-Term Follow-Up of Intravitreal Ranibizumab for the Treatment of Choroidal Neovascularization due to Choroidal Osteoma

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    Zenith H.Y. Wu

    2012-06-01

    Full Text Available Choroidal osteoma is an uncommon benign osseous intraocular tumor that typically affects young adult women. Choroidal neovascularization (CNV is one of the complications that can develop in eyes with choroidal osteoma. We present a case of CNV secondary to choroidal osteoma treated with intravitreal ranibizumab. A 57-year-old lady presented with painless loss of vision with a right-eye visual acuity of 20/800. Fundus examination showed a well-demarcated yellowish peripapillary choroidal osteoma with associated retinal and subretinal hemorrhage due to CNV. Three intravitreal ranibizumab injections at monthly intervals were given and her visual acuity improved to 20/30 following treatment. After 1.2 years of follow-up, the right eye visual acuity was maintained at 20/30 with no evidence of CNV recurrence. Our findings suggest that intravitreal ranibizumab may be an effective therapeutic option for treating CNV secondary to choroidal osteoma.

  4. Early detection of choroidal neovascularization in age related macular degeneration

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    Tural Galbinur

    2012-01-01

    Full Text Available Purpose: to identify factors associated with early detection of choroidal neovascularization CNV in clinical practice.Methods: Seventy six AMD patients who had history of CNV in one eye and presented with CNV in the second eye and evaluated for association with visual acuity (VA at time of presentation. Demographics, clinical data and lesion characteristics were retrospectively collected.Results: Better VA was associated with history of CNV in the fellow eye (p<0.0001, adherence to follow-up every four-months (p=0.015, younger age (p=0.03, smaller lesion (p<0.0001, and non-subfoveal localization (p=0.048. VA of the fellow eye did not correlate with VA at presentation with CNV.Conclusion: these data suggest that experience of CNV, regardless of VA, facilitates early diagnosis in the fellow eye. Adherence to follow-up in the routine clinic setting also facilitates early detection of CNV.

  5. Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice

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    Alina Adriana Ivanescu

    2015-07-01

    Full Text Available We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids on choroidal neovascularization (CNV. Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline, group S (oral supplement, intravitreal saline, group V + aVEGF (oral vehicle, intravitreal anti-VEGF, and group S + aVEGF (oral supplement, intravitreal anti-VEGF. Vehicle and nutritional supplements were administered daily for 38 days beginning 10 days before laser. Intravitreal injections were administered 48 h after laser. Fluorescein angiography (FA and flat-mount CD31 staining evaluated leakage and CNV lesion area. Expression of VEGF, MMP-2 and MMP-9 activity, and NLRP3 were evaluated with RT-PCR, zymography, and western-blot. Leakage, CNV size, VEGF gene and protein expression were lower in groups V + aVEGF, S + aVEGF, and S than in V (all p < 0.05. Additionally, MMP-9 gene expression differed between groups S + aVEGF and V (p < 0.05 and MMP-9 activity was lower in S + aVEGF than in V and S (both p < 0.01. Levels of MMP-2 and NLRP3 were not significantly different between groups. Nutritional supplements either alone or combined with anti-VEGF may mitigate CNV development and inhibit retinal disease involving VEGF overexpression and CNV.

  6. Subfoveal choroidal thickness changes after intravitreal bevacizumab therapy for neovascular age-related macular degeneration

    Institute of Scientific and Technical Information of China (English)

    Cihan; ünlü; Gurkan; Erdogan; Betul; Onal; Gunay; Betul; Ilkay; Sezgin; Akcay; Esra; Kardes

    2015-01-01

    <正>Dear Sir,Iam Dr.Cihanünlü,from the Department of Opthalmology,ümraniye Training and Research Hospital,Istanbul,Turkey.I write to present our study findings on subfoveal choroidal thickness(SFCT)changes after intravitreal bevacizumab(IVB)therapy for neovascular age-related macular degeneration(AMD).AMD is the leading cause of severe visual loss in adults older than 60y[1].Visual loss in late stages of AMD may be the result of one of the two processes:geographic atrophy(GA)or choroidal neovascularization(CNV).Many types of

  7. Hedgehog Signaling Components Are Expressed in Choroidal Neovascularization in Laser-induced Retinal Lesion

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    Nochioka, Katsunori; Okuda, Hiroaki; Tatsumi, Kouko; Morita, Shoko; Ogata, Nahoko; Wanaka, Akio

    2016-01-01

    Choroidal neovascularization is one of the major pathological changes in age-related macular degeneration, which causes devastating blindness in the elderly population. The molecular mechanism of choroidal neovascularization has been under extensive investigation, but is still an open question. We focused on sonic hedgehog signaling, which is implicated in angiogenesis in various organs. Laser-induced injuries to the mouse retina were made to cause choroidal neovascularization. We examined gene expression of sonic hedgehog, its receptors (patched1, smoothened, cell adhesion molecule down-regulated by oncogenes (Cdon) and biregional Cdon-binding protein (Boc)) and downstream transcription factors (Gli1-3) using real-time RT-PCR. At seven days after injury, mRNAs for Patched1 and Gli1 were upregulated in response to injury, but displayed no upregulation in control retinas. Immunohistochemistry revealed that Patched1 and Gli1 proteins were localized to CD31-positive endothelial cells that cluster between the wounded retina and the pigment epithelium layer. Treatment with the hedgehog signaling inhibitor cyclopamine did not significantly decrease the size of the neovascularization areas, but the hedgehog agonist purmorphamine made the areas significantly larger than those in untreated retina. These results suggest that the hedgehog-signaling cascade may be a therapeutic target for age-related macular degeneration. PMID:27239075

  8. Evaluation of 10 AMD Associated Polymorphisms as a Cause of Choroidal Neovascularization in Highly Myopic Eyes

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    Anter, Jaouad; Bezunartea, Jaione; Hernandez-Sanchez, Maria; García-García, Laura; Alonso, Elena; Ruiz-Moreno, Jose María; Araiz-Iribarren, Javier; Fernandez-Robredo, Patricia; García-Layana, Alfredo

    2016-01-01

    Choroidal neovascularization (CNV) commonly occurs in age related macular degeneration and pathological myopia patients. In this study we conducted a case-control prospective study including 431 participants. The aim of this study was to determine the potential association between 10 single nucleotide polymorphisms (SNPs) located in 4 different genetic regions (CFI, COL8A1, LIPC, and APOE), and choroidal neovascularization in age-related macular degeneration and the development of choroidal neovascularization in highly myopic eyes of a Caucasian population. Univariate and multivariate logistic regression analysis adjusted for age, sex and hypertension was performed for each allele, genotype and haplotype frequency analysis. We found that in the univariate analysis that both single-nucleotide polymorphisms in COL8A1 gene (rs13095226 and rs669676) together with age, sex and hypertension were significantly associated with myopic CNV development in Spanish patients (p0.05); however, analysis of the axial length between genotypes of rs13095226 revealed an important influence of COL8A1 in the development of CNV in high myopia. Furthermore we conducted a meta-analysis of COL8A1, CFI and LIPC genes SNPs (rs669676, rs10033900 and rs10468017) and found that only rs669676 of these SNPs were associated with high myopia neovascularization. PMID:27643879

  9. Intravitreal bevacizumab for treatment of choroidal neovascularization associated with osteogenesis imperfecta

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    Pukhraj Rishi

    2012-01-01

    Full Text Available A 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml. Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch′s membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

  10. Intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to ocular toxoplasmosis

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    Nikunj J Shah

    2011-01-01

    Full Text Available The purpose of the study was to report a case of choroidal neovascularization (CNV secondary to ocular toxoplasmosis in an 18-year-old female patient. She was treated with a single intravitreal injection of ranibizumab. The CNV resolved as confirmed by fluorescein angiography and optical coherence tomography (OCT. The visual acuity improved to 20/30, which was maintained till the last follow-up visit at two years, without requisition of a repeat injection.

  11. Possible vitreous involvement in a case with rapidly progressing choroidal neovascularization

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    Masayuki Hata

    2012-01-01

    Full Text Available A 65-year-old man with subfoveal choroidal neovascularization (CNV underwent photodynamic therapy (PDT. Despite the sequential treatments, the CNV grew larger and finally penetrated the retina. Vitreous adhesion was observed at the edge of the supraretinal fibrotic tissue. The case highlighted the possible unexpected side-effect of PDT. The upregulation of the vascular endothelial growth factor or the enhanced vitreous traction was considered to be responsible for the event.

  12. Effect of photodynamic therapy combined with intravitreal injection of Lucentis therapy on choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    Yan-Mei Su

    2016-01-01

    Objective:To analyze the efficacy of photodynamic therapy combined with intravitreal injection of Lucentis therapy for choroidal neovascularization.Methods: A total of 82 cases with choroidal neovascularization receiving inpatient therapy in our hospital from August 2013 to August 2014 were selected as research subjects, and according to random number table method, all enrolled patients were divided into control group (received photodynamic therapy) and observation group (received photodynamic therapy combined with intravitreal injection of Lucentis therapy), each group with 41 cases. Differences in best corrected visual acuity, intraocular pressure and central macular thickness, mean sensitivity of visual field and so on of two groups were compared.Results:After treatment, visual acuity improvement ratio of observation group was significantly higher than that of control group and visual acuity decrease ratio was lower than that of control group (P<0.05); intraocular pressure and central macular thickness were significantly less than those of control group (P<0.05); mean sensitivity of 10o and 30o visual field was higher than that of control group (P<0.05).Conclusions:Photodynamic therapy combined with intravitreal injection of Lucentis therapy can effectively improve vision and visual acuity of patients with choroidal neovascularization and reduce intraocular pressure and central macular thickness; it is an ideal treatment method.

  13. Fluorocoxib A enables targeted detection of cyclooxygenase-2 in laser-induced choroidal neovascularization

    Science.gov (United States)

    Uddin, Md. Jashim; Moore, Chauca E.; Crews, Brenda C.; Daniel, Cristina K.; Ghebreselasie, Kebreab; McIntyre, J. Oliver; Marnett, Lawrence J.; Jayagopal, Ashwath

    2016-09-01

    Ocular angiogenesis is a blinding complication of age-related macular degeneration and other retinal vascular diseases. Clinical imaging approaches to detect inflammation prior to the onset of neovascularization in these diseases may enable early detection and timely therapeutic intervention. We demonstrate the feasibility of a previously developed cyclooxygenase-2 (COX-2) targeted molecular imaging probe, fluorocoxib A, for imaging retinal inflammation in a mouse model of laser-induced choroidal neovascularization. This imaging probe exhibited focal accumulation within laser-induced neovascular lesions, with minimal detection in proximal healthy tissue. The selectivity of the probe for COX-2 was validated in vitro and by in vivo retinal imaging with nontargeted 5-carboxy-X-rhodamine dye, and by blockade of the COX-2 active site with nonfluorescent celecoxib prior to injection of fluorocoxib A. Fluorocoxib A can be utilized for imaging COX-2 expression in vivo for further validation as an imaging biomarker in retinal diseases.

  14. Anti-vascular endothelial growth factors for choroidal neovascularization secondary to choroidal osteoma: Long-term results

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    T Lekha

    2015-01-01

    Full Text Available Choroidal osteoma is an uncommon benign osseous intraocular tumor typically seen unilaterally in young women. Visual loss can occur due to choroidal neovascularization (CNV complicating osteoma. We report a rare case of bilateral choroidal osteoma with secondary CNV in a young male and the long-term results following anti-vascular endothelial growth factor (VEGF therapy. A 30-year-old male with history of defective vision in both eyes since several years and recent worsening in the right eye (RE since 2 months was found to have bilateral macular osteoma with CNV in the RE based on clinical evaluation, fluorescein angiography, optical coherence tomography, and ultrasonography. Intravitreal injection of ranibizumab at monthly intervals for three doses resulted in resolution of CNV and remained stable for 5 years. Recurrent CNV detected 6 years later responded to an injection of intravitreal bevacizumab and has remained stable till date. Anti-VEGF therapy stabilized the secondary CNV in our patient for 7 years with satisfactory structural and functional outcome, demonstrating the long-term efficacy of this modality of treatment.

  15. Transpupillary thermotherapy in subfoveal choroidal neovascular membrane secondary to age-related macular degeneration

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    Verma Lalit

    2004-01-01

    Full Text Available Purpose: To report our initial experience in the treatment of subfoveal choroidal neovascular membrane, secondary to age-related macular degeneration (AMD by transpupillary thermotherapy (TTT. Methods: Fifty consecutive patients with subfoveal choroidal neovascularisation (CNV secondary to AMD, were included in the study. The parameters assessed before the TTT were visual acuity by ETDRS chart, scotoma score by Amsler grid chart, reading speed, fundus examination by direct and indirect ophthalmoscope as well as +90 Diopter lens followed by digital fundus photography and fluorescein angiography (FA. Results: The letter visual acuity improved or stabilized in 72% cases up to 12 weeks after TTT. Mean scotoma score decreased from a mean of 47.56, to 43.56 at 6 weeks and to 37 at 12 weeks. Mean reading speed increased from 27.04 words/minute at pretreatment to 34.52 words/minute at 6 weeks and 37.33 words/minute 12 weeks after TTT. Conclusion: TTT is not only a cheaper alternative to photodynamic therapy (PDT, but also is an efficacious tool in stabilisation or improvement of visual acuity in the management of subfoveal choroidal neovascular membrane due to AMD.

  16. VEGF Mediates ApoE4-Induced Neovascularization and Synaptic Pathology in the Choroid and Retina.

    Science.gov (United States)

    Antes, Ran; Salomon-Zimri, Shiran; Beck, Susanne C; Garcia Garrido, Marina; Livnat, Tami; Maharshak, Idit; Kadar, Tamar; Seeliger, Mathias; Weinberger, Dov; Michaelson, Daniel M

    2015-01-01

    Apolipoprotein E4 (apoE4), the most prevalent genetic risk factor for Alzheimer's disease (AD), is associated with neuronal and vascular impairments. Recent findings suggest that retina of apoE4 mice have synaptic and functional impairments. We presently investigated the effects of apoE4 on retinal and choroidal vasculature and the possible role of VEGF in these effects. There were no histological differences between the retinal and choroidal vasculatures of naïve apoE3 and apoE4 mice. In contrast, laserdriven choroidal injury induced higher levels of choroidal neovascularization (CNV) in apoE4 than in apoE3 mice. These effects were associated with an inflammatory response and with activation of the Muller cells and asrocytic markers gluthatione synthetase and GFAP, all of which were more pronounced in the apoE4 mice. CNV also induced a transient increase in the levels of the synaptic markers synaptophysin and PSD95 which were however similar in the apoE4 and apoE3 naive mice. Retinal and choroidal VEGF and apoE levels were lower in naïve apoE4 than in corresponding apoE3 mice. In contrast, VEGF and apoE levels rose more pronouncedly following laser injury in the apoE4 than in apoE3 mice. Taken together, these findings suggest that the apoE4-induced retinal impairments, under basal conditions, may be related to reduced VEGF levels in the eyes of these mice. The hyper-neovascularization in the apoE4 mice might be driven by increased inflammation and the associated surge in VEGF following injury. Retinal and choroidal VEGF and apoE levels were lower in naïve apoE4 than in corresponding apoE3 mice. In contrast, VEGF and apoE levels rose more pronouncedly following laser injury in the apoE4 than in apoE3 mice. Taken together, these findings suggest that the apoE4-induced retinal impairments, under basal conditions, may be related to reduced VEGF levels in the eyes of these mice. The hyper-neovascularization in the apoE4 mice might be driven by increased inflammation

  17. Inflammatory Mediators and Angiogenic Factors in Choroidal Neovascularization: Pathogenetic Interactions and Therapeutic Implications

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    Claudio Campa

    2010-01-01

    Full Text Available Choroidal neovascularization (CNV is a common and severe complication in heterogeneous diseases affecting the posterior segment of the eye, the most frequent being represented by age-related macular degeneration. Although the term may suggest just a vascular pathological condition, CNV is more properly definable as an aberrant tissue invasion of endothelial and inflammatory cells, in which both angiogenesis and inflammation are involved. Experimental and clinical evidences show that vascular endothelial growth factor is a key signal in promoting angiogenesis. However, many other molecules, distinctive of the inflammatory response, act as neovascular activators in CNV. These include fibroblast growth factor, transforming growth factor, tumor necrosis factor, interleukins, and complement. This paper reviews the role of inflammatory mediators and angiogenic factors in the development of CNV, proposing pathogenetic assumptions of mutual interaction. As an extension of this concept, new therapeutic approaches geared to have an effect on both the vascular and the extravascular components of CNV are discussed.

  18. Quantification of choroidal neovascularization vessel length using optical coherence tomography angiography

    Science.gov (United States)

    Gao, Simon S.; Liu, Li; Bailey, Steven T.; Flaxel, Christina J.; Huang, David; Li, Dengwang; Jia, Yali

    2016-07-01

    Quantification of choroidal neovascularization (CNV) as visualized by optical coherence tomography angiography (OCTA) may have importance clinically when diagnosing or tracking disease. Here, we present an automated algorithm to quantify the vessel skeleton of CNV as vessel length. Initial segmentation of the CNV on en face angiograms was achieved using saliency-based detection and thresholding. A level set method was then used to refine vessel edges. Finally, a skeleton algorithm was applied to identify vessel centerlines. The algorithm was tested on nine OCTA scans from participants with CNV and comparisons of the algorithm's output to manual delineation showed good agreement.

  19. Role of Intravitreal Antivascular Endothelial Growth Factor Injections for Choroidal Neovascularization due to Choroidal Osteoma.

    Science.gov (United States)

    Mansour, Ahmad M; Arevalo, J Fernando; Al Kahtani, Eman; Zegarra, Hernando; Abboud, Emad; Anand, Rajiv; Ahmadieh, Hamid; Sisk, Robert A; Mirza, Salman; Tuncer, Samuray; Navea Tejerina, Amparo; Mataix, Jorge; Ascaso, Francisco J; Pulido, Jose S; Guthoff, Rainer; Goebel, Winfried; Roh, Young Jung; Banker, Alay S; Gentile, Ronald C; Martinez, Isabel Alonso; Morris, Rodney; Panday, Neeraj; Min, Park Jung; Mercé, Emilie; Lai, Timothy Y Y; Massoud, Vicky; Ghazi, Nicola G

    2014-01-01

    We treated 26 eyes of 25 young patients having a mean age of 30 years with intravitreal vascular endothelial growth factor (VEGF) inhibitor for choroidal new vessel (CNV) formation overlying choroidal osteoma over a mean follow-up of 26 months. Mean number of injections was 2.4 at 6 months, 3.2 at 12 months, and 5.5 at 24 months. CNV was subfoveal in 14 eyes, juxtafoveal in 5, extrafoveal in 5, and peripapillary in 2. By paired comparison, mean decrease from baseline was 119.7 microns at 6 months (n = 15; P = 0.001), 105.3 microns at 1 year (n = 10; P = 0.03), and 157.6 microns at 2 years (n = 7; P = 0.08). BCVA improved by 3.3 lines at 6 months after therapy (n = 26; P < 0.001), 2.8 lines (n = 20; P = 0.01) at 1 year, and 3.1 lines (n = 13; P = 0.049) at 2 years. We conclude that intravitreal anti-VEGF injections improve vision in majority of eyes with CNV from choroidal osteoma.

  20. Role of Intravitreal Antivascular Endothelial Growth Factor Injections for Choroidal Neovascularization due to Choroidal Osteoma

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    Ahmad M. Mansour

    2014-01-01

    Full Text Available We treated 26 eyes of 25 young patients having a mean age of 30 years with intravitreal vascular endothelial growth factor (VEGF inhibitor for choroidal new vessel (CNV formation overlying choroidal osteoma over a mean follow-up of 26 months. Mean number of injections was 2.4 at 6 months, 3.2 at 12 months, and 5.5 at 24 months. CNV was subfoveal in 14 eyes, juxtafoveal in 5, extrafoveal in 5, and peripapillary in 2. By paired comparison, mean decrease from baseline was 119.7 microns at 6 months (n=15; P=0.001, 105.3 microns at 1 year (n=10; P=0.03, and 157.6 microns at 2 years (n=7; P=0.08. BCVA improved by 3.3 lines at 6 months after therapy (n=26; P<0.001, 2.8 lines (n=20; P=0.01 at 1 year, and 3.1 lines (n=13; P=0.049 at 2 years. We conclude that intravitreal anti-VEGF injections improve vision in majority of eyes with CNV from choroidal osteoma.

  1. Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness

    Institute of Scientific and Technical Information of China (English)

    Shi Xuehui; Wei Wenbin; Zhang Cong

    2014-01-01

    Background Photodynamic therapy (PDT) has been recommended as a main treatment for idiopathic choroidal neovascularization (I-CNV).But the visual results of PDT were inconsistent and variable,and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries.In recent years,intravitreal ranibizumab therapy,showing favorable visual outcomes,has developed as an advanced treatment for choroidal neovascularization (CNV).Although both methods have been reported to be effective in treating I-CNV,there is no detailed comparative report between the two methods.This study aimed to compare visual outcomes,retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV,and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.Methods Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT.The best corrected visual acuity (BCVA) was recorded before and at each follow-up visit after treatments (IogMAR).Enhanced-depth imaging optical coherence tomography (EDI-OCT) was used to evaluate the retinal structural changes,and to measure central retinal thickness (CRT) and central choroidal thickness (CCT).Results Mean BCVA was 0.64±0.27 in PDT group and 0.69±0.22 in ranibizumab group at baseline (P=0.55).When compared with the baseline,mean BCVA in PDT group was improved significantly at 3-month after PDT (0.41±0.16,P=0.002),then changed little (0.42±0.25 at 12-month,P=0.88).Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit.It improved much more obviously in the first month and then remained stable.The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT (P <0.05).When compared with the baseline,mean CRT in PDT group decreased significantly since 3-month visit

  2. The Use of Intravitreal Ranibizumab for Choroidal Neovascularization Associated with Vogt-Koyanagi-Harada Syndrome

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    A. M. Kolomeyer

    2011-01-01

    Full Text Available Purpose. To describe the use of intravitreal ranibizumab for choroidal neovascular membrane (CNVM secondary to Vogt-Koyanagi-Harada (VKH syndrome. Methods. Interventional case report. Results. A 50-year-old woman presented with conjunctival injection and bilateral eye pain. Vision was 20/400 and 20/80 in the right and left eyes, respectively. Bilateral iritis, vitritis, and choroidal thickening were evident. Exudative retinal detachment was present in the left eye. Corticosteroid treatment improved vision to 20/40 bilaterally. Methotrexate (MTX was initiated and vision remained stable for 3 months. After a 5-month loss to follow-up, vision in the left eye decreased to finger counting (CF and a parafoveal CNVM was identified. After 3 intravitreal ranibizumab injections, vision improved to 20/40. Twelve months later, despite inflammation control, vision decrease to CF due to recurrent CNVM. A fourth ranibizumab injection was given. Twenty months later, best-corrected vision was 20/400, and an inactive CNVM was present in the left eye. Conclusion. After initial CNVM regression and visual acuity improvement due to ranibizumab, the CNVM recurred and became refractory to treatment. Despite control of inflammation and neovascularization, VKH chronicity lead to permanent vision loss in our patient. A combinational treatment approach may be required in such patients.

  3. Photodynamic therapy of choroidal neovascularization with enlargement of the spot size to include the feeding complex

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    Ilias Georgalas

    2008-12-01

    Full Text Available Ilias Georgalas, Alexandros A Rouvas, Dimitrios A Karagiannis, Athanasios I Kotsolis, Ioannis D LadasDepartment of Ophthalmology, Medical School of Athens University, Athens, GreeceAbstract: This is a case report of a 83-year-old man with choroidal neovascularization (CNV, due to age-related macular degeneration (AMD in his right eye. Digital fluorescein (FA and indocyanine green angiography (ICG were performed, which disclosed predominantly classic subfoveal CNV and a dilated and tortuous feeding complex. The visual acuity was 20/800. Anti-vascular endothelial growth factor (anti-VEGF treatment was suggested, however, the patient was not keen to receive an intraocular injection. Modified photodynamic therapy (PDT with spot size enlarged, to include not only the CNV lesion but the feeding complex as well, was performed. Ten days after one session of PDT, ICG showed absence of leakage from the CNV and complete occlusion of the feeding complex. The visual acuity gradually improved to 20/100 and remained stable during the following 23 months. No evidence of CNV leakage was seen in the FA and ICG during the follow up period. Adjustment of the PDT spot size to include the detectable by ICG feeding complex might be an additional option in order to close the subfoveal CNV and might be considered as an alternative to intravitreal injection of anti-VEGF in selected cases where anti-VEGF treatment is not available.Keywords: age-related macular degeneration, choroidal neovascularization, photodynamic treatment, feeder vessel

  4. MFGE8 does not influence chorio-retinal homeostasis or choroidal neovascularization in vivo.

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    William Raoul

    Full Text Available PURPOSE: Milk fat globule-epidermal growth factor-factor VIII (MFGE8 is necessary for diurnal outer segment phagocytosis and promotes VEGF-dependent neovascularization. The prevalence of two single nucleotide polymorphisms (SNP in MFGE8 was studied in two exsudative or "wet" Age-related Macular Degeneration (AMD groups and two corresponding control groups. We studied the effect of MFGE8 deficiency on retinal homeostasis with age and on choroidal neovascularization (CNV in mice. METHODS: The distribution of the SNP (rs4945 and rs1878326 of MFGE8 was analyzed in two groups of patients with "wet" AMD and their age-matched controls from Germany and France. MFGE8-expressing cells were identified in Mfge8(+/- mice expressing ß-galactosidase. Aged Mfge8(+/- and Mfge8(-/- mice were studied by funduscopy, histology, electron microscopy, scanning electron microscopy of vascular corrosion casts of the choroid, and after laser-induced CNV. RESULTS: rs1878326 was associated with AMD in the French and German group. The Mfge8 promoter is highly active in photoreceptors but not in retinal pigment epithelium cells. Mfge8(-/- mice did not differ from controls in terms of fundus appearance, photoreceptor cell layers, choroidal architecture or laser-induced CNV. In contrast, the Bruch's membrane (BM was slightly but significantly thicker in Mfge8(-/- mice as compared to controls. CONCLUSIONS: Despite a reproducible minor increase of rs1878326 in AMD patients and a very modest increase in BM in Mfge8(-/- mice, our data suggests that MFGE8 dysfunction does not play a critical role in the pathogenesis of AMD.

  5. Macrophage activation associated with chronic murine cytomegalovirus infection results in more severe experimental choroidal neovascularization.

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    Scott W Cousins

    Full Text Available The neovascular (wet form of age-related macular degeneration (AMD leads to vision loss due to choroidal neovascularization (CNV. Since macrophages are important in CNV development, and cytomegalovirus (CMV-specific IgG serum titers in patients with wet AMD are elevated, we hypothesized that chronic CMV infection contributes to wet AMD, possibly by pro-angiogenic macrophage activation. This hypothesis was tested using an established mouse model of experimental CNV. At 6 days, 6 weeks, or 12 weeks after infection with murine CMV (MCMV, laser-induced CNV was performed, and CNV severity was determined 4 weeks later by analysis of choroidal flatmounts. Although all MCMV-infected mice exhibited more severe CNV when compared with control mice, the most severe CNV developed in mice with chronic infection, a time when MCMV-specific gene sequences could not be detected within choroidal tissues. Splenic macrophages collected from mice with chronic MCMV infection, however, expressed significantly greater levels of TNF-α, COX-2, MMP-9, and, most significantly, VEGF transcripts by quantitative RT-PCR assay when compared to splenic macrophages from control mice. Direct MCMV infection of monolayers of IC-21 mouse macrophages confirmed significant stimulation of VEGF mRNA and VEGF protein as determined by quantitative RT-PCR assay, ELISA, and immunostaining. Stimulation of VEGF production in vivo and in vitro was sensitive to the antiviral ganciclovir. These studies suggest that chronic CMV infection may serve as a heretofore unrecognized risk factor in the pathogenesis of wet AMD. One mechanism by which chronic CMV infection might promote increased CNV severity is via stimulation of macrophages to make pro-angiogenic factors (VEGF, an outcome that requires active virus replication.

  6. Repeatability of swept-source optical coherence tomography retinal and choroidal thickness measurements in neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Hanumunthadu, Daren; Ilginis, Tomas; Restori, Marie

    2017-01-01

    BACKGROUND: The aim was to determine the intrasession repeatability of swept-source optical coherence tomography (SS-OCT)-derived retinal and choroidal thickness measurements in eyes with neovascular age-related macular degeneration (nAMD). METHODS: A prospective study consisting of patients with...

  7. Ranibizumab for choroidal neovascular membrane in a rare case of Bietti′s crystalline dystrophy: A case report

    OpenAIRE

    Kasinathan Nachiappan; Tandava Krishnan; Jagadeesan Madhavan

    2012-01-01

    We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab. The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

  8. Lipopolysaccharide Promotes Choroidal Neovascularization by Up-Regulation of CXCR4 and CXCR7 Expression in Choroid Endothelial Cell.

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    Yi-fan Feng

    Full Text Available Stromal cell-derived factor-1 (SDF-1 has been confirmed to participate in the formation of choroidal neovascularization (CNV via its two receptors: CXC chemokine receptors 4 (CXCR4 and CXCR7. Previous studies have indicated that the activation of Toll-like receptors (TLRs by lipopolysaccharide (LPS might elevate CXCR4 and/or CXCR7 expression in tumor cells, enhancing the response to SDF-1 to promote invasion and cell dissemination. However, the impact of LPS on the CXCR4 and CXCR7 expression in endothelial cells and subsequent pathological angiogenesis formation remains to be elucidated. The present study shows that LPS enhanced the CXCR4 and CXCR7 expression via activation of the TLR4 pathway in choroid-retinal endothelial (RF/6A cells. In addition, the transcriptional regulation of CXCR4 and CXCR7 by LPS was found to be mediated by phosphorylation of the extracellular signal-related kinase (ERK 1/2 and activation of nuclear factor kappa B (NF-κB signaling pathways, which were blocked by ERK- or NF-κB-specific inhibitors. Furthermore, the increased CXCR4 and CXCR7 expression resulted in increased SDF-1-induced RF/6A cells proliferation, migration and tube formation. In vivo, LPS-treated rat had significantly higher mRNA levels of CXCR4 and CXCR7 expression and lager laser-induced CNV area than vehicle-treated rat. SDF-1 blockade with a neutralizing antibody attenuated the progression of CNV in LPS-treated rat after a single intravitreal injection. Altogether, these results demonstrated that LPS might influence CNV formation by enhancing CXCR7 and CXCR7 expression in endothelial cells, possibly providing a new perspective for the treatment of CNV-associated diseases.

  9. Identification of Chlamydia pneumoniae within human choroidal neovascular membranes secondary to age-related macular degeneration.

    Science.gov (United States)

    Kalayoglu, Murat V; Bula, Deisy; Arroyo, Jorge; Gragoudas, Evangelos S; D'Amico, Donald; Miller, Joan W

    2005-11-01

    Age-related macular degeneration (AMD) is a leading cause of blindness in the United States, and increasing evidence suggests that it is an inflammatory disease. The prokaryotic obligate intracellular pathogen Chlamydia pneumoniae is emerging as a novel risk factor in cardiovascular disease, and recent sero-epidemiological data suggest that C. pneumoniae infection is also associated with AMD. In this study, we examined choroidal neovascular membrane (CNV) tissue from patients with neovascular AMD for the presence of C. pneumoniae and determined whether the pathogen can dysregulate the function of key cell types in ways that can cause neovascular AMD. Nine CNV removed from patients with neovascular AMD were examined for the presence of C. pneumoniae by immunohistochemistry (IHC) and polymerase chain reaction (PCR); in addition, we performed PCR on nine non-AMD eyes, and IHC on five non-AMD CNV, seven non-AMD eyes, and one internal limiting membrane specimen. Finally, human monocyte-derived macrophages and retinal pigment epithelial (RPE) cells were exposed to C. pneumoniae and assayed in vitro for the production of pro-angiogenic immunomodulators (VEGF, IL-8, and MCP-1). C. pneumoniae was detected in four of nine AMD CNV by IHC and two of nine AMD CNV by PCR, induced VEGF production by human macrophages, and increased production of IL-8 and MCP-1 by RPE cells. In contrast, none of the 22 non-AMD specimens showed evidence for C. pneumoniae. These data indicate that a pathogen capable of inducing chronic inflammation and pro-angiogenic cytokines can be detected in some AMD CNV, and suggest that infection may contribute to the pathogenesis of AMD.

  10. Retinal Inhibition of CCR3 Induces Retinal Cell Death in a Murine Model of Choroidal Neovascularization.

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    Haibo Wang

    Full Text Available Inhibition of chemokine C-C motif receptor 3 (CCR3 signaling has been considered as treatment for neovascular age-related macular degeneration (AMD. However, CCR3 is expressed in neural retina from aged human donor eyes. Therefore, broad CCR3 inhibition may be harmful to the retina. We assessed the effects of CCR3 inhibition on retina and choroidal endothelial cells (CECs that develop into choroidal neovascularization (CNV. In adult murine eyes, CCR3 colocalized with glutamine-synthetase labeled Műller cells. In a murine laser-induced CNV model, CCR3 immunolocalized not only to lectin-stained cells in CNV lesions but also to the retina. Compared to non-lasered controls, CCR3 mRNA was significantly increased in laser-treated retina. An intravitreal injection of a CCR3 inhibitor (CCR3i significantly reduced CNV compared to DMSO or PBS controls. Both CCR3i and a neutralizing antibody to CCR3 increased TUNEL+ retinal cells overlying CNV, compared to controls. There was no difference in cleaved caspase-3 in laser-induced CNV lesions or in overlying retina between CCR3i- or control-treated eyes. Following CCR3i, apoptotic inducible factor (AIF was significantly increased and anti-apoptotic factor BCL2 decreased in the retina; there were no differences in retinal vascular endothelial growth factor (VEGF. In cultured human Műller cells exposed to eotaxin (CCL11 and VEGF, CCR3i significantly increased TUNEL+ cells and AIF but decreased BCL2 and brain derived neurotrophic factor, without affecting caspase-3 activity or VEGF. CCR3i significantly decreased AIF in RPE/choroids and immunostaining of phosphorylated VEGF receptor 2 (p-VEGFR2 in CNV with a trend toward reduced VEGF. In cultured CECs treated with CCL11 and/or VEGF, CCR3i decreased p-VEGFR2 and increased BCL2 without increasing TUNEL+ cells and AIF. These findings suggest that inhibition of retinal CCR3 causes retinal cell death and that targeted inhibition of CCR3 in CECs may be a safer if CCR3

  11. Natural history of choroidal neovascularization after surgical induction in an animal model

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; la Cour, Morten

    2008-01-01

    PURPOSE: To study an expanded time course of surgically induced choroidal neovascularization (CNV) in a porcine model applying fluorescence angiography and immunohistology. METHODS: Twenty-two porcine eyes underwent vitrectomy, a retinal bleb was raised and the detached retina perforated using...... endodiathermy. Bruch's membrane was perforated with a retinal perforator at a site where the overlying neuroretina was normal. Eyes were enucleated in a time interval between 30 min and 42 days after the perforation, and the pigs were subsequently killed. Immediately prior to enucleation, fundus photographs...... and fluorescein angiograms were obtained. Sections of paraffin-embedded eyes were immunohistochemically stained. RESULTS: On fluorescein angiography, membranes aged 14 days or less exhibited leakage in 10/11 cases while the remaining showed persistent staining. The propensity to leak diminished with time and only...

  12. Management of Myopic Choroidal Neovascularization: Focus on Anti-VEGF Therapy.

    Science.gov (United States)

    Teo, Kelvin Yi Chong; Ng, Wei Yan; Lee, Shu Yen; Cheung, Chui Ming Gemmy

    2016-07-01

    Myopic choroidal neovascularization (mCNV) is the second most common form of CNV after age-related macular degeneration (AMD). It is a sight-threatening complication of pathologic myopia (PM) and often affects patients in their working years causing significant impact on quality of life. Previous therapies such as photodynamic therapy with verteporfin have shown limited success. Due to the similarities in pathogenesis of mCNV and AMD CNV, anti-vascular endothelial growth factor therapy (anti-VEGF), which has so far been the mainstay of treatment for AMD CNV, has been shown to be effective in the treatment of mCNV and has become the first-line treatment of choice. This article aims to examine briefly the epidemiology and pathophysiology of mCNV, as well as review the evidence for efficacy, safety, and clinical use of anti-VEGF treatment for mCNV.

  13. Combined choroidal neovascularization and hypopituitarism in a patient with homozygous mutation in methylenetetrahydrofolate reductase gene

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    Aydogan Aydogdu

    2014-01-01

    Full Text Available We report a case of choroidal neovascularization (CNV secondary to methylenetetrahydrofolate reductase (MTHFR gene mutation in a 20-year-old male patient with hypopituitarism. Treatment with three consecutive injections of intravitreal ranibizumab (anti-vascular endothelial growth factor resulted in significant improvement of the patient′s vision and the appearance of the macula. A search of the literature produced no previously reported case of MTHFR gene mutation associated both CNV and possibly hypopituitarism. With hormone replacement therapy of hypopituitarism, acetyl salicylic acid 100 mg/day also was started. The patient was clinically stable both for CNV and other thromboembolic disorders over a 6-month follow-up and also 1-year follow-up period.

  14. Tissue inhibitor of metalloproteinases-3 peptides inhibit angiogenesis and choroidal neovascularization in mice.

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    Jian Hua Qi

    Full Text Available Tissue inhibitors of metalloproteinases (TIMPs while originally characterized as inhibitors of matrix metalloproteinases (MMPs have recently been shown to have a wide range of functions that are independent of their MMP inhibitory properties. Tissue inhibitor of metalloproteinases-3 (TIMP-3 is a potent inhibitor of VEGF-mediated angiogenesis and neovascularization through its ability to block the binding of VEGF to its receptor VEGFR-2. To identify and characterize the anti-angiogenic domain of TIMP-3, structure function analyses and synthetic peptide studies were performed using VEGF-mediated receptor binding, signaling, migration and proliferation. In addition, the ability of TIMP-3 peptides to inhibit CNV in a mouse model was evaluated. We demonstrate that the anti-angiogenic property resides in the COOH-terminal domain of TIMP-3 protein which can block the binding of VEGF specifically to its receptor VEGFR-2, but not to VEGFR-1 similar to the full-length wild-type protein. Synthetic peptides corresponding to putative loop 6 and tail region of TIMP-3 have anti-angiogenic properties as determined by inhibition of VEGF binding to VEGFR-2, VEGF-induced phosphorylation of VEGFR-2 and downstream signaling pathways as well as endothelial cell proliferation and migration in response to VEGF. In addition, we show that intravitreal administration of TIMP-3 peptide could inhibit the size of laser-induced choroidal neovascularization lesions in mice. Thus, we have identified TIMP-3 peptides to be efficient inhibitors of angiogenesis and have a potential to be used therapeutically in diseases with increased neovascularization.

  15. Enhanced depth imaging optical coherence tomography of choroidal osteoma with secondary neovascular membranes: report of two cases

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    Patrícia Correa de Mello

    2016-06-01

    Full Text Available ABSTRACT We report enhanced depth imaging optical coherence tomography (EDI-OCT features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle. Both lesions had multiple intralesional layers and a typical intrinsic transparency with visibility of the sclerochoroidal junction.

  16. Relapse of choroidal neovascularization in Bietti's crystalline retinopathy following anti-vascular endothelial growth factor therapy: A case report

    Science.gov (United States)

    HUA, RUI; CHEN, KANG; HU, YUEDONG; WANG, XINLING; CHEN, LEI

    2015-01-01

    Choroidal neovascularization secondary to retinitis pigmentosa is rarely observed in clinical practice. The present study describes a case of atypical retinitis pigmentosa, crystalline retinal pigmentary degeneration, complicated by choroidal neovascularization (CNV) in a 26-year-old man presenting with blurred vision in the right eye. Heidelberg multimodality imaging was performed to achieve a confirmed diagnosis. Bevacizumab was injected once intravitreally. The 3-month follow-up included visualization of the lesion's regression with spectral domain optical coherence tomography (SD-OCT). However, at 3 months after the injection, the CNV reoccurred. To the best of our knowledge, this is the first time that a case of CNV secondary to retinitis pigmentosa, in which the diagnosis was confirmed via multimodality imaging and the therapeutic efficacy was evaluated by SD-OCT, has been reported in China. PMID:26640540

  17. Clinical and histological findings after intravitreal injection of bevacizumab (Avastin) in a porcine model of choroidal neovascularization

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik;

    2010-01-01

    was identified immunohistochemically in the inner limiting membrane (ILM) and to a lesser degree in the remaining retina. Strong staining was also detected in both retinal blood vessels and entire CNV membranes with no cellular predisposition. Vascular endothelial growth factor expression was found in the CNV...... membranes, in the ILM, in the ganglion cell layer, in Müller cells throughout the neuroretina and in retinal blood vessels. CONCLUSIONS: Bevacizumab significantly reduced the proliferation of vascular endothelial cells in CNV membranes and showed a strong trend towards a reduction of leakage from......PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...

  18. Ranibizumab for choroidal neovascular membrane in a rare case of Bietti′s crystalline dystrophy: A case report

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    Kasinathan Nachiappan

    2012-01-01

    Full Text Available We report a rare case of Bietti′s crystalline dystrophy presenting with choroidal neovascular membrane (CNVM which was treated with three injections of intravitreal ranibizumab. The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

  19. Metabolic syndrome triggered by high-fructose diet favors choroidal neovascularization and impairs retinal light sensitivity in the rat.

    Science.gov (United States)

    Thierry, Magalie; Pasquis, Bruno; Acar, Niyazi; Grégoire, Stéphane; Febvret, Valérie; Buteau, Bénédicte; Gambert-Nicot, Ségolène; Bron, Alain M; Creuzot-Garcher, Catherine P; Bretillon, Lionel

    2014-01-01

    Diabetic retinopathy and age-related macular degeneration are the leading causes of blindness in Western populations. Although it is a matter of controversy, large-scale population-based studies have reported increased prevalence of age-related macular degeneration in patients with diabetes or diabetic retinopathy. We hypothesized that metabolic syndrome, one of the major risk factors for type 2 diabetes, would represent a favorable environment for the development of choroidal neovascularization, the main complication of age-related macular degeneration. The fructose-fed rat was used as a model for metabolic syndrome in which choroidal neovascularization was induced by laser photocoagulation. Male Brown Norway rats were fed for 1, 3, and 6 months with a standard equilibrated chow diet or a 60%-rich fructose diet (n = 24 per time point). The animals expectedly developed significant body adiposity (+17%), liver steatosis at 3 and 6 months, hyperleptinemia at 1 and 3 months (two-fold increase) and hyperinsulinemia at 3 and 6 months (up to two-fold increase), but remained normoglycemic and normolipemic. The fructose-fed animals exhibited partial loss of rod sensitivity to light stimulus and reduced amplitude of oscillatory potentials at 6 months. Fructose-fed rats developed significantly more choroidal neovascularization at 14 and 21 days post-laser photocoagulation after 1 and 3 months of diet compared to animals fed the control diet. These results were consistent with infiltration/activation of phagocytic cells and up-regulation of pro-angiogenic gene expression such as Vegf and Leptin in the retina. Our data therefore suggested that metabolic syndrome would exacerbate the development of choroidal neovascularization in our experimental model.

  20. Optimization of an Image-Guided Laser-Induced Choroidal Neovascularization Model in Mice.

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    Yan Gong

    Full Text Available The mouse model of laser-induced choroidal neovascularization (CNV has been used in studies of the exudative form of age-related macular degeneration using both the conventional slit lamp and a new image-guided laser system. A standardized protocol is needed for consistent results using this model, which has been lacking. We optimized details of laser-induced CNV using the image-guided laser photocoagulation system. Four lesions with similar size were consistently applied per eye at approximately double the disc diameter away from the optic nerve, using different laser power levels, and mice of various ages and genders. After 7 days, the mice were sacrificed and retinal pigment epithelium/choroid/sclera was flat-mounted, stained with Isolectin B4, and imaged. Quantification of the area of the laser-induced lesions was performed using an established and constant threshold. Exclusion criteria are described that were necessary for reliable data analysis of the laser-induced CNV lesions. The CNV lesion area was proportional to the laser power levels. Mice at 12-16 weeks of age developed more severe CNV than those at 6-8 weeks of age, and the gender difference was only significant in mice at 12-16 weeks of age, but not in those at 6-8 weeks of age. Dietary intake of omega-3 long-chain polyunsaturated fatty acid reduced laser-induced CNV in mice. Taken together, laser-induced CNV lesions can be easily and consistently applied using the image-guided laser platform. Mice at 6-8 weeks of age are ideal for the laser-induced CNV model.

  1. Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application

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    Zhang Y

    2015-07-01

    Full Text Available Yan Zhang,1 Qian Han,2 Yusha Ru,1 Qiyu Bo,1 Rui Hua Wei1 1Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin Medical University, Tianjin, 2Tangshan Eye Hospital, Tangshan, Hebei Province, People’s Republic of China Abstract: Choroidal neovascularization (CNV secondary to pathologic myopia has a very high incidence in global, especially in Asian, populations. It is a common cause of irreversible central vision loss, and severely affects the quality of life in the patients with pathologic myopia. The traditional therapeutic modalities for CNV secondary to pathologic myopia include thermal laser photocoagulation, surgical management, transpupillary thermotherapy, and photodynamic therapy with verteporfin. However, the long-term outcomes of these modalities are disappointing. Recently, intravitreal administration of anti-VEGF biological agents, including bevacizumab, ranibizumab, pegaptanib, aflibercept, and conbercept, has demonstrated promising outcomes for this ocular disease. The anti-VEGF regimens are more effective on improving visual acuity, reducing central fundus thickness and central retina thickness than the traditional modalities. These anti-VEGF agents thus hold the potential to become the first-line medicine for treatment of CNV secondary to pathologic myopia. This review follows the trend of “from bench to bedside”, initially discussing the pathogenesis of myopic CNV, delineating the molecular structures and mechanisms of action of the currently available anti-VEGF drugs, and then systematically comparing the up to date clinical applications as well as the efficacy and safety of the anti-VEGF drugs to the CNV secondary to pathologic myopia. Keywords: formation of new vessels, choroid membrane, pathologic myopia, vascular endothelial growth factor, molecular mechanisms, clinical trials

  2. Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration

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    Roberto Gallego-Pinazo

    2011-02-01

    Full Text Available Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Ester Francés-Muñoz1, J María Millán2,3, J Fernando Arevalo4, J Luis Mullor5, Manuel Díaz-Llopis1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, Clínica Oftalmológica Centro Caracas, Caracas, Venezuela; 5Unit of Experimental Ophthalmology, Fundación para la Investigación del Hospital Universitario La Fe, Valencia, Spain; 6University of Valencia, Faculty of Medicine, Valencia, SpainBackground: The aim of our study was to evaluate the functional and anatomic outcomes of intravitreal ranibizumab for the treatment of symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration.Methods: This was a prospective, single-center, uncontrolled, interventional pilot study. Six consecutive eyes (six patients with drusenoid pigment epithelial detachment with a visual acuity of 20/63 to 20/100 and no evidence of choroidal neovascularization in age-related macular degeneration participated. Patients were given at least one intravitreal ranibizumab injection and were followed for a mean of 66.67 ± 10.3 weeks. Main outcome measures included best-corrected visual acuity (BCVA measured by Early Treatment Diabetic Retinopathy Study charts and optical coherence tomography, and central macular thickness measured by optical coherence tomography.Results: The mean number of intravitreal ranibizumab injections was 3.0 at the end of follow-up. Regarding BCVA and optical coherence tomography, 33.3% of eyes gained between 19 and 21 letters of BCVA, with a median decrease in central macular thickness of 21 µm. There was a statistically significant difference between baseline and final BCVA (P = 0.046. There was a positive

  3. Bevacizumab (Avastin and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes

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    Sean D. Adrean

    2017-01-01

    Full Text Available Objective. This is a retrospective interventional case series describing the results of 5 eyes from 5 patients with symptomatic peripapillary choroidal neovascularization (CNVM receiving initial bevacizumab treatment followed by thermal laser and bevacizumab combination therapy. Methods. Patients received intravitreal bevacizumab injections until the lesions were well-defined. Thermal laser ablation was then administered and followed by an additional bevacizumab injection after one week. Visual outcomes, OCT changes, and rates of recurrence were recorded and analyzed. Results. Median visual outcomes improved from 20/50 to 20/30 (p=0.0232. Median central macular thickness decreased from 347 μm to 152 μm (p=0.0253. The mean visual improvement was 3 lines. An average of 3.8 bevacizumab injections per patient were given overall. Patients were followed for an average of 24 months, during which all eyes were absent for recurrence. Conclusion. Symptomatic peripapillary CNVM may be successfully managed with bevacizumab followed by a combination of thermal laser and bevacizumab without the need for frequent retreatment. The area requiring treatment may be better defined using bevacizumab, limiting the ablation of the healthy retina and improving treatment margins. With this treatment regimen, the patients experience improved visual outcomes and have a low rate of recurrence.

  4. Aflibercept: a review of its use in the treatment of choroidal neovascularization due to age-related macular degeneration.

    Science.gov (United States)

    Balaratnasingam, Chandrakumar; Dhrami-Gavazi, Elona; McCann, Jesse T; Ghadiali, Quraish; Freund, K Bailey

    2015-01-01

    Choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) is an important cause of visual morbidity globally. Modern treatment strategies for neovascular AMD achieve regression of CNV by suppressing the activity of key growth factors that mediate angiogenesis. Vascular endothelial growth factor (VEGF) has been the major target of neovascular AMD therapy for almost two decades, and there have been several intravitreally-administered agents that have enabled anatomical restitution and improvement in visual function with continual dosing. Aflibercept (EYLEA(®)), initially named VEGF Trap-eye, is the most recent anti-VEGF agent to be granted US Food and Drug Administration approval for the treatment of neovascular AMD. Biologic advantages of aflibercept include its greater binding affinity for VEGF, a longer intravitreal half-life relative to other anti-VEGF agents, and the capacity to antagonize growth factors other than VEGF. This paper provides an up-to-date summary of the molecular mechanisms mediating CNV. The structural, pharmacodynamic, and pharmacokinetic advantages of aflibercept are also reviewed to rationalize the utility of this agent for treating CNV. Results of landmark clinical investigations, including VIEW 1 and 2 trials, and other important studies are then summarized and used to illustrate the efficacy of aflibercept for managing treatment-naïve CNV, recalcitrant CNV, and CNV due to polypoidal choroidal vasculopathy. Safety profile, patient tolerability, and quality of life measures related to aflibercept are also provided. The evidence provided in this paper suggests aflibercept to be a promising agent that can be used to reduce the treatment burden of neovascular AMD.

  5. Aflibercept: a review of its use in the treatment of choroidal neovascularization due to age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Balaratnasingam C

    2015-12-01

    Full Text Available Chandrakumar Balaratnasingam,1–3 Elona Dhrami-Gavazi,1,2,4 Jesse T McCann,1,2,4,5 Quraish Ghadiali,1,2 K Bailey Freund1,2,4,5 1Vitreous-Retina-Macula Consultants of New York, NY, USA; 2LuEsther T Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; 3Centre for Ophthalmology and Visual Sciences, Lions Eye Institute, University of Western Australia, Perth, WA, Australia; 4Department of Ophthalmology, Edward S Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA; 5Department of Ophthalmology, New York University School of Medicine, New York, NY, USA Abstract: Choroidal neovascularization (CNV due to age-related macular degeneration (AMD is an important cause of visual morbidity globally. Modern treatment strategies for neovascular AMD achieve regression of CNV by suppressing the activity of key growth factors that mediate angiogenesis. Vascular endothelial growth factor (VEGF has been the major target of neovascular AMD therapy for almost two decades, and there have been several intravitreally-administered agents that have enabled anatomical restitution and improvement in visual function with continual dosing. Aflibercept (EYLEA®, initially named VEGF Trap-eye, is the most recent anti-VEGF agent to be granted US Food and Drug Administration approval for the treatment of neovascular AMD. Biologic advantages of aflibercept include its greater binding affinity for VEGF, a longer intravitreal half-life relative to other anti-VEGF agents, and the capacity to antagonize growth factors other than VEGF. This paper provides an up-to-date summary of the molecular mechanisms mediating CNV. The structural, pharmacodynamic, and pharmacokinetic advantages of aflibercept are also reviewed to rationalize the utility of this agent for treating CNV. Results of landmark clinical investigations, including VIEW 1 and 2 trials, and other important studies are then summarized and used to

  6. Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

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    Martinez-Serrano MG

    2016-12-01

    Full Text Available Maria Guadalupe Martinez-Serrano,1 Abelardo Rodriguez-Reyes,2 Jose Luis Guerrero-Naranjo,1,3 Guillermo Salcedo-Villanueva,1 Jans Fromow-Guerra,1,3 Gerardo García-Aguirre,1,3 Virgilio Morales-Canton,1 Raul Velez-Montoya1,3 1Retina Department, 2Pathology Department, Asociación para Evitar la Ceguera en Mexico, Hospital “Dr Luis Sanchez Bulnes” IAP, 3Macula Retina Consultants, Mexico City, Mexico Background: The following case series describes the long-term anatomical and functional outcome of a group of seven patients with choroidal neovascularization (CNV, secondary to angioid streaks (AS, who were treated with antiangiogenic drugs in a pro re nata (PRN regimen. After the 4-year mark, visual acuity tends to return to pretreatment level. Treatment delays and lack of aware­ness and self-referral by the patients are believed to be the cause of the PRN regimen failure. Purpose: To assess the long-term outcomes (>4 years of patients with CNV due to AS treated with a PRN regimen of antiangiogenic. Methods: This was a retrospective, case series, single-center study. We reviewed the electronic medical records from patients with CNV due to AS. From each record, we noted general demographic data and relevant medical history; clinical presentation, changes in best-corrected visual acuity (BCVA over time, optical coherent tomography parameters, treatment and retreatment details, and systemic associations. Changes in BCVA and central macular thickness were assessed with a Wilcoxon two-sample test, with an alpha value of ≤0.05 for statistical significance. Results: The mean follow-up time was 53.8±26.8 months. BCVA at baseline was: 1.001±0.62 logMAR; at the end of follow-up: 0.996±0.56 logMAR (P=0.9. Central macular thickness at baseline was: 360.85±173.82 µm; at the end of follow-up: 323.85±100.34 µm (P=0.6. Mean number of intravitreal angiogenic drugs: 6±4.16 injections (range 4–15. Mean time between injections was 3.8±2.7 months (range

  7. The complement regulatory protein CD59: insights into attenuation of choroidal neovascularization.

    Science.gov (United States)

    Schnabolk, Gloriane; Tomlinson, Stephen; Rohrer, Bärbel

    2014-01-01

    Complement activation is associated with age-related macular degeneration (AMD), with the retinal pigment epithelium (RPE) being one of the main target tissues. In AMD, disease severity is correlated with the formation of the membrane attack complex (MAC), the terminal step in the complement cascade, as well as diminished RPE expression of CD59, a membrane-bound regulatory protein of MAC formation. This has prompted the search for therapeutic strategies based on MAC inhibition, and soluble forms of CD59 (sCD59) have been investigated in mouse laser-induced choroidal neovascularization, a model for "wet" AMD. Unlike membrane-bound CD59, sCD59 provides relatively poor cell protection from complement, and different strategies to increase sCD59 activity at the cell membrane level have been investigated. These include increasing the circulatory half-life of sCD59 by the addition of an Fc moiety; increasing the half-life of sCD59 in target tissues by modifying CD59 with a (non-specific) membrane-targeting domain; and by locally overexpressing sCD59 via adenoviral vectors. Finally, a different strategy currently under investigation employs complement receptor (CR)2-mediated targeting of CD59 exclusively to membranes under complement attack. CR2 recognizes long-lasting membrane-bound breakdown activation fragments of complement C3. CR2-CD59 may have greater therapeutic potential than other complement inhibitory approaches, since it can be administered either systemically or locally, it will bind specifically to membranes containing activated complement activation fragments, and dosing can be regulated. Hence, this strategy might offer opportunities for site-specific inhibition of complement in diseases with restricted sites of inflammation such as AMD.

  8. Oscillatory Photodynamic Therapy for Choroidal Neovascularization and Central Serous Retinopathy; a Pilot Study

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    Gholam A Peyman

    2011-01-01

    Full Text Available Purpose: To report the preliminary results of oscillatory photodynamic therapy (OPDT for choroidal neovascularization (CNV and central serous retinopathy (CSR. Methods: This study included 7 eyes of 6 patients with CSR (2 eyes, idiopathic CNV (2 eyes, CNV due to age-related macular degeneration (AMD (2 eyes, and peripapillary CNV secondary to presumed ocular histoplasmosis syndrome (1 eye. Intravenous verteporfin (6 mg/m2 body surface area was infused over 10 minutes followed by oscillating laser (wavelength 689 nm covering slightly beyond the entire lesion. An Area Centralis lens was applied and laser was delivered (600 mW/cm2 fluence rate and 50 J/cm2 dose. Intravitreal bevacizumab and dexamethasone combination therapy was used with OPDT in 4 eyes with CNV; intravitreal dexamethasone and triamcinolone acetonide were injected in the other eye with CNV. Clinical examination, funduscopy, fluorescein angiography, and optical coherence tomography (OCT were performed at baseline and after treatment. Results: After mean follow-up of 7.1±5.1 months, visual acuity improved from 0.87±0.69 logMAR (20/160 to 0.60±0.65 logMAR (20/80 (P = 0.027; central foveal thickness decreased from 322±62.1 to 240.7±34.8 microns as measured by OCT (P = 0.018. Fluorescein angiography and OCT demonstrated cessation of vascular leakage, and resolution of hemorrhage and subretinal fluid in all eyes. No adverse events or recurrence were noted. Conclusion: OPDT was effective in treating CNV lesions and CSR. OPDT may be an improvement on standard PDT due to reduced side effects, thermal damage and scarring.

  9. Diagnosis and Follow-Up of Nonexudative Choroidal Neovascularization With Multiple Optical Coherence Tomography Angiography Devices: A Case Report

    Science.gov (United States)

    Lane, Mark; Ferrara, Daniela; Louzada, Ricardo Noguera; Fujimoto, James G.; Seddon, Johanna M.

    2017-01-01

    Nonexudative choroidal neovascularization (CNV) is a new phenomenon that has only recently been described in the literature with the advent of optical coherence tomography angiography (OCTA) imaging. The authors present a 1-year longitudinal follow-up of a nonexudative CNV lesion secondary to age-related macular degeneration. This report describes the appearance of the lesion on two commercially available spectral-domain OCTA devices and one prototype swept-source OCTA device. Management of these cases is still debatable. Watchful waiting with regular follow-up using serial OCTA to monitor disease progression has been valuable in this case. PMID:27548457

  10. Prostate-specific membrane antigen is undetectable in choroidal neovascular membrane

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    Godeiro Katyanne

    2006-08-01

    Full Text Available Abstract Background Choroidal neovascular membrane (CNVM is one of the leading causes of severe visual loss and is often associated with age-related macular degeneration (AMD. Various modalities of treatment, including photocoagulation and surgery, are being considered as options, but with limited success. Prostate-specific membrane antigen (PSMA is a type II membrane glycoprotein expressed in benign and malignant prostatic tissues, in some non-prostatic tissues, and in the endothelium of tumor-associated neovasculature of non-prostatic neoplasm. Some studies have suggested that the expression of PSMA is restricted to endothelium from tumor-associated neovasculature and might be stimulated by some tumor-secreted angiogenic factors. However, no previous study demonstrating PSMA expression in non-related tumor neovasculature, such as CNVM, has been performed to date. Furthermore, demonstration of PSMA expression in CNVM in AMD patients could reveal a novel target for antineovascular therapy. The purpose of this study was to evaluate the immunohistochemical expression of PSMA in CNVM from AMD. Methods Immunohistochemical analysis, with a standard avidin-biotin complex technique, was performed using an anti-PSMA mouse monoclonal antibody in 30 specimens of surgically excised CNVM from AMD patients. Antibody to an endothelial cell specific marker, factor VIII, was used to confirm the location of the endothelial cells. Results The angiogenic microvessels of the 30 cases demonstrated negative staining to PSMA while factor VIII was expressed in all cases. Seventy-five percent of the secretory-acinar epithelium of the prostatic hyperplasia specimen stained positive, confirming that the immunohistochemical technique was correctly performed. Conclusion The absence of PSMA expression in non-tumoral neovasculature supports the theory, previously suggested, that endothelial cell PSMA expression may be stimulated by one or more tumor-secreted angiogenic

  11. Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

    Science.gov (United States)

    Martinez-Serrano, Maria Guadalupe; Rodriguez-Reyes, Abelardo; Guerrero-Naranjo, Jose Luis; Salcedo-Villanueva, Guillermo; Fromow-Guerra, Jans; García-Aguirre, Gerardo; Morales-Canton, Virgilio; Velez-Montoya, Raul

    2017-01-01

    Background The following case series describes the long-term anatomical and functional outcome of a group of seven patients with choroidal neovascularization (CNV), secondary to angioid streaks (AS), who were treated with antiangiogenic drugs in a pro re nata (PRN) regimen. After the 4-year mark, visual acuity tends to return to pretreatment level. Treatment delays and lack of awareness and self-referral by the patients are believed to be the cause of the PRN regimen failure. Purpose To assess the long-term outcomes (>4 years) of patients with CNV due to AS treated with a PRN regimen of antiangiogenic. Methods This was a retrospective, case series, single-center study. We reviewed the electronic medical records from patients with CNV due to AS. From each record, we noted general demographic data and relevant medical history; clinical presentation, changes in best-corrected visual acuity (BCVA) over time, optical coherent tomography parameters, treatment and retreatment details, and systemic associations. Changes in BCVA and central macular thickness were assessed with a Wilcoxon two-sample test, with an alpha value of ≤0.05 for statistical significance. Results The mean follow-up time was 53.8±26.8 months. BCVA at baseline was: 1.001±0.62 logMAR; at the end of follow-up: 0.996±0.56 logMAR (P=0.9). Central macular thickness at baseline was: 360.85±173.82 μm; at the end of follow-up: 323.85±100.34 μm (P=0.6). Mean number of intravitreal angiogenic drugs: 6±4.16 injections (range 4–15). Mean time between injections was 3.8±2.7 months (range 1.9–5.8 months). Conclusion Despite initial anatomical and functional improvement, patients at the end of the follow-up had no visual improvement after a pro re nata regimen of antiangiogenic drugs. The amount of retreatments, number of recurrences, and time between intravitreal injections were similar to previous reports with shorter follow-up. PMID:28031699

  12. Evaluation of visual functional and morphology change in young patients with idiopathic choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    WANG Wen-qiu; WANG Feng-hua; SUN Xiao-dong; LIU Hai-yun; LU Feng-qing; HU Wei-ting; GONG Yuan-yuan; WU Ying; XU Shan; WANG Wei-jun; XU Xun

    2011-01-01

    Background Idiopathic choroidal neovascularization (ICNV) is an uncommon disorder affecting primarily individuals younger than the age of 50 years. In CNV patients, no apparent cause can be determined. This study aimed to evaluate the functional and morphological change of the retina with ICNV in young adults.Methods In this retrospective study, 32 eyes of 32 patients with subfoveal or juxta/extra foveal ICNV had been admitted into the Shanghai First People's Hospital from January 2009 to July 2010. The functional changes were evaluated using the best corrected visual acuity (BCVA) and the microperimetry in the macular area. The morphology changes were evaluated using optical coherence tomography (OCT), the color fundus photography and the fluorescein angiography.Results Seventeen patients with juxta/extra foveal and 15 subfoveal CNV were investigated. The mean logarithm of the minimum angle of resolution (LogMAR) BCVA was 0.39, the mean central retinal thickness (CRT) was 334 urn, and the mean sensitivity (MS) was 11.8 decibels (dB). In the subfoveal group, there was a strong correlation between CRT and BCVA (r=-0.675, F=2.167, P<0.01); as well as that between CRT and MS (r=-0.681, F=22.91, P<0.01). While in the juxta/extra foveal CNV group, the correlation of CRT and BCVA was not significant (r=-0.071, P=1.018, P >0.05); neither was the correlation of CRT and MS (r=-0.142, F=36.54, P>0.05). The microperimetry (MP-1) test revealed 17 (53%) patients with stable fixation, 9 (28%) with relatively unstable and 6 (19%) with unstable fixation. Fixation stability correlated positively with sensitivity in the central 2° diameter area (r=0.380, F=3.213, P <0.05) and the duration of symptoms (r=0.401, F=7.933, P<0.05).Conclusions ICNV was associated with reduced total MS, unstable fixation and eccentric fixation. These findings emphasized functional change in ICNV is beyond the BCVA and regular morphology change, which provided additional information of

  13. The anti-angiogenic role of discoidin domain receptor 2 (DDR2) in laser-induced choroidal neovascularization.

    Science.gov (United States)

    Zhu, Tong; Zhu, Jie; Bu, Xin; Zhao, Hu; Zhang, Shuya; Chang, Yuan; Li, Rong; Yao, Libo; Wang, Yusheng; Su, Jin

    2015-02-01

    Choroidal neovascularization (CNV), an aberrant growth of blood vessels in the choroid layer of the eye, is a major cause of vision loss. In view of our recent finding that discoidin domain receptor 2 (DDR2), a collagen-binding receptor tyrosine kinase, is involved in control of vascular endothelial activity and tumor angiogenesis, the present study aims to investigate whether and how DDR2 affects the pathogenesis of CNV. We initially found that a spontaneous DDR2 mutant mouse colony (slie) exhibited enhanced amplitude of laser-induced CNV. The inhibitory role of DDR2 in CNV development was further confirmed by experiments through intravitreous injection of DDR2 small interference RNA (siRNA) or DDR2-expressing adenovirus. Quantitative real-time polymerase chain reaction (qPCR) and immunoblot analysis showed that DDR2 regulates the expression of several major pro-angiogenic factors in the laser-injured choroid as well as in retinal pigment epithelium (RPE) cells. In addition, it was demonstrated that the CNV-induced increases in the phosphorylation levels of Akt and mTOR were affected by the upregulation or downregulation of DDR2. Thus, the data from this study for the first time revealed that DDR2 negatively regulates the development of experimental CNV in vivo, which may provide a novel target for preventing human pathological ocular neovascularization. Key messages: DDR2 does not affect retinal development. DDR2 inhibits laser-induced CNV. DDR2 regulates angiogenic factor expression in CNV lesion as well as in RPE cells. DDR2 is involved in modulation of CNV-induced activation of PI3K pathway.

  14. Simple, reliable and fast spectrofluorometric method for determination of plasma Verteporfin (Visudyne) levels during photodynamic therapy for choroidal neovascularization.

    Science.gov (United States)

    Aquaron, R; Forzano, O; Murati, J L; Fayet, G; Aquaron, C; Ridings, B

    2002-12-01

    Photodynamic therapy with Verteporfin, a potent photosensitizer dye, is a very effective treatment for age related macular degeneration due to choroidal neovascularization. Photodynamic therapy offers the potential for selective tissue injury in part attributable to preferential localization of Verteporfin, administrated by intravenous infusion, to the choroidal neovascularization complex and irradiation of the complex with non-laser thermal light at 690 nm resulting in at least temporary thrombosis and vessel closure. Verteporfin is a benzoporphyrin derivative monoacid ring A formulated as a unilamellar liposome. In the blood Verteporfin is associated with lipoprotein fractions and is rapidly cleared via a receptor-mediated uptake mechanism due the high expression of LDL receptors in neovascular tissues. Verteporfin was undetectable in plasma 24 hr after infusion of the recommended dose: 6 mg/m2 of body surface area. The main side effect is photosensitivity of skin which is usually short-lived (24-48 hr) with a low incidence (2.3%). As skin photosensitivity depends on circulating rather than tissue drug levels, we investigate the possibility of developing a simple, fast and reliable spectrofluorometric method to measure plasma Verteporfin levels. Fluorescence emission spectrum (550-750 nm) of 1:10 saline diluted plasma with lambda exc=430 nm showed a characteristic emission peak at 692 nm, the height being proportional to the Verteporfin levels. The sensitivity is around 100 ng/ml and the pharmacokinetics of Verteporfin has been studied from 0 to 5 hr after infusion in six patients older than 65 years with age-related macular degeneration.

  15. Anti-angiogenic effects of a mutant endostatin: a new prospect for treating retinal and choroidal neovascularization.

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    Yujing Bai

    Full Text Available Pathological fundus angiogenesis is a major cause of vision loss in retina diseases. Endostatin, a C-terminal fragment of collagen XVIII, is an endogenous anti-angiogenic protein. The present study aimed to investigate the in vitro and in vivo anti-angiogenic properties of two proteins: an N-terminal H1D/H3D mutant endostatin (M-ES and a polyethylene glycol propionaldehyde (PEG covalent M-ES (PEG-M-ES.M-ES and PEG-M-ES properties were characterized in vitro using a zinc ion binding assay and a stability test. Activity assays, including migration, proliferation, and tube formation assays, were performed with human retinal microvascular endothelial cells (HRMECs and human umbilical vein endothelial cells (HUVECs. Mouse oxygen-induced retinopathy (OIR and choroidal neovascularization (CNV models were used to evaluate in vivo anti-angiogenic effects. In addition, a rabbit model was used to study the retinal pharmacokinetic profile following an intravitreal injection.The results indicated that the H1D/H3D mutations of endostatin reduced the zinc binding capacity of M-ES and facilitated PEG covalent binding. PEG-M-ES was more stable and persisted longer in the retina compared with M-ES. The in vitro studies demonstrated that M-ES and PEG-M-ES inhibited HRMEC and HUVEC proliferation, migration, and tube formation more efficiently than ES. In vivo, a single intravitreal injection of M-ES and PEG-M-ES significantly decreased neovascularization in both the OIR and CNV animal models.The present study demonstrated for the first time that PEG-M-ES exhibits a long-term inhibitory effect on neovascularization in vitro and in vivo. These data suggest that PEG-M-ES may represent an innovative therapeutic strategy to prevent fundus neovascularization.

  16. IKK2 inhibition using TPCA-1-loaded PLGA microparticles attenuates laser-induced choroidal neovascularization and macrophage recruitment.

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    Subhash Gaddipati

    Full Text Available The inhibition of NF-κB by genetic deletion or pharmacological inhibition of IKK2 significantly reduces laser-induced choroid neovascularization (CNV. To achieve a sustained and controlled intraocular release of a selective and potent IKK2 inhibitor, 2-[(aminocarbonylamino]-5-(4-fluorophenyl-3-thiophenecarboxamide (TPCA-1 (MW: 279.29, we developed a biodegradable poly-lactide-co-glycolide (PLGA polymer-delivery system to further investigate the anti-neovascularization effects of IKK2 inhibition and in vivo biosafety using laser-induced CNV mouse model. The solvent-evaporation method produced spherical TPCA-1-loaded PLGA microparticles characterized with a mean diameter of 2.4 ¼m and loading efficiency of 80%. Retrobulbar administration of the TPCA-1-loaded PLGA microparticles maintained a sustained drug level in the retina during the study period. No detectable TPCA-1 level was observed in the untreated contralateral eye. The anti-CNV effect of retrobulbarly administrated TPCA-1-loaded PLGA microparticles was assessed by retinal fluorescein leakage and isolectin staining methods, showing significantly reduced CNV development on day 7 after laser injury. Macrophage infiltration into the laser lesion was attenuated as assayed by choroid/RPE flat-mount staining with anti-F4/80 antibody. Consistently, laser induced expressions of Vegfa and Ccl2 were inhibited by the TPCA-1-loaded PLGA treatment. This TPCA-1 delivery system did not cause any noticeable cellular or functional toxicity to the treated eyes as evaluated by histology and optokinetic reflex (OKR tests; and no systemic toxicity was observed. We conclude that retrobulbar injection of the small-molecule IKK2 inhibitor TPCA-1, delivered by biodegradable PLGA microparticles, can achieve a sustained and controllable drug release into choroid/retina and attenuate laser-induced CNV development without causing apparent systemic toxicity. Our results suggest a potential clinical application of

  17. Small laser spot versus standard laser spot photodynamic therapy for idiopathic choroidal neovascularization: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-xin; TAO Yong

    2012-01-01

    Backcround Idiopathic choroidal neovascularization (ICNV) affects young patients and thus may have a significant impact on vision and life quality over a patient's lifespan.This study was designed to compare the visual outcome and retinal pigment epithelium (RPE) damage after photodynamic therapy (PDT) with small laser spot and PDT with standard laser spot for idiopathic choroidal neovascularization (ICNV).Methods This was a randomized controlled study.Fifty-two patients with ICNV were enrolled and randomly divided into a study group (small laser spot PDT,n=27) and a control group (standard laser spot PDT,n=25).Best corrected visual acuity (BCVA),optic coherence tomography (OCT) and fluorescein angiography (FA) findings were the main measurements.The patients were followed up 1 week,1,3,6,9 months and 1 year after PDT.Results BCVA improvement was statistically significantly higher in the study group than the control group at 6-month ((25.53±15.01) letters vs.(14.71±11.66) letters,P=0.025) and 9-month follow-ups ((27.53±17.78) letters vs.(15.59±12.21) letters,P=0.039).At 3-and 6-month follow-ups,the quadrants of RPE damage between the two groups varied significantly (P <0.001 and P=0.023,respectively).In each follow-up,the number of cases with decreased or unchanged leakage of choroidal neovascularization by FA and reduced subretinal fluid by OCT did not vary significantly between the two groups.Ten cases (37.0%) in the study group and eight cases (32.0%) in the control group suffered from recurrent CNV (P=0.703).Conclusions Better visual improvements,less RPE damage,a similar recurrent rate of CNV and change of subretinal fluid were observed in the small laser spot PDT group than in the standard laser spot PDT group for ICNV.

  18. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration

    DEFF Research Database (Denmark)

    Larsen, Michael; Schmidt-Erfurth, Ursula; Lanzetta, Paolo;

    2012-01-01

    To compare the efficacy and safety of same-day verteporfin photodynamic therapy (PDT) and intravitreal ranibizumab combination treatment versus ranibizumab monotherapy in neovascular age-related macular degeneration....

  19. Pneumatic displacement and intravitreal bevacizumab: A new approach for management of submacular hemorrhage in choroidal neovascular membrane

    Directory of Open Access Journals (Sweden)

    Chawla Shobhit

    2009-01-01

    Full Text Available Choroidal neovascular membrane (CNVM is one of the most common causes of submacular hemorrhage (SMH. Conventional treatment involves management of the SMH with pneumatic displacement with or without tissue plasminogen activator (TPA followed by intravitreal injection of bevacizumab in a second sitting. We decided to assess the efficacy of treating SMH secondary to CNVM with pneumatic displacement using sulphur hexafluoride (SF6 gas and intravitreal bevacizumab. Four patients with SMH secondary to CNVM were included in this study. Intravitreal bevacizumab, 0.05 ml, along with 0.5 ml of SF6 was injected through the pars plana into the vitreous cavity. Postoperative best corrected visual acuity improved in all eyes with complete or partial displacement of SMH out of the foveal area.

  20. Topical ocular delivery to laser-induced choroidal neovascularization by dual internalizing RGD and TAT peptide-modified nanoparticles

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    Chu YC

    2017-02-01

    Full Text Available Yongchao Chu,1,* Ning Chen,2,* Huajun Yu,2,* Hongjie Mu,1 Bin He,1 Hongchen Hua,1 Aiping Wang,1 Kaoxiang Sun1 1School of Pharmacy, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Yantai University, Yantai, Shandong, People’s Republic of China; 2Department of Ophthalmology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People’s Republic of China *These authors contributed equally to this work Abstract: A nanoparticle (NP was developed to target choroidal neovascularization (CNV via topical ocular administration. The NPs were prepared through conjugation of internalizing arginine-glycine-aspartic acid RGD (iRGD; Ac-CCRGDKGPDC and transactivated transcription (TAT (RKKRRQRRRC peptide to polymerized ethylene glycol and lactic-co-glycolic acid. The iRGD sequence can specifically bind with integrin αvβ3, while TAT facilitates penetration through the ocular barrier. 1H nuclear magnetic resonance and high-performance liquid chromatography demonstrated that up to 80% of iRGD and TAT were conjugated to poly(ethylene glycol–poly(lactic-co-glycolic acid. The resulting particle size was 67.0±1.7 nm, and the zeta potential of the particles was −6.63±0.43 mV. The corneal permeation of iRGD and TAT NPs increased by 5.50- and 4.56-fold compared to that of bare and iRGD-modified NPs, respectively. Cellular uptake showed that the red fluorescence intensity of iRGD and TAT NPs was highest among primary NPs and iRGD- or TAT-modified NPs. CNV was fully formed 14 days after photocoagulation in Brown Norway (BN rats as shown by optical coherence tomography and fundus fluorescein angiography analyses. Choroidal flat mounts in BN rats showed that the red fluorescence intensity of NPs followed the order of iRGD and TAT NPs > TAT-modified NPs > iRGD-modified NPs

  1. Correlation of In Vivo and In Vitro Methods in Measuring Choroidal Vascularization Volumes Using a Subretinal Injection Induced Choroidal Neovascularization Model

    Institute of Scientific and Technical Information of China (English)

    Chuang Nie; Mao-Nian Zhang; Hong-Wei Zhao; Thomas D Olsen; Kyle Jackman; Lian-Na Hu; Wen-Ping Ma

    2015-01-01

    Background:In vivo quantification of choroidal neovascularization (CNV) based on noninvasive optical coherence tomography (OCT) examination and in vitro choroidal flatmount immunohistochemistry stained of CNV currently were used to evaluate the process and severity of age-related macular degeneration (AMD) both in human and animal studies.This study aimed to investigate the correlation between these two methods in murine CNV models induced by subretinal injection.Methods:CNV was developed in 20 C57BL6/j mice by subretinal injection of adeno-associated viral delivery of a short hairpin RNA targeting sFLT-1 (AAV.shRNA.sFLT-1),as reported previously.After 4 weeks,CNV was imaged by OCT and fluorescence angiography.The scaling factors for each dimension,x,y,and z (μm/pixel) were recorded,and the corneal curvature standard was adjusted from human (7.7) to mice (1.4).The volume of each OCT image stack was calculated and then normalized by multiplying the number of voxels by the scaling factors for each dimension in Seg3D software (University of Utah Scientific Computing and Imaging Institute,available at http://www.sci.utah.edu/cibc-software/seg3d.html).Eighteen mice were prepared for choroidal flatmounts and stained by CD31.The CNV volumes were calculated using scanning laser confocal microscopy after immunohistochemistry staining.Two mice were stained by Hematoxylin and Eosin for observing the CNV morphology.Results:The CNV volume calculated using OCT was,on average,2.6 times larger than the volume calculated using the laser confocal microscopy.The correlation statistical analysis showed OCT measuring of CNV correlated significantly with the in vitro method (R2 =0.448,P=0.001,n =18).The correlation coefficient for CNV quantification using OCT and confocal microscopy was 0.693 (n =18,P =0.001).Conclusions:There is a fair linear correlation on CNV volumes between in vivo and in vitro methods in CNV models induced by subretinal injection.The result might provide a useful

  2. Correlation of In Vivo and In Vitro Methods in Measuring Choroidal Vascularization Volumes Using a Subretinal Injection Induced Choroidal Neovascularization Model

    Directory of Open Access Journals (Sweden)

    Chuang Nie

    2015-01-01

    Full Text Available Background: In vivo quantification of choroidal neovascularization (CNV based on noninvasive optical coherence tomography (OCT examination and in vitro choroidal flatmount immunohistochemistry stained of CNV currently were used to evaluate the process and severity of age-related macular degeneration (AMD both in human and animal studies. This study aimed to investigate the correlation between these two methods in murine CNV models induced by subretinal injection. Methods: CNV was developed in 20 C57BL6/j mice by subretinal injection of adeno-associated viral delivery of a short hairpin RNA targeting sFLT-1 (AAV.shRNA.sFLT-1, as reported previously. After 4 weeks, CNV was imaged by OCT and fluorescence angiography. The scaling factors for each dimension, x, y, and z (μm/pixel were recorded, and the corneal curvature standard was adjusted from human (7.7 to mice (1.4. The volume of each OCT image stack was calculated and then normalized by multiplying the number of voxels by the scaling factors for each dimension in Seg3D software (University of Utah Scientific Computing and Imaging Institute, available at http://www.sci.utah.edu/cibc-software/seg3d.html. Eighteen mice were prepared for choroidal flatmounts and stained by CD31. The CNV volumes were calculated using scanning laser confocal microscopy after immunohistochemistry staining. Two mice were stained by Hematoxylin and Eosin for observing the CNV morphology. Results: The CNV volume calculated using OCT was, on average, 2.6 times larger than the volume calculated using the laser confocal microscopy. The correlation statistical analysis showed OCT measuring of CNV correlated significantly with the in vitro method (R 2 =0.448, P = 0.001, n = 18. The correlation coefficient for CNV quantification using OCT and confocal microscopy was 0.693 (n = 18, P = 0.001. Conclusions: There is a fair linear correlation on CNV volumes between in vivo and in vitro methods in CNV models induced by subretinal

  3. Combination treatment of low fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane secondary to angioid streaks in Paget′s disease - 12 month results

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    Varsha V Prabhu

    2011-01-01

    Full Text Available Angioid streaks also called Knapp striae are small breaks in the Bruch′s membrane and have been reported with a host of systemic diseases. Rupture of streaks or development of secondary choroidal neovascular membrane (CNVM carries a dismal visual prognosis. We report the successful treatment of CNVM secondary to Paget′s disease using low fluence photodynamic therapy (PDT and intravitreal ranibizumab.

  4. Correlation of CD105 and Vascular Endothelial Growth Factor in Laser-induced Choroidal Neovascularization in Rats

    Institute of Scientific and Technical Information of China (English)

    Jianfeng Xu; Yusheng Wang; Xiumei Yang; Peng Zhang; Lijun Chen

    2006-01-01

    Purpose: Choroidal neovascularization (CNV) plays an important role in pathogenesis of age-related macular degeneration (AMD), ocular histoplasmosis syndrome (OHS) and so on. However, mechanisms of CNV formation are not fully understood. The aim of this study is to investigate the correlation between expressions of CD105 and vascular endothelial growth factor (VEGF) in experimental laserinduced CNV in rats.Methods: CNV model was established by 532 nm laser photocoagulation in BrownNorway rats. The expression of CD105 and VEGF in CNV was observed by immunohistochemistry at 3, 7, 14, 21, 28 and 56 days after laser photocoagulation.The image analysis was performed with the professional software of Image-Pro Plus.Results: Fluorescein angiography showed fluorescein leakage in CNV from days 7 to 56 after photocoagulation. VEGF expression was mainly observed in vascular endothelial cells, ganglion cells, inner nuclear layers and retinal pigment epithelial cells in normal retina and vascular endothelial cells in normal choroid of the rats. On day 3 after photocoagulation, VEGF began to express in laser-induced lesions. VEGF was strongly expressed in CNV after 7 days (P<0.05) and decreased after 14 days (P>0.05). CD105 was initially presented in CNV at 7 days and obviously expressed at 14 days after photocoagulation (P<0.05). Four weeks later, when angiogenesis tended toward inactive status, expression of CD 105 was markedly decreased (P>0.05).There was notablely direct correlation between CD105-positive-microvessel density and positively semiquantitative scoring of VEGF in the CNV(r=0.989, P<0.01).Conclusions: There is direct correlation between the expression of CD105 and VEGF in the laser-induced CNV in rat. It suggests that CD105 and VEGF might participate in the new blood vessel formation and promote the growth of CNV.

  5. Topical ocular delivery to laser-induced choroidal neovascularization by dual internalizing RGD and TAT peptide-modified nanoparticles

    Science.gov (United States)

    Chu, Yongchao; Chen, Ning; Yu, Huajun; Mu, Hongjie; He, Bin; Hua, Hongchen; Wang, Aiping; Sun, Kaoxiang

    2017-01-01

    A nanoparticle (NP) was developed to target choroidal neovascularization (CNV) via topical ocular administration. The NPs were prepared through conjugation of internalizing arginine-glycine-aspartic acid RGD (iRGD; Ac-CCRGDKGPDC) and transactivated transcription (TAT) (RKKRRQRRRC) peptide to polymerized ethylene glycol and lactic-co-glycolic acid. The iRGD sequence can specifically bind with integrin αvβ3, while TAT facilitates penetration through the ocular barrier. 1H nuclear magnetic resonance and high-performance liquid chromatography demonstrated that up to 80% of iRGD and TAT were conjugated to poly(ethylene glycol)– poly(lactic-co-glycolic acid). The resulting particle size was 67.0±1.7 nm, and the zeta potential of the particles was −6.63±0.43 mV. The corneal permeation of iRGD and TAT NPs increased by 5.50- and 4.56-fold compared to that of bare and iRGD-modified NPs, respectively. Cellular uptake showed that the red fluorescence intensity of iRGD and TAT NPs was highest among primary NPs and iRGD- or TAT-modified NPs. CNV was fully formed 14 days after photocoagulation in Brown Norway (BN) rats as shown by optical coherence tomography and fundus fluorescein angiography analyses. Choroidal flat mounts in BN rats showed that the red fluorescence intensity of NPs followed the order of iRGD and TAT NPs > TAT-modified NPs > iRGD-modified NPs > primary NPs. iRGD and TAT dual-modified NPs thus displayed significant targeting and penetration ability both in vitro and in vivo, indicating that it is a promising drug delivery system for managing CNV via topical ocular administration. PMID:28260884

  6. Topical application of PPADS inhibits complement activation and choroidal neovascularization in a model of age-related macular degeneration.

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    Kerstin Birke

    Full Text Available Age-related macular degeneration (AMD is the most common cause of blindness among the elderly. AMD patients have elevated levels of membrane attack complex (MAC in their choroidal blood vessels and retinal pigment epithelium (RPE. MAC forms pores in cell membranes. Low levels of MAC result in an elevation of cytokine release such as vascular endothelial growth factor (VEGF that promotes the formation of choroidal neovascularization (CNV. High levels of MAC result in cell lysis and RPE degeneration is a hallmark of advanced AMD. The current standard of care for CNV associated with wet AMD is intravitreal injection of anti-VEGF molecules every 4 to 12 weeks. Such injections have significant side effects. Recently, it has been found that membrane pore-forming proteins such as α-haemolysin can mediate their toxic effects through auto- and paracrine signaling and that complement-induced lysis is amplified through ATP release followed by P2X receptor activation. We hypothesized that attenuation of P2X receptor activation may lead to a reduction in MAC deposition and consequent formation of CNV. Hence, in this study we investigated topical application of the purinergic P2X antagonist Pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS as a potential treatment for AMD. We found that 4.17 µM PPADS inhibited formation of HUVEC master junctions and master segments by 74.7%. In a human complement mediated cell lysis assay, 104 µM PPADS enabled almost complete protection of Hepa1c1c7 cells from 1% normal human serum mediated cell lysis. Daily topical application of 4.17 mM PPADS for 3 days attenuated the progression of laser induced CNV in mice by 41.8% and attenuated the deposition of MAC at the site of the laser injury by 19.7%. Our data have implications for the future treatment of AMD and potentially other ocular disorders involving CNV such as angioid streaks, choroidal rupture and high myopia.

  7. EXPRESSION OF PEDF mRNA AND PROTEIN IN NORMAL MOUSE RETINA AND EXPERIMENTAL CHOROIDAL NEO-VASCULARIZATION TISSUES

    Institute of Scientific and Technical Information of China (English)

    张雷; 王康孙; 王玲; 张士胜; 石海云

    2004-01-01

    Objective To study the expression of pigment epithelium derived factor ( PEDF) in normal mouse retina and experimental choroidal neovascularization (CNV) tissues. Methods CNV mouse models were induced by diode laser. The expression of PEDF mRNA and protein in normal mouse retina and CNV tissues were detected by in situ hybridization and immunohistochemical study. Results In normal mouse retina,PEDF mRNA was observed in the ganglion cell layer, inner nuclear layer and RPE cell layer, and PEDF protein was observed mainly in the nerve fiber layer, ganglion cell layer, photoreceptor cell layer and RPE cell layer, and lower level expression of PEDF protein was also observed in the inner plexiform layer and outer plexiform layer. In CNV tissues,the expression of PEDF mRNA and protein was also observed. 3d and 1 week after photocoagulation, the expression level of PEDF was relatively lower, and increased following the development of CNV. The level was the highest 2 weeks after photocoagulation, then decreased at 3 weeks. Conclusion PEDF was expressed in different layers of retina and was obviously expressed in the CNV tissues induced by laser photocoagulation. These findings suggest that PEDF may participate and modulate the development of CNV.

  8. Photodynamic monotherapy or combination treatment with intravitreal triamcinolone acetonide, bevacizumab or ranibizumab for choroidal neovascularization associated with pathological myopia

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    Pukhraj Rishi

    2011-01-01

    Full Text Available This retrospective, interventional case series analyses treatment outcomes in eyes with choroidal neovascularization (CNV secondary to pathological myopia, managed with photodynamic therapy, (PDT, (Group 1, N = 11, PDT and intravitreal triamcinolone acetonide (4 mg/0.1ml (Group 2, N = 3, PDT and intravitreal anti-vascular endothelial growth factor (anti-VEGF bevacizumab 1.25 mg/0.05 ml, ranibizumab 0.5 mg/0.05 ml and reduced-fluence PDT and intravitreal ranibizumab 0.5 mg/0.05 ml (Group 3, N=12. All the patients underwent PDT. Intravitreal injections were repeated as required. SPSS 14 software was used to evaluate the data. Wilcoxon signed ranks test was used to evaluate pre- and post-treatment vision. The Kruskal-Wallis test was used for comparison between the groups. All the groups were statistically comparable. All the eyes showed complete regression of CNV, with a minimum follow-up of six months. All groups had visual improvement; significantly in Group 3 ( p = 0.003. Combination PDT with anti-VEGF agents appeared to be efficacious in eyes with myopic CNV. However, a larger study with a longer follow-up is required to validate these results.

  9. Different treatment modalities for choroidal neovascularization in two eyes of one patient with bilateral type 2A parafoveal telangiectasia

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    Vivek Dave

    2013-01-01

    Full Text Available A 60-year-old diabetic man presented with a history of decrease in vision in both eyes since 2 weeks. At presentation, best corrected visual acuity (BCVA in the right eye (RE was 20/30 and that in the left eye (LE was 20/80. The right fundus revealed a grayish reflex, yellowish crystalline deposits and retinal pigment epithelial hyperplasia at the macula. The left fundus showed subretinal fluid and temporal subretinal hemorrhage near a grayish reflex at the macula. A diagnosis in both eyes of idiopathic macular telangiectasia (IMT type 2A with RE stage 4 and LE stage 5, choroidal neovascularization (CNVM was made. The patient was treated with photodynamic therapy (PDT in LE. The visual acuity improved to 20/40 over the next 6 months. At a 4-year follow-up, he developed decreased vision in RE diagnosed as IMT with CNV and was treated with intravitreal ranibizumab. At 6-month follow-up post injection, the vision was 20/40p.

  10. Transpupillary thermotherapy for choroidal neovascular membrane in age related macular degeneration

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    Agarwal Manisha

    2004-01-01

    Full Text Available Purpose: To evaluate the efficacy of transpupillary thermotherapy (TTT in choroidal neovasularisation (CNVM secondary to age related macular degeneration ( AMD. Material and methods: Retrospective, non-randomized study of 28 eyes of 28 patients with subfoveal CNVM (classic, occult or mixed secondary to AMD. Results: Fifteen patients (53.57% maintained their pre-treatment vision, 2 (7.14% patients showed improvement of more than 2 lines and 11(39.28% patients showed deterioration of vision by> 2 lines. Angiographic and clinical regression of CNVM was noted in 19 patients (67.8% on an average follow up of 15.32 ± 3.31 months. Conclusion: TTT leads to stabilisation of vision in 60% of treated eyes with CNVM due to AMD.

  11. A Quantitative and Standardized Method for the Evaluation of Choroidal Neovascularization Using MICRON III Fluorescein Angiograms in Rats.

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    Jonathan P Wigg

    Full Text Available In-vivo imaging of choroidal neovascularization (CNV has been increasingly recognized as a valuable tool in the investigation of age-related macular degeneration (AMD in both clinical and basic research applications. Arguably the most widely utilised model replicating AMD is laser generated CNV by rupture of Bruch's membrane in rodents. Heretofore CNV evaluation via in-vivo imaging techniques has been hamstrung by a lack of appropriate rodent fundus camera and a non-standardised analysis method. The aim of this study was to establish a simple, quantifiable method of fluorescein fundus angiogram (FFA image analysis for CNV lesions.Laser was applied to 32 Brown Norway Rats; FFA images were taken using a rodent specific fundus camera (Micron III, Phoenix Laboratories over 3 weeks and compared to conventional ex-vivo CNV assessment. FFA images acquired with fluorescein administered by intraperitoneal injection and intravenous injection were compared and shown to greatly influence lesion properties. Utilising commonly used software packages, FFA images were assessed for CNV and chorioretinal burns lesion area by manually outlining the maximum border of each lesion and normalising against the optic nerve head. Net fluorescence above background and derived value of area corrected lesion intensity were calculated.CNV lesions of rats treated with anti-VEGF antibody were significantly smaller in normalised lesion area (p < 0.001 and fluorescent intensity (p < 0.001 than the PBS treated control two weeks post laser. The calculated area corrected lesion intensity was significantly smaller (p < 0.001 in anti-VEGF treated animals at 2 and 3 weeks post laser. The results obtained using FFA correlated with, and were confirmed by conventional lesion area measurements from isolectin stained choroidal flatmounts, where lesions of anti-VEGF treated rats were significantly smaller at 2 weeks (p = 0.049 and 3 weeks (p < 0.001 post laser.The presented method of in

  12. CD105与脉络膜新生血管%CD105 and choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    徐建锋; 王雨生

    2008-01-01

    CD105(endoglin)为一种同型二聚体的膜结合性糖蛋白,是转化生长因子-β(transforming growth factor, TGF-β)受体超家族的成员之一.它参与TGF-β受体的信号转导,调节细胞对TGF-β的反应,在新生血管组织及肿瘤组织边缘部分血管起源的内皮细胞中高度表达,是新生血管的标志物之一.脉络膜新生血管(choroidal neovascularization, CNV)的生成是年龄相关性黄斑变性(age-related macular degeneration, AMD)、眼拟组织胞浆菌病综合征(presumed ocular histoplasmosis syndrome, POHS)和病理性近视黄斑变性等CNV相关疾病的的主要病理特征.近年研究表明,CD105与CNV密切相关,可能成为治疗CNV重要的靶分子之一.

  13. Choroidal neovascularization associated with sympathetic ophthalmia: case report Neovascularização coroidiana associada à oftalmia simpática: relato de caso

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    Raul Nunes Galvarro Vianna

    2005-06-01

    Full Text Available A 7-year-old boy with sympathetic ophthalmia secondary to penetrating ocular trauma developed choroidal neovascularization in the macular region of the sympathizing eye. Posterior segment biomicroscopy disclosed a single, round, small, slightly elevated yellow-white lesion temporal to the fovea, linked to the temporal edge of the optic disc by a fibrotic band. On fluorescein angiography the round lesion showed a gradual hyperfluorescence, with late staining and leakage, and was interpreted as a fibrovascular scar from previous choroidal neovascularization. Despite intense immunosuppressive therapy, the patient's final visual acuity was 20/400. Although rarely associated with sympathetic ophthalmia, choroidal neovascularization and its cicatricial stages can occur and compromise the visual prognosis of an already debilitated eye. The best course of treatment for choroidal neovascularization in these types of cases has not yet been determined.Paciente com oftalmia simpática (OS desenvolveu neovascularização coroidiana (NVC na região macular do olho simpatizado. A biomicroscopia do segmento posterior do olho afetado revelou uma pequena lesão branco-amarelada, discretamente elevada, localizada na região temporal à fóvea. Uma banda fibrosa ligava o disco óptico à lesão foveal. À angiografia fluoresceínica, a lesão revelou hiperfluorescência progressiva, com impregnação e extravazamento tardio do corante, achados esses característicos de uma cicatriz fibrovascular. Apesar de intenso tratamento com medicação imunossupressora, a acuidade visual final do paciente foi de 20/400. Embora raramente associada à oftalmia simpática a neovascularização coroidiana pode ocorrer e comprometer o prognóstico visual de um olho já debilitado. A melhor opção para o tratamento da neovascularização coroidiana em casos de oftalmia simpática ainda não está determinada.

  14. Influence of Dll4 via HIF-1α-VEGF signaling on the angiogenesis of choroidal neovascularization under hypoxic conditions.

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    Xiao Dong

    Full Text Available Choroidal neovascularization (CNV is the common pathological basis of irreversible visual impairment encountered in a variety of chorioretinal diseases; the pathogenesis of its development is complicated and still imperfectly understood. Recent studies indicated that delta-like ligand 4 (Dll4, one of the Notch family ligands might participate in the HIF-1α-VEGF pathway to regulate CNV angiogenesis. But little is known about the influence and potential mechanism of Dll4/Notch signals on CNV angiogenesis. Real-time RT-PCR, Western blotting were used to analyze the expression alteration of Dll4, VEGF and HIF-1α in hypoxic RF/6A cells. Immunofluorescence staining, a laser-induced rat CNV model and intravitreal injection techniques were used to confirm the relationships among these molecules in vitro and in vivo. RPE-RF/6A cell co-culture systems were used to investigate the effects of Dll4/Notch signals on CNV angiogenesis. We found that the Dll4 was involved in hypoxia signaling in CNV angiogenesis. Results from the co-culture system showed that the enhancement of Dll4 expression in RF/6A cells led to the significantly faster proliferation and stronger tube forming ability, but inhibited cells migration and invasion across a monolayer of RPE cells in hypoxic environment, while siRNA-mediated Dll4 silencing caused the opposite effects. Pharmacological disruption of Notch signaling using gamma-secretase inhibitor (GSI produced similar, but not identical effects, to that caused by the Dll4 siRNA. In addition, the expression of several key molecules involved in the angiogenesis of CNV was altered in RF/6A cells showing constitutively active Dll4 expression. These results suggest that Dll4 play an important role in CNV angiogenesis, which appears to be regulated by HIF-1α and VEGF during the progression of CNV under hypoxic conditions. Targeting Dll4/Notch signaling may facilitate further understanding of the mechanisms that underlie CNV angiogenesis.

  15. Ultrasound-mediated microbubble delivery of pigment epithelium-derived factor gene into retina inhibits choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    ZHOU Xi-yuan; LIAO Qing; PU Yi-min; TANG Yong-qiang; GONG Xiao; LI Jia; XU Yan; WANG Zhi-gang

    2009-01-01

    Background Many studies have suggested that the imbalance of angiogenic factor and anti-angiogenic factor expression contributes significantly to the development of choroidal neovascularization (CNV), and ultrasound microbubble combination system can increase the gene transfection efficiency successfully. This study was designed to investigate whether ultrasound-mediated microbubble destruction could effectively deliver therapeutic plasmid into the retina of rat, and whether gene transfer of pigment epithelium-derived factor (PEDF) could inhibit CNV.Methods Human retinal pigment epithelial cells were isolated and treated either with ultrasound or plasmid alone, or with a combination of plasmid, ultrasound and microbubbles to approach feasibility of microbubble-enhanced ultrasound enhance PEDFgene expression; For in vivo animal studies, CNV was induced by argon lasgon laser in rats. These rats were randomly assigned to five groups and were treated by infusing microbubbles attached with the naked plasmid DNA of PEDF into the vitreous of rats followed by immediate ultrasound exposure (intravitreal injection); infusing liposomes with the naked plasmid DNA of PEDF into the vitreous (lipofectamine + PEDF); infusing microbubbles attached with PEDF into the orbit of rats with ultrasound irradiation immediately (retrobular injection); infusing microbubbles attached with PEDF into the femoral vein of rats with exposed to ultrasound immediately (vein injection). The CNV rats without any treatment served as control. Rats were sacrificed and eyes were enucleated at 7, 14, and 28 days after treatment. Gene and protein expression of PEDF was detected by quantitative real-time RT-PCR, Western blotting and immunofluorescence staining, respectively. The effect of PEDF gene transfer on CNV was examined by fluorescein fundus angiography.Results In vitro cell experiments showed that microbubbles with ultrasound irradiation could significantly enhance PEDF delivery as compared with

  16. Intravitreal Ranibizumab for Subfoveal Choroidal Neovascularization from Age-Related Macular Degeneration with Combined Severe Diabetic Retinopathy

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    So Young Han

    2015-02-01

    Full Text Available BackgroundTo evaluate the efficacy of intravitreal ranibizumab for subfoveal choroidal neovascularization (CNV from age-related macular degeneration (AMD with combined severe diabetic retinopathy (DR.MethodsThis retrospective, interventional case series included eleven patients (mean age, 70.09 years; range, 54 to 83 years with at least severe non-proliferative DR and subfoveal CNV secondary to AMD. Each subject was treated with intravitreal injections of 0.5 mg ranibizumab. The primary outcomes included change in best-corrected visual acuity and central subfield thickness (CST on optical coherence tomography (OCT.ResultsThe mean follow-up time was 16.7±14 months (range, 6 to 31 months. Mean visual acuity improved from 1.21±0.80 logarithm of the minimum angle of resolution (logMAR to 1.0±0.6 logMAR (P=0.107, 0.95±0.62 logMAR (P=0.044, 1.10±0.68 logMAR (P=0.296, and 1.13±0.66 logMAR (P=0.838 at 1, 3, 6, and 12 months after injection, respectively. Eight patients (72.7% gained or maintained vision (mean 0.32 logMAR, whereas three patients (27.3% lost more than one line of vision (mean 0.51 logMAR. The mean OCT CST was 343.9±134.6 µm at baseline, and the mean CST at 1, 3, 6, 12 months after the injection was 367.8±172.1 (P=0.864, 346.2±246.2 (P=0.857, 342±194.1 (P=0.551, and 294.2±108.3 µm (P=0.621, respectively.ConclusionIntravitreal ranibizumab injection can be considered to be a therapy for the stabilization of subfoveal CNV secondary to AMD with combined severe DR. However, these patients might exhibit limited visual improvement after treatment.

  17. Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration

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    M Naseripour

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF, no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy (TTT with subtenon triamcinolone acetonide (TA injection in treatment of choroidal neovascularization (CNV in patients with ARMD. Materials & Methods: In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration (ARMD were studied. All CNVs (including 20 predominantly classic and 43 predominantly occult lesions were treated with diode laser (810nm. In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months (ranging from 5.5 to 16 months. The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months (4.5 to 23 months. Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination.collected data were analyzed by one-sample and paired –sample T test, using SPSS software. Results: At the end of the study in first group, visual acuity remained stable (0 to ± one line in 14 out of 20 (70 % of eyes, improved (> one line in 2 of 20 (10 % eyes and showed a

  18. Choroidal Neovascular Membrane Formation and Retinochoroidopathy in a Patient with Systemic Langerhans Cell Histiocytosis: A Case Report and Review of the Literature

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    Aristomenis Thanos

    2012-04-01

    Full Text Available We report a case of bilateral atrophic retinochoroidopathy with choroidal neovascular membrane (CNVM formation in a patient with systemic Langerhans cell histiocytosis (LCH. A 35-year-old female, diagnosed with LCH at the age of 3, experienced an episode of acute vision loss in her right eye. Visual acuity was counting fingers. Dilated fundus exam and fluorescein angiography revealed the presence of CNVM along with bilateral widespread areas of chorioretinal atrophy. The patient underwent removal of CNVM with excellent postoperative visual acuity (20/25; however, indolent progression of her disease led to gradual deterioration of visual acuity (20/80 in the right eye and 20/320 in the left. This case shows that in contrast to previous reports, intraocular involvement of LCH does not need to be dramatic and clinically evident but it can acquire a chronic degenerative form. This report aims to raise awareness among ophthalmologists concerning the potential intraocular sequelae of LCH.

  19. 经瞳孔温热疗法治疗脉络膜新生血管%Transpupillary thermotherapy of choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    高玲; 胡蓉; 唐罗生; 朱小华; 唐朝珍; 王涛

    2005-01-01

    目的初步观察TTT激光治疗脉络膜新生血管的疗效.方法23例24眼CNV行TTT(transpupillary thermotherapy,TTT)治疗,根据CNV(choroidal neovascularization,CNV)的大小选择不同的光斑大小和能量,照射时间为1分钟.结果24眼CNV经TTT治疗后,大部分患者黄斑出血、渗出、水肿减轻或吸收,FFA显示大多数CNV渗漏减少或停止,原CNV瘢痕化,但视力无明显提高.结论TTT治疗脉络膜新生血管有效,但还需要更多的病例来评价治疗效果.

  20. Topical application of a G-Quartet aptamer targeting nucleolin attenuates choroidal neovascularization in a model of age-related macular degeneration.

    Science.gov (United States)

    Leaderer, Derek; Cashman, Siobhan M; Kumar-Singh, Rajendra

    2015-11-01

    Choroidal neovascularization (CNV) associated with the 'wet' form of age related macular degeneration (AMD) is one of the most common causes of central vision loss among the elderly. The 'wet' form of AMD is currently treated by intravitreal delivery of anti-VEGF agents. However, intravitreal injections are associated with complications and long-term inhibition of VEGF leads to macular atrophy. Thus, there is currently an unmet need for the development of therapies for CNV that target molecules other than VEGF. Here, we describe nucleolin as a novel target for the 'wet' form of AMD. Nucleolin was found on the surface of endothelial cells that migrate from the choroid into the subretinal space in the laser-induced model of 'wet' AMD. AS1411 is a previously described G-quartet oligonucleotide that has been shown to bind nucleolin. We found that AS1411 inhibited the formation of tubes by human umbilical vein endothelial cells (HUVECs) by approximately 27.4% in vitro. AS1411 co-localized with the site of laser induced CNV in vivo. Intravitreally injected AS1411 inhibited laser-induced CNV by 37.6% and attenuated infiltration of macrophages by 40.3%. Finally, topical application of AS1411 led to a 43.4% reduction in CNV. Our observations have potential implications for the development of therapies for CNV and specifically for the 'wet' form of AMD.

  1. The Sustained Delivery of Resveratrol or a Defined Grape Powder Inhibits New Blood Vessel Formation in a Mouse Model of Choroidal Neovascularization

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    Mozhgan Rezaie Kanavi

    2014-10-01

    Full Text Available The objective of this study was to determine whether resveratrol or a defined, reconstituted grape powder can attenuate the formation of new blood vessels in a mouse model of choroidal neovascularization (CNV. To accomplish this objective, C57BL/6J mice were randomized into control or treatment groups which received either resveratrol or grape powder by daily oral gavage, resveratrol or grape powder delivered ad libitum through the drinking water, or resveratrol by slow release via implanted osmotic pumps. A laser was used to rupture Bruch’s membrane to induce CNV which was then detected in sclerochoroidal eyecups stained with antibodies against intercellular adhesion molecule-2. CNV area was measured using fluorescence microscopy and Image J software. Ad libitum delivery of both resveratrol and grape powder was shown to significantly reduce the extent of CNV by 68% and 57%, respectively. Parallel experiments conducted in vitro demonstrated that resveratrol activates p53 and inactivates Akt/protein kinase B in choroidal endothelial cells, contributing to its anti-proliferative and anti-migratory properties. In addition resveratrol was shown to inhibit the formation of endothelial cell networks, augmenting its overall anti-angiogenic effects. The non-toxic nature of resveratrol makes it an especially attractive candidate for the prevention and/or treatment of CNV.

  2. 丙烯醛诱导大鼠脉络膜新生血管的形成%The formation of rats’ choroidal neovascularization induced by acrolein

    Institute of Scientific and Technical Information of China (English)

    王观峰; 邹秀兰; 李东豪; 王琛; 李文立; 皮荣标

    2016-01-01

    目的::探讨丙烯醛( AC)诱导大鼠脉络膜新生血管( CNV)的形成。方法:选取远交群大鼠( SD)12只,随机将大鼠分为三组,即空白组,AC诱导4wk组和AC诱导8wk组,其中空白对照组每日200μL新鲜自来水灌胃,实验组为200μL AC溶液(2.5 mg/kg/d)每日灌胃,分为诱导4wk组和8wk组,取材后视网膜组织石蜡包埋,切片及HE染色。结果:空白对照组及AC诱导4 wk组均见RPE-Bruch膜连续性完整,未见明显异常;AC 诱导8 wk 组发现 RPE-Bruch膜连续性缺失,脉络膜新生血管长入视网膜神经上皮层内。结论:长期使用AC可以诱导大鼠脉络膜新生血管形成。%AlM:To investigate the formation of rats′ choroidal neovascularization ( CNV) induced by acrolein.METHODS:Twelve Sprague-Dawley rats were randomly divided into three groups. Acrolein 200μL (2. 5 mg/kg/d) was poured into the rats′stomach for 4wk as acrolein 4wk and for 8wk as acrolein 8wk group. The same volume of fresh water was also done to the rats as the control group. Remove all eye balls and embed into paraffin with HE staining.RESLUTS:The RPE-Bruch membrane was intact with no obvious abnormality in the control group and acrolein 4wk group. Lost in the continuity of RPE and the movement of choroidal neovascularization were found in the acrolein 8wk.CONCLUSlON:The long time use of acrolein can induce the formation of choroial neovascularization in rats.

  3. Two Different Doses of Intravitreal Bevacizumab for Treatment of Choroidal Neovascularization Associated with Age-related Macular Degeneration

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    Mehdi Modarreszadeh

    2008-12-01

    Full Text Available

    PURPOSE: To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB for treatment of choroidal neovascularization (CNV associated with age-related macular degeneration (AMD. METHODS: In this randomized clinical trial, consecutive patients with active CNV associated with AMD received 1.25 mg or 2.5 mg IVB. Best corrected visual acuity (BCVA, foveal thickness and side effects of therapy were evaluated one and three months after intervention. RESULTS: Overall 86 subjects were enrolled and completed the scheduled follow-up. Forty seven and 39 patients received 1.25 and 2.5 mg IVB respectively. The study groups were balanced in terms of baseline characteristics such as age, BCVA and foveal thickness. Mean improvement in BCVA was 0.06±0.3 logMAR in the 1.25 mg group and 0.07±0.34 logMAR in the 2.5 mg group (P=0.9. Mean decrease in foveal thickness was 49±36 µm in the 1.25 mg group and 65±31µm in the 2.5 mg group (P=0.6. Three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed in the 2.5 mg group. CONCLUSION: Double dose (2.5 mg IVB does not seem to be more effective than regular dose (1.25 mg injections for treatment of CNV due to AMD and may lead to more complications.

  1. Choroidal neovascularization and angioid streaks in pseudoxanthoma elasticum%弹性假黄瘤的脉络膜新生血管和血管样条纹症

    Institute of Scientific and Technical Information of China (English)

    Melisa Nika; Cagri G Besirli

    2011-01-01

    creases. Pathologic examination of skin biopsy confirmed the diagnosis of PXE, showing calcium deposition and fragmented, clumped elastic fibers in the deep reticular dermis. She responded well to intravitreal bevacizumab injections and visual acuity improved to 20/25 OD. Preventative care was emphasized and the patient was referred to cardiology, gastroenterology and human genetics for counseling. CONCLUSION: PXE is a multisystem disorder affecting the dermatologic, ocular, and cardiovascular systems. Ophthalmic findings of angioid streaks and choroidal neovascularization in the presence of stereotypical skin changes and prominent mental creases should prompt evaluation for PXE.

  2. Swept Source OCT Angiography of Neovascular Macular Telangiectasia Type 2

    Science.gov (United States)

    Zhang, Qinqin; Wang, Ruikang K.; Chen, Chieh-Li; Legarreta, Andrew D.; Durbin, Mary K.; An, Lin; Sharma, Utkarsh; Stetson, Paul F.; Legarreta, John E.; Roisman, Luiz; Gregori, Giovanni; Rosenfeld, Philip J.

    2015-01-01

    Objective To image subretinal neovascularization in proliferative macular telangiectasia type 2 (MacTel2) using swept source optical coherence tomography based microangiography (OMAG). Study Design Patients with MacTel2 were enrolled in a prospective, observational study known as the MacTel Project and evaluated using a high-speed 1050nm swept-source OCT (SS-OCT) prototype system. The OMAG algorithm generated en face flow images from three retinal layers, as well as the region bounded by the outer retina and Bruch’s membrane, the choriocapillaris, and the remaining choroidal vasculature. The en face OMAG images were compared to images from fluorescein angiography (FA) and indocyanine green angiography (ICGA). Results Three eyes with neovascular MacTel2 were imaged. The neovascularization was best identified from the en face OMAG images that included a layer between the outer retinal boundary and Bruch’s membrane. OMAG images identified these abnormal vessels better than FA and were comparable to the images obtained using ICGA. In all three cases, OMAG identified choroidal vessels communicating with the neovascularization, and these choroidal vessels were evident in the two cases with ICGA imaging. In one case, monthly injections of bevacizumab reduced the microvascular complexity of the neovascularization, as well as the telangiectatic changes within the retinal microvasculature. In another case, less frequent bevacizumab therapy was associated with growth of the subretinal neovascular complex. Conclusions OMAG imaging provided detailed, depth-resolved information about subretinal neovascularization in MacTel2 eyes demonstrating superiority to FA imaging and similarities to ICGA imaging for documenting the retinal microvascular changes, the size and extent of the neovascular complex, the communications between the neovascular complex and the choroidal circulation, and the response to monthly bevacizumab therapy. PMID:26457402

  3. Fluorescent antibody labeling for experimental choroidal neovascularization in mice%荧光抗体标记法在小鼠脉络膜新生血管中的应用

    Institute of Scientific and Technical Information of China (English)

    顾丽萍; 陈莉; 陈辉; 庹旌生; 高小伟

    2011-01-01

    背景 脉络膜新生血管(CNV)是导致多种眼底疾病视力损害的主要原因,准确建立CNV模型对于其实验和临床研究具有重要的意义,但目前尚无一种可重复且可靠的评估CNV模型及其有效治疗的方法.目的 探讨荧光抗体标记法在定性和定量评价氪激光诱导的小鼠CNV中的应用价值.方法 选取15只雄性SPF级 C57BL/6J小鼠,用氪激光(波长为647.1nm)视网膜光凝的方式建立CNV模型.分别于光凝后5min,4、7、14 及28d随机选取3只模型小鼠行眼底照相和荧光素眼底血管造影(FFA)检查.摘除眼球行脉络膜铺片,用荧光抗体(DAPI、isolectin-B4及phalloidin)分别标记光凝区域的细胞核、内皮细胞和肌动蛋白.用Image pro plus 6.0软件测量CNV面积.结果 FFA和脉络膜铺片检查结果显示激光光凝后5min及4d无CNV形成,光凝后7d开始出现CNV.光凝后7、14、28d有荧光素渗漏的光凝斑的百分率分别为76.47%(26/34)、81.81%(18/22)和50.00%(5/10).脉络膜铺片后荧光显微镜检测结果显示,在正常的未光凝区域,视网膜色素上皮(RPE)细胞呈均匀一致的六边形排列;光凝后5min,在光凝部位可检测到一个环形荧光素缺损区,表明脉络膜-Bruch膜-RPE复合体已被破坏;光凝后4d出现一些细胞碎片以及核碎片,Bruch膜破损处可见自发荧光环.光凝后7d时,激光损伤区出现界限清楚的CNV网,并持续到28d.7、14及28d时根据脉络膜铺片所测得的CNV面积分别为(7.99±0.42)×103、(16.89±8.77)×103、(14.37±4.02)×103μm2,差异有统计学意义(F=17.340,P=0.000).光凝后14d和28d脉络膜铺片上CNV面积相差不大,但与7d时相比面积均明显增加(q=16.46、q=15.54,P<0.01).结论 荧光抗体标记法不仅能很好地显示氪激光诱导的小鼠实验性CNV及其形态,而且能测定CNV的面积,为抗新生血管药物应用的疗效研究提供依据.%Background Choroidal neovascularization (CNV) is a main cause of visual

  4. Regulation of signaling events involved in the pathophysiology of neovascular AMD

    OpenAIRE

    Wang, Haibo; Hartnett, M. Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual’s genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than ha...

  5. [Bilateral choroidal osteoma--a case report].

    Science.gov (United States)

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  6. [Macular serpiginous choroiditis complicated by macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2014-01-01

    Macular serpiginouschoroiditis is a rare variant of serpiginous choroiditis characterized by a severe recurrent inflammation of both central choroid and retinal pigment epithelium. Visual prognosis is severe due to subsequent distruction of retinal structures. Permanent central visual loss is the consequence of retinal pigment epithelium hyper or hypoplasia and/or subretinal neovascularization leading to fibrous scarring. This article reports the unusual case of rapid development of a macular hole soon after the onset of characteristic clinical features. Despite anti-inflammatory treatment and successful macular hole surgery the visual function remained significantly impaired by secondary central retinal pigment epithelium changes.

  7. Toxoplasmosis retinochoroiditis after photodynamic therapy and intravitreal triamcinolone for a supposed choroidal neovascularization: a case report Retinocoroidite toxoplásmica após terapia fotodinâmica e triancinolona intravítrea em suposta neovascularização de coróide: relato de um caso

    Directory of Open Access Journals (Sweden)

    Mário Junqueira Nóbrega

    2007-02-01

    Full Text Available The purpose is to report a complication after photodynamic therapy (PDT and intravitreal triamcinolone for a presumed choroidal neovascularization in age-related macular degeneration. Photodynamic therapy and intravitreal triamcinolone were used in an 84-year-old man with choroidal neovascularization in the left eye. Forty-five days after therapy, the patient returned with a severe necrotizing uveitis in the posterior pole and vitritis. Laboratory investigation disclosed a high anti-Toxoplasma IgG titer. Therapy with pyrimethamine, sulfadiazine and folinic acid resulted in total lesion healing although central vision was lost. Intravitreal triamcinolone may have had an influence on the exacerbation of retinochoroiditis in the posterior pole of the patient. Although rare, this complication may not be disregarded in the cases that require intraocular corticosteroids for treatment of several conditions, especially in patients who had previously suffered from toxoplasmosis infection.O objetivo é relatar complicação após terapia fotodinâmica (PDT e triancinolona intravítrea para presumida neovascularização de coróide em degeneração macular relacionada à idade. A terapia fotodinâmica e triancinolona intravítrea foram utilizados em paciente de 84 anos, do sexo masculino, com neovascularização de coróide no olho esquerdo. Quarenta e cinco dias após o tratamento, o paciente retornou com grave retinite necrosante do pólo posterior e vitreíte. Investigação laboratorial indicou alto título de IgG anti-Toxoplasma. Tratamento com pirimetamina, sulfadiazina e ácido folínico levaram à total cicatrização da lesão embora a visão central tenha sido comprometida. Conclui-se que a triancinolona intravítrea pode ter influenciado na exacerbação da retinocoroidite no pólo posterior do paciente. Embora rara, esta complicação não pode ser descartada nos casos que necessitem corticóide intra-ocular para tratamento de várias doen

  8. Comparison of the original Amsler grid with the preferential hyperacuity perimeter for detecting choroidal neovascularization in age-related macular degeneration Comparação entre a tela de Amsler original e o perímetro de hiperacuidade preferencial para a detecção de neovascularização de coróide secundária à degeneração macular relacionada à idade

    Directory of Open Access Journals (Sweden)

    David Leonardo Cruvinel Isaac

    2007-10-01

    Full Text Available PURPOSE: To compare the preferential hyperacuity perimeter (Preview PHP; Carl Zeiss Meditec, Dublin, CA with the original Amsler grid in the detection of choroidal neovascularization (CNV in patients with age-related macular degeneration (AMD. METHODS: Patients were classified into groups, based on the severity of the age-related macular degeneration and underwent preferential hyperacuity perimeter and Amsler grid testing. High sensitivity and or high specificity of a method were defined as the observation of at least 80% of each one the parameters. RESULTS: Sixty-five patients (65 eyes were analyzed statistically. The sensitivity of detection of choroidal neovascularization was 70% by the Amsler grid and 90% by the preferential hyperacuity perimeter and the specificity of the Amsler grid was 85.5% and that of the preferential hyperacuity perimeter 81.8%. CONCLUSIONS: The preferential hyperacuity perimeter has greater sensitivity than the Amsler grid in the detection of choroidal neovascularization among patients over 50 years of age and is a promising method for monitoring patients with age-related macular degeneration. Although the original Amsler grid is less sensitive, it is a portable method, not expensive, accessible and presents reasonable sensitivity and high specificity in the diagnosis of choroidal neovascularization. Its use can be recommended for self-monitoring in patients with age-related macular degeneration as an alternative to preferential hyperacuity perimeter and when this method is not available.OBJETIVO: Comparar o perímetro de hiperacuidade preferencial (Preview PHP; Carl Zeiss Meditec, Dublin, Califórnia - EUA com a tela de Amsler original na detecção de neovascularização de coróide (NVC em pacientes com degeneração macular relacionada à idade (DMRI. MÉTODOS: Os pacientes foram classificados em grupos baseados no grau de gravidade da degeneração macular relacionada à idade e foram submetidos aos testes do per

  9. Primary transpupillary thermotherapy of choroidal melanocytic lesions

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz

    2011-01-01

    Full Text Available Purpose : To evaluate the role of primary transpupillary thermotherapy (TTT in the treatment of choroidal melanocytic lesions. Materials and Methods : Retrospective chart review of 24 patients (24 eyes with choroidal melanocytic lesions, including 20 choroidal melanoma and four choroidal nevus treated with primary TTT. Choroidal nevus cases treated with primary TTT either demonstrated risk factors for growth into an early melanoma or had overlying choroidal neovascularization. Results : The mean initial tumor basal diameter was 6.6 (3.0-10.0 mm and the mean initial tumor thickness was 3.0 (1.0-5.0 mm. The mean number of TTT sessions was 2.5 (1-6. The mean decrease in tumor thickness was 1.2 mm (from 3.0 to 1.8 mm at a mean follow-up of 22.7 (range 3-90 months. On the LogMar scale, visual acuity was stable at 1.0. Complications occurred in 50% of eyes. The most frequent complications were vitreous hemorrhage [5 patients (20.8%], focal cataract [5 patients (20.8%], iris atrophy [4 patients (16.6%] and posterior synechia [4 patients (16.6%]. There was no significant difference in the complication rate with respect to tumor thickness >3 mm versus tumor thickness ≤3 mm and juxtapapillary versus nonjuxtapapillary location (Fisher′s exact test, P>0.05. Kaplan-Meier curves showed that 9% of eyes develop recurrence by 1 year and 27% develop recurrence by 5 years after primary TTT. Two eyes (8.3% were enucleated because of neovascular glaucoma and one eye (4.1% was exenterated because of extraocular tumor recurrence. Globe salvage was achieved in 21 patients (87.5%. One patient (4.1% with extraocular tumor recurrence developed liver metastasis and expired. Conclusions : Although TTT may be useful in the treatment of small choroidal melanocytic lesions, the high complication and recurrence rates warrant close monitoring of patients after primary TTT even when a flat chorioretinal scar has been achieved.

  10. lntravitreal injection of triamcinolone acetonide combined photodynamic therapy for choroidal neovascularization in high myopia efficacy%玻璃体腔注射曲安奈德联合光动力疗法治疗高度近视脉络膜新生血管疗效观察

    Institute of Scientific and Technical Information of China (English)

    葛建杰; 高夕宁; 王沫学

    2011-01-01

    Objective To observe the clinical efficacy of intravitreal injection of triamcinolone acetonide (TA) combined photodynamic therapy (PDT) of choroidal revascularization (CNV) in high myopia.Methods Based on history,age,symptoms and by visual acuity,fundus examination,fundus photography,fundus fluorescein angiography (FFA),optical coherence tomography (OCT),high myopia diagnosed with choroidal neovascularization (CNV) of 153 patients (165 eyes) were randomly divided into group A,B and C.group A consisted of 51 cases (58 eyes),group B 51 cases (54 eyes),group C of 51 cases (53 eyes).Group A treated with intravitreal injection of TA combined with photodynamic therapy,group B with photodynamic therapy alone (PDT),group C with intravitreal injection of TA alone.All cases were follow-up 3,6 months after treatment.Results At the final follow up,corrected visual acuity was 0.01-1.2.In group A,58 eyes of 51 patients accounted for 43.10% cured in 25 eyes,improved 27 for 47.37%,invalid 6 for 9.53%,the total effective rate 90.47%,5.17% recurrence in 3 eyes.In group B,51 patients were cured 9 out of 54 eyes for 16.67%,27.78% improvement in 15 eyes,55.55% invalid in 30 eyes,total effective rate of 44.45%,recurrence 13 24.07%.In group C,53 eyes of 51 patients were cured in 10 eyes 18.88%,improved 14 eyes 26.41%,invalid 29eyes 54.71%,total effective rate of 45.29%,recurrence 14 26.41%.The total efficiency of the three groups had statistically significant difference (u =2.05693,P <0.05).Conclusions Intravitreous injection of TA combined photodynamic therapy for choroidal neovascularization in high myopia is effective and safe.It solves the problems that a single treatment exist many complications and high recurrence rate.%目的 观察玻璃体腔注射曲安奈德(triamcinolone acetonide TA)联合光动力疗法治疗高度近视脉络膜新生血管的临床疗效.方法 依据病史、年龄、症状及经视力、眼底检查、眼底彩色照相

  11. 玻璃体腔注射康柏西普联合递法明片治疗病理性近视脉络膜新生血管的疗效观察%Clinical observation of intravitreal injection of conbercept combined with difrarel in the treatment of choroidal neovas-cularization in pathologic myopia

    Institute of Scientific and Technical Information of China (English)

    史志洁

    2016-01-01

    Objective To observe the clinical effect and safety of intravitreal injection of conbercept combined with difrarel in the treatment of choroidal neovascularization in pathologic myopia. Methods The clinical records of 16 patients(16 eyes)with choroidal neovascularization in pathologic myopia were retrospectively reviewed. All patients were treated by intravitreal injection of cbonbercept 0. 5 mg(0. 05 ml)as the first initial measurement,and oral difrarel were used for 2 months after injection. BC-VA,FFA,OCT and intraocular pressure were observed 1 month,3 months,6 montha after operation. During the follow-up peri-od,intravitreal injection of conbercept was performed again if active CNV or CNV expansion or new CNV were observed. Results The best corrected visual acuity after intravitreal injection in 1 month,3 months,6 months were respectively 0. 28 ± 0. 03,0. 36 ± 0. 03,0. 38 ± 0. 04,there were statistically significant differences(F = 21. 506,P = 0. 000);There were signifi-cantly improved in 1 month,3 months,6 months compared with before treatment(P ﹤ 0. 05). The central macular retinal thick-ness after intravitreal injection in 1 month,3 months,6 months were respectively 261. 0 ± 8. 56,233. 9 ± 6. 71,229. 0 ± 5. 80, there were statistically significant differences( F = 286. 28,P = 0. 000);There were significantly decreased in 1 month,3 months,6 months compared with before treatment(P ﹤ 0. 05). After 6 months,FFA examination results showed that the CNV was completely closed in 15 eyes,and most closed in 1 eye. During the follow-up period,10 eyes were treated with 1 time,5 eyes were treated with 2 times of intravitreal injection,1 eye were treated with 3 times of intravitreal injection,the average injec-tion times was 1. 43 times;during the follow-up period,there was no high intraocular pressure after intravitreal injection. All pa-tients did not have severe ocular and systemic complications. Conclusion Intravitreal injection of conbercept combined with

  12. 基质金属蛋白酶抑制剂GM6001抑制大鼠脉络膜新生血管形成的初步研究%Effects of matrix metalloproteinases inhibitor GM6001 on choroidal neovascularization

    Institute of Scientific and Technical Information of China (English)

    陈学国; 何守志

    2012-01-01

    Objective To explore the efficiency of GM6001 for the inhibition of choroidal neovascularization. Methods Experimental study. Twenty-four Brown Norvy ( BN ) rats after photocoagulation were randomly divided into 3 groups as GM6001 group,DMSO group and CONT group.GM6001 (0.2 ml of 0.1% suspension) was injected retrobulbarly for GM6001 group and0.2 ml DMSO was injected for DMSO group on days 1,3,6,9,and 12 after photocoagulation.No injection was performed in the CONT group.Fundus fluorescence angiography,histopathology,immunohistochemistry and quantitative analysis of choroidal neovascularization ( CNV ) were performed 3 weeks after photocoagulation. One-way ANOVA was used in conjunction with SNK-t test to assess statistical significance within groups. Resufts The fluorescein leakage appeared in all three groups; but fluorescein leakage of GM6001 group( 74.56 ± 2.33 ) was less than that of DMSO group ( 119.57 ± 1.15 ) and CONT group ( 122.36 ± 2.38 ) ( F =403.23,P =0.001 ;LSD-t test,all P value <0.01 ),whereas fluoresecin leakage of DMSO group was similar to that in the CONT group.The retinal and choroidal capillaries in the CONT group were damaged and disordered;a great deal of CNV and migration and proliferation of retinal pigment epithelium cells,fibrocytes and collagen fibers were discovered.Pathological changes in DMSO group were similar to those in the CONT group.There were a small quantity of retinal pigment epithelium cells,fibrocytes and CNV in GM6001 group.Although the immunohistochemical staining for CD105 displayed positive results in all three groups,positive staining of GM6001 group ( 19.85 ± 1.59 ) was significantly less than that of the CONT group (38.02 ± 2.57 ) and DMSO group (39.02 ± 3.12 ) (F =55.57,P =0.001 ; LSD-t test,all P value < 0.01 ).Positive staining of CD105 in the CONT group was similar to that of DMSO group (P > 0.05 ).The size of CNV in GM6001 group ( 15.35 ±0.77) was significantly less than that of CONT group( 28.38

  13. Ranibizumab: the evidence of its therapeutic value in neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Peter K. Kaiser

    2008-07-01

    Full Text Available Peter K. KaiserCole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USAIntroduction: Neovascular age-related macular degeneration (AMD is the leading cause of severe, irreversible visual impairment in people over 60 years of age. Neovascular AMD is characterized by abnormal growth of blood vessels under the retina, specifically the macula. These vessels leak blood and fluids, damaging the retina and its photoreceptors, resulting in permanent loss of central vision. Vascular endothelial growth factor-A (VEGF-A has been shown to play a critical role in the pathogenesis of neovascular AMD. In the US, ranibizumab, a VEGF-A blocker, is approved and indicated for the treatment of patients with neovascular AMD.Aims: To review the clinical evidence for ranibizumab in the treatment of neovascular AMD.Evidence review: Phase III clinical trial data have established ranibizumab as a safe and well-tolerated treatment for neovascular AMD. Monthly intravitreal injections of ranibizumab result in a statistically significantly greater proportion of patients losing <15 letters of visual acuity (VA and statistically significant increases in the mean number of letters gained compared with controls. Anatomically, ranibizumab results in stabilization in the mean area of choroidal neovascularization (CNV and statistically significant reductions in the mean area of leakage compared with controls. Although there is limited economic evidence available, ranibizumab therapy for neovascular AMD appears to deliver a significant degree of value gain in terms of quality of life when compared with other neovascular AMD interventions.Place in therapy: Clinical evidence establishes ranibizumab as a first-line therapy option for virtually all treatable neovascular AMD patients. Updating neovascular AMD treatment guidelines to reflect the evidence base for ranibizumab as a preferred first-line therapy would be beneficial for physicians in making informed treatment

  14. Intravitreal ranibizumab and bevacizumab for the treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration Ranibizumab e bevacizumab intravítreo no tratamento da neovascularização de coróide extrafoveal da degeneração macular relacionada à idade

    Directory of Open Access Journals (Sweden)

    Aaron Brock Roller

    2009-10-01

    Full Text Available PURPOSE: To investigate the efficacy of vascular endothelial growth factor-specific (VEGF monoclonal antibodies in the treatment of choroidal neovascularization secondary to age-related macular degeneration (AMD that does not extend beneath the foveal center (nonsubfoveal CNV. METHODS: The study design was a retrospective chart review of consecutive patients over a two-month period under active treatment with bevacizumab and/or ranibizumab for neovascular AMD. Patients with neovascularization within the macula that did not extend beneath the center of the foveal avascular zone, along with at least one large drusen (>125 µ or many intermediate size (63-124 µ drusen were included. Best corrected Snellen visual acuity and optical coherence tomography (OCT analysis of the central macular thickness was recorded for each visit. Serial injections of bevacizumab and/or ranibizumab were administered until there was resolution of subretinal fluid clinically or by OCT. Data over the entire follow-up period were analyzed for overall visual acuity and OCT changes. All patients had follow-up since diagnosis of at least 6 months (mean=9.6 months. RESULTS: Of the thirteen included patients, eleven had reduction of retinal thickening in the area involved by the CNV. The remaining two patients did not have OCT data available but had no fluid or activity on clinical examination at last follow-up. One patient (8% lost one line of vision; one (8% remained stable, and eleven (84% gained one or more lines of visual acuity. Three patients (23% gained three or more lines. The average treatment outcome for all patients was a gain of 1.7 ± 1.3 lines of Snellen acuity. Both therapeutic agents were effective, with an average gain of 1.6 ± 0.6 lines for patients treated with bevacizumab, 1.5 ± 1.9 lines gained for patients treated with ranibizumab and 2.5 ± 0.7 lines gained in the two patients who received both agents over the course of their treatment. CONCLUSIONS

  15. Resistance to anti-VEGF therapy in neovascular age-related macular degeneration: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Yang S

    2016-06-01

    Full Text Available Shiqi Yang,1 Jingke Zhao,1 Xiaodong Sun1–3 1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 2Eye Research Institute of Shanghai Jiao Tong University, 3Shanghai Key Laboratory of Fundus Disease, Shanghai, People’s Republic of China Abstract: As a progressive chronic disease, age-related macular degeneration (AMD is the leading cause of irreversible vision impairment worldwide. Experimental and clinical evidence has demonstrated that vascular endothelial growth factor (VEGF plays a vital role in the formation of choroidal neovascularization. Intravitreal injections of anti-VEGF agents have been recommended as a first-line treatment for neovascular AMD. However, persistent fluid or recurrent exudation still occurs despite standardized anti-VEGF therapy. Patients suffering from refractory or recurrent neovascular AMD may develop mechanisms of resistance to anti-VEGF therapy, which results in a diminished therapeutic effect. Until now, there has been no consensus on the definitions of refractory neovascular AMD and recurrent neovascular AMD. This article aims at clarifying these concepts to evaluate the efficacy of switching drugs, which contributes to making clinical decision more scientifically. Furthermore, insight into the causes of resistance to anti-VEGF therapy would be helpful for developing possible therapeutic approaches, such as combination therapy and multi-target treatment that can overcome this resistance. Keywords: age-related macular degeneration, vascular endothelial growth factor, choroidal neovascularization, resistance

  16. Our Treatment Results of Circumscribed and Diffuse Choroidal Hemangiomas

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    Esra Savku

    2013-08-01

    Full Text Available Purpose: To discuss our treatment results of choroidal hemangiomas. Material and Method: The records of 39 cases of choroidal hemangioma followed up at our clinic between July 1999–October 2012 were reviewed retrospectively. Asymptomatic cases were followed up. Symptomatic cases with subretinal fluid and impaired vision received treatment. Results: Mean age of the 39 patients was 44 (12-80 years. Thirty-five of 39 cases had circumscribed choroidal hemangioma, and 4 cases had diffuse choroidal hemangioma. Sturge-Weber syndrome was present in 3 cases with diffuse choroidal hemangioma. Cases with circumscribed choroidal hemangioma and minimal subretinal fluid were treated with TTT in 11 cases, PDT in 12 cases, and PDT+TTT in 1 case. Cases with circumscribed choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy in 1 case, Ru-106 plaque radiotherapy+TTT in 1 case, EBRT in 3 cases, and TTT+EBRT in 1 case. One painful blind eye with neovascular glaucoma and complicated cataract was enucleated. Cases with diffuse choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy+TTT in 1 case and EBRT in 1 case. Ahmed glaucoma valve implantation and FAKO emulsification were applied to a case with neovascular glaucoma and complicated cataract. Complete resorption of subretinal fluid was achieved in 23 (72% of treated 32 cases. When mean initial tumor thickness was 2.6 mm (0.5-6, mean final tumor thickness was 1.4 mm (0-6. When mean initial visual acuity (LogMAR was 1.5 (0-3, mean final visual acuity was 1.1 (0-3. No recurrence was observed. Discussion: The amount of the subretinal fluid determines the method of treatment in circumscribed choroidal hemangioma. While TTT and PDT are effective treatment modalities for minimal subretinal fluid, plaque radiotherapy and EBRT are applied in cases with excessive subretinal fluid. Combination therapies may be necessary according to the

  17. Surgical induction of choroidal neovascularization in a porcine model

    DEFF Research Database (Denmark)

    Lassota, Nathan; Kiilgaard, Jens Folke; Prause, Jan Ulrik;

    2007-01-01

    were compared with the original method. In ten porcine eyes retinal pigment epithelial (RPE) cells were removed using a silicone tipped cannula, in ten porcine eyes Bruch's membrane was perforated once with a retinal perforator without prior RPE removal and in ten eyes RPE removal was followed...... microscopy and by immunohistochemical staining. In addition to these 30 eyes, two eyes underwent surgery with the purpose of subsequent scanning electron microscopic (SEM) examination. RESULTS: In eyes enucleated immediately after surgery neuroretinas overlying the induced lesions were intact without...... apparent atrophy of cells regardless of the surgical technique applied. The process of RPE removal was found to induce breaks in Bruch's membrane and both the size and the number of breaks varied between eyes. CNV membranes were identified in 15 of 15 eyes enucleated after 14 days. CNV membranes induced...

  18. 口服酪氨酸激酶抑制剂CM082对实验大鼠脉络膜新生血管的影响%Effects of oral tyrosine kinase inhibitor CM082 on experimental choroidal neovascularization in rat

    Institute of Scientific and Technical Information of China (English)

    危清泉; 任成达; 时慧; 刘晴雨; 杜亚茹; 何梦梅; 刘俊伶; 王倩怡; 蔡雯婷

    2016-01-01

    目的 建立脉络膜新生血管(choroidal neovascularization,CNV)大鼠模型,观察药物酪氨酸激酶抑制剂CM082对CNV的影响.方法 采用532 nm倍频激光视网膜光凝法制备棕色挪威(brown norway,BN)大鼠CNV模型.将50只光凝造模后大鼠随机分为对照组(n=25)、实验组(n=25).造模7d后给予实验组口服给药CM082 30 mg·kg-1·d-1,对照组造模后给予药物溶媒5mL· kg-1·d-1.分别于造模后7d及给药后7d、14 d行眼底荧光血管造影(fundus fluorescein angiography,FFA)、组织病理学和视网膜色素上皮(reti-nal pigment epithelium,RPE)-脉络膜-巩膜铺片进行评估.结果 FFA结果显示,实验组给药后7d、14 d光凝斑部位荧光渗漏强度(0.43 ±0.17、0.55±0.15)显著低于对照组(0.74±0.19、0.80±0.13),差异有统计学意义(P<0.05).苏木精-伊红染色的CNV病理组织学显示,实验组中病变范围较小.免疫组织化学检查表明,CM082的治疗可以明显抑制p-VEGFR-2的表达.RPE-脉络膜-巩膜铺片显示,给药后7d、14d,实验组中CNV损伤区域为(4.26±0.93)×104 μm2、(3.58±0.72)×104 μm2,明显小于对照组(12.90±6.40)×104 μm2、(17.81±5.34)×104 μm2,差异有统计学意义(P<0.05).结论 CM082口服给药30mg·kg-1·d-1能有效抑制激光诱导的BN大鼠CNV病变.

  19. Benzoporphyrin (verteporfin photodynamic therapy for choroidal neovascularization in age-related macular degeneration Terapia fotodinâmica de neovascularização de coróide por degeneração macular relacionada à idade com benzoporfirina (verteporfirina

    Directory of Open Access Journals (Sweden)

    Evandro G. Lucena

    2000-12-01

    Full Text Available Purpose: To review and discuss the available treatments for choroidal neovascularization (CNV due to age-related macular degeneration (AMD emphasizing to photodynamic therapy (PDT. Methods: Published papers from 1974 until 1999 related to AMD, its available treatments and PDT were reviewed. Results: The most used effective treatment for CNV is laser photocoagulation which does not have a major impact on the blindness due to AMD. Alternative techniques of prevention and treatment are under investigation including surgery, pharmacological antiangiogenic treatment and prevention with photocoagulation. PDT using verteporfin demonstrated effectiveness in closing CNV membranes in an experimental model. A clinical trial showed that a single course treatment could stabilize the area and extent of leakage from subfoveal CNV with classic component in the majority of patients for up to 3 months (Phase I/II. A 12-month data for quaterly treatments was recently reported and showed that vision stabilization, meaning vision improvement, no change, or loss of Objetivo: Rever e discutir os tratamentos disponíveis para neovascularização subrretiniana (CNV secundária a degeneração macular relacionada a idade (DMRI com ênfase especial a terapia fotodinâmica (PDT. Métodos: Revisamos artigos publicados a partir de 1974 até 1999 relacionados a DMRI, seus tratamentos dispo- níveis e PDT. Resultados: O tratamento provadamente efetivo mais utilizado para CNV é fotocoagulação com laser o qual não apresenta um impacto expressivo na deficiência visual causada pela DMRI. Técnicas alternativas de prevenção e tratamento estão sob investigação incluindo cirurgias, tratamento farmacológico antiangiogênico e prevenção com fotocoagulação. PDT com Verteporfina demonstrou ser efetiva no fechamento de CNV em nosso modelo experimental. Um estudo clínico inicial demonstrou que uma aplicação única poderia estabilizar a área de CNV subfoveal com

  20. Molecular pathogenesis of retinal and choroidal vascular diseases.

    Science.gov (United States)

    Campochiaro, Peter A

    2015-11-01

    There are two major types of ocular neovascularization that affect the retina, retinal neovascularization (NV) and subretinal or choroidal NV. Retinal NV occurs in a group of diseases referred to as ischemic retinopathies in which damage to retinal vessels results in retinal ischemia. Most prevalent of these are diabetic retinopathy and retinal vein occlusions. Subretinal and choroidal NV occur in diseases of the outer retina and Bruch's membrane, the most prevalent of which is age-related macular degeneration. Numerous studies in mouse models have helped to elucidate the molecular pathogenesis underlying retinal, subretinal, and choroidal NV. There is considerable overlap because the precipitating event in each is stabilization of hypoxia inducible factor-1 (HIF-1) which leads to upregulation of several hypoxia-regulated gene products, including vascular endothelial growth factor (VEGF), angiopoietin 2, vascular endothelial-protein tyrosine phosphatase (VE-PTP), and several others. Stimulation of VEGF signaling and suppression of Tie2 by angiopoietin 2 and VE-PTP are critical for sprouting of retinal, subretinal, and choroidal NV, with perturbation of Bruch's membrane also needed for the latter. Additional HIF-1-regulated gene products cause further stimulation of the NV. It is difficult to model macular edema in animals and therefore proof-of-concept clinical trials were done and demonstrated that VEGF plays a central role and that suppression of Tie2 is also important. Neutralization of VEGF is currently the first line therapy for all of the above disease processes, but new treatments directed at some of the other molecular targets, particularly stabilization of Tie2, are likely to provide additional benefit for subretinal/choroidal NV and macular edema. In addition, the chronicity of these diseases as well as the implication of VEGF as a cause of retinal nonperfusion and progression of background diabetic retinopathy make sustained delivery approaches for VEGF

  1. De novo appearance of a choroidal osteoma in an eye with previous branch retinal vein occlusion.

    Science.gov (United States)

    Adhi, Mehreen; Bryant, Juanita Sonya; Alwassia, Ahmad A; Chen, Carolyn; Duker, Jay S

    2013-01-01

    This report describes the de novo appearance of a choroidal osteoma occurring 8 years after laser photocoagulation for previous branch retinal vein occlusion (BRVO). A 62-year-old man presented with an asymptomatic yellowish orange lesion in the macula on fundus examination of his left eye during a regular follow-up visit for bilateral BRVO associated with macular edema that had previously been treated with laser photocoagulation. The lesion was observed for 1.5 years until a decrease in vision occurred. Fundus photography revealed a yellow-to-orange, well-defined lesion in the macular region. Fluorescein angiography was consistent with choroidal neovascularization (CNV). Optical coherence tomography and B-scan ultrasonography showed features consistent with choroidal osteoma. This is the first report of the de novo appearance of a choroidal osteoma occurring years after laser photocoagulation for BRVO. CNV developed secondary to the lesion, which was treated with intravitreal bevacizumab, leading to subjective and anatomic improvement.

  2. 柚皮素β-环糊精包合物对大鼠实验性脉络膜新生血管的抑制作用%Inhibition of naringenin complex with β-cyclodextrin on experimental choroidal neovascularization in rats

    Institute of Scientific and Technical Information of China (English)

    徐新荣; 于海涛; 杭丽; 邵雁; 丁淑华; 杨学文

    2015-01-01

    Background Choroidal neovascularization (CNV) leads to blindness in many fundus diseases.Study showed that naringenin suppresses CNV,but it presents with poor bioavailability because of its poor solubility in water.β-cyclodextrin (β-CD) can increase the water-solubility of drugs, however, whether the inhibitory effect of naringenin on CNV can be improved after clathrated with β-CD remains unclear.Objective This study was to compare the inhibitory effects of naringenin with naringenin/β-CD compounds on CNV in rats.Methods Naringenin/β-CD clathrate compounds were prepared with saturated solution,the solubility of naringenin in water was calculated based on standard curve.Thirty-two male Brown Norway rats were randomized into normal control group, model control group, naringenin group and naringenin/β-CD group.Laser-induced CNV models were created in the right eyes of rats from the model control group, naringenin group and naringenin/β-CD group.Naringenin and naringenin/β-CD clathrate compounds were intraperitoneally injected at a dose of 20 mg/kg in the rats of naringenin group and naringenin/β-CD group since the day after modeling, respectively, once per day for 4 weeks, and equal volume of DMSO was injected in the same way in the model control group.Fluorescein isothiocyanate dextran (FITC-D) was injected via rat hypoglossal vein for the preparation of flatmounts of choroid in the fourth week,and the areas of CNV were measured and compared among the groups.The retinal pigment epithelium (RPE)-choroid-sclera tissues were isolated from the rats, and the relative expression levels of vascular endothelial growth factor (VEGF) , cyclooxygenase-2 (COX-2),phosphatidylinositol-3-kinase (PI3K),p38mitogen-activated protein kinase (p38MAPK), matrix metalloproteinase (MMP)-2, MMP-9 mRNA and their proteins in RPE-choroid-sclera tissue were detected using real-time PCR and Western blot.Results The solubility of naringenin in water increased by 11.8 folds after

  3. Choroidal osteoma: a very unusual form of intraocular clarification; Osteoma coroideo. Una inusual forma de calcificacion del globo ocular

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Y.; Lasierra, R.; Pina, J. I.; Madariaga, B. [Hospital Clinico Universitario Lozano Blesa. Zaragoza (Spain)

    2000-07-01

    Choroidal osteoma is a very uncommon benign choroidal tumor that is capable of producing real bone tissue. It is normally found in healthy young women. It tends to be located in the juxtapapillary region, and is generally unilateral. The etiology is unknown. Both ultrasonography and computed tomography demonstrate the presence of calcified plaquet the identifies the lesions. The major complications is choroidal neovascularization, which can occur in up to one third of cases. Choroidal osteoma must be differentiated mainly from other intraocular tumors and dystrophic or metastatic calcifications We present a case of choroidal osteoma in a 16-year-old girl who had loss of visual acuity in both eyes and possible optic nerve glioma in her right eye. (Author) 11 refs.

  4. Neuropilin 1 Involvement in Choroidal and Retinal Neovascularisation

    Science.gov (United States)

    Fernández-Robredo, Patricia; Sim, Dawn A.; Fruttiger, Marcus

    2017-01-01

    Purpose Inhibiting VEGF is the gold standard treatment for neovascular age-related macular degeneration (AMD). It is also effective in preventing retinal oedema and neovascularisation (NV) in diabetic retinopathy (DR) and retinal vein occlusions (RVO). Neuropilin 1 (Nrp1) is a co-receptor for VEGF and many other growth factors, and therefore a possible alternative drug target in intra ocular neovascular disease. Here we assessed choroidal and retinal NV in an inducible, endothelial specific knock out model for Nrp1. Methods Crossing Nrp1 floxed mice with Pdgfb-CreERT2 mice produced tamoxifen-inducible, endothelial specific Nrp1 knock out mice (Nrp1ΔEC) and Cre-negative, control littermates. Cre-recombinase activity was confirmed in the Ai3(RCL-EYFP) reporter strain. Animals were subjected to laser-induced CNV (532 nm) and spectral domain-optical coherence tomography (SD-OCT) was performed immediately after laser and at day 7. Fluorescein angiography (FA) evaluated leakage and postmortem lectin staining in flat mounted RPE/choroid complexes was also used to measure CNV. Furthermore, retinal neovascularisation in the oxygen induced retinopathy (OIR) model was assessed by immunohistochemistry in retinal flatmounts. Results In vivo FA, OCT and post-mortem lectin staining showed a statistically significant reduction in leakage (p<0.05), CNV volume (p<0.05) and CNV area (p<0.05) in the Nrp1ΔEC mice compared to their Cre-negative littermates. Also the OIR model showed reduced retinal NV in the mutant animals compared to wild types (p<0.001). Conclusion We have demonstrated reduced choroidal and retinal NV in animals that lack endothelial Nrp1, confirming a role of Nrp1 in those processes. Therefore, Nrp1 may be a promising drug target for neovascular diseases in the eye. PMID:28107458

  5. Circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Saeed Karimi

    2015-01-01

    Full Text Available Circumscribed choroidal hemangiomas are benign vascular hamartomas without systemic associations. Generally, they are orange-red elevated masses, which are found posterior to the equator. Lesions are usually solitary and unilateral. Overlying subretinal fluid, serous retinal detachment and cystoid macular edema are common findings. Intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography and enhanced depth imaging are helpful ancillary tests for diagnosis of circumscribed choroidal hemangiomas. Asymptomatic circumscribed choroidal hemangiomas do not require treatment. For symptomatic lesions with exudative retinal detachment or cystoid macular edema, photodynamic therapy has emerged as the treatment of choice with high rates of tumor regression, subretinal fluid resorption and minimal complications. Lens-sparing external beam radiotherapy, plaque brachytherapy, proton beam therapy, stereotactic radiosurgery, transpupillary thermotherapy, laser photocoagulation and anti-VEGF injections are other treatment modalities.

  6. CCR3 is a therapeutic and diagnostic target for neovascular age-related macular degeneration

    OpenAIRE

    2009-01-01

    Age-related macular degeneration (AMD), a leading cause of blindness worldwide, is as prevalent as cancer in industrialized nations. Most blindness in AMD results from invasion of the retina by choroidal neovascularization (CNV). We report that the eosinophil/mast cell chemokine receptor CCR3 is specifically expressed in CNV endothelial cells in humans with AMD, and that, despite the expression of its ligands eotaxin-1, -2, and -3, neither eosinophils nor mast cells are present in human CNV. ...

  7. Broad spectrum antiangiogenic treatment for ocular neovascular diseases.

    Directory of Open Access Journals (Sweden)

    Ofra Benny

    Full Text Available UNLABELLED: Pathological neovascularization is a hallmark of late stage neovascular (wet age-related macular degeneration (AMD and the leading cause of blindness in people over the age of 50 in the western world. The treatments focus on suppression of choroidal neovascularization (CNV, while current approved therapies are limited to inhibiting vascular endothelial growth factor (VEGF exclusively. However, this treatment does not address the underlying cause of AMD, and the loss of VEGF's neuroprotective can be a potential side effect. Therapy which targets the key processes in AMD, the pathological neovascularization, vessel leakage and inflammation could bring a major shift in the approach to disease treatment and prevention. In this study we have demonstrated the efficacy of such broad spectrum antiangiogenic therapy on mouse model of AMD. METHODS AND FINDINGS: Lodamin, a polymeric formulation of TNP-470, is a potent broad-spectrum antiangiogenic drug. Lodamin significantly reduced key processes involved in AMD progression as demonstrated in mice and rats. Its suppressive effects on angiogenesis, vascular leakage and inflammation were studied in a wide array of assays including; a Matrigel, delayed-type hypersensitivity (DTH, Miles assay, laser-induced CNV and corneal micropocket assay. Lodamin significantly suppressed the secretion of various pro-inflammatory cytokines in the CNV lesion including monocyte chemotactic protein-1 (MCP-1/Ccl2. Importantly, Lodamin was found to regress established CNV lesions, unlike soluble fms-like tyrosine kinase-1 (sFlk-1. The drug was found to be safe in mice and have little toxicity as demonstrated by electroretinography (ERG assessing retinal and by histology. CONCLUSIONS: Lodamin, a polymer formulation of TNP-470, was identified as a first in its class, broad-spectrum antiangiogenic drug that can be administered orally or locally to treat corneal and retinal neovascularization. Several unique properties

  8. Morphological patterns of indirect choroidal rupture on spectral domain optical coherence tomography

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    Nair U

    2013-07-01

    Full Text Available Unnikrishnan Nair,1 Manoj Soman,1 Sunil Ganekal,2 Vaishnavi Batmanabane,1 KGR Nair11Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, 2Nayana Super Specialty Eye Hospital and Research Center, Davangere, Karnataka, IndiaPurpose: To evaluate the morphological types of indirect choroidal rupture (ICR using spectral domain optical coherence tomography (SD-OCT.Methods: This was a prospective interventional study of 18 eyes of 18 patients who presented with a history of blunt ocular trauma resulting in choroidal rupture. All patients underwent detailed ophthalmic evaluation and SD-OCT examination.Results: Mean age of the patients was 32±9.6 years. Morphologically, two types of choroidal rupture were seen on SD-OCT. The first type seen (Type 1 ICR was a forward protrusion of the retinal pigment epithelium-choriocapillaris (RPE-CC layer with an acutely angled pyramid or dome shape. This was associated with either a small loss of continuity of the retinal pigment epithelium layer or elevated RPE-CC projection accompanied by a significant quantity of subretinal hemorrhage. The second type observed (Type 2 ICR was a larger area of disruption of the RPE-CC layer, photoreceptor inner segment/outer segment junction, and external limiting membrane, with a posteriorly directed concave contour depression at that area and downward sliding of tissues into the defect. At presentation, ten eyes were observed to have Type 1 ICR and eight to have Type 2 ICR. Of the 18 eyes, one with Type 1 ICR and two with Type 2 ICR developed choroidal neovascularization (16.6%.Conclusion: Two distinct tomographic patterns of choroidal ruptures were identified on SD-OCT, which may allow ruptures to be classified into two morphological types. There are morphometric and clinical differences between the two types, which may help to prognosticate visual outcome and anticipate complications following choroidal ruptures.Keywords: SD-OCT, ICR, blunt ocular trauma

  9. Transvitreal retino-choroidal biopsy of suspected malignant lesions of the choroid

    DEFF Research Database (Denmark)

    Jensen, O.A.; Prause, J.U.; Scherfig, E.

    1997-01-01

    ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy......ophthalmology, intraocular biopsy, transvitreal retino-choroidal biopsy, malignant melanoma of choroid, histopathology, brachytherapy...

  10. Role of pigment epithelium-derived factor on proliferation and migration of choroidal capillary endothelium induced by vascular endothelial growth factor in vitro

    Institute of Scientific and Technical Information of China (English)

    WANG Feng-hua; SUN Xiao-dong; ZHANG Xi; XU Xun; ZHU Qi; HUANG Jian-nan; FAN Ying; GU Qing; LIU Hai-yang

    2007-01-01

    Background Pigment epithelium-derived factor (PEDF) is expressed in several normal organs and identified as an inhibitor of neovascularization. In the present study, we investigated the effect of PEDF in an in vitro model of ocular choroidal neovascularization.Methods Microdissection was used to isolate the human choroidal endothelial cells (CECs), followed by the use of superparamagnetic beads (Dynabeads) coated with the CD31 antibody, which selectively binds to the endothelial cell surface. The mitogenic and motogenic effects of vascular endothelial growth factor (VEGF) on cultured choroidal capillary endothelial cells were examined in the presence or absence of PEDF (1, 10, 100, and 1000 ng/ml) using cell counts and migration assays.Results Cells bound to the beads were isolated using a magnetic particle concentrator and they were successfully cultured and characterized to be endothelial cells that possessed greater than 95% immunoreactivity to von Willebrand factor. PEDF suppressed the proliferation and migration of VEGF-induced choroidal capillary endothelial cells. However,the concentration of PEDF which we used has little effect on normal CECs.Conclusions PEDF played an important role on the growth and migration of VEGF-stimulated choroidal endothelial cell.These findings suggest that PEDF may be an effective approach to the treatment of choroidal neovascular disorders.

  11. Central areolar choroidal dystrophy.

    NARCIS (Netherlands)

    Boon, C.J.F.; Klevering, B.J.; Cremers, F.P.M.; Zonneveld-Vrieling, M.N.; Theelen, T.; Hollander, A.I. den; Hoyng, C.B.

    2009-01-01

    OBJECTIVE: To describe the clinical characteristics, follow-up data and molecular genetic background in a large group of patients with central areolar choroidal dystrophy (CACD). DESIGN: Retrospective case series study. PARTICIPANTS: One hundred three patients with CACD from the Netherlands. METHODS

  12. Treatment of neovascular age-related macular degeneration: Current therapies

    Directory of Open Access Journals (Sweden)

    Albert J Augustin

    2009-01-01

    Full Text Available Albert J Augustin, Stefan Scholl, Janna KirchhofDepartment of Ophthalmology, Klinikum Karlsruhe, GermanyAbstract: Choroidal neovascularization (CNV secondary to age-related macular degeneration (AMD is now the leading cause of blindness and severe vision loss among people over the age of 40 in the Western world. Its prevalence is certain to increase substantially as the population ages. Treatments currently available for the disease include laser photocoagulation, verteporfin photodynamic therapy, and intravitreal injections of corticosteroids and anti-angiogenic agents. Many studies have reported the benefits of each of these treatments, although none is without its risks. No intervention actually cures AMD, nor the neovascularization associated with it. However, its symptoms are treated with varying degrees of success. Some treatments stabilize or arrest the progress of the disease. Others have been shown to reverse some of the damage that has already been done. These treatments can even lead to visual improvement. This paper will review the major classes of drugs and therapies designed to treat this condition.Keywords: wet AMD, neovascularization, PDT, steroids, anti-angiogenesis

  13. Polymeric materials for neovascularization

    Science.gov (United States)

    DeVolder, Ross John

    Revascularization therapies have emerged as a promising strategy to treat various acute and chronic wounds, cardiovascular diseases, and tissue defects. It is common to either administer proangiogenic growth factors, such as vascular endothelial growth factor (VEGF), or transplant cells that endogenously express multiple proangiogenic factors. Additionally, these strategies utilize a wide variety of polymeric systems, including hydrogels and biodegradable plastics, to deliver proangiogenic factors in a sophisticated manner to maintain a sustained proangiogenic environment. Despite some impressive results in rebuilding vascular networks, it is still a challenging task to engineer mature and functional neovessels in target tissues, because of the increasing complexities involved with neovascularization applications. To resolve these challenges, this work aims to design a wide variety of proangiogenic biomaterial systems with tunable properties used for neovascularization therapies. This thesis describes the design of several biomaterial systems used for the delivery of proangiogenic factors in neovascularization therapies, including: an electrospun/electrosprayed biodegradable plastic patch used for directional blood vessel growth (Chapter 2), an alginate-g-pyrrole hydrogel system that biochemically stimulates cellular endogenous proangiogenic factor expression (Chapter 3), an enzyme-catalyzed alginate-g-pyrrole hydrogel system for VEGF delivery (Chapter 4), an enzyme-activated alginate-g-pyrrole hydrogel system with systematically controllable electrical and mechanical properties (Chapter 5), and an alginate-g-pyrrole hydrogel that enables the decoupled control of electrical conductivity and mechanical rigidity and is use to electrically stimulate cellular endogenous proangiogenic factor expression (Chapter 6). Overall, the biomaterial systems developed in this thesis will be broadly useful for improving the quality of a wide array of molecular and cellular based

  14. Strategies for improving early detection and diagnosis of neovascular age-related macular degeneration

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    Keane PA

    2015-02-01

    Full Text Available Pearse A Keane,1 Gabriella de Salvo,2 Dawn A Sim,1 Srini Goverdhan,2 Rupesh Agrawal,1 Adnan Tufail1 1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, 2Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Treatment of the neovascular form of age-related macular degeneration (AMD has been revolutionized by the introduction of such agents as ranibizumab, bevacizumab, and aflibercept. As a result, the incidence of legal blindness occurring secondary to AMD has fallen dramatically in recent years in many countries. While these agents have undoubtedly been successful in reducing visual impairment and blindness, patients with neovascular AMD typically lose some vision over time, and often lose the ability to read, drive, or perform other important activities of daily living. Efforts are therefore under way to develop strategies that allow for earlier detection and treatment of this disease. In this review, we begin by providing an overview of the rationale for, and the benefits of, early detection and treatment of neovascular AMD. To achieve this, we begin by providing an overview of the pathophysiology and natural history of choroidal neovascularization, before reviewing the evidence from both clinical trials and “real-world” outcome studies. We continue by highlighting an area that is often overlooked: the importance of patient education and awareness for early AMD detection. We conclude the review by reviewing an array of both established and emerging technologies for early detection of choroidal neovascularization, ranging from Amsler chart testing, to hyperacuity testing, to advanced imaging techniques, such as optical coherence tomography. Keywords: Amsler, detection, choroidal neovascularization, hyperacuity, optical coherence tomography

  15. Malignant melanoma of choroid

    Directory of Open Access Journals (Sweden)

    Manohar S

    1991-01-01

    Full Text Available Four cases of malignant melanoma of the choroid are reported due to rarity of the condition in India. One of the cases presented with Naevus of Ota. All the cases had typical clinical and investigative features. All cases were enucleated. Histopathologically three of them were of mixed type and one was of the epithelioid type. Two of the cases were seen in patients below 40 years of age.

  16. A Case of Choroidal Tubercles

    Institute of Scientific and Technical Information of China (English)

    Chaoran Zhang

    2004-01-01

    Purpose: To report a case of choroidal tubercles in a miliary tuberculosis boy.Method: Clinical features description.Results: A 14-year-old boy was found to have multifocal choroidal tubercles. Angiography was performed. He was followed up for 12 months. The choroidal lesions regressed after using anti-tuberculosis drugs for 8 months. Pigment changes remained. Conclusion: Tuberculosis may present as a posterior segment inflammation. In miliary tuberculosis, choroid is also a target tissue. Eye Science 2004;20:23-24.

  17. Breaking barriers: insight into the pathogenesis of neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Hartnett ME

    2011-09-01

    Full Text Available Haibo Wang1, Erika S Wittchen2, M Elizabeth Hartnett11Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, UT; 2Department of Cell and Developmental Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: Neovascular age-related macular degeneration (AMD is a leading cause of central visual acuity loss in a growing segment of the population, those over the age of 60 years. Treatment has improved over the last decade, with the availability of agents that inhibit the bioactivity of vascular endothelial growth factor (VEGF, but it is still limited, because of tachyphylaxis and potential risk and toxicity of anti-VEGF agents. The authors have sought to understand the mechanisms of choroidal endothelial cell (CEC activation and transmigration of the retinal pigment epithelium (RPE and of RPE barrier dysfunction, events preceding vision-threatening neovascular AMD. The authors developed physiologically relevant human RPE and CEC coculture and transmigration models that have been important in helping to understand causes of events in human neovascular AMD. The authors can control for interactions between these cells and can separately assess activation of signaling pathways in each cell type relevant during CEC transmigration. Using these models, it was found that VEGF, particularly the cell-associated VEGF splice variant VEGF189, accounts for about 40% of CEC transmigration across the RPE. This percentage is in the range of similar reports following clinical inhibition of VEGF in neovascular AMD. RPE VEGF189 working through CEC VEGF receptor 2 activates the small guanosine triphosphatase (GTPase of the Rho family, Rac1, in CECs, which in turn facilitates CEC transmigration. Conversely, inhibition of Rac1 activity prevents CEC transmigration. Once activated, Rac1 aggregates with subunits of nicotinamide adenine dinucleotide phosphate (NADPH oxidase, resulting in the generation of reactive

  18. Resistance to anti-VEGF therapy in neovascular age-related macular degeneration: a comprehensive review.

    Science.gov (United States)

    Yang, Shiqi; Zhao, Jingke; Sun, Xiaodong

    2016-01-01

    As a progressive chronic disease, age-related macular degeneration (AMD) is the leading cause of irreversible vision impairment worldwide. Experimental and clinical evidence has demonstrated that vascular endothelial growth factor (VEGF) plays a vital role in the formation of choroidal neovascularization. Intravitreal injections of anti-VEGF agents have been recommended as a first-line treatment for neovascular AMD. However, persistent fluid or recurrent exudation still occurs despite standardized anti-VEGF therapy. Patients suffering from refractory or recurrent neovascular AMD may develop mechanisms of resistance to anti-VEGF therapy, which results in a diminished therapeutic effect. Until now, there has been no consensus on the definitions of refractory neovascular AMD and recurrent neovascular AMD. This article aims at clarifying these concepts to evaluate the efficacy of switching drugs, which contributes to making clinical decision more scientifically. Furthermore, insight into the causes of resistance to anti-VEGF therapy would be helpful for developing possible therapeutic approaches, such as combination therapy and multi-target treatment that can overcome this resistance.

  19. Pegaptanib sodium for neovascular age-related macular degeneration: clinical experience in the UK

    Directory of Open Access Journals (Sweden)

    Sobha Sivaprasad

    2008-06-01

    Full Text Available Sobha Sivaprasad, Nachiketa Acharya, Phil HykinMoorfields Eye Hospital, London, UKAbstract: The pathogenesis of age-related macular degeneration (AMD is unclear, but it can take either a neovascular/exudative/wet form, characterized by choroidal neovascularization (CNV, or a dry form. No treatments are available for the dry form, but there are a number of pharmacological interventions that inhibit vascular endothelial growth factor (VEGF, which is central to the pathogenesis of CNV and neovascular AMD. Available anti-VEGF agents either target all active VEGF isoforms (eg, ranibizumab, or take a more selective approach and inhibit only VEGF165 (eg, pegaptantib sodium. Current guidance on their use is equivocal and restrictive at best, resulting in associated difficulties in securing adequate, timely funding for treatment. The Moorfields Eye Hospital undertook an audit of 70 patients receiving intravitreal (ITV pegaptanib sodium on a pro re nata (prn dosing schedule. Despite initial funding delays, the audit recorded superior treatment outcomes compared with those reported in the VISION trials at 12 weeks: 88% of audit patients maintained stable vision, 29% gained vision and 6% experienced severe vision loss compared with 70%, ≥6% and ≤10% of patients in VISION at 54 weeks, respectively. The audit indicates a positive correlation between patients with better baseline visual acuity (VA and improved therapeutic benefits, including a greater likelihood of both vision gain and vision preservation. Experience at Moorfields also suggests that pegaptanib sodium is more useful in occult lesions than minimally classic lesions, and clinical experience suggests that combination therapies may offer the best approach with anti-VEGF therapies. Further randomized clinical trials will help better determine the optimal treatment strategies with pegaptanib sodium in neovascular AMD.Keywords: age-related macular degeneration, choroidal neovascularization

  20. Treatment of choroid metastases.

    Science.gov (United States)

    Dobrowsky, W

    1988-02-01

    Sixteen patients with choroid secondary tumours were treated with irradiation consisting of 40-50 Gy in 3-5 weeks. There were 14 female patients with breast cancer, one male patient with prostatic cancer and one male patient with cancer of unknown origin. In four cases bilateral ocular metastases were seen. Ten out of 20 treated eyes showed complete response to treatment, seven out of 20 showed partial response and three out of 20 were not influenced by irradiation. Survival of patients, all having widespread metastatic disease, was 3-48 months (median 20 months). All patients responding to treatment showed increased quality of life.

  1. Regulation of signaling events involved in the pathophysiology of neovascular AMD.

    Science.gov (United States)

    Wang, Haibo; Hartnett, M Elizabeth

    2016-01-01

    Neovascular age-related macular degeneration (AMD) is a complex disease in which an individual's genetic predisposition is affected by aging and environmental stresses, which trigger signaling pathways involving inflammation, oxidation, and/or angiogenesis in the RPE cells and choroidal endothelial cells (CECs), to lead to vision loss from choroidal neovascularization. Antiangiogenic therapies have greatly improved clinical outcomes in the last decade; however, vision improves in less than half of patients treated for neovascular AMD, and treatments remain inadequate for atrophic AMD. Many studies focus on genetic predisposition or the association of outcomes in trials of human neovascular AMD but are unable to evaluate the effects between different cell types involved in AMD and the signaling events that take place to cause pathologic biologic events. This manuscript complements other reviews in that it describes what is known generally in human AMD studies and clinical trials testing methods to inhibit vascular endothelial growth factor (VEGF inhibitors) and presents pathologic signaling events that develop in two important cell types, the RPE cells and the CECs, when stimulated by stresses or placed into conditions similar to what is currently understood to occur in neovascular AMD. This manuscript complements other reviews by discussing signaling events that are activated by cell-cell or cell-matrix interactions. These considerations are particularly important when considering growth factors, such as VEGF, which are important in physiologic and pathologic processes, or GTPases that are present but active only if GTP bound. In either case, it is essential to understand the role of signaling activation to distinguish what is pathologic from what is physiologic. Particularly important is the essential role of activated Rac1 in CEC transmigration of the RPE monolayer, an important step in blindness associated with neovascular AMD. Other concepts discussed include

  2. Clinical and histological findings after intravitreal injection of bevacizumsb (Avastin®) in a porcine model of choroidal neovascularisation

    DEFF Research Database (Denmark)

    Lassota, Nathan; Prause, Jan Ulrik; Scherfig, Erik;

    2010-01-01

    was identified immunohistochemically in the inner limiting membrane (ILM) and to a lesser degree in the remaining retina. Strong staining was also detected in both retinal blood vessels and entire CNV membranes with no cellular predisposition. Vascular endothelial growth factor expression was found in the CNV...... membranes, in the ILM, in the ganglion cell layer, in Müller cells throughout the neuroretina and in retinal blood vessels. CONCLUSIONS: Bevacizumab significantly reduced the proliferation of vascular endothelial cells in CNV membranes and showed a strong trend towards a reduction of leakage from......PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...

  3. CD36 deficiency leads to choroidal involution via COX2 down-regulation in rodents.

    Directory of Open Access Journals (Sweden)

    Marianne Houssier

    2008-02-01

    Full Text Available BACKGROUND: In the Western world, a major cause of blindness is age-related macular degeneration (AMD. Recent research in angiogenesis has furthered the understanding of choroidal neovascularization, which occurs in the "wet" form of AMD. In contrast, very little is known about the mechanisms of the predominant, "dry" form of AMD, which is characterized by retinal atrophy and choroidal involution. The aim of this study is to elucidate the possible implication of the scavenger receptor CD36 in retinal degeneration and choroidal involution, the cardinal features of the dry form of AMD. METHODS AND FINDINGS: We here show that deficiency of CD36, which participates in outer segment (OS phagocytosis by the retinal pigment epithelium (RPE in vitro, leads to significant progressive age-related photoreceptor degeneration evaluated histologically at different ages in two rodent models of CD36 invalidation in vivo (Spontaneous hypertensive rats (SHR and CD36-/- mice. Furthermore, these animals developed significant age related choroidal involution reflected in a 100%-300% increase in the avascular area of the choriocapillaries measured on vascular corrosion casts of aged animals. We also show that proangiogenic COX2 expression in RPE is stimulated by CD36 activating antibody and that CD36-deficient RPE cells from SHR rats fail to induce COX2 and subsequent vascular endothelial growth factor (VEGF expression upon OS or antibody stimulation in vitro. CD36-/- mice express reduced levels of COX2 and VEGF in vivo, and COX2-/- mice develop progressive choroidal degeneration similar to what is seen in CD36 deficiency. CONCLUSIONS: CD36 deficiency leads to choroidal involution via COX2 down-regulation in the RPE. These results show a novel molecular mechanism of choroidal degeneration, a key feature of dry AMD. These findings unveil a pathogenic process, to our knowledge previously undescribed, with important implications for the development of new therapies.

  4. Intravitreal dobesilate in the treatment of choroidal neovascularisation associated with age-related macular degeneration: report of two cases.

    Science.gov (United States)

    Cuevas, Pedro; Outeiriño, Luis; Azanza, Carlos; Giménez-Gallego, Guillermo

    2012-09-03

    This case report presents the effectiveness of intravitreal administration of dobesilate, a synthetic fibroblast growth factor inhibitor, in two patients showing neovascular age-related macular degeneration of the classic, and of the occult choroidal neovascularisation types, respectively. Our study demonstrates that the treatment induces the regression of both forms of this pathology, as assessed by spectral optical coherence tomography. Improvement of the lesions was accompanied of visual acuity improvement.

  5. Expulsive choroidal haemorrhage

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    Srinivasan M

    1992-01-01

    Full Text Available Expulsive choroidal haemorrhage is a dramatic and serious complication of cataract surgery that occurred in five patients out of ten thousand consecutive cataract surgeries performed by the author during the year 1989 and 1990. Report about this dreaded complication after cataract surgery are scanty and as far as I can remember I have not seen any report in Indian ophthalmic literature recently. Since cataract surgery forms the major part of intra ocular surgeries performed in our country, I thought it would be appropriate to report about this rare complication which may occur to all of us. Out of five cases 3 were males and 2 were females in the age group ranging between 45-72 years. Two eyes regained vision up to 6/12 after intra operative expulsive haemorrhage. All the eyes were salvaged by doing anterior sclerotomy. Diabetes, hypertension, glaucoma and myopia are the commonest predisposing factors.

  6. [Choroidal melanoma - evolution and prognosis].

    Science.gov (United States)

    Chiruţa, Daria; Stan, Cristina

    2014-01-01

    Choroidal melanoma is the most common primary intraocular malignant tumor. We present the case of a 62 year old patient who was diagnosed with intraocular tumor in his right eye, for about three years. Regarding the fact that the patient refused any kind of treatment during this period, we just had the opportunity to monitor this case. Finally, the diagnosis was choroidal melanoma, confirmed by the histopathological exam.

  7. Spectral-domain Optical Coherence Tomography Retinal and Choroidal Thickness Metric Repeatability in Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Hanumunthadu, Daren; Ilginis, Tomas; Restori, Marie

    2016-01-01

    PURPOSE: To determine the intrasession repeatability of spectral-domain OCT (SDOCT)-derived macular retinal and choroidal metrics in patients with neovascular age-related macular degeneration (nAMD) in the Distance of Choroid Study (DOCS). DESIGN: Validity and reliability analysis. METHODS......: Enrolled patients underwent repeated SDOCT imaging using the Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). A single technician certified for clinical trials took 3 macular volume scans. Retinal thicknesses were calculated for each of the 9 Early Treatment Diabetic Retinopathy Study (ETDRS......) macular subfields. Center point thickness and total macular volume were also included in the analysis. Manual subfoveal choroidal thickness measurements were made by a masked observer. RESULTS: A total of 40 eyes of 40 patients were included in this analysis (mean [± standard deviation] age: 74.1 [± 7...

  8. Antivascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Ilias Zampros

    2012-01-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of severe visual loss and blindness over the age of 50 in developed countries. Vascular endothelial growth factor (VEGF is considered as a critical molecule in the pathogenesis of choroidal neovascularization (CNV, which characterizes the neovascular AMD. Anti-VEGF agents are considered the most promising way of effectively inhibition of the neovascular AMD process. VEGF is a heparin-binding glycoprotein with potent angiogenic, mitogenic and vascular permeability-enhancing activities specific for endothelial cells. Two anti-VEGF agents have been approved by the US Food and Drug Administration (FDA for the treatment of neovascular AMD. Pegaptanib sodium, which is an aptamer and ranibizumab, which is a monoclonal antibody fragment. Another humanized monoclonal antibody is currently off-label used, bevacizumab. This paper aims to discuss in details the effectiveness, the efficacy and safety of these three anti-VEGF agents. New anti-VEGF compounds which are recently investigated for their clinical usage (VEGF-trap, small interfering RNA are also discussed for their promising outcomes.

  9. Panretinal cryotherapy in neovascular disease.

    OpenAIRE

    Vernon, S A; Cheng, H.

    1988-01-01

    Panretinal cryotherapy (PRC) was used to treat 15 eyes with rubeosis, nine of which had established neovascular glaucoma, and seven eyes with proliferative diabetic retinopathy. The rubeosis regressed, with preservation of vision and return to normal of intraocular pressure, in all but one eye. With one exception all eyes with proliferative retinopathy also showed new vessel regression after treatment. PRC may be considered an effective alternative to retinal photocoagulation in the treatment...

  10. Choroidal osteoma: US and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Park, Sang Woo [Armed Forces Kwangju Hospital, Kwangju (Korea, Republic of); Kim, Jeong Hun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2003-02-01

    The purpose of this study was to evaluate US and CT features of choroidal osteoma. US and CT scans of seven cases of choroidal osteoma occurring in six patients were retrospectively analyzed. We analysed US and CT findings with particular attention to the location, size, and shape of calcification associated with choroidal osteoma, and sought the possible cause of the tumor, if any. None of six patients had any possible cause related to choroidal osteoma. All of seven cases of choroidal osteoma were manifested as calcified mass which were located in the posterior wall of the eyeball near the juxtapapillary region. Calcification ranged in size from 1 to 2 cm and had curvilinear shape. Both US and CT were equally useful to evaluate choroidal osteoma. By depicting the characteristic calcification, US and CT are useful imaging modalities in evaluating choroidal osteoma.

  11. [Current trends in neovascular glaucoma treatment].

    Science.gov (United States)

    Vancea, P P; Abu-Taleb, A

    2005-01-01

    Neovascular glaucoma is divided in three clinical stages: rubeosis iridis, secondary open-angle glaucoma, and synechia of the angle-closure glaucoma. 36% of neovascular glaucomas occurs after central retinal vein occlusion, 32% after diabetic proliferative retinopathy, and 13% occurs after carotid artery obstructive. The key of success in the treatment of neovascular glaucoma is the early and rightly diagnosis, the treatment is aimed mainly at relieving pain, as the prognosis for maintaining visual function is extremely poor. The most important surgical procedures are trabeculectomy, artificial drainage shunts and cyclo-distraction by trans-scleral diode laser. This essay presents a synthesis of modern principle data concerning neovascular glaucoma.

  12. Pegaptanib sodium treatment in neovascular age-related macular degeneration: clinical experience in Germany

    Directory of Open Access Journals (Sweden)

    Nikolaus Feucht

    2008-06-01

    Full Text Available Nikolaus Feucht, Huebner Matthias, Chris P Lohmann, Mathias MaierAugenklinik rechts der Isar, Technical University Munich, GermanyBackground: The VEGF Inhibition Study In Ocular Neovascularisation (VISION reported the efficacy of intravitreal (ITV vascular endothelial growth factor (VEGF inhibition with pegaptanib sodium (Macugen® for the treatment of neovascular age-related macular degeneration (AMD. This paper reports clinical experience with pegaptanib sodium for the treatment of occult or minimally classic choroidal neovascularization (CNV due to AMD.Material and methods: The study included 50 eyes (in 49 patients with either occult CNV or minimally classic CNV secondary to neovascular AMD who were not eligible for photodynamic therapy (PDT. Study data were analyzed retrospectively. During the 6-month study, patients were administered an average 2.74 injections of 0.3 mg ITV pegaptanib sodium. Angiography and optical coherence tomography (OCT examinations were carried out and intraocular pressure (IOP and visual acuity (VA were measured at baseline, at 3 months and at 6 months. An eye examination was performed and VA was measured the 2 days following treatment and then again at weeks 4–6, and at 3 and 6 months. OCT, VA, and IOP were also assessed at 1 month.Results: ITV pegaptanib sodium was well tolerated and no treatment complications arose. Mean VA was measured as: 0.37 ± 0.24 at baseline; 0.37 ± 0.25 at 1 month; 0.37 ± 0.25 at 3 months and 0.40 ± 0.26 at 6 months. VA was stabilized in approximately 90% of eyes treated with pegaptanib sodium. OCT examination showed a minimal change in central retinal thickness (CRT during the course of the study, from 251.19 µm at baseline to 251.63 µm at 6 months. No elevation in IOP was measured during treatment at 4–6 months in patients receiving pegaptanib sodium.Conclusions: ITV therapy with pegaptanib sodium for occult and minimally classic CNV secondary to neovascular AMD offered good

  13. 玻璃体腔注射抗血管内皮生长因子药物治疗特发性脉络膜新生血管的临床疗效观察%Intravitreal anti-vascular endothelial growth factor in the treatment of idiopathic choroidal neovascularization:a retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    吴秋菊; 钱芳; 刘瑜玲; 赵琳; 陈晓勇; 马志中; 郭彤

    2015-01-01

    Objective To evaluate the efficacy of intravitreal anti-vascular endothelial growth factor ( VEGF) in the treatment of idiopathic neovascularization ( ICNV ) .Methods This retrospective study Involved 40 patients (40 eyes) with ICNV diagnosed based on the results from indirect ophthalmoscopy, fundus fluorescein angiography( FFA) ,ICG angiography ( ICGA) and optical coherence tomography ( OCT) . ICNV was subfoveal in 16 eyes and juxtafoveal in 24 eyes.Patients received 1-4 doses of intravitreal ranibizumab ( n=18 ) or intravitreal bevacizumab ( n=22 ) .Data on the best corrected visual acuity ( BCVA) ,OCT and central retinal thickness ( CRT) after treatment were retrieved and analyzed.Correlations between the post-treatment BCVA and other parameters were tested.Results The average BCVA was (55.3±18.19) prior to treatment and (76.45±13.03) at 6 months after treatment (P0.05),ICNV location (r=0.036, P>0.05),number of anti-VEGF injections (r=0.099,P>0.05) and type of anti-VEGF agent (ranibizumab or bevacizumab,r=0.089,P>0.05).No severe systemic complications were observed during the follow-up period.Conclusion Intravitreal injection of anti-VEGF agents may improve visual acuity and reduce central retinal thickness in patients with ICNV,thus having great therapeutic potential.%目的:观察玻璃体腔注射抗血管内皮生长因子( VEGF)药物治疗特发性脉络膜新生血管( ICNV)的临床效果及影响其预后的相关因素。方法收集2012年1月至2013年6月北京大学第三医院眼科中心40例(40只眼)ICNV患者的临床资料,进行回顾性分析。所有患者经间接检眼镜检查、荧光素眼底血管造影( FFA)检查、吲哚菁绿血管造影( ICGA)检查及光学相干断层扫描( OCT)检查确诊为ICNV。对所有患者行玻璃体腔注射抗VEGF药物进行治疗,注药次数1~4次,平均(2.5±0.72)次。术后患者复诊1次/月,在复诊时经OCT检查发现病变部位仍存

  14. [Neovascular glaucoma--etipathogeny and diagnosis].

    Science.gov (United States)

    Călugăru, D; Călugăru, M

    2012-01-01

    Neovascular glaucoma is defined as an iris and/or anterior chamber angle neovascularization associated with increased intraocular presure. It is a secondary glaucoma most frequently determined by a severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion and ocular ischemic syndrome; the uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and probably predominant agent in the pathogenesis of both intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis as well as neovacular glaucoma is divided into four grades that is prerubeotic, preglaucomatous, open-angle and angle closure glaucoma stages.

  15. Clinical applications of choroidal imaging technologies

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    Jay Chhablani

    2015-01-01

    Full Text Available Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.

  16. Unusual Orange-Colored Choroidal Metastases

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    Hatem Krema

    2013-01-01

    Full Text Available Purpose: To report the clinical and paraclinical features of two patients with orangecolored choroidal metastases in whom the primary cancers have not previously been associated with such lesions. Case Report: Orange-colored choroidal lesions were detected on the fundus examination of one patient with metastatic small cell neuroendocrine tumor of the larynx and oropharynx, and in another subject with metastatic alveolar soft part sarcoma of the leg. Although ultrasonographic characteristics of the choroidal masses were comparable to those of choroidal hemangiomas, fluorescein angiography revealed delayed initial fluorescence along with minimal fluorescence in subsequent phases of the angiogram which were in clear distinction from the earlier appearing and progressively intense fluorescence observed with circumscribed choroidal hemangiomas. Conclusion: Small cell neuroendocrine tumors and alveolar soft part sarcomas should be considered among the differential diagnoses for orange-colored choroidal metastases. Identifying these choroidal lesions could facilitate localizing the occult primary tumor. Fluorescein angiography may differentiate a unifocal orange choroidal metastasis from a circumscribed choroidal hemangioma.

  17. Metastasis rates and sites after treatment for choroidal melanoma by proton beam irradiation or by enucleation

    Directory of Open Access Journals (Sweden)

    Chryssanthi Koutsandrea

    2008-08-01

    Full Text Available Chryssanthi Koutsandrea, Marilita M Moschos, Michael Dimissianos, Gerasimos Georgopoulos, Ioannnis Ladas, Michael ApostolopoulosDepartment of Ophthalmology, Athens University, Athens, GreecePurpose: To investigate tumor thickness and location, the interval of time between treatment for choroidal melanoma (proton beam irradiation or enucleation and diagnosis of metastatic disease, and rates and sites of metastasis.Design: Retrospective, interventional, noncomparative case series.Methods: Follow-up of 152 patients with primary choroidal melanoma, between 1992 and 2006 (14 years. One hundred and twenty-one patients were treated with proton beam irradiation and 31 patients were treated with enucleation. Baseline and annual or semiannual ophthalmic examination, B-scan ultrasonography, systemic and laboratory evaluations (liver enzymes, chest X-ray, ultrasonography or magnetic resonance imaging of the liver were performed according to a standard protocol.Results: Nineteen patients (12.5% were diagnosed with metastasis during follow-up time after treatment for choroidal melanoma. Thirteen patients (10.7% of the irradiation group and 6 patients (19.3% of the enucleation group were diagnosed with metastasis. Eight patients (6.6% of the irradiation group and 5 patients (16.1% of the enucleation group were diagnosed with liver metastasis. Ocular complications after proton beam irradiation were recorded. Fifty-nine patients (48.7% of the irradiation group presented with cataract. Other complications were retinal detachment, retinopathy, vitreous haemorrhage, iris neovascularization, neovascular glaucoma, optic neuropathy, and corneal opacification.Conclusions: In our series, 10.7% of the irradiation group and 19.3% of the enucleation group were diagnosed with metastasis. The liver was the most common site of metastasis in both groups. Cataract was the most common complication in the irradiation group.Keywords: melanoma, metastasis, irradiation, enucleation

  18. Stereotactic radiotherapy in neovascular age-related macular degeneration

    Science.gov (United States)

    Ranjbar, Mahdy; Kurz, Maximilian; Holzhey, Annekatrin; Melchert, Corinna; Rades, Dirk; Grisanti, Salvatore

    2016-01-01

    Abstract Stereotactic radiotherapy (SRT) is a new approach to treat neovascular age-related macular degeneration (nAMD). The INTREPID trial suggested that SRT could reduce the frequency of regular intravitreal injections (IVIs) with antivascular endothelial growth factor drugs, which are necessary to control disease activity. However, the efficacy of SRT in nAMD and resulting morphological changes have not been validated under real-life circumstances, an issue, which we would like to address in this retrospective analysis. Patients who met the INTREPID criteria for best responders were eligible for SRT. A total of 32 eyes of 32 patients were treated. Thereafter, patients were examined monthly for 12 months and received pro re nata IVI of aflibercept or ranibizumab. Outcome measures were: mean number of injections, best-corrected visual acuity, and morphological changes of the outer retina-choroid complex as well as patient safety. Mean number of IVI decreased by almost 50% during the 12 months after SRT compared to the year before, whereas visual acuity increased by one line (logMAR). Morphological evaluation showed that most changes affect outer retinal layers. Stereotactic radiotherapy significantly reduced IVI retreatment in nAMD patients under real-life circumstances. Therefore, SRT might be the first step to stop visual loss as a result of IVI undertreatment, which is a major risk. PMID:28033280

  19. Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

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    Shih Hao Wang

    2017-01-01

    Full Text Available A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV, intravitreal bevacizumab (1.25 mg/0.05 mL injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.

  20. Bietti crystalline dystrophy and choroidal neovascularisation.

    Science.gov (United States)

    Gupta, B; Parvizi, S; Mohamed, M D

    2011-02-01

    Bietti crystalline dystrophy is a rare autosomal recessive condition characterised by the presence of crystals in the retina and is followed by retinal and choroidal degeneration. We present a novel finding of juxtafoveal choroidal neovascularisation in Bietti crystalline dystrophy and demonstrate a spectral domain optical coherence tomography image of this disorder.

  1. Decalcified choroidal osteoma found in the retina

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    Yoshikawa T

    2012-11-01

    Full Text Available Tadanobu Yoshikawa, Kanji TakahashiDepartment of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, JapanAbstract: Choroidal osteoma is a benign tumor of the choroid. Herein, we report a rare case of decalcified choroidal osteoma found in the retina. A 27-year-old woman presented with visual loss. Her best-corrected visual acuity was 20/50 OS. Ophthalmoscopy of the left eye revealed a yellow-white calcified region accompanied by a decalcified region of four disc diameters in size. After 6 years, spectral-domain optical coherence tomography showed a tumor projected strongly upwards from the choroid and partially through the retina with serous retinal detachment, with both a lamellar appearance and mound-like area. The calcified region became more contractive than was observed on the first visit. Conversely, the decalcified region was wider than was observed on the first visit. Her best-corrected visual acuity was 20/400 OS. Choroidal osteoma was worsened by progression of decalcification. The decalcified choroidal osteoma resulted in poor visual acuity, and projected strongly upward from the choroid and into the retina.Keywords: osteoma, decalcification, choroidal osteoma

  2. Circulating monocytes and B-lymphocytes in neovascular age-related macular degeneration

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    Hector SM

    2017-01-01

    imbalance in the recruitment of macrophages into the retina during disease development. Keywords: macular degeneration, choroidal neovascularization, flow cytometry

  3. Tomografia de coerência óptica em osteoma de coróide: relato de caso Optical coherence tomography in choroidal osteoma: case report

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    Mário Junqueira Nóbrega

    2005-10-01

    Full Text Available Os autores apresentam um caso de osteoma de coróide diagnosticado em paciente do sexo masculino aos 62 anos de idade. A lesão bem delimitada e pouco elevada no pólo posterior do olho direito acompanhada de vascularização interna e neovascularização de coróide em sua borda temporal superior e inferior levaram à suspeita do tumor. O diagnóstico de certeza foi obtido com ecografia A e B e tomografia computadorizada. A tomografia de coerência óptica mostrou alta refletividade em toda a espessura do osteoma bem como elevação do complexo EPR-cório-capilar na região da membrana neovascular subretiniana. Embora os achados tomográficos descritos na literatura e os observados neste caso sejam variados, a tomografia de coerência óptica pode colaborar no diagnóstico de osteoma de coróide.The authors present a case of choroidal osteoma diagnosed in a 62-year-old male patient. A well-defined and slightly elevated lesion located in the posterior pole of the right eye associated with internal vasculature and choroidal neovascularization at its superior and inferior temporal edge were suspicious of the tumor. Confirmation of diagnosis was obtained with A and B ecography and computed tomography. Optical coherence tomography showed high reflectivity through its thickness as well as elevation of the RPE-choriocapillaris complex at the choroidal neovascularization site. Although the literature and the present case show several different tomographical findings, optical coherence tomography can help establishing the diagnosis of choroidal osteoma.

  4. Focal choroidal excavation: a preliminary interpretation based on clinic and review

    Institute of Scientific and Technical Information of China (English)

    Guang-Hui; Liu; Bing; Lin; Xin-Quan; Sun; Zi-Fang; He; Ji-Rong; Li; Rong; Zhou; Xiao-Ling; Liu

    2015-01-01

    AIM: To describe the clinical and imaging characteristics associated with focal choroidal excavation(FCE), analyze the possible complication, and interpret its probable etiopathogenesis.METHODS: Retrospective descriptive case series of 37 eyes of 32 patients with FCE. Findings of spectral-domain optical coherence tomography(SD-OCT),fluorescein angiography, indocyanine green angiography,and clinical features were analyzed. RESULTS: All patients were Chinese. Five patients(15.6%) were bilaterally involved. Patients’ ages ranged from 7 to 66 y. Refractive error ranged between +2.0 D and 11.0 D. Mean best-corrected visual acuity was 0.6(range, 0.1 to 1.2). Fundus examinations exhibited mild-moderate localized pigmentary disturbances in the corresponding area of 17 eyes. Fluorescein angiography performed in 18 patients showed varying degrees of hyperfluorescence and hypofluorescence related to a range of retinal pigment epithelium(RPE) alterations.Indocyanine green angiography performed in 7 patients showed hypofluorescence at the excavation. SD-OCT demonstrated choroidal excavation in all 37 eyes.Twenty-nine eyes showed a single lesion of FCE, and three eyes showed 2-3 separated lesions. Fifteen eyes showed separation between the photoreceptor tips andRPE consistent with nonconforming FCE. Central serous chorioretinopathy(CSC, n =1) and choroidal neovascularization(CNV, n =1) developed during follow-up.CONCLUSION: FCE could be interpreted as congenital focal choroidal dysplasia involving the RPE,choriocapillaris, and photoreceptor associated with the faulty anatomy. The abnormal anatomy of FCE was similar to anatomy at risk of CSC and CNV.

  5. [Evaluation of antiangiogenic treatment results in choroidal neovascularization related to pathological myopia].

    Science.gov (United States)

    Carvalho, Beatriz; Freitas-Costa, Paulo; Pinheiro-Costa, João; Falcão, Manuel; Carneiro, Ângela; Falcão-Reis, Fernando

    2014-01-01

    Introdução: A neovascularização coroideia associada à miopia patológica é uma das principais causas de perda de visão central e irreversível em indivíduos jovens. Os objetivos deste estudo são avaliar os resultados a longo prazo do tratamento antiangiogénico, com ranibizumab e/ou bevacizumab, na neovascularização coroideia associada à miopia patológica e caraterizar os fatores preditivos dos resultados funcionais e anatómicos obtidos.Material e Métodos: Avaliámos os resultados de 84 olhos de 81 doentes com neovascularização coroideia miópica, dos quais 84 (100%) completaram 12 meses de seguimento, 67 (79,8%) 24 meses de seguimento, 54 (64,3%) 36 meses de seguimento, 29 (34,5%) 48 meses de seguimento e 15 (16,7%) 60 meses de seguimento. Procedemos à recolha de dados relativos à melhor acuidade visual corrigida em escala ETDRS, espessura foveal na tomografia de coerência óptica e caraterísticas da angiografia fluoresceínica, inicial e após tratamento.Resultados: As melhorias na melhor acuidade visual corrigida e na espessura foveal foram significativas para todos os tempos de seguimento (p < 0,05). A média da melhor acuidade visual corrigida inicial era de 43,7 ± 20,1 letras e da espessura foveal inicial de 304,8 ± 127,9μm. As médias da melhor acuidade visual corrigida foram de 55,6 ± 18,5, 52,1 ± 22,3, 52,1 ± 22,6, 50,3 ± 23,8 e 47,8 ± 24,5 para os 12, 24, 36, 48 e 60 meses de tratamento, respetivamente. As médias das espessuras foveais foram de 209,7 ± 86,2, 190,6 ± 76,1, 174,7 ± 60,6, 189,8 ± 96,7 e 159,4 ± 73,3 para os mesmos tempos de seguimento. Apenas a melhor acuidade visual corrigida inicial foi preditiva de melhores resultados na melhor acuidade visual corrigida final (p < 0,001).Discussão/Conclusão: As injecções intravítreas de anti-VEGF em doentes com neovascularização coroideia miópica cursam com uma melhoria funcional e anatómica significativa e sustentada no tempo. Ensaios clínicos randomizados com follow-up mais extenso são necessários para comprovar a eficácia sustentada destes agentes.

  6. New approaches in the management of choroidal neovascular membrane in age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Verma Lalit

    2000-01-01

    Full Text Available Age-related macular degeneration (AMD is a leading cause of blindness in the elderly population. The prevalence is reported to be 1.2-1.4% in several population-based epidemiological studies. Currently 25-30 million people worldwide are blind due to AMD. With the aging world population it is bound to increase significantly, and could become a significant public health problem in next two decades, with serious socio-economic implications. Several strategies are today available to treat the wet form of AMD, which is responsible for significant visual loss. These were until recently confined to laser photocoagulation, and subretinal surgery, but today two other modalities, namely, radiation and photodynamic therapy, are available. These treatment modalities however, are aimed at preservation of vision only, and not at reversing the process of the disease. Further research on antiangiogenic drugs and gene therapy could significantly help AMD patients.

  7. Choroidal Metastases From Cutaneous Melanoma.

    Science.gov (United States)

    Mercado, Carmel L; Toy, Brian C; Kistler, Henry B; Moshfeghi, Darius M

    2016-05-01

    A 92-year-old man presented with months of progressive blurry vision, worsening acutely in his right eye. He denied pain, diplopia, or photopsias. His history was significant for multiple myeloma, prostate cancer, and malignant melanoma of his right shoulder treated with local excision. He had local recurrence with hepatic metastasis of the melanoma treated with radiation and chemotherapy. On examination, his visual acuity was counting fingers in the right eye and 20/60 in the left eye. Amsler grid testing demonstrated metamorphopsia in the right eye. Fundus exam of the right and left eyes revealed multiple, elevated, pigmented choroidal lesions, with associated subretinal fluid in the right macula. This appearance is consistent with hematogenous metastasis of cutaneous malignant melanoma to the choroid and associated serous fluid-causing metamorphopsia. The patient was enrolled in a clinical trial combining plasmid IL-12 with pembrolizumab (Keytruda; Merck, Whitehouse Station, NJ). He passed away 2 months after initial presentation to our clinic. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:497.].

  8. Cytokines in neovascular age-related macular degeneration: fundamentals of targeted combination therapy.

    Science.gov (United States)

    de Oliveira Dias, João Rafael; Rodrigues, Eduardo Büchele; Maia, Mauricio; Magalhães, Octaviano; Penha, Fernando Marcondes; Farah, Michel Eid

    2011-12-01

    The neovascular form of age-related macular degeneration (AMD), called wet-AMD or choroidal neovascularisation, begins with damage to the outer retinal cells and retinal pigment epithelium (RPE), which elicits a cascade of inflammatory and angiogenic responses leading to neovascularisation under the macula. Studies showed that oxidative damage, chronic inflammation of the RPE and complement misregulation work at different steps of this disease. After established neovascularisation, several pro- and antiangiogenic agents start to play an important role. Vascular endothelial growth factors (VEGFs) are the most specific and potent regulators of angiogenesis, which are inhibited by intravitreal injections of ranibizumab, bevacizumab, VEGF Trap, pegaptanib sodium and other agents under investigation. Pigment epithelium-derived factor, on the other hand, shows neuroprotective and antiangiogenic activities. Hepatocyte growth factor (HGF) has a mitogenic effect on a wide range of epithelial and endothelial cells, and it is inhibited by an anti-HGF monoclonal antibody. Platelet-derived growth factor is a potent chemoattractant and mitogen for both fibroblasts and retinal RPE cells, which has been inhibited experimentally by VEGF Trap and human anti-platelet-derived growth factor-D monoclonal antibody. Fibroblast growth factor-2 has pleiotropic effects in different cell and organ systems, and it is blocked by anti-FGF antibodies, with a greater benefit regarding antiangiogenesis when combined treatment with anti-VEGF is performed. Tumour necrosis factor alpha is expressed in the retina and the choroid, and its blockade in choroidal neovascularisation includes the use of monoclonals such as infliximab. This paper reviews the most important cytokines involved in the pathogenesis of wet-AMD, with emphasis on potential combined therapies for disease control.

  9. Radiogenic Side Effects After Hypofractionated Stereotactic Photon Radiotherapy of Choroidal Melanoma in 212 Patients Treated Between 1997 and 2007

    Energy Technology Data Exchange (ETDEWEB)

    Dunavoelgyi, Roman [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Dieckmann, Karin [Department of Radiology, Medical University of Vienna, Vienna (Austria); Gleiss, Andreas [Section of Clinical Biometrics, Medical University of Vienna, Vienna (Austria); Sacu, Stefan; Kircher, Karl; Georgopoulos, Michael [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Georg, Dietmar [Department of Radiology, Medical University of Vienna, Vienna (Austria); Zehetmayer, Martin, E-mail: martin.zehetmayer@meduniwien.ac.at [Department of Ophthalmology, Medical University of Vienna, Vienna (Austria); Poetter, Richard [Department of Radiology, Medical University of Vienna, Vienna (Austria)

    2012-05-01

    Purpose: To evaluate side effects of hypofractionated stereotactic photon radiotherapy for patients with choroidal melanoma. Patients and Methods: Two hundred and twelve patients with choroidal melanoma unsuitable for ruthenium-106 brachytherapy or local resection were treated stereotactically at the Medical University of Vienna between 1997 and 2007 with a Linac with 6-MV photon beams in five fractions with 10, 12, or 14 Gy per fraction. Examinations for radiogenic side effects were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and then once a year thereafter until 10 years after radiotherapy. Adverse side effects were assessed using slit-lamp examination, funduscopy, gonioscopy, tonometry, and, if necessary, fundus photography and fluorescein angiography. Evaluations of incidence of side effects are based on an actuarial analysis. Results: One hundred and eighty-nine (89.2%) and 168 (79.2%) of the tumors were within 3 mm of the macula and the optic disc, respectively. The five most common radiotherapy side effects were retinopathy and optic neuropathy (114 cases and 107 cases, respectively), cataract development (87 cases), neovascular glaucoma (46 cases), and corneal epithelium defects (41 cases). In total, 33.6%, 38.5%, 51.2%, 75.5%, and 77.6% of the patients were free of any radiation retinopathy, optic neuropathy, cataract, neovascular glaucoma, or corneal epithelium defects 5 years after radiotherapy, respectively. Conclusion: In centrally located choroidal melanoma hypofractionated stereotactic photon radiotherapy shows a low to moderate rate of adverse long-term side effects comparable with those after proton beam radiotherapy. Future fractionation schemes should seek to further reduce adverse side effects rate while maintaining excellent local tumor control.

  10. Management of neovascular age-related macular degeneration: current state-of-the-art care for optimizing visual outcomes and therapies in development

    Directory of Open Access Journals (Sweden)

    Agarwal A

    2015-06-01

    Full Text Available Aniruddha Agarwal, William R Rhoades, Mostafa Hanout, Mohamed Kamel Soliman, Salman Sarwar, Mohammad Ali Sadiq, Yasir Jamal Sepah, Diana V Do, Quan Dong Nguyen Stanley M Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA Abstract: Contemporary management of neovascular age-related macular degeneration (AMD has evolved significantly over the last few years. The goal of treatment is shifting from merely salvaging vision to maintaining a high quality of life. There have been significant breakthroughs in the identification of viable drug targets and gene therapies. Imaging tools with near-histological precision have enhanced our knowledge about pathophysiological mechanisms that play a role in vision loss due to AMD. Visual, social, and vocational rehabilitation are all important treatment goals. In this review, evidence from landmark clinical trials is summarized to elucidate the optimum modern-day management of neovascular AMD. Therapeutic strategies currently under development, such as gene therapy and personalized medicine, are also described. Keywords: AMD, neovascular AMD, choroidal neovascular membrane, pharmacogenomics, VEGF, low-vision rehabilitation, gene therapy

  11. Fundus Analysis and Visual Prognosis of Macular Hemorrhage in Pathological Myopia without Choroidal Neovasculopathy

    Institute of Scientific and Technical Information of China (English)

    Haitao Li; Feng Wen; De-zheng Wu; Guangwei Luo; Shizhou Huang; Tianqin Guan; Caijiao Liu

    2004-01-01

    Purpose:To analysis and evaluate the fundus characteristics and visual prognosis of macular hemorrhage in pathological myopia without choroidal neovasculopathy. Methods:Thirty-seven patients (38 eyes) of pathological myopia with macular hemorrhage and without choroidal neovascularization (CNV) underwent color photograph and fundus fiuorescein angiography (FFA) examinations. Indocyanine green angiography (ICGA) was also performed on 11 patients (11 eyes). Follow-up ranged from 3 to 21 months.Results :The macular hemorrhage in pathological, myopia without CNV demonstrated oval, less than 1PD, without edema and exudation. Lacquer cracks appeared at the site of previous subretinal bleeding in 84.2% of the eyes. The visual acuities were improved in 81.6% of eyes during the follow-up period. ICGA revealed linear hypofluorescence in 7 of 11 eyes (63.6%), indicating a ruptured Bruch's membrance at the onset of subretinal bleeding.Conclusion: A rupture of choriocapillaris complex and Bruch's membrane causes macular hemorrhage of pathological myopia without CNV, leading to the formation of a new lacquer crack. Its prognosis is favorable. Eye Science 2004;20:57-62.

  12. Stereotactic Fractionated Radiotherapy in the Treatment of Juxtapapillary Choroidal Melanoma: The McGill University Experience

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    Al-Wassia, Rolina; Dal Pra, Alan; Shun, Kitty; Shaban, Ahmed [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); Corriveau, Christine [Department of Ophthalmology, Notre Dame Hospital, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Edelstein, Chaim; Deschenes, Jean [Department of Ophthalmology, McGill University Health Centre, Montreal, Quebec (Canada); Ruo, Russel; Patrocinio, Horacio [Department of Medical Physics, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); Cury, Fabio L.B. [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada); DeBlois, Francois [Department of Medical Physics, Jewish General Hospital, McGill University, Montreal, Quebec (Canada); Shenouda, George, E-mail: george.shenouda@muhc.mcgill.ca [Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec (Canada)

    2011-11-15

    Purpose: To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. Methods and Materials: We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. Results: The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Conclusions: Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.

  13. Intravitreal bevacizumab has initial clinical benefit lasting eight weeks in eyes with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    P William Conrad

    2008-06-01

    Full Text Available P William Conrad, David N Zacks, Mark W JohnsonDepartment of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USAPurpose: To determine whether the effect of a single initial intravitreal injection of bevacizumab for neovascular age-related macular degeneration (AMD persists for 8 weeks.Methods: We reviewed the records of 25 consecutive patients with neovascular AMD treated with intravitreal bevacizumab. Patients were included (n = 15 if follow up data were available from 4 and 8 week visits after a single initial injection. Additionally, optical coherence tomography (OCT images were graded qualitatively in a masked fashion by a single reader.Results: Baseline mean visual acuity was 20/200, improving to 20/125 at 4 weeks (p = 0.0153 and 20/100 at 8 weeks (p = 0.0027. Mean central retinal thickness was 316 ± 107 µm at baseline and decreased to 223 ± 70 µm and 206 ± 45 µm at 4 and 8 weeks post-injection, respectively (p = 0.0003 and 0.0005. By masked OCT grading, macular fluid was resolved in 10/15 (66.7% and 11/15 (73.3% eyes at 4 and 8 weeks, respectively, and 3/15 (20% eyes had continued reduction in residual macular fluid between 4 and 8 weeks.Conclusions: A single initial bevacizumab injection has persistent clinical benefit lasting 8 weeks in most eyes with neovascular AMD. Results of prospective randomized studies are needed before changes in treatment regimens can be recommended.Keywords: age-related macular degeneration, bevacizumab, choroidal neovascular membrane, optical coherence tomography

  14. Intravitreal Expansile Gas and Bevacizumab Injection for Submacular Hemorrhage Due to Neovascular Age-related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Ramin Nourinia

    2010-01-01

    Full Text Available Purpose: To evaluate the results of intravitreal expansile gas injection, with or without recombinant tissue plasminogen activator (rtPA, followed by intravitreal bevacizumab injection for treatment of submacular hemorrhage (SMH secondary to neovascular age-related macular degeneration (AMD. Methods: In this interventional case series, 5 eyes of 5 patients with SMH secondary to choroidal neovascularization (CNV due to neovascular AMD were treated with 0.3 cc intravitreal SF6 (and 50 μg of rtPA in two eyes, followed by face-down positioning; 24 hours later, 1.25 mg of bevacizumab was injected intravitreally. Main outcome measures included displacement of SMH and best corrected visual acuity (BCVA. Results: Mean patient age was 75.6±9.2 (range, 60-83 years, mean duration of symptoms was 6.4±3.2 (range, 3-10 days, and mean number of bevacizumab injections was 1.8 (range, 1-3. Mean preoperative BCVA was 1.28±0.27 logMAR which improved significantly to 0.57±0.33 logMAR at 12 months (P=0.042. SMH displacement occurred in all eyes, and visual acuity improved and remained stable during the follow-up period of 12 months. Conclusion: Intravitreal expansile gas injection, with or without rtPA, followed by intravitreal bevacizumab injection, seems to be an effective modality for SMH displacement and treatment of the underlying CNV in neovascular AMD.

  15. Subretinal lipid exudation associated with untreated choroidal melanoma

    Directory of Open Access Journals (Sweden)

    C K Minija

    2011-01-01

    Full Text Available Subretinal lipid exudation in an untreated choroidal melanoma is very rare. It is seen following plaque radiotherapy in choroidal melanoma. There is only one case report of untreated choroidal melanoma with massive lipid exudation in a patient with metastatic hypernephroma. We report here a rare case of untreated choroidal melanoma with lipid exudation. Subretinal exudation that is rarely seen following plaque brachytherapy was noted at the borders of this untreated tumor. Lipid exudation partially resolved following brachytherapy.

  16. De novo Evolution of a Small Choroidal Melanoma

    Science.gov (United States)

    Aleksidze, Nino; Medina, Carlos A.; Singh, Arun D.

    2015-01-01

    Aim To report the evolution of a de novo choroidal melanoma. Method This is a case report of a 22-year-old white male patient who has been undergoing periodic examination for a choroidal ‘freckle’ since 10 years of age. Results In 2007, a fundus photograph of the left eye showed a nondescript area of choroidal hyperpigmentation temporal to the fovea. Progressive growth was observed and, by 2012, the lesion had become well circumscribed and raised. One year later, a 4.5 × 4.5 × 1.5 mm, dome-shaped, pigmented, choroidal mass with subretinal fluid and orange pigmentation was evident. The lesion was classified as a small choroidal melanoma. Six months after plaque radiotherapy, tumor regression with total resolution of the subretinal fluid was documented. Conclusion The distinction between small choroidal melanoma and choroidal nevus is not absolute; therefore, some choroidal melanomas may initially be mislabeled as choroidal nevi because of their small size until continued growth identifies them to be small choroidal melanomas. In our case, the documented growth of the choroidal lesion on each consecutive visit and its high-risk features strongly suggest that it had been a melanoma from the beginning. To our knowledge, this is only the second documented case of a de novo evolution of a small choroidal melanoma. PMID:27231689

  17. Treatment with cyclosporine A in serpiginous choroiditis: A case report

    OpenAIRE

    Kovačević Dragana; Detanac Dženana A.; Marković Vujica; Radosavljević Aleksandra; Doklestić Krstina; Detanac Džemail S; Milenković Svetislav

    2012-01-01

    Serpiginous choroiditis is a rare clinical entity. The clinical course of serpiginous choroiditis is very variable, there is no universal marker of treatment success, and even among experts there is debate about what is the most appropriate treatment. The aim of this paper is to describe a case of serpiginous choroiditis treated with Cyclosporine A at a tertiary uveitis referral centre.

  18. Treatment with cyclosporine A in serpiginous choroiditis: A case report

    Directory of Open Access Journals (Sweden)

    Kovačević Dragana

    2012-03-01

    Full Text Available Serpiginous choroiditis is a rare clinical entity. The clinical course of serpiginous choroiditis is very variable, there is no universal marker of treatment success, and even among experts there is debate about what is the most appropriate treatment. The aim of this paper is to describe a case of serpiginous choroiditis treated with Cyclosporine A at a tertiary uveitis referral centre.

  19. Intravitreal bevacizumab (avastin for circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Subrata Mandal

    2011-01-01

    Full Text Available Circumscribed choroidal hemangiomas are rare ophthalmic entities that cause diminution in vision due to accumulation of subretinal and/or intraretinal fluid in the macular area. Various treatment options ranging from conventional laser to photodynamic therapy have been employed to destroy the tumor and reduce the exudation; however, either the inability to penetrate through the exudative fluid or the collateral retinal damage induced by these treatment modalities make them unsuitable for lesions within the macula. We evaluated the role of intravitreal bevacizumab, a pan-vascular endothelial growth factor (VEGF inhibitor, in reducing the sub- and intraretinal fluid in three patients with circumscribed choroidal hemangiomas. All the patients had complete resolution of the serous retinal detachment that was maintained till at least 12 months after the first injection. Intravitreal bevacizumab may be used in combination with thermal laser or photodynamic therapy in treating circumscribed choroidal hemangiomas with subretinal fluid.

  20. [Diagnostic Approaches to Suspected Choroidal Melanoma].

    Science.gov (United States)

    Girbardt, C; Rehak, M; Wiedemann, P

    2017-03-10

    Whenever funduscopy reveals possible choroidal melanoma, all available information must be gathered to either confirm or exclude the diagnosis. Well-defined funduscopic criteria are available, which can already lead to a high degree of diagnostic certainty. Additional technical examinations can be used to exclude possible differential diagnoses. In cases where no clear diagnosis can be established, it is possible to take a biopsy or to watch and wait in order to observe possible growth. Whenever the diagnosis of a choroidal melanoma is established, cancer staging has to be performed in order to search for possible metastases.

  1. Choroidal Tuberculoma in an Immunocompetent Young Patient

    Institute of Scientific and Technical Information of China (English)

    Xiu-fen Yang; Jun Xu; Kai Ma

    2011-01-01

    @@ TUBERCULOSIS (TB) remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis (M.tuberculosis).Ocular involvement in patients with systemic TB has traditionally been considered uncommon.The incidence of ocular TB was reported to be 1.46% among 10 524 patients in a TB sanatorium2 and there are only few reports of choroidal tuberculoma in the literature .3-5 Here we reported a case of choroidal tuberculoma in an immunocompetent young patient with a history of tuberculous pleurisy.

  2. Choroidal Freckling in Pediatric Patients Affected by Neurofibromatosis Type 1.

    Science.gov (United States)

    Vagge, Aldo; Nelson, Leonard B; Capris, Paolo; Traverso, Carlo Enrico

    2016-09-01

    Greater understanding of choroidal freckling in patients affected by neurofibromatosis type 1 (NF1) has changed the previous belief that choroidal lesions are unusual in eyes with this disease. In fact, the high frequency of freckling suggests that the choroid is a structure commonly affected in patients with NF1. A review of patients aged 16 years or younger was performed. Recent studies using near-infrared reflectance imaging have shown that choroidal freckling frequently occurred in pediatric patients. As a result of these findings, some authors have suggested that choroidal freckling should be considered as a new diagnostic criterion for NF1. [J Pediatr Ophthalmol Strabismus. 2016;53(5):271-274.].

  3. The Choroidal Eye Oximeter - An instrument for measuring oxygen saturation of choroidal blood in vivo

    Science.gov (United States)

    Laing, R. A.; Danisch, L. A.; Young, L. R.

    1975-01-01

    The Choroidal Eye Oximeter is an electro-optical instrument that noninvasively measures the oxygen saturation of choroidal blood in the back of the human eye by a spectrophotometric method. Since choroidal blood is characteristic of blood which is supplied to the brain, the Choroidal Eye Oximeter can be used to monitor the amount of oxygen which is supplied to the brain under varying external conditions. The instrument consists of two basic systems: the optical system and the electronic system. The optical system produces a suitable bi-chromatic beam of light, reflects this beam from the fundus of the subject's eye, and onto a low-noise photodetector. The electronic system amplifies the weak composite signal from the photodetector, computes the average oxygen saturation from the area of the fundus that was sampled, and displays the value of the computed oxygen saturation on a panel meter.

  4. Transthyretin represses neovascularization in diabetic retinopathy

    Science.gov (United States)

    Shao, Jun

    2016-01-01

    Purpose The apoptosis of human umbilical vein endothelial cells has been reportedly induced by the protein transthyretin (TTR). In human ocular tissue, TTR is generally considered to be secreted mainly by retinal pigment epithelial cells (hRPECs); however, whether TTR affects the development of neovascularization in diabetic retinopathy (DR) remains unclear. Methods Natural and simulated DR media were used to culture human retinal microvascular endothelial cells (hRECs). Hyperglycemia was simulated by increasing the glucose concentration from 5.5 mM up to 25 mM, while hypoxia was induced with 200 µM CoCl2. To understand the effects of TTR on hRECs, cell proliferation was investigated under natural and DR conditions. Overexpression of TTR, an in vitro wound-healing assay, and a tube formation assay were employed to study the repression of TTR on hRECs. Real-time fluorescence quantitative PCR (qRT-PCR) was used to study the mRNA levels of DR-related genes, such as Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2. Results The proliferation of hRECs was significantly decreased in the simulated hyperglycemic and hypoxic DR environments. The cells were further repressed by added exogenous or endogenous TTR only under hyperglycemic conditions. The in vitro migration and tube formation processes of the hRECs were inhibited with TTR; furthermore, in the hyperglycemia and hyperglycemia/hypoxia environments, the levels of Tie2 and Angpt1 mRNA were enhanced with exogenous TTR, while those of VEGFR1, VEGFR2, and Angpt1 were repressed. Conclusions In hyperglycemia, the proliferation, migration, and neovascularization of hRECs were significantly inhibited by TTR. The key genes for DR neovascularization, including Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2, were regulated by TTR. Under DR conditions, TTR significantly represses neovascularization by inhibiting the proliferation, migration and tube formation of hRECs. PMID:27746673

  5. Choroidal melanoma clinically simulating a retinal angioma

    Energy Technology Data Exchange (ETDEWEB)

    Shields, J.A.; Joffe, L.; Guibor, P.

    1978-01-01

    An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

  6. Choroidal melanoma clinically simulating a retinal angioma.

    Science.gov (United States)

    Shields, J A; Joffe, L; Guibor, P

    1978-01-01

    An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

  7. Photodynamic therapy of symptomatic choroidal nevi

    Directory of Open Access Journals (Sweden)

    Luis Amselem

    2011-01-01

    Full Text Available Purpose : To evaluate the role of photodynamic therapy (PDT for patients with symptomatic choroidal nevi involving the fovea or located near the fovea with subretinal fluid extending to the fovea. Materials and Methods : Retrospective review of five patients who underwent PDT for choroidal nevi at two separate centers in Ankara and Barcelona. Results : The mean initial logMAR visual acuity was 0.5 (range: 0 to 1.5. The mean largest tumor base diameter was 3.2 mm (range: 2.1-4.5 mm and the mean tumor thickness was 1.1 mm (range: 0.7-1.6 mm. The mean number of PDT sessions was 1.6 (range:1-3. The mean final tumor thickness was 1.0 mm (range: 0-1.6 mm at a mean follow-up of 19 months (range: 12-32 months. The mean final logMAR visual acuity was 0.4 (range: 0-1.5. Subfoveal fluid disappeared or decreased significantly in 4 of 5 eyes (80% after PDT. Conclusions : PDT led to resolution of subretinal fluid with preservation of visual acuity in many symptomatic choroidal nevi in this study. Careful case selection is important as PDT of indeterminate pigmented tumors may delay the diagnosis and treatment of an early choroidal melanoma and thereby increase the risk for metastasis.

  8. Purtscher's retinopathy followed by neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Kuroda M

    2013-11-01

    Full Text Available Masasko Kuroda,1 Akihiro Nishida,1 Masashi Kikuchi,2 Yasuo Kurimoto11Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; 2Kikuchi Eye Clinic, Kobe, Hyogo, JapanAbstract: We report the case of a 66-year-old Japanese man who developed neovascular glaucoma secondary to Purtscher's retinopathy following a head injury. The patient presented at our hospital with blurred vision and a visual field abnormality in his left eye 1 month after suffering from a head injury. Upon initial presentation, his best-corrected visual acuity on a decimal chart was 1.5 oculus dexter and 0.6 oculus sinister. The intraocular pressure (IOP was 12 mmHg in both eyes. Fundus examination of the left eye revealed multiple white lesions in the posterior pole. Optical coherence tomography demonstrated retinal edema, particularly in the inner retina. On the basis of these findings, a diagnosis of Purtscher's retinopathy was made. One month after the initial examination, the visual acuity in the left eye deteriorated to 0.01 in decimal chart, and the IOP increased to 37 mmHg. Gonioscopy showed angle neovascularization. The patient received an intravitreal bevacizumab injection and panretinal photocoagulation. Subsequently, the IOP normalized and the angle neovascularization regressed.Keywords: blurred vision, visual field, retinal edema, head injury, head trauma

  9. Predictors of anti-VEGF treatment response in neovascular age-related macular degeneration.

    Science.gov (United States)

    Finger, Robert P; Wickremasinghe, Sanjeewa S; Baird, Paul N; Guymer, Robyn H

    2014-01-01

    Currently available evidence on predictors of anti-vascular endothelial growth factor (VEGF) treatment response in neovascular age-related macular degeneration was reviewed. No meta-analysis of results is possible because of a lack of controlled and randomized trials, varying treatment regimes and outcome measures used, as well as suboptimal reporting. For genetic factors, most evidence to date has been generated for single nucleotide polymorphisms (SNPs) in the complement factor H (CFH), and VEGF-A genes. Just under half of the SNPs assessed in the CFH gene and 15% of the SNPs assessed in the VEGF gene were found to be associated with visual outcomes or the number of injections required during follow-up. Some evidence suggests association of worse treatment outcomes as well as a younger age at treatment onset with an increasing number of risk alleles in known risk genes (CFH and ARMS2/HTRA1) and polymorphisms in the VEGF-A gene. Clinical factors such as higher age, a better visual acuity (VA), a larger choroidal neovascularization (CNV) lesion at baseline, and a delay between symptom onset and initiation of treatment of more than 3 weeks also impact outcomes. Conversely, a worse acuity at baseline predicted more gain in vision. Overall, patients presenting with good acuity at baseline were more likely to have good VA at follow up, but the gain afforded by treatment was impacted by a ceiling effect. Most available evidence suggests a strong association of clinical factors such as age, baseline VA, and CNV lesion size with anti-VEGF treatment outcomes. No behavioral factors such as smoking influence treatment outcomes. Based on the studies conducted so far, the evidence suggests that underlying genotype of known AMD risk associated genes or of the VEGF-A gene have a limited effect, whereas presenting clinical factors appear to be more important in determining treatment outcomes.

  10. The Use of Microperimetry to Detect Functional Progression in Non-Neovascular Age-Related Macular Degeneration: A Systematic Review.

    Science.gov (United States)

    Wong, Evan N; Chew, Avenell L; Morgan, William H; Patel, Praveen J; Chen, Fred K

    2017-01-01

    We reviewed the current literature on the ability of microperimetry to detect non-neovascular age-related macular degeneration (AMD) disease progression. The index test was retinal sensitivity measurement assessed by microperimetry and comparators were other functional measures (best-corrected and low-luminance visual acuities, and fixation stability) and structural parameters [retinal thickness, choroidal thickness, and area of geographic atrophy (GA) determined by color fundus photographs, short-wave or near-infrared fundus autofluorescence]. The reference standard was area of GA. The literature search was conducted in January 2016 and included MEDLINE, EMBASE, the Cochrane Library, Biosis, Science Citation Index, ProQuest Health and Medicine, CINAHL, and Highwire Press. We included 6 studies that enrolled 41 eyes with intermediate AMD (from a single study) and 80 eyes with GA secondary to AMD. Retinal sensitivity measured by microperimetry was the only functional measure that consistently detected progression in each cohort. Insufficient reported data precluded meta-analysis. Various microperimetry parameters were used to assess cohort-level change in retinal sensitivity, but the methods of analysis have yet to mature in complexity in comparison with established glaucoma field progression analysis. Microperimetry-assessed retinal sensitivity measurement may be more sensitive in detecting progression than other functional measures in non-neovascular AMD. However, the lack of standardized testing protocol and methods of progression analysis hindered comparison. Harmonization of testing protocol and development of more robust methods of analyzing raw microperimetric data will facilitate clinical implementation of this valuable retinal assessment tool.

  11. IL-23-independent induction of IL-17 from γδT cells and innate lymphoid cells promotes experimental intraocular neovascularization.

    Science.gov (United States)

    Hasegawa, Eiichi; Sonoda, Koh-Hei; Shichita, Takashi; Morita, Rimpei; Sekiya, Takashi; Kimura, Akihiro; Oshima, Yuji; Takeda, Atsunobu; Yoshimura, Takeru; Yoshida, Shigeo; Ishibashi, Tatsuro; Yoshimura, Akihiko

    2013-02-15

    Choroidal neovascularization (CNV) is a characteristic of age-related macular degeneration. Genome-wide association studies have provided evidence that the immune system is involved in the pathogenesis of age-related macular degeneration; however, the role of inflammatory cytokines in CNV has not been established. In this study, we demonstrated that IL-17 had a strong potential for promoting neovascularization in a vascular endothelial growth factor-independent manner in laser-induced experimental CNV in mice. Infiltrated γδT cells and Thy-1(+) innate lymphoid cells, but not Th17 cells, were the main sources of IL-17 in injured eyes. IL-23 was dispensable for IL-17 induction in the eye. Instead, we found that IL-1β and high-mobility group box 1 strongly promoted IL-17 expression by γδT cells. Suppression of IL-1β and high-mobility group box 1, as well as depletion of γδT cells, reduced IL-17 levels and ameliorated experimental CNV. Our findings suggest the existence of a novel inflammatory cytokine network that promotes neovascularization in the eye.

  12. High Frequency Color Doppler Image of Choroidal Detachment

    Institute of Scientific and Technical Information of China (English)

    Jinghong Wu; Lijuan Zou; Zhongyao Wu; Lixun Cheng

    2000-01-01

    Purpose: To study the Color Doppler Image (CDI) characteristics of choroidal detachment and the applied value of CDI.Methods: Seventy-two cases (74 eyes) of choroidal detachment were studied retrospectively.Results: The typical ultragraph of chroridal detachment displayed one or several smooth hemispherical or lobuler circular thick bands, with convex side toward vitreous cavity. Most of the choroidal detachments were located before the equator, a few of them were beyond the equator. CDI displayed blood flow singnal in the band. Pulse Doppler showed the frequency spectrum features of retinal detachment band were similar to those of central retinal vessels, whereas the frequency spectum features of choroidal detachment bend resembled those of ciliary artery in some cases of retinal detachment (RD) accompanied by choroidal detachment.Conclusion: CDI could make a correct and precise diagnosis of choroidal detachment.Eye Science 2000; 16. 61 ~ 64.

  13. Polarisation-sensitive OCT is useful for evaluating retinal pigment epithelial lesions in patients with neovascular AMD

    Science.gov (United States)

    Schütze, Christopher; Teleky, Katharina; Baumann, Bernhard; Pircher, Michael; Götzinger, Erich; Hitzenberger, Christoph K; Schmidt-Erfurth, Ursula

    2016-01-01

    Background/aims To examine the reproducibility of lesion dimensions of the retinal pigment epithelium (RPE) in neovascular age-related macular degeneration (AMD) with polarisation-sensitive optical coherence tomography (PS-OCT), specifically imaging the RPE. Methods Twenty-six patients (28 eyes) with neovascular AMD were included in this study, and examined by a PS-OCT prototype. Each patient was scanned five times at a 1-day visit. The PS-OCT B-scan located closest to the macular centre presenting with RPE atrophy was identified, and the longitudinal diameter of the lesion was quantified manually using AutoCAD 2008. This procedure was followed for the identical B-scan position in all five scans per eye and patient. Reproducibility of qualitative changes in PS-OCT was evaluated. Interobserver variability was assessed. Results were compared with intensity-based spectral-domain OCT (SD-OCT) imaging. Results Mean variability of all atrophy lesion dimensions was 0.10 mm (SD±=0.06 mm). Coefficient of variation (SD±/mean) was 0.06 on average (SD±=0.03). Interobserver variability assessment showed a mean difference of 0.02 mm across all patients regarding RPE lesion size evaluation (paired t test: p=0.38). Spearman correlation coefficient was r=0.98, p<0.001. Results revealed a good overall reproducibility of ∼90%. PS-OCT specifically detected the RPE in all eyes compared with conventional intensity-based SD-OCT that was not capable to clearly identify RPE atrophy in 25 eyes (89.3%, p<0.01). Conclusions PS-OCT offers good reproducibility of RPE atrophy assessment in neovascular AMD, and may be suitable for precise RPE evaluation in clinical practice. PS-OCT unambiguously identifies RPE changes in choroidal neovascularisation compared with intensity-based SD-OCT that does not identify the RPE status reliably. PMID:26183936

  14. [Radiotherapy of choroid metastases in breast carcinoma].

    Science.gov (United States)

    Dobrowsky, W; Schmid, A P; Dobrowsky, E

    1987-06-01

    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  15. Notch receptors in human choroid plexus tumors.

    Science.gov (United States)

    Beschorner, R; Waidelich, J; Trautmann, K; Psaras, T; Schittenhelm, J

    2013-08-01

    Notch signaling plays a role in development and formation of the normal choroid plexus (nCP), and in formation of various tumors in humans. Activation of Notch3 has been reported to promote tumor growth in invasive gliomas and to initiate formation of choroid plexus tumors (CPT) in mice. We investigated the expression of all currently known Notch receptors (Notch 1-4) in 55 samples of nCP and 88 CPT, including 61 choroid plexus papillomas (CPP), 22 atypical CPP and 5 choroid plexus carcinomas by immunohistochemistry. Notch expression was semiquantitatively evaluated separately for membranous/cytoplasmic and for nuclear staining. In addition, we examined Her2 expression (EGFR2, Her2/neu, ErbB2, CD340) because of its functional link to Notch signaling. All samples were negative for Notch3. Membranous/cytoplasmic expression of Notch1 (pnCP compared to CPT. Nuclear expression of Notch1, -2 and -4 was significantly higher in CPT compared to nCP (pnCP to a predominant nuclear expression in CPT. Her2 was weakly expressed in 42/84 CPT but only in 2/53 nCP (p=0.0001) and positively correlated with nuclear expression of Notch1, -2 and 4 in CPT. In summary, a shift between membranous/cytoplasmic (non-canonical signaling pathway) and nuclear expression (canonical signaling pathway) of Notch1, -2 and -4 and upregulation of Her2 indicate neoplastic transformation in human CP and may reveal new therapeutic approaches.

  16. Idiopathic polypoidal choroidal vasculopathy masquerading as choroidal tumors: one year follow-up of a peripheral lesion

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    Rony Carlos Preti

    2015-06-01

    Full Text Available ABSTRACT This case report describes peripheral idiopathic polypoidal choroidal vasculopathy (IPCV with a collection of small aneurysmal dilations that masqueraded as choroidal tumors in an elderly patient. A 68-year-old African American woman was referred to us with a suspected diagnosis of asymptomatic vascular choroidal tumor and choroidal capillary hemangioma, affecting the temporal peripheral fundus. Upon examination, optical coherence tomography (OCT revealed two large hemorrhagic pigment epithelium detachments (PED, and indocyanine green angiography (ICG confirmed the diagnosis of IPCV. One year later, there was reduction in the hemorrhagic pigment epithelium detachments and the lesion took on a different appearance, resembling a choroidal osteoma. No treatment was necessary despite the presence of multiple polyps. IPCV is a rare condition that can resemble other choroidal diseases depending on the stage of presentation. OCT is the best tool to determine the characteristics of the lesions, and indocyanine green angiography should be used to confirm the diagnosis. Not all cases require treatment.

  17. The Ahmed Glaucoma Valve in Neovascular Glaucoma (An AOS Thesis)

    Science.gov (United States)

    Netland, Peter A.

    2009-01-01

    Purpose: To evaluate the results of Ahmed glaucoma valve surgery in neovascular glaucoma and control patients. Methods: In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, without further glaucoma surgery, and without loss of light perception. Results: Average follow-up for control and neovascular glaucoma patients was 18.4 and 17.4 months, respectively (P = .550). At last follow-up, mean IOP was 16.2 ± 5.2 mm Hg and 15.5 ± 12.5 mm Hg (P = .115) in control and neovascular glaucoma patients, respectively. Life-table analysis showed a significantly lower success for neovascular glaucoma patients compared with controls (P = .0096), with success at 1 year of 89.2% and 73.1%, at 2 years of 81.8% and 61.9%, and at 5 years of 81.8% and 20.6% for control and neovascular glaucoma eyes, respectively. Cox proportional hazards regression analysis showed neovascular glaucoma as a risk factor for surgical failure (odds ratio, 5.384, 95% CI, 1.22–23.84, P = .027). Although IOP control and complications were comparable between the two groups, visual outcomes were worse in neovascular glaucoma patients, with 9 eyes (23.7%) with neovascular glaucoma compared with no controls losing light perception vision (P = .002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period. Conclusion: Neovascular glaucoma patients have greater risk of surgical failure after Ahmed glaucoma valve surgery compared with controls. Despite improved mean IOP with drainage implants, visual outcomes may be poor, possibly due to progression of underlying disease. PMID:20126506

  18. Lonafarnib is a potential inhibitor for neovascularization.

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    Linlin Sun

    Full Text Available Atherosclerosis is a common cardiovascular disease that involves the build-up of plaque on the inner walls of the arteries. Intraplaque neovacularization has been shown to be essential in the pathogenesis of atherosclerosis. Previous studies showed that small-molecule compounds targeting farnesyl transferase have the ability to prevent atherosclerosis in apolipoprotein E-deficient mice, but the underlying mechanism remains to be elucidated. In this study, we found that lonafarnib, a specific inhibitor of farnesyl transferase, elicits inhibitory effect on vascular endothelial capillary assembly in vitro in a dose-dependent manner. In addition, we showed that lonafarnib treatment led to a dose-dependent decrease in scratch wound closure in vitro, whereas it had little effect on endothelial cell proliferation. These data indicate that lonafarnib inhibits neovascularization via directly targeting endothelial cells and disturbing their motility. Moreover, we demonstrated that pharmacological inhibition of farnesyl transferase by lonafarnib significantly impaired centrosome reorientation toward the leading edge of endothelial cells. Mechanistically, we found that the catalytic β subunit of farnesyl transferase associated with a cytoskeletal protein important for the establishment and maintenance of cell polarity. Additionally, we showed that lonafarnib remarkably inhibited the expression of the cytoskeletal protein and interrupted its interaction with farnesyl transferase. Our findings thus offer novel mechanistic insight into the protective effect of farnesyl transferase inhibitors on atherosclerosis and provide encouraging evidence for the potential use of this group of agents in inhibiting plaque neovascularization.

  19. HTRA1 variant confers similar risks to geographic atrophy and neovascular age-related macular degeneration.

    Science.gov (United States)

    Cameron, D Joshua; Yang, Zhenglin; Gibbs, Daniel; Chen, Haoyu; Kaminoh, Yuuki; Jorgensen, Adam; Zeng, Jiexi; Luo, Ling; Brinton, Eric; Brinton, Gregory; Brand, John M; Bernstein, Paul S; Zabriskie, Norman A; Tang, Shibo; Constantine, Ryan; Tong, Zongzhong; Zhang, Kang

    2007-05-02

    Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy (GA) and choroidal neovascularization (wet AMD), represent two types of degenerative processes in the macula that lead to loss of central vision. Soft confluent drusen, characterized by deposits in macula without visual loss are considered a precursor of advanced AMD. A single nucleotide polymorphism, rs11200638, in the promoter of HTRA1 has been shown to increases the risk for wet AMD. However, its impact on soft confluent drusen and GA or the relationship between them is unclear. To better understand the role the HTRA1 polymorphism plays in AMD subtypes, we genotyped an expanded Utah population with 658 patients having advanced AMD or soft confluent drusen and 294 normal controls and found that the rs11200638 was significantly associated with GA. This association remains significant conditional on LOC387715 rs10490924. In addition, rs11200638 was significantly associated with soft confluent drusen, which are strongly immunolabeled with HTRA1 antibody in an AMD eye with GA similar to wet AMD. Two-locus analyses were performed for CFH Y402H variant at 1q31 and the HTRA1 polymorphism. Together CFH and HTRA1 risk variants increase the odds of having AMD by more than 40 times. These findings expand the role of HTRA1 in AMD. Understanding the underlying molecular mechanism will provide an important insight in pathogenesis of AMD.

  20. Submacular hemorrhage in neovascular age-related macular degeneration: A synthesis of the literature.

    Science.gov (United States)

    Stanescu-Segall, Dinu; Balta, Florian; Jackson, Timothy L

    2016-01-01

    Large submacular hemorrhage, an uncommon manifestation of neovascular age-related macular degeneration, may also occur with idiopathic polypoidal choroidal vasculopathy. Submacular hemorrhage damages photoreceptors owing to iron toxicity, fibrin meshwork contraction, and reduced nutrient flux, with subsequent macular scarring. Clinical and experimental studies support prompt treatment, as tissue damage can occur within 24 hours. Without treatment the natural history is poor, with a mean final visual acuity (VA) of 20/1600. Reported treatments include retinal pigment epithelial patch, macular translocation, pneumatic displacement, intravitreal or subretinal tissue plasminogen activator, intravitreal anti-vascular endothelial growth factor (VEGF) drugs, and combinations thereof. In the absence of comparative studies, we combined eligible studies to assess the VA change before and after each treatment option. The greatest improvement occurred after combined pars plana vitrectomy, subretinal tissue plasminogen activator, intravitreal gas, and anti-vascular endothelial growth factor treatment, with VA improving from 20/1000 to 20/400. The best final VA occurred using combined intravitreal tissue plasminogen activator, gas, and anti-vascular endothelial growth factor therapy, with VA improving from 20/200 to 20/100. Both treatments had an acceptable safety profile, but most studies were small, and larger randomized controlled trials are needed to determine both safety and efficacy.

  1. Hemosideric heterochromia iridum in malignant melanoma of the choroid.

    Science.gov (United States)

    Awan, K J

    1975-08-01

    A case is reported in which hyperchromic heterochromia iridum developed due to blood staining of an eye with malignant melanoma of the choroid in which massive hemorrhage developed. It is suggested that a possibility of the malignant melanoma of the choroid be kept in mind where hemosiderin deposits are suspected to be the cause of heterochromia but no intraocular iron foreign body is present.

  2. Angiographic results of retinal-retinal anastomosis and retinal-choroidal anastomosis after treatments in eyes with retinal angiomatous proliferation

    Directory of Open Access Journals (Sweden)

    Saito M

    2012-08-01

    Full Text Available Masaaki Saito,1 Tomohiro Iida,1,2 Mariko Kano,1 Kanako Itagaki11Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 2Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to evaluate the angiographic results of retinal-retinal anastomosis (RRA and retinal-choroidal anastomosis (RCA for eyes with retinal angiomatous proliferation (RAP after treatment with intravitreal bevacizumab injections as monotherapy or intravitreal bevacizumab combined with photodynamic therapy.Methods: In this interventional, consecutive case series, we retrospectively reviewed five naïve eyes from four patients (mean age 80 years treated with three consecutive monthly intravitreal bevacizumab (1.25 mg/0.05 mL injections as initial treatment, and followed up for at least 3 months. In cases with over 3 months of follow-up and having recurrence of RAP or leakage by fluorescein angiography, retreatment was performed with a single intravitreal bevacizumab injection and photodynamic therapy.Results: Indocyanine green angiography showed RRA in three eyes with subretinal neovascularization and RCA in two eyes with choroidal neovascularization at baseline. At 3 months after baseline (month 3, neither the RRA nor RCA was occluded in any eye on indocyanine green angiography. Retreatment with intravitreal bevacizumab plus photodynamic therapy was performed in three eyes at months 3 (persistent leakage on fluorescein angiography, 6, and 7 (recurrence of RAP lesion, which achieved obvious occlusion of the RRA and RCA. Mean best-corrected visual acuity improved from 0.13 to 0.21 at month 3 (P = 0.066. No complications or systemic adverse events were noted.Conclusion: Although intravitreal bevacizumab for RAP was effective in improving visual acuity during short-term follow-up, intravitreal bevacizumab could not achieve complete occlusion of RRA and RCA, which could

  3. Suprachoroidal collection of internal tamponading agents through a choroidal hole

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    Gopal Lingam

    2008-01-01

    Full Text Available We report two cases of significantly large choroidal holes following penetrating trauma that led to suprachoroidal migration of internal tamponading agents during repair of retinal detachments with proliferative vitreoretinopathy secondary to penetrating trauma. In the first case, choroidal hole was a direct result of the injury and was identified immediately after vitreoretinal surgery which was done for traumatic retinal detachment with hemorrhagic choroidal detachment. In the second case, the hole occurred over a period of several months after the repair of traumatic retinal detachment with silicone oil tamponade. This was attributed to progressive fibrosis exerting traction on the bare choroid/retinal pigment epithelium. Choroidal hole significant enough to cause suprachoroidal migration of internal tamponading agents is a very rare complication seen in eyes with posttraumatic retinal detachment with proliferative vitreoretinopathy.

  4. [Photodynamic therapy in treatment of chorioid neovascularization].

    Science.gov (United States)

    Avetisov, S E; Budzinskaia, M V; Kiseleva, T N; Kazarian, E E; Gurova, I V; Loshchenov, V B; Shevchik, S A; Kuz'min, S G; Vorozhtsov, G N

    2007-01-01

    The authors studied the effectiveness of photodynamic therapy (PDT) with Photosence, a Russian photosensitizer, in treatment of chorioid neovascularization (CNV) in cases of age-related macular degeneration (ARMD) and pathological myopia (PM). The subjects were 73 patients with CNV suffering from ARMD and PM. The efficiency of PDT and complex conservative therapy was compared using vision acuity measurement, retinal morphometry, and fluorescent eye ground angiography (FEGA), performed before treatment, immediately after treatment, and 1, 3, 6, and 12 months later. The study showed that PDT in patients with CNV, ARMD and PM was more efficient than pharmacotherapy. Vision acuity improved or stabilized, and the parameters of retinal morphometry and FEGA improved as well. The results of the study evidence high efficiency of PDT with Photosence in treatment of CNV with ARMD and PM.

  5. Corneal neovascularization and contemporary antiangiogenic therapeutics.

    Science.gov (United States)

    Hsu, Chih-Chien; Chang, Hua-Ming; Lin, Tai-Chi; Hung, Kuo-Hsuan; Chien, Ke-Hung; Chen, Szu-Yu; Chen, San-Ni; Chen, Yan-Ting

    2015-06-01

    Corneal neovascularization (NV), the excessive ingrowth of blood vessels from conjunctiva into the cornea, is a common sequela of disease insult that can lead to visual impairment. Clinically, topical steroid, argon laser photocoagulation, and subconjunctival injection of bevacizumab have been used to treat corneal NV. Sometimes, the therapies are ineffective, especially when the vessels are large. Large vessels are difficult to occlude and easily recanalized. Scientists and physicians are now dedicated to overcoming this problem. In this article, we briefly introduce the pathogenesis of corneal NV, and then highlight the existing animal models used in corneal NV research-the alkali-induced model and the suture-induced model. Most of all, we review the potential therapeutic targets (i.e., vascular endothelial growth factor and platelet-derived growth factor) and their corresponding inhibitors, as well as the immunosuppressants that have been discovered in recent years by corneal NV studies.

  6. Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

    Science.gov (United States)

    Liu, Shaohui; Sun, Lisa L.; Kavanaugh, A. Scott; Langford, Marlyn P.; Liang, Chanping

    2013-01-01

    We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP). Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients. PMID:24348402

  7. Recurrent Annular Peripheral Choroidal Detachment after Trabeculectomy

    Directory of Open Access Journals (Sweden)

    Shaohui Liu

    2013-10-01

    Full Text Available We report a challenging case of recurrent flat anterior chamber without hypotony after trabeculectomy in a 54-year-old Black male with a remote history of steroid-treated polymyositis, cataract surgery, and uncontrolled open angle glaucoma. The patient presented with a flat chamber on postoperative day 11, but had a normal fundus exam and intraocular pressure (IOP. Flat chamber persisted despite treatment with cycloplegics, steroids, and a Healon injection into the anterior chamber. A transverse B-scan of the peripheral fundus revealed a shallow annular peripheral choroidal detachment. The suprachoroidal fluid was drained. The patient presented 3 days later with a recurrent flat chamber and an annular peripheral choroidal effusion. The fluid was removed and reinforcement of the scleral flap was performed with the resolution of the flat anterior chamber. A large corneal epithelial defect developed after the second drainage. The oral prednisone was tapered quickly and the topical steroid was decreased. One week later, his vision decreased to count fingers with severe corneal stromal edema and Descemet's membrane folds that improved to 20/50 within 24 h of resumption of the oral steroid and frequent topical steroid. The patient's visual acuity improved to 20/20 following a slow withdrawal of the oral and topical steroid. Eight months after surgery, the IOP was 15 mm Hg without glaucoma medication. The detection of a shallow anterior choroidal detachment by transverse B-scan is critical to making the correct diagnosis. Severe cornea edema can occur if the steroid is withdrawn too quickly. Thus, steroids should be tapered cautiously in steroid-dependent patients.

  8. Pitfalls in colour photography of choroidal tumours.

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-02-01

    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown.

  9. Pitfalls in colour photography of choroidal tumours

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-01-01

    Colour imaging of fundus tumours has been transformed by the development of digital and confocal scanning laser photography. These advances provide numerous benefits, such as panoramic images, increased contrast, non-contact wide-angle imaging, non-mydriatic photography, and simultaneous angiography. False tumour colour representation can, however, cause serious diagnostic errors. Large choroidal tumours can be totally invisible on angiography. Pseudogrowth can occur because of artefacts caused by different methods of fundus illumination, movement of reference blood vessels, and flattening of Bruch's membrane and sclera when tumour regression occurs. Awareness of these pitfalls should prevent the clinician from misdiagnosing tumours and wrongfully concluding that a tumour has grown. PMID:23238442

  10. Telocytes in meninges and choroid plexus.

    Science.gov (United States)

    Popescu, B O; Gherghiceanu, M; Kostin, S; Ceafalan, L; Popescu, L M

    2012-05-16

    Telocytes (TCs) are a recently identified type of interstitial cells present in a wide variety of organs in humans and mammals (www.telocytes.com). They are characterized by a small cell body, but extremely long cell processes - telopodes (Tp), and a specific phenotype. TCs establish close contacts with blood capillaries, nerve fibers and stem cells. We report here identification of TCs by electron microscopy and immunofluorescence in rat meninges and choroid plexus/subventricular zone, in the vicinity of putative stem cells. The presence of TCs in brain areas involved in adult neurogenesis might indicate that they have a role in modulation of neural stem cell fate.

  11. En-face optical coherence tomography in the diagnosis and management of age-related macular degeneration and polypoidal choroidal vasculopathy

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    Tiffany Lau

    2015-01-01

    Full Text Available Optical coherence tomography (OCT is a noninvasive imaging modality providing high-resolution images of the central retina that has completely transformed the field of ophthalmology. While traditional OCT has produced longitudinal cross-sectional images, advancements in data processing have led to the development of en-face OCT, which produces transverse images of retinal and choroidal layers at any specified depth. This offers additional benefit on top of longitudinal cross-sections because it provides an extensive overview of pathological structures in a single image. The aim of this review was to discuss the utility of en-face OCT in the diagnosis and management of age-related macular degeneration (AMD and polypoidal choroidal vasculopathy (PCV. En-face imaging of the inner segment/outer segment junction of retinal photoreceptors has been shown to be a useful indicator of visual acuity and a predictor of the extent of progression of geographic atrophy. En-face OCT has also enabled high-resolution analysis and quantification of pathological structures such as reticular pseudodrusen (RPD and choroidal neovascularization, which have the potential to become useful markers for disease monitoring. En-face Doppler OCT enables subtle changes in the choroidal vasculature to be detected in eyes with RPD and AMD, which has significantly advanced our understanding of their pathogenesis. En-face Doppler OCT has also been shown to be useful for detecting the polypoid lesions and branching vascular networks diagnostic of PCV. It may therefore serve as a noninvasive alternative to fluorescein and indocyanine green angiography for the diagnosis of PCV and other forms of the exudative macular disease.

  12. Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration

    OpenAIRE

    Roberto Gallego-Pinazo; Ana Marina Suelves-Cogollos; Ester Francés-Muñoz; et. al.

    2011-01-01

    Roberto Gallego-Pinazo1,2, Ana Marina Suelves-Cogollos1, Ester Francés-Muñoz1, J María Millán2,3, J Fernando Arevalo4, J Luis Mullor5, Manuel Díaz-Llopis1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, C...

  13. Intravitreal ranibizumab for symptomatic drusenoid pigment epithelial detachment without choroidal neovascularization in age-related macular degeneration

    OpenAIRE

    Diaz-Llopis,Manuel; Suelves-Cogollos,; Frances-Munoz,E; Millan, J.M.; Mullor ,Jose; Gallego-Pinazo, Roberto; Arevalo, J Fernando

    2011-01-01

    Roberto Gallego-Pinazo,1,2 Ana Marina Suelves-Cogollos1, Ester Francés-Muñoz,1 J María Millán,2,3 J Fernando Arevalo,4 J Luis Mullor,5 Manuel Díaz-Llopis,1,2,61Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain; 2Centro de Investigación Biomédica en Red de Enfermedades Raras, Valencia, Spain; 3Department of Genetics, Hospital Universitario La Fe, Valencia, Spain; 4Retina and Vitreous Service, ...

  14. Resolution of choroidal neovascularization secondary to punctate inner choroidopathy (PIC) with intravitreal anti-VEGF agents: a case series.

    Science.gov (United States)

    Mangat, Simran S; Ramasamy, B; Prasad, Som; Walters, Gavin; Mohammed, Moin; Mckibbin, Martin

    2011-01-01

    Case series of four patients with CNVM secondary to PIC treated solely with anti VEGF in three cases and in combination with PDT in the other. This series reveals long term follow up (3 months to 28 months) which is currently not described in the literature.

  15. Peripapillary choroidal thickness in healthy Turkish subjects

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    Erbagci H

    2015-07-01

    Full Text Available Hulya Erbagci,1 Burak Oren,2 Seydi Okumus,3 Serhat Kenan,3 Pelin Celemler,3 Ibrahim Erbagci3 1Department of Anatomy, Medical Faculty, Zirve University Emine Bahattin Nakiboglu, Gaziantep, 2Department of Ophthalmology, Kilis State Hospital, Kilis, 3Department of Ophthalmology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey Aim: The objective of the study reported here was to investigate the normal peripapillary choroidal thickness (CT, measured by enhanced depth imaging optical coherence tomography (EDI-OCT, in healthy Turkish volunteers. Materials and methods: In this prospective cross-sectional study, 57 eyes of 57 healthy Turkish subjects were enrolled. Each participant underwent a comprehensive ophthalmic examination and peripapillary CT measurement using EDI-OCT. Results: The mean age of the 25 female and 32 male patients in the study was 30.9±10.6 years (range, 18–56 years. The mean peripapillary CT at the superior, inferior, nasal, and temporal sites was 225±57, 183±47, 220±57, and 233±59 µm, respectively. The inferior peripapillary CT value was significantly lower than the peripapillary CT values (P<0.001 for all, whereas no significant differences were found between the superior, nasal, and temporal peripapillary CT values. Conclusion: The findings of the study revealed that Turkish people had significantly lower peripapillary CT values in the inferior quadrant than in the superior, nasal, and temporal quadrants. Keywords: peripapillary choroidal thickness, enhanced depth imaging optical coherence tomography, EDI-OCT

  16. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

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    Sertan Goktas

    2014-01-01

    Full Text Available Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1 or subconjunctival instillation of 1 mg/mL tigecycline (group 3 for 7 days. Control rats received topical (group 2 or subconjunctival (group 4 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI, 44.2–55.8% and 33.5% (95% CI, 26.6–39.2%, respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group (P=0.03 and P<0.001, resp.. Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization.

  17. Metástasis coroideas Choroidal metastases

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    C. Camarillo

    2008-01-01

    Full Text Available Las metástasis uveales son el tumor intraocular maligno más frecuente y de ellas, más del 80% se localizan en la coroides. Esto, unido al progresivo aumento de la incidencia, hace necesario su estudio y revisión para un correcto diagnóstico y tratamiento en la práctica clínica actual. La etiología varía según el sexo del paciente, siendo el carcinoma de pulmón el que con más frecuencia metastatiza en el varón y el de mama en la mujer. Tienden a la multifocalidad y generalmente se localizan en el polo posterior. En el 50% de los casos cursan de forma asintomática, pero pueden producir pérdida de visión, escotomas, metamorfopsias, y fotopsias. La exploración oftalmoscópica característica muestra una lesión coroidea placoide, homogénea y de aspecto cremoso. En el diagnóstico diferencial se debe considerar el nevus amelanótico, el melanoma amelanótico de coroides, el hemangioma coroideo, la escleritis posterior, el osteoma de coroides, las coriorretinitis, la enfermedad de Harada, el desprendimiento de retina rhegmatógeno, el síndrome de efusión uveal, y la coriorretinopatía serosa central. Una exhaustiva anamnesis y exploración oftalmológica completa son imprescindibles para el diagnóstico, a lo que se pueden añadir como pruebas complementarias la angiografía con fluoresceína, la ecografía ocular, la punción-aspiración con aguja fina (PAAF, la tomografía computarizada y la resonancia magnética. El tratamiento de estos tumores suele ser el tratamiento sistémico del tumor primario; las posibilidades de tratamiento local son la observación, la radioterapia externa, la braquiterapia, la termoterapia transpupilar y la enucleación.Uveal metastases are the most frequent malign intraocular tumour, of which more than 80% are localized in the choroids. This, together with the progressive increase in its incidence, makes its study and review necessary for a correct diagnosis and treatment in current clinical practice

  18. Neovascular events in eyes with central retinal vein occlusion undergoing serial bevacizumab or ranibizumab intravitreal injections: A retrospective review

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    Francis Char DeCroos

    2014-01-01

    Conclusion: Neovascular events occur in eyes with CRVO undergoing serial anti-VEGF therapy, and these events may be delayed compared to the natural history of CRVO-associated neovascularization. Iris neovascularization occurred most frequently.

  19. Characterization of a spontaneous retinal neovascular mouse model.

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    Eiichi Hasegawa

    Full Text Available BACKGROUND: Vision loss due to vascular disease of the retina is a leading cause of blindness in the world. Retinal angiomatous proliferation (RAP is a subgroup of neovascular age-related macular degeneration (AMD, whereby abnormal blood vessels develop in the retina leading to debilitating vision loss and eventual blindness. The novel mouse strain, neoretinal vascularization 2 (NRV2, shows spontaneous fundus changes associated with abnormal neovascularization. The purpose of this study is to characterize the induction of pathologic angiogenesis in this mouse model. METHODS: The NRV2 mice were examined from postnatal day 12 (p12 to 3 months. The phenotypic changes within the retina were evaluated by fundus photography, fluorescein angiography, optical coherence tomography, and immunohistochemical and electron microscopic analysis. The pathological neovascularization was imaged by confocal microscopy and reconstructed using three-dimensional image analysis software. RESULTS: We found that NRV2 mice develop multifocal retinal depigmentation in the posterior fundus. Depigmented lesions developed vascular leakage observed by fluorescein angiography. The spontaneous angiogenesis arose from the retinal vascular plexus at postnatal day (p15 and extended toward retinal pigment epithelium (RPE. By three months of age, histological analysis revealed encapsulation of the neovascular lesion by the RPE in the photoreceptor cell layer and subretinal space. CONCLUSIONS: The NRV2 mouse strain develops early neovascular lesions within the retina, which grow downward towards the RPE beginning at p15. This retinal neovascularization model mimics early stages of human retinal angiomatous proliferation (RAP and will likely be a useful in elucidating targeted therapeutics for patients with ocular neovascular disease.

  20. Symptomatic third ventricular choroid plexus cysts

    Energy Technology Data Exchange (ETDEWEB)

    Lam, A.H. (Children' s Hospital, Sydney (Australia). Dept. of Radiology); Villanueva, A.C. (Jose Reyes Memorial Medical Center, Manila (Philippines))

    1992-10-01

    We describe the imaging findings in 3 children with choroid plexus cysts (CPC) at the foramen of Monro. All CPC measured less than 2 cm and produced symptoms of raised intracranial pressure when located at the foramen of Monro where there was obstruction to the cerebrospinal fluid (CSF) flow. Two of our patients had relief of symptoms after resection of the cyst. One patient with inoperable cardiac defects died and had no surgery performed. Cranial sonography and CT-ventriculography are the modalities of choice in evaluating ventriculomegaly when the diagnosis of occult obstructive CPC is entertained in children. Cranial sonography is indicated in infants with an open fontanelle and CT-ventriculography is reserved for older children with hydrocephalus which is not responding to shunting. (orig./GDG).

  1. Automatic measurements of choroidal thickness in EDI-OCT images.

    Science.gov (United States)

    Tian, Jing; Marziliano, Pina; Baskaran, Mani; Tun, Tin Aung; Aung, Tin

    2012-01-01

    Enhanced Depth Imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid in vivo, and hence is used in many clinical studies. However, measurement of choroidal thickness depends on the manual labeling, which is tedious and subjective of inter-observer differences. In this paper, we propose a fast and accurate algorithm that could measure the choroidal thickness automatically. The lower boundary of the choroid is detected by searching the biggest gradient value above the retinal pigment epithelium (RPE) and the upper boundary is formed by finding the shortest path of the graph formed by valley pixels using dynamic programming. The average of Dice's Coefficient on 10 EDI-OCT images is 94.3%, which shows good consistency of the algorithm with the manual labeling. The processing time for each image is about 2 seconds.

  2. Morphological features of choroidal metastases: An OCT analysis

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    Ludovico Iannetti

    2013-01-01

    Full Text Available The morphological characteristics and retinal changes of chroidal metastases using Spectral Domain OCT are described in a case with primary lung adenocarcinoma and secondary choroidal involvement.

  3. Genetics Home Reference: gyrate atrophy of the choroid and retina

    Science.gov (United States)

    ... newborn period. Gyrate atrophy usually does not affect intelligence; however, abnormalities may be observed in brain imaging ... the choroid and retina in a child with myopia. Indian Pediatr. 2001 Aug;38(8):914-8. ...

  4. Treatment of neovascular age-related macular degeneration with anti-VEGF agents: retrospective analysis of 5-year outcomes

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    Pedrosa AC

    2016-03-01

    Full Text Available Ana Catarina Pedrosa,1 Adriana Reis-Silva,2 João Pinheiro-Costa,1,3 João Beato,1 Paulo Freitas-da-Costa,1,3 Manuel S Falcão,1,2 Fernando Falcão-Reis,1,2 Ângela Carneiro1,2 1Department of Ophthalmology, Hospital de São João, 2Department of Sense Organs, 3Department of Anatomy, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD with anti-VEGF agents.  Materials and methods: We retrospectively analyzed all patients with nAMD who initiated anti-VEGF treatment before October 2009. We collected data regarding visual and anatomical outcomes.  Results: A total of 278 patients met the selection criteria. The mean number of intravitreal injections was 5.7 in the first year and 3.7 in the fifth year. A positive mean visual acuity variation of +3.7 Early Treatment Diabetic Retinopathy Study letters occurred in the first year, but no significant differences relative to baseline were observed thereafter. The majority of patients (71% maintained stable visual acuity throughout follow-up. At 5 years, mean central macular thickness remained substantially inferior to baseline (-96.6 µm, and 56% of patients maintained dry retinas.  Conclusion: Anti-VEGF therapy leads to long-term visual stabilization in the great majority of patients. Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, visual acuity

  5. Severe iritis and choroidal effusion following selective laser trabeculoplasty.

    Science.gov (United States)

    Kim, Danny Y; Singh, Anna

    2008-01-01

    A patient with uncontrolled primary open-angle glaucoma underwent selective laser trabeculoplasty and developed a significant anterior chamber reaction, shallow anterior chamber, and choroidal effusion. Common complications associated with selective laser trabeculoplasty include conjunctival injection, mild anterior chamber reaction, and post-treatment intraocular pressure elevation. The authors believe this is the first reported case of severe iritis and choroidal effusion following selective laser trabeculoplasty.

  6. Automatic segmentation of choroidal thickness in optical coherence tomography.

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    Alonso-Caneiro, David; Read, Scott A; Collins, Michael J

    2013-01-01

    The assessment of choroidal thickness from optical coherence tomography (OCT) images of the human choroid is an important clinical and research task, since it provides valuable information regarding the eye's normal anatomy and physiology, and changes associated with various eye diseases and the development of refractive error. Due to the time consuming and subjective nature of manual image analysis, there is a need for the development of reliable objective automated methods of image segmentation to derive choroidal thickness measures. However, the detection of the two boundaries which delineate the choroid is a complicated and challenging task, in particular the detection of the outer choroidal boundary, due to a number of issues including: (i) the vascular ocular tissue is non-uniform and rich in non-homogeneous features, and (ii) the boundary can have a low contrast. In this paper, an automatic segmentation technique based on graph-search theory is presented to segment the inner choroidal boundary (ICB) and the outer choroidal boundary (OCB) to obtain the choroid thickness profile from OCT images. Before the segmentation, the B-scan is pre-processed to enhance the two boundaries of interest and to minimize the artifacts produced by surrounding features. The algorithm to detect the ICB is based on a simple edge filter and a directional weighted map penalty, while the algorithm to detect the OCB is based on OCT image enhancement and a dual brightness probability gradient. The method was tested on a large data set of images from a pediatric (1083 B-scans) and an adult (90 B-scans) population, which were previously manually segmented by an experienced observer. The results demonstrate the proposed method provides robust detection of the boundaries of interest and is a useful tool to extract clinical data.

  7. Radiation therapy for neovascular age-related macular degeneration

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    Robert Petrarca

    2011-01-01

    Full Text Available Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King’s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF therapies represent the standard of care for most patients presenting with neovascular (wet age-related macular degeneration (neovascular AMD. Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET. Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002, with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.Keywords: wet age-related macular degeneration, neovascular, radiation therapy, epimacular brachytherapy, stereotactic radiosurgery, anti-VEGF

  8. Intravitreal bevacizumab and Ahmed glaucoma valve implantation in patients with neovascular glaucoma

    Institute of Scientific and Technical Information of China (English)

    Hai-Tao; Zhang; Yu-Xin; Yang; Ying-Ying; Xu; Rui-Min; Yang; Bao-Jun; Wang; Jun-Xi; Hu

    2014-01-01

    AIM:To explore the efficacy of preoperative intravitreal bevacizumab(IVB) injection combined with Ahmed glaucoma valve(AGV) implantation in the treatment of neovascular glaucoma(NVG).METHODS:This retrospective study included 35 eyes from 35 patients who underwent preoperative IVB and AGV implantation for treatment of NVG. Findings such as intraocular pressure(IOP) number of anti-glaucoma medications, visual acuity(VA), surgical success rates,and complications were recorded.RESULTS:AfterAGVimplantation,IOPwas18.2±4.0mmHg,15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36 mo,significantly decreased compared with pre-IOP(P <0.01).The number of anti-glaucoma medications was 0.9 ±0.5,0.8 ±0.9 and 0.8 ±0.6 at 6, 12 and 36 mo, significantly decreased compared to pre-treatment(P <0.01). At last visit, there were 19 eyes with stable VA, 4 with VA improvement, 12 with diminished VA and 3 with complete loss light perception. There were 7 cases that failed during 3-year fellow up period. Cumulative probabilities of valve survival by Kaplan-Meier analysis were 82.9%,74.1% and 71.0% at 12, 24 and 36 mo, respectively. Cox stepwise regression analysis found that the survival time was significant associated with the pre-visual acuity <2/400(P <0.05). Post-operative complications occurred in 8eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION:The procedure of preoperative IVB andAGV implantation should be one of treatments for NVG because of its safety and effectiveness.

  9. Complement Factor H Expressed by Retinal Pigment Epithelium Cells Can Suppress Neovascularization of Human Umbilical Vein Endothelial Cells: An in vitro Study.

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    Yi Zhang

    Full Text Available Complement factor H (CFH is one of the most important soluble complement regulatory proteins and is closely associated with age-related macular degeneration (AMD, the leading cause of irreversible central vision loss in the elderly population in developed countries. Our study searches to investigate whether CFH expression is changed in oxidative damaged retinal pigment epithelium (RPE cells and the role of CFH in the in vitro neovascularization. First, it was confirmed by immunofluorescence staining that CFH was expressed by ARPE-19 cells. CFH mRNA and protein in oxidative (H2O2 damaged ARPE-19 cells were both reduced, as determined by Real-time PCR and Western blotting analysis. Enzyme-linked immunosorbent assay (ELISA also showed that ARPE-19 cells treated with H2O2 caused an increase in C3a content, which indicates complement activation. Then, wound assays were performed to show that CFH expression suppression promoted human umbilical vein endothelial cell (HUVECs migration. Thereafter, ARPE-19 cells were transfected with CFH-specific siRNA and CFH knockdown was confirmed with the aid of Real-time PCR, immunofluorescence staining and Western blotting. The ELISA results showed that specific CFH knockdown in ARPE-19 cells activated the complement system. Finally, in vitro matrigel tube formation assay was performed to determine whether change of CFH expression in RPE would affect tube formation by HUVECs. More tubes were formed by HUVECs co-cultured with ARPE-19 cells transfected with CFH specific-siRNA when compared with controls. Our results suggested that RPE cells might be the local CFH source, and RPE cell injuries (such as oxidative stress may cause CFH expression suppression, which in turn may lead to complement activation and promotion of tube formation by HUVECs. This finding is of importance in elucidating the role of complement in the pathogenesis of ocular neovascularization including choroidal neovascularization.

  10. Choroidal and macular thickness changes induced by cataract surgery

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    Falcão MS

    2013-12-01

    Full Text Available Manuel S Falcão,1,2 Nuno M Gonçalves,2 Paulo Freitas-Costa,1,3 João B Beato,2 Amândio Rocha-Sousa,1,2 Ângela Carneiro,1,2 Elisete M Brandão,2 Fernando M Falcão-Reis1,21Department of Sense Organs, Faculty of Medicine, University of Porto, 2Department of Ophthalmology of Hospital de São João, 3Department of Anatomy, Faculty of Medicine, University of Porto, Porto, PortugalBackground: The aim of this study was to evaluate the effect of uneventful phacoemulsification on the morphology and thickness of the macula, the submacular choroid, and the peripapillary choroid.Methods: In 14 eyes from 14 patients, retinal macular thickness, choroidal submacular thickness, and choroidal peripapillary thickness were measured preoperatively and at one week and one month after phacoemulsification using enhanced depth imaging spectral domain optical coherence tomography. Changes in thickness of the different ocular tissues were evaluated.Results: There was a statistically significant increase in mean retinal macular thickness at one month. In horizontal scans, the mean increase was +8.67±6.75 µm (P<0.001, and in vertical scans, the mean increase was +8.80±7.07 µm (P=0.001. However, there were no significant changes in choroidal morphology in the submacular and peripapillary areas one month after surgery. In vertical scans, there was a nonsignificant increase in choroidal thickness (+4.21±20.2 µm; P=0.47 whilst in horizontal scans a nonsignificant decrease was recorded (−9.11±39.59 µm; P=0.41. In peripapillary scans, a nonsignificant increase in mean choroidal thickness was registered (+3.25±11.80 µm; P=0.36.Conclusion: Uncomplicated phacoemulsification induces nonpathologic increases in retinal macular thickness probably due to the inflammatory insult of the surgery; however these changes are not accompanied by significant changes in choroidal thickness. In the posterior segment, the morphologic response to the inflammatory insult of

  11. Outcomes of Proton Radiation Therapy for Peripapillary Choroidal Melanoma at the BC Cancer Agency

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    Tran, Eric, E-mail: etran2@bccancer.bc.ca [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada); Ma, Roy [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada); Paton, Katherine [Department of Ophthalmology and Visual Sciences, Vancouver Hospital Eye Care Centre and University of British Columbia, Vancouver, British Columbia (Canada); Blackmore, Ewart [TRIUMF, Vancouver, British Columbia (Canada); Pickles, Tom [Radiation Therapy Program, BC Cancer Agency and University of British Columbia, Vancouver, British Columbia (Canada)

    2012-08-01

    Purpose: To report toxicity, local control, enucleation, and survival rates for patients with peripapillary choroidal melanoma treated with proton therapy in Canada. Methods and Materials: We performed a retrospective analysis of patients with peripapillary choroidal melanoma ({<=}2 mm from optic disc) treated between 1995 and 2007 at the only Canadian proton therapy facility. A prospective database was updated for follow-up information from a chart review. Descriptive and actuarial data are presented. Results: In total, 59 patients were treated. The median age was 59 years. According to the 2010 American Joint Committee on Cancer TNM classification, there were 20 T1 tumors (34%), 28 T2 tumors (48%), and 11 T3 tumors (19%). The median tumor diameter was 11.4 mm, and the median thickness was 3.5 mm. Median follow-up was 63 months. Nineteen patients received 54 cobalt gray equivalents (CGE) and forty patients received 60 CGE, each in 4 fractions. The 5-year actuarial local control rate was 91% (T1, 100%; T2, 93%; and T3, 59%) (p = 0.038). There was a suggestive relationship between local control and dose. The local control rate was 97% with 60 CGE and 83% with 54 CGE (p = 0.106). The metastasis-free survival rate was 82% and related to T stage (T1, 94%; T2, 84%; and T3, 47%) (p < 0.001). Twelve patients died, including eleven with metastases. The 5-year actuarial rate of neovascular glaucoma was 31% (23% for T1-T2 and 68% for T3, p < 0.001), and that of enucleation was 0% for T1, 14% for T2, and 72% for T3 (p < 0.001). Radiation retinopathy (74%) and optic neuropathy (64%) were common within-field effects. Conclusions: Proton therapy provides excellent local control with acceptable toxicity while conserving the globe in 80% of cases. These results are consistent with other single-institution series using proton radiotherapy, and toxicity rates were acceptable. T3 tumors carry a higher rate of both local recurrence and metastasis.

  12. Effect of Factor XIII-A G185T Polymorphism on Visual Prognosis after Photodynamic Therapy for Neovascular Macular Degeneration

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    Francesco Parmeggiani

    2015-08-01

    Full Text Available Macular degenerations represent leading causes of central blindness or low vision in developed countries. Most of these severe visual disabilities are due to age-related macular degeneration (AMD and pathologic myopia (PM, both of which are frequently complicated by subfoveal choroidal neovascularization (CNV. Photodynamic therapy with verteporfin (PDT-V is still employed for CNV treatment in selected cases or in combined regimen. In Caucasian patients, the common polymorphism G185T of factor XIII-A gene (FXIII-A-G185T; rs5985 has been described as predictor of poor angiographic CNV responsiveness to PDT-V. Nevertheless, the prognostic implications of this pharmacogenetic determinant on long-term visual outcome after a PDT-V regimen have not been evaluated. We retrospectively selected Caucasian patients presenting with treatment-naive CNV and receiving standardized PDT-V protocol for two years. The study population included patients affected by subfoveal CNV secondary to AMD or PM. We assessed the correlations between the polymorphic allele T of FXIII-A-G185T and: (1 total number of photodynamic treatments; and (2 change in visual acuity from baseline to the end of the follow-up period. Considering a total study population of 412 patients with neovascular AMD or PM, the carriers of 185 T-allele of FXIII-A (GT or TT genotype received a higher number of photodynamic treatments than patients without it (GG wild-type genotype (p < 0.01; mean number of PDT-V: 5.51 vs. 3.76, respectively. Moreover, patients with 185 T-allele of FXIII-A had a more marked worsening of visual acuity at 24 months than those with the GG-185 wild genotype (p < 0.01; mean difference in logMAR visual acuity: 0.22 vs. 0.08, respectively. The present findings show that the G185T polymorphism of the FXIII-A gene is associated with significant differences in the long-term therapeutic outcomes of patients treated with standardized PDT-V protocol. The comprehensive appraisal of

  13. Clinical correlates of common corneal neovascular diseases: a literature review

    Institute of Scientific and Technical Information of China (English)

    Nizar; Saleh; Abdelfattah; Mohamed; Amgad; Amira; A; Zayed; Hamdy; Salem; Ahmed; E; Elkhanany; Heba; Hussein; Nawal; Abd; El-Baky

    2015-01-01

    A large subset of corneal pathologies involves the formation of new vessels(neovascularization), leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization(CNV) by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis,contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatment available so far.

  14. Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

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    Krema, Hatem, E-mail: htmkrm19@yahoo.com [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Heydarian, Mostafa [Department of Radiation Medicine, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Beiki-Ardakani, Akbar [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Weisbrod, Daniel [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Xu, Wei [Department of Biostatistics, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Laperriere, Normand J.; Sahgal, Arjun [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada)

    2013-07-01

    Purpose: To compare the dose distributions and late radiation toxicities for {sup 125}I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46 months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma.

  15. Choroidal metastasis from early rectal cancer: Case report and literature review

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    Mitsuyoshi Tei

    2014-01-01

    CONCLUSION: This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer.

  16. Ultrastructural changes in the melanocytes of aging human choroid.

    Science.gov (United States)

    Nag, Tapas Chandra

    2015-12-01

    Retinal pigment epithelial cells as well as choroidal melanocytes (CM) possess melanin granules. The former show clear, age-related changes (formation of lipofuscin granules with a concomitant decrease in melanin content); however, data on changes in the CM with aging are fairly limited. We examined CM in human macular and mid-peripheral areas by light- and transmission electron microscopy in 50-94 year-old donor eyes (N=12). Unlike in the choroid of lower ages, the melanocytes from aging choroid (>75 years) showed partial fusion of about 8-15 melanosomes, forming rosettes-like structures. Besides, there was evidence of emptiness in cytoplasm caused by the loss of melanosomes in aged CM, as was confirmed by quantification in macular part of choroid. In advanced aged eyes (85-94-year-old), the CM possessed many lipid droplets as well as irregular lipofuscin granules, the latter had a tendency to fuse with melanosomes, as happens in aged retinal pigment epithelium. Macrophages in their cytoplasm contained abundant irregular as well as clumped melanosomes of variable size, suggesting that damaged granules/melanocytes are cleared by these phagocytes. These obvious changes in the CM are likely to make the choroid prone to damage by visible light.

  17. Review of spectral domain enhanced depth imaging optical coherence tomography of tumors of the choroid

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    Carol L Shields

    2015-01-01

    Full Text Available Background: Spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT can provide anatomic localization of intraocular tumors. Aims: The aim was to identify topographical and intrinsic patterns of choroidal tumors on EDI-OCT. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office based EDI-OCT. Results: Using EDI-OCT, choroidal nevus displayed a smooth, dome-shaped topography with overlying retinal pigment epithelium alterations, drusen, and occasional subretinal cleft demonstrating photoreceptor loss. Small choroidal melanoma showed smooth, moderately dome-shaped topography, commonly with overlying shallow subretinal fluid that often depicted "shaggy" photoreceptors. Choroidal metastasis showed a minimally "lumpy, bumpy" surface topography and with overlying subretinal fluid and shaggy photoreceptors. Choroidal hemangioma showed a smooth, dome-shaped topography, with expansion of the affected small, medium, and large choroidal vessels. Choroidal lymphoma showed varying topography with increasing tumor thickness as "flat, rippled, or undulating (seasick" surface. Choroidal osteoma displayed a smooth undulating surface with visible intralesional horizontal lines suggestive of bone lamellae and occasional horizontal and vertical tubules with intralesional "spongy" flecks. Choroidal melanocytosis appeared as uniformly thickened choroid with increased stromal density surrounding the normal choroidal vascular structures. Conclusions: Enhanced depth imaging-OCT can depict characteristic patterns that are suggestive of various choroidal tumors.

  18. Neovascularity as a prognostic marker in renal cell carcinoma.

    Science.gov (United States)

    Bauman, Tyler M; Huang, Wei; Lee, Moon Hee; Abel, E Jason

    2016-11-01

    Endothelial markers platelet and endothelial cell adhesion molecule (PECAM-1), cluster of differentiation (CD31) and endoglin (CD105) may be used to identify endothelium and activated endothelium, respectively, with the CD105/CD31 ratio used to measure neovascularity. This study investigated the hypothesis that neovascularity in renal cell carcinoma (RCC) is associated with more aggressive RCC tumors and can be used to predict oncological outcomes. Multiplexed immunohistochemistry using antibodies to detect endoglin and PECAM-1 was performed on tissue microarray of benign kidney samples and RCC tumors including clear cell, papillary, chromophobe, and collecting duct and unclassified tumors (combined for statistics), and multispectral imaging was used for analysis. The CD105/CD31 ratio was compared with clinical and pathologic features of RCC as well as clinical outcomes after surgery using Cox proportional hazards regression and Kaplan-Meier analysis. A total of 502 tumor samples and 122 normal kidney samples from 251 RCC patients were analyzed. The average CD105/CD31 expression ratio, an indicator of neovascularization, was increased in higher pathologic stage tumors (P< .0001). Among RCC morphotypes, the ratio was lower in papillary RCC morphotype tumors (P= .001) and higher in collecting duct/unclassified tumors (P= .0001) compared with clear cell RCC. Among nuclear grades, grade 4 RCC displayed a significantly elevated CD105/CD31 ratio (P< .0001). In multivariable analysis, increased neovascularity was associated with decreased overall survival (hazard ratio, 1.54 [95% confidence interval, 1.06-2.23]; P= .02). In patients receiving anti-vascular endothelial growth factor therapy (VEGF, n = 13) for metastatic RCC, a low CD105/CD31 ratio was associated with increased survival (P= .02). We conclude that higher neovascularity is associated with worse outcomes after surgery for RCC. The ratio of CD105/CD31 expression is a potential indicator of response to anti

  19. Choroid plexus failure in the Kearns-Sayre syndrome

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    Spector Reynold

    2010-08-01

    Full Text Available Abstract The Kearns-Sayre syndrome is a mitochondrial disorder (generally due to mitochondrial DNA deletions that causes ophthalmoplegia, retinopathy, ataxia and brain abnormalities such as leukoencephalopathy. In this syndrome, the choroid plexus epithelial cells, unlike brain cells, are greatly enlarged and granular, consistent with their inability to adequately transport folate from blood into cerebrospinal fluid (CSF, and homovanillic acid (a dopamine metabolite from CSF into blood. This inability to transport folates from blood into CSF (and brain adequately, causes cerebral folate deficiency that can be partially reversed by very high doses of reduced folates. The Kearns-Sayre syndrome is a disease that interferes with key choroid plexus functions and is a cause of generalized choroid plexus failure.

  20. [Radiation therapy in simultaneous choroidal and brain metastases].

    Science.gov (United States)

    Conill, C; Jorcano, S; Planas, I; Marruecos, J; Casas, F; Fontenla, J R

    2005-09-01

    Choroidal metastases from lung cancer can be the initial clinical manifestation of metastasic disease, although they generally coexist with at least two more metastasic sites. The most common symptom is decreased vision, however 20% of brain metastases can present with visual alterations. A differential diagnosis within brain metastases and/or choroidal is necessary. We present the case of a patient with lung cancer and decreased vision who was diagnosed as simultaneous choroidal and brain metastases. Radiation therapy (20Gy/5fractions) significantly improves decreased vision. This case shows that, although life expectancy of patients with metastasic lung cancer is short, an adequate diagnosis and treatment, can improve the quality of life of those patients.

  1. Peripheral Exudative Hemorrhagic Chorioretinopathy: A Variant of Polypoidal Choroidal Vasculopathy?

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    Arman Mashayekhi

    2013-01-01

    Full Text Available Purpose: To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR in an elderly patient. Case Report: A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in the development of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of the large hemorrhagic PED was typical of PEHCR. Conclusion: This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.

  2. Clinical characteristics and treatment of neurofibroma of the choroid

    Institute of Scientific and Technical Information of China (English)

    WEI Wen-bin; JIE Ying; MO Jing; LI Bin

    2012-01-01

    Background Neurofibroma is a kind of benign neoplasm that derives from nervous tissues.Though this tumor is the most common types in the peripheral nervous system,it is rarely seen in the choroid and easy to be misdiagnosed of choroidal melanoma.The aim of this study was to review the clinical features of neurofibroma of the choroid in the Chinese race.Methods A retrospective case series design was used.Two male and one female patients diagnosed with choroidal neurofibroma in Beijing Tongren Eye Center were included in this study.The clinical histories were abstracted from the patients' medical records.Routine eye examinations including visual acuity,intraocular pressure,slit lamp and ophthalmoscope were performed.Auxiliary examinations included fluorescein fundus angiography (FFA),AB-ultrasound scan,color doppler imaging (CDI),and magnetic resonance imaging (MRI).Local resection of the tumors was performed and the specimens underwent pathological examinations.Results The tumors were of yellow-pink color with pigmentation on the surface.CDI showed arterial blood signals in the tumor and MRI showed high-intensity in the T1-weighted image and a slightly increased intensity in the T2-weighted image.FFA and indocyaninegreen angiography demonstrated the tumors were of hypofluorescence at early stage and hyperfluorescence with prominent leakage at late stage.The pathological examination confirmed the tumors were choroidal neurofibroma.After 5-10-year follow-up,there were no recurrences of the tumors and the retinas were well attached.Conclusions Choroidal neurofibroma is difficult to be diagnosed clinically and pathological confirmation is important.These tumors can be managed conservatively by local resection.

  3. Comparative analysis of choroidal osteoma fundus angiography using indocyanine green and fluorescein%脉络膜骨瘤吲哚青绿与荧光素眼底血管造影对比观察

    Institute of Scientific and Technical Information of China (English)

    张苑苑; 刘志强; 闫素霞; 杨荣; 苑志峰; 张胜娟; 李成泉; 吕丽娜; 郭自元

    2013-01-01

    Objective To investigate the manifestations of choroidal osteoma between ICGA and FFA,to understand the different manifestations of choroidal osteoma and neovascularization secondary to choroidal osteoma and to deepen the awareness of the disease.Methods Retrospective analysis of 13 cases (16 eyes) diagnosed with choroidal osteoma using ICGA and FFA from 2006 to 2012.Results FFA showed punctate fluorescence in the lesion in 16 eyes before choroidal background fluorescence appeared.Plexiform vascular was appeared in 10 eyes and showed diffuse intense fluorescence gradually with the retinal arteriovenous filling,in which six eyes showed strong fluorescence associated with neovascular in lesions and four eyes showed strong fluorescence accompanied by hemorrhage.ICGA not only could show the plexiform vascular as FFA founded in early stage but also show spiderweb-like blood vessels.Spiderweb-like blood vessels had some similarities with neovascularization,but it was not associated with bleeding or serous edema.Conclusions ICGA can show spiderweb-like blood vessels except for plexiform vascular that FFA showed.ICGA confirm the connection between the plexiform vascular that FFA observed and spiderweb-like blood vessels that ICGA observed.Both are osteoma inherent vascular.Leakage caused by the two kinds of blood vessels is similar to leakage caused by the neovascularization secondary to osteoma,but they are essentially different.%目的 探讨脉络膜骨瘤的吲哚青绿血管造影(indocyanine green angiography,ICGA)与荧光素眼底血管造影(fundus fluorescein angiography,FFA)的表现,加深认识,深入了解脉络膜骨瘤继发新生血管与骨瘤丛状血管的表现.方法 回顾分析2006年4月至2012年12月在邢台市眼科医院已确诊为脉络膜骨瘤13例16只眼的ICGA与FFA表现.结果 FFA在脉络膜背景荧光显现前病变区16只眼均出现了斑点状荧光,7只眼并可见到骨瘤丛状血管的出现,随着视网膜动静脉的充

  4. Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

    Science.gov (United States)

    Vishnevskia-Dai, Vicktoria; Zur, Dinah; Yaacobi, Shiran; Moroz, Iris; Newman, Hadas; Neudorfer, Meira

    2016-01-01

    Purpose. To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface. Methods. This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well. Results. OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p = 0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p < 0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors. Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface. PMID:26998354

  5. Bilateral Choroidal Metastasis from Non-Small Cell Lung Cancer

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    Tariq Namad

    2014-01-01

    Full Text Available Breast and lung cancers are the most common primary neoplasms to manifest with choroidal metastases. The incidence of choroidal metastases from metastatic lung cancer was reported to be 2–6.7%. We report a case of bilateral choroidal metastasis from non-small cell lung cancer. A 59-year-old Caucasian female patient, never a smoker, was diagnosed with stage IV lung adenocarcinoma metastatic to the pleura, bones, and the brain. Her initial scan of the chest showed innumerable soft tissue nodules and mediastinal adenopathy compatible with metastatic disease. Her initial brain MRI showed numerous small enhancing lesions consistent with extensive disease. Unfortunately, during her follow-up visits, she presented with bulge on her left eye. Simultaneously, her follow-up chest scan showed increase in the size of the lung nodules. She continued to have a reasonable performance status at that time, except for mild increase in her dyspnea. The choroidal metastases require a multidisciplinary care and should be among the differential patients with malignancy who present with ocular symptoms.

  6. Increased choroidal thickness in patient with high-altitude retinopathy

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    Kyoko Hirukawa-Nakayama

    2014-01-01

    Full Text Available We report a case of high-altitude retinopathy with increased choroidal thickness detected by spectral-domain optical coherence tomography (SD-OCT. A 36-year-old Japanese man developed an acute vision decrease in his left eye after he had trekked at an altitude of 4600 m in Tibet for 1 week. His visual acuity was 20/20 OD and 20/200 OS with refractive errors of − 0.25 diopters (D OD and − 0.50 D OS 3 weeks after the onset of the visual decrease. Funduscopic examinations revealed multiple intraretinal hemorrhages bilaterally and a macular hemorrhage in the left eye. SD-OCT showed that the thickness of choroidal layer at the fovea was 530 μm OD and 490 μm OS which is thicker than that in normal subjects of approximately 300 μm. We suggest that the increase in the retinal blood flow under hypoxic conditions may be associated with an increase in the choroidal blood flow resulting in an increase in choroidal thickness.

  7. Primary Vitrectomy for Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Zhao; Yiqiao Xing; Ying Chen

    2006-01-01

    Purpose: To evaluate the role and the anatomic and visual results of primary pars plana vitrectomy (PPV) in treating cases with rhegmatogenous retinal detachment associated with choroidal detachment.Methods: All patients were divided into 2 groups. Each group included 23 consecutive eyes with rhegmatogenous retinal detachment and choroidal detachment with proliferative vitreoretinopathy less than grade C. In the study group, controlled removal of vitreous traction was achieved by primary vitrectomy and augmented by scleral buckling if needed. The breaks were treated by focused endolaser coagulation.Postoperative tamponade was done by SF6 or C3F8 gas. In the control group, all patients underwent regular scleral buckling procedure. The cases were followed up for 6 to 12 months.Results: In the study group, retinal reattachment could be achieved in 21 cases (91.30%) after the first operation and in all cases after the second procedure. No occurrence of choroidal detachment occurred after the first procedure. Retinal reattachment rate and visual results tended to be better compared with conventional surgical techniques in the control group.Conclusion: Primary vitrectomy represents a safe, effective method in the management of rhegmatogenous retinal detachment associated with choroidal detachment.

  8. Influx mechanisms in the embryonic and adult rat choroid plexus

    DEFF Research Database (Denmark)

    Saunders, Norman R; Dziegielewska, Katarzyna M; Møllgård, Kjeld

    2015-01-01

    The transcriptome of embryonic and adult rat lateral ventricular choroid plexus, using a combination of RNA-Sequencing and microarray data, was analyzed by functional groups of influx transporters, particularly solute carrier (SLC) transporters. RNA-Seq was performed at embryonic day (E) 15 and a...

  9. Stereotactic radiotherapy in neovascular age-related macular degeneration

    OpenAIRE

    Ranjbar, Mahdy; Kurz, Maximilian; Holzhey, Annekatrin; Melchert, Corinna; Rades, Dirk; Grisanti, Salvatore

    2016-01-01

    Abstract Stereotactic radiotherapy (SRT) is a new approach to treat neovascular age-related macular degeneration (nAMD). The INTREPID trial suggested that SRT could reduce the frequency of regular intravitreal injections (IVIs) with antivascular endothelial growth factor drugs, which are necessary to control disease activity. However, the efficacy of SRT in nAMD and resulting morphological changes have not been validated under real-life circumstances, an issue, which we would like to address ...

  10. Neovascular glaucoma treatment with extraction of anterior chamber fibrovascular tissue.

    Science.gov (United States)

    Nadal, Jeroni; Carreras, Elisa; Kudsieh, Bachar; Canut, Maribel

    2013-08-01

    The use of antibody to vascular endothelial growth factor to treat neovascular glaucoma yields good anatomic results in most cases. However, this type of glaucoma can cause angle closure with decompensation of intraocular pressure secondary to fibrovascular tissue contraction in the anterior chamber. Our surgical technique treats the cause by removing the anterior chamber fibrous complex after administration of antibody to vascular endothelial growth factor, thus restoring the chamber angle.

  11. Treatment of Corneal Neovascularization Using Anti-VEGF Bevacizumab

    Directory of Open Access Journals (Sweden)

    Deli Krizova

    2014-01-01

    Full Text Available Purpose. To evaluate antiangiogenic effect of local use of bevacizumab (anti-VEGF antibody in patients with corneal neovascularization. Methods. Patients were divided into two groups. All patients suffered from some form of corneal neovascularization (NV. Patients in group A received 0.2–0.5 mL of bevacizumab solution subconjunctivally (concentration 25 mg/mL in a single dose. Group A included 28 eyes from 27. Patients in group B applied bevacizumab eye drops twice daily (concentration 2.5 mg/mL for two weeks. Group B included 38 eyes from 35 patients. We evaluated the number of corneal segments affected by NV, CDVA, and the incidence of complications and subjective complaints related to the treatment. The minimum follow-up period was six months. Results. By the 6-month follow-up, in group A the percentage reduction of the affected peripheral segments was 21.6% and of the central segments was 9.6%; in group B the percentage reduction of the central segments was 22.7% and of the central segments was 38.04%. In both groups we noticed a statistically significant reduction in the extent of NV. Conclusion. The use of bevacizumab seems to be an effective and safe method in the treatment of corneal neovascularization, either in the subconjunctival or topical application form.

  12. Emerging therapies for the treatment of neovascular age-related macular degeneration and diabetic macular edema.

    Science.gov (United States)

    Emerson, M Vaughn; Lauer, Andreas K

    2007-01-01

    Diabetic macular edema (DME) and choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) are the leading causes of vision loss in the industrialized world. The mainstay of treatment for both conditions has been thermal laser photocoagulation, while there have been recent advances in the treatment of CNV using photodynamic therapy with verteporfin. While both of these treatments have prevented further vision loss in a subset of patients, vision improvement is rare. Anti-vascular endothelial growth factor (VEGF)-A therapy has revolutionized the treatment of both conditions. Pegaptanib, an anti-VEGF aptamer, prevents vision loss in CNV, although the performance is similar to that of photodynamic therapy. Ranibizumab, an antibody fragment, and bevacizumab, a full-length humanized monoclonal antibody against VEGF, have both shown promising results, with improvements in visual acuity in the treatment of both diseases. VEGF trap, a modified soluble VEGF receptor analog, binds VEGF more tightly than all other anti-VEGF therapies, and has also shown promising results in early trials. Other treatment strategies to decrease the effect of VEGF have used small interfering RNA to inhibit VEGF production and VEGF receptor production. Corticosteroids have shown efficacy in controlled trials, including anacortave acetate in the treatment and prevention of CNV, and intravitreal triamcinolone acetonide and the fluocinolone acetonide implant in the treatment of DME. Receptor tyrosine kinase inhibitors, such as vatalanib, inhibit downstream effects of VEGF, and have been effective in the treatment of CNV in early studies. Squalamine lactate inhibits plasma membrane ion channels with downstream effects on VEGF, and has shown promising results with systemic administration. Initial results are also encouraging for other growth factors, including pigment epithelium-derived factor administered via an adenoviral vector. Ruboxistaurin, which decreases protein

  13. Ultrasound imaging of breast tumor perfusion and neovascular morphology.

    Science.gov (United States)

    Hoyt, Kenneth; Umphrey, Heidi; Lockhart, Mark; Robbin, Michelle; Forero-Torres, Andres

    2015-09-01

    A novel image processing strategy is detailed for simultaneous measurement of tumor perfusion and neovascular morphology parameters from a sequence of dynamic contrast-enhanced ultrasound (DCE-US) images. After normalization and tumor segmentation, a global time-intensity curve describing contrast agent flow was analyzed to derive surrogate measures of tumor perfusion (i.e., peak intensity, time-to-peak intensity, area under the curve, wash-in rate, wash-out rate). A maximum intensity image was generated from these same segmented image sequences, and each vascular component was skeletonized via a thinning algorithm. This skeletonized data set and collection of vessel segments were then investigated to extract parameters related to the neovascular network and physical architecture (i.e., vessel-to-tissue ratio, number of bifurcations, vessel count, average vessel length and tortuosity). An efficient computation of local perfusion parameters was also introduced and operated by averaging time-intensity curve data over each individual neovascular segment. Each skeletonized neovascular segment was then color-coded by these local measures to produce a parametric map detailing spatial properties of tumor perfusion. Longitudinal DCE-US image data sets were collected in six patients diagnosed with invasive breast cancer using a Philips iU22 ultrasound system equipped with a L9-3 transducer and Definity contrast agent. Patients were imaged using US before and after contrast agent dosing at baseline and again at weeks 6, 12, 18 and 24 after treatment started. Preliminary clinical results suggested that breast tumor response to neoadjuvant chemotherapy may be associated with temporal and spatial changes in DCE-US-derived parametric measures of tumor perfusion. Moreover, changes in neovascular morphology parametric measures may also help identify any breast tumor response (or lack thereof) to systemic treatment. Breast cancer management from early detection to therapeutic

  14. Changes in Choroidal Thickness follow the RNFL Changes in Leber’s Hereditary Optic Neuropathy

    Science.gov (United States)

    Borrelli, Enrico; Triolo, Giacinto; Cascavilla, Maria Lucia; La Morgia, Chiara; Rizzo, Giovanni; Savini, Giacomo; Balducci, Nicole; Nucci, Paolo; Giglio, Rosa; Darvizeh, Fatemeh; Parisi, Vincenzo; Bandello, Francesco; Sadun, Alfredo A.; Carelli, Valerio; Barboni, Piero

    2016-01-01

    Leber’s hereditary optic neuropathy (LHON) is typically characterized by vascular alterations in the acute phase. The aim of this study was to evaluate choroidal changes occurring in asymptomatic, acute and chronic stages of LHON. We enrolled 49 patients with LHON, 19 with Dominant Optic Atrophy (DOA) and 22 healthy controls. Spectral Domain-Optical Coherence Tomography (SD-OCT) scans of macular and peripapillary regions were performed in all subjects, to evaluate macular and peripapillary choroidal thickness, and retinal nerve fiber layer (RNFL) thicknes. Macular and peripapillary choroidal thicknesses were significantly increased in the acute LHON stage. On the contrary, macular choroidal thickness was significantly reduced in the chronic stage. Furthermore, peripapillary choroidal thickness was decreased in chronic LHON and in DOA. Both RNFL and choroid had the same trend (increased thickness, followed by thinning), but RNFL changes preceded those affecting the choroid. In conclusion, our study quantitatively demonstrated the involvement of the choroid in LHON pathology. The increase in choroidal thickness is a feature of the LHON acute stage, which follows the thickening of RNFL. Conversely, thinning of the choroid is the common outcome in chronic LHON and in DOA. PMID:27853297

  15. Real-time in vivo micromorphology and histopathology of choroidal osteoma using enhanced depth imaging

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    Rameez Hussain

    2015-01-01

    Full Text Available Choroidal osteoma is a usually unilateral benign tumor of the choroid composed of mature bone. Optical coherence tomography (OCT has been used to image osteoma for several years. With the advent of enhanced depth imaging (EDI feature of spectral-domain OCT (SD-OCT, better visualization of the morphology of choroidal lesions has been possible. Herein we present a case of choroidal osteoma in a 45-year-old woman, wherein in vivo morphology of the choroidal osteoma had been visualized using EDI technique of SD-OCT before and after performing photodynamic therapy. EDI OCT has proven to be a valuable noninvasive imaging modality, almost comparable to histopathological examination, for diagnosing choroidal osteomas and for providing an insight into the in vivo micromorphological changes occurring during the course of the disease.

  16. Diffuse choroid plexus hyperplasia: an under-diagnosed cause of hydrocephalus in children?

    Energy Technology Data Exchange (ETDEWEB)

    Aziz, Azian Abd.; Coleman, Lee [Royal Children' s Hospital Melbourne, Department of Medical Imaging, Parkville, Victoria (Australia); Morokoff, Andrew; Maixner, Wirginia [Royal Children' s Hospital Melbourne, Department of Neurosurgery, Parkville (Australia)

    2005-08-01

    Hydrocephalus is a common neurological disorder in children and the result of a variety of causes. However, with the advancement of imaging modalities, particularly MRI, previously reported rarer causes of hydrocephalus in children are now being more readily appreciated. We report an 11-year-old boy with diffuse villous hyperplasia of the choroid plexus. He had a ventriculo-peritoneal (VP) shunt in-situ and a prior diagnosis from infancy of congenital aqueduct stenosis as the cause of his hydrocephalus. His current presentation was with further shunt dysfunction. CT and MRI demonstrated enlarged choroid plexuses but did not confirm aqueduct stenosis. CSF overproduction was demonstrated from the externalized ventricular drain. The enlarged choroid plexuses were surgically resected and histology confirmed choroid plexus hyperplasia. Identification of choroid plexus hyperplasia is important since the neurosurgical management of hydrocephalus is not VP shunt insertion, but resection of the hyperplastic choroid plexus. (orig.)

  17. Real-time in vivo micromorphology and histopathology of choroidal osteoma using enhanced depth imaging.

    Science.gov (United States)

    Hussain, Rameez; Anantharaman, Giridhar; Rajesh, Bindu; Gopalakrishnan, Mahesh

    2015-05-01

    Choroidal osteoma is a usually unilateral benign tumor of the choroid composed of mature bone. Optical coherence tomography (OCT) has been used to image osteoma for several years. With the advent of enhanced depth imaging (EDI) feature of spectral-domain OCT (SD-OCT), better visualization of the morphology of choroidal lesions has been possible. Herein we present a case of choroidal osteoma in a 45-year-old woman, wherein in vivo morphology of the choroidal osteoma had been visualized using EDI technique of SD-OCT before and after performing photodynamic therapy. EDI OCT has proven to be a valuable noninvasive imaging modality, almost comparable to histopathological examination, for diagnosing choroidal osteomas and for providing an insight into the in vivo micromorphological changes occurring during the course of the disease.

  18. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    Energy Technology Data Exchange (ETDEWEB)

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))

    1991-05-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

  19. On the radiotherapy of choroid metastases in mammary carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.; Schmid, A.P.; Dobrowsky, E.

    1987-06-01

    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  20. Verteporfin photodynamic therapy combined with intravitreal ranibizumab in neovascular age-related macular degeneration: 24-month follow-up

    Directory of Open Access Journals (Sweden)

    Rosalia Giustolisi

    2014-09-01

    Full Text Available Purpose: to evaluate the efficacy and safety of combined therapy with Photodynamic Therapy with Verteporfin (PDT-V and intravitreal ranibizumab same-day compared with monotherapy with ranibizumab (three monthly injections for the treatment of the choroidal neovascularization (CNV due to age-related macular degeneration (AMD. Type of study : open-label, randomized controlled trial (RCT. Materials and Methods: 17 eyes of 17 patients were consecutively enrolled and randomly assigned to ranibizumab intravitreal injection + PDT compared with a control group of 30 eyes of 30 patients treated with only ranibizumab 0.5mg in three monthly injections. Best corrected visual acuity (BCVA, central macular thickness (CMT on optical coherence tomography were examined before and after treatment. Patients were followed-up for twelve months. Results: in the combined therapy group, the mean baseline BCVA is 32.6 letters, at 24-months after treatment it’s 31.4 letters with a loss of 1.2 letters. The mean central thickness at baseline is 314.6 µm. After twenty four months the mean CMT is 222.5 µm, with mean CMT reduction of 92.1µm. In the ranibizumab-alone group, the mean baseline BCVA is 29.1 letters at 24-months it’s 28.6 letters with a little loss of 0.5 letters. The mean baseline CMT is 297.6 µm, at 24-months it is 235.9 µm, with mean CMT reduction of 61,7µm. Conclusions: the two treatments showed the same efficacy from a functional and anatomic point of view with a less number of retreatments in the combined therapy group. There were no serious ocular adverse events such as retinal detachment, endophthalmitis or ocular hypertone.

  1. Altered choroid plexus gene expression in major depressive disorder

    Directory of Open Access Journals (Sweden)

    Cortney Ann Turner

    2014-04-01

    Full Text Available Given the emergent interest in biomarkers for mood disorders, we assessed gene expression in the choroid plexus, the region that produces cerebrospinal fluid (CSF, in individuals with major depressive disorder (MDD. Genes that are expressed in the choroid plexus (CP can be secreted into the CSF and may be potential biomarker candidates. Given that we have previously shown that fibroblast growth factor family members are differentially expressed in post-mortem brain of subjects with MDD and the CP is a known source of growth factors in the brain, we posed the question whether growth factor dysregulation would be found in the CP of subjects with MDD. We performed laser capture microscopy of the choroid plexus at the level of the hippocampus in subjects with MDD and psychiatrically normal controls. We then extracted, amplified, labeled and hybridized the cRNA to Illumina BeadChips to assess gene expression. In controls, the most highly abundant known transcript was transthyretin. Moreover, half of the 14 most highly expressed transcripts in controls encode ribosomal proteins. Using BeadStudio software, we identified 169 transcripts differentially expressed (p< 0.05 between control and MDD samples. Using pathway analysis we noted that the top network altered in subjects with MDD included multiple members of the transforming growth factor-beta (TGFβ pathway. Quantitative real-time PCR (qRT-PCR confirmed downregulation of several transcripts that interact with the extracellular matrix in subjects with MDD. These results suggest that there may be an altered cytoskeleton in the choroid plexus in MDD subjects that may lead to a disrupted blood-CSF-brain barrier.

  2. Circulating human CD34(+) progenitor cells modulate neovascularization and inflammation in a nude mouse model

    NARCIS (Netherlands)

    van der Strate, B. W. A.; Popa, E. R.; Schipper, M.; Brouwer, L. A.; Hendriks, M.; Harmsen, M. C.; van Luyn, M. J. A.

    2007-01-01

    CD34(+) progenitor cells hold promise for therapeutic neovascularization in various settings. In this study, the role of human peripheral blood CD34(+) cells in neovascularization and inflammatory cell recruitment was longitudinally studied in vivo. Human CD34(+) cells were incorporated in Matrigel,

  3. The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Harun Çakmak

    2013-01-01

    Full Text Available Purpose. To evaluate association between erectile dysfunction (ED and neovascular age-related macular degeneration (AMD. Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF questionnaire’s erectile function (EF domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73 and 60 (54–68, in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16 in neovascular AMD and 18 (9.5–27 in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4% had some degree of ED, whereas 68 men (64.8% had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (. There was a significant association between ED and neovascular AMD (. Conclusions. Our results suggested that neovascular AMD has a high association with ED.

  4. Development and Notch signaling requirements of the zebrafish choroid plexus.

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    Brent R Bill

    Full Text Available BACKGROUND: The choroid plexus (CP is an epithelial and vascular structure in the ventricular system of the brain that is a critical part of the blood-brain barrier. The CP has two primary functions, 1 to produce and regulate components of the cerebral spinal fluid, and 2 to inhibit entry into the brain of exogenous substances. Despite its importance in neurobiology, little is known about how this structure forms. METHODOLOGY AND PRINCIPAL FINDINGS: Here we show that the transposon-mediated enhancer trap zebrafish line Et(Mn16 expresses green fluorescent protein within a population of cells that migrate toward the midline and coalesce to form the definitive CP. We further demonstrate the development of the integral vascular network of the definitive CP. Utilizing pharmacologic pan-notch inhibition and specific morpholino-mediated knockdown, we demonstrate a requirement for Notch signaling in choroid plexus development. We identify three Notch signaling pathway members as mediating this effect, notch1b, deltaA, and deltaD. CONCLUSIONS AND SIGNIFICANCE: This work is the first to identify the zebrafish choroid plexus and to characterize its epithelial and vasculature integration. This study, in the context of other comparative anatomical studies, strongly indicates a conserved mechanism for development of the CP. Finally, we characterize a requirement for Notch signaling in the developing CP. This establishes the zebrafish CP as an important new system for the determination of key signaling pathways in the formation of this essential component of the vertebrate brain.

  5. Tratamento da forma neovascular de degeneração macular relacionada à idade com drogas antiangiogênicas Treatment of neovascular age-related macular degeneration with antiangiogenic drugs

    Directory of Open Access Journals (Sweden)

    Eduardo Büchele Rodrigues

    2006-10-01

    , whereas choroidal neovascularization (CNV represents an important manifestation suitable for treatment. The treatment of CNV has been a major focus of research in the past decades, and the first evidence-based established therapy was laser photocoagulation, which reduces the risk of visual loss in extrafoveal lesions. In the late 90's photodynamic therapy has been established as an efficient method for the treatment of predominantly classic and occult CNV. Additional therapies such as macular translocation, submacular surgery, and indocyanine-mediated prothrombosis are currently under investigation in large-scale clinical trials. Molecular biology has recently provided a better comprehension of the pathogenesis of ARMD, and vascular endothelial growth factor (VEGF was recognized as key mediator in the angiogenesis of CNV-formation. Therefore, the pharmacological approach rose as a key research area to treat CNV. The first FDA-approved agent for CNV-therapy is aptamer pegaptanib sodium (Macugen®, which inactivates the key angiogenic isoform VEGF165. Additional VEGF-blockers such as ranibizumab RhuFab V2 (Lucentis® and bevacizumab (Avastin® are under evaluation in major clinical studies. Impressive results of intravitreal bevacizumab were released recently. Moreover, the steroid-derived anecortave acetate as well as the corticosteroid triamcinolone acetate have been proposed as methods for treatment of wet-ARMD. This paper presents the rationale and principles of the pharmacologic antiangiogenic therapy for CNV in ARMD.

  6. Neovascular Glaucoma in a Patient with X-linked Juvenile Retinoschisis

    Institute of Scientific and Technical Information of China (English)

    Chengguo Zuo; Changzheng Chen; Yiqiao Xing; Lei Du

    2005-01-01

    Purpose: To report the rubeosis iridis and neovascular glaucoma findings in one patient of X-linked juvenile retinoschisis (XLRS).Methods: Color fundus photography, fluorescein angiography (FFA), OCT and B-scan were performed in a patient with X-linked juvenile retinoschisis complicated with neovascular glaucoma.Result: Color fundus photography, fluorescein angiography (FFA), OCT and B-scan unveiled a rare condition of XLRS complicated with neovascular glaucoma.Conclusion: XLRS may complicate with neovascular glaucoma. It is necessary to test OCT, FFA, ERG and carefully examine the fundus of the follow eye when it comes to uncertain neovascular glaucoma of youth and child. And only in this way, can we exclude XLRS.

  7. The effects of chemokines in ocular neovascular diseases%趋化因子与眼部新生血管性疾病研究进展

    Institute of Scientific and Technical Information of China (English)

    苏梦茹

    2013-01-01

    Chemokine is a family of small chemotactic cytokines.Chemokine mainly locates in neutrophile granulocyte,monocyte,macrophage,T lymphocyte and B lymphocyte,and some cells and immunoactive cells also secret cytokines.Researches showed that chemokine plays important roles in many patho-physiological activities,such as inflammatory response,infection procedure,wound healing,regulation of immunity,angiogenesis,invasion and metastases of cancer,etc..Some chemokine factors,such as hyperglycemia,hypoxia,oxidative stress,stimulate the ocular histiocytes to up-regulate the expressions of CXC chemokines and CC chemokines,which participate in the development of choroidal neovascularization and ocular neovascular diseases.This article reviews current progress in chemokine and the relationship between chemokines and ocular neovascular diseases,especially in diabetic retinopathy (DR) and age-related macular degeneration (AMD) etc..%趋化因子是机体内一组具有趋化作用的细胞因子,主要表达于中性粒细胞、单核细胞、巨噬细胞、T淋巴细胞和B淋巴细胞,眼部的组织细胞及免疫活性细胞亦可分泌产生多种趋化因子.研究表明,趋化因子在炎症反应、感染、创伤愈合、免疫调节、血管发生、肿瘤的侵袭和转移等生理病理过程中发挥重要作用.高糖、缺氧、氧化应激等因素刺激眼部组织细胞上调CXC趋化因子、CC趋化因子的表达,参与脉络膜新生血管(CNV)及眼部新生血管性疾病的发展.就趋化因子的基本概念和功能以及其与常见眼部新生血管性疾病,如糖尿病视网膜病变(DR)、年龄相关性黄斑变性(AMD)的关系进行综述.

  8. Nanotechnology in corneal neovascularization therapy--a review.

    Science.gov (United States)

    Gonzalez, Lilian; Loza, Raymond J; Han, Kyu-Yeon; Sunoqrot, Suhair; Cunningham, Christy; Purta, Patryk; Drake, James; Jain, Sandeep; Hong, Seungpyo; Chang, Jin-Hong

    2013-03-01

    Nanotechnology is an up-and-coming branch of science that studies and designs materials with at least one dimension sized from 1-100 nm. These nanomaterials have unique functions at the cellular, atomic, and molecular levels. The term "nanotechnology" was first coined in 1974. Since then, it has evolved dramatically and now consists of distinct and independent scientific fields. Nanotechnology is a highly studied topic of interest, as nanoparticles can be applied to various fields ranging from medicine and pharmacology, to chemistry and agriculture, to environmental science and consumer goods. The rapidly evolving field of nanomedicine incorporates nanotechnology with medical applications, seeking to give rise to new diagnostic means, treatments, and tools. Over the past two decades, numerous studies that underscore the successful fusion of nanotechnology with novel medical applications have emerged. This has given rise to promising new therapies for a variety of diseases, especially cancer. It is becoming abundantly clear that nanotechnology has found a place in the medical field by providing new and more efficient ways to deliver treatment. Ophthalmology can also stand to benefit significantly from the advances in nanotechnology research. As it relates to the eye, research in the nanomedicine field has been particularly focused on developing various treatments to prevent and/or reduce corneal neovascularization among other ophthalmologic disorders. This review article aims to provide an overview of corneal neovascularization, currently available treatments, and where nanotechnology comes into play.

  9. MicroRNA signature and function in retinal neovascularization

    Institute of Scientific and Technical Information of China (English)

    Saloni; Agrawal; Brahim; Chaqour

    2014-01-01

    Ischemic retinopathies are clinically well-defined chronic microvascular complications characterized by gradually progressive alterations in the retinal microvasculature and a compensatory aberrant neovascularization of the eye. The subsequent metabolic deficiencies result in structural and functional alterations in the retina which is highly susceptible to injurious stimuli such as diabe-tes, trauma, hyperoxia, inflammation, aging and dys-plipidemia. Emerging evidence indicates that an effec-tive therapy may require targeting multiple components of the angiogenic pathway. Conceptually, mircoRNA(miRNA)-based therapy provides the rationale basis for an effective antiangiogenic treatment. miRNAs are an evolutionarily conserved family of short RNAs, each regulating the expression of multiple protein-coding genes. The activity of specific miRNAs is important for vascular cell signaling and blood vessel formation and function. Recently, important progress has been made in mapping the miRNA-gene target network andmiRNA-mediated gene expression control. Here wehighlight the latest findings on angiogenic and antian-giogenic miRNAs and their targets as well as potentiaimplications in ocular neovascular diseases. Emphasis isplaced on how specific vascular-enriched miRNAs regu-late cell responses to various cues by targeting severafactors, receptors and/or signaling molecules in orderto maintain either vascular function or dysfunction. Fur-ther improvement of our knowledge in not only miRNAspecificity, turnover, and transport but also how miRNAsequences and functions can be altered will enhancethe therapeutic utility of such molecules.

  10. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma.

    Science.gov (United States)

    Nakano, Satoko; Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro; Kubota, Toshiaki

    2016-01-01

    Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.

  11. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma

    Directory of Open Access Journals (Sweden)

    Satoko Nakano

    2016-01-01

    Full Text Available Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP with neovascular glaucoma (NVG, including antivascular endothelial growth factor (VEGF intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes with ischemic retinal diseases [proliferative diabetic retinopathy (PDR in 134 eyes, retinal vein occlusion (RVO in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3% eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC had persistent declines in IOP (≤21 mmHg. Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.

  12. Choroidal Thickness Variation According to Refractive Error Measured by Spectral Domain-optical Coherence Tomography in Korean Children

    Science.gov (United States)

    Lee, Geun Young; Yu, Sung; Kang, Hyun Gu; Kim, Jin Seon; Lee, Kyoo Won

    2017-01-01

    Purpose To assess choroidal thickness (CT) variation according to refractive errors using enhanced-depth imaging optical coherence tomography. Methods Eighty-nine eyes (in 89 children) Korean children, CTs were greater in the hyperopia group than in the emmetropia and myopia groups. The temporal choroid was thicker than the nasal choroid, regardless of the refractive error. The thickest location in the hyperopia group was the fovea; however, the temporal choroid was thickest in the emmetropia and myopia groups.

  13. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2014-07-01

    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  14. Assessment of effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2013-01-01

    Full Text Available Purpose: To evaluate the effect of intravitreal ranibizumab injection on the ocular blood flow in patients with neovascular agerelatedmacular degeneration (AMD.Methods: 35 patients with wet AMD undergone intravitreal 0.5 mg ranibizumab injection. Color Doppler Imaging (CDI and dopplerographywere used to measure hemodynamic parameters including the peak systolic velocity (Vsyst, cm / s, end-diastolic velocity (V diast, cm / s, and resistance index (RI of blood flow in the central retinal artery (CRA, the short posterior ciliary arteries (PCA, and the ophthalmic artery (OA. All patients were examined before and after injection on day 1‑7 and 30 day during the 3‑month follow up period.Results: Before intravitreal injection Vsyst was decreased in short PCA (p<0.05, RI in CRA and in short PCA significantly increased in comparison with normal index in same vessels. The peak systolic velocity in OA, in CRA and in short PCA was not significantly changed. After second injection resistance index in CRA and in short PCA was normalized.Conclusion: There was not impairment of ocular blood flow in retinal and choroidal after monthly intravitreal injection of ranibizumab during the 3‑month follow up period.

  15. Genetic and functional dissection of ARMS2 in age-related macular degeneration and polypoidal choroidal vasculopathy.

    Directory of Open Access Journals (Sweden)

    Yong Cheng

    Full Text Available Age-related maculopathy susceptibility 2(ARMS2 was suggested to be associated with neovascular age-related macular degeneration (nAMD and polypoidal choroidal vasculopathy (PCV in multiple genetic studies in Caucasians and Japanese. To date, no biological properties have been attributed to the putative protein in nAMD and PCV. The complete genes of ARMS2 and HTRA1 including all exons and the promoter region were assessed using direct sequencing technology in 284 unrelated mainland northern Chinese individuals: 96 nAMD patients, 92 PCV patients and 96 controls. Significant associations with both nAMD and PCV were observed in 2 polymorphisms of ARMS2 and HTRA1 rs11200638, with different genotypic distributions between nAMD and PCV (p<0.001. After adjusting for rs11200638, ARMS2 rs10490924 remained significantly associated with nAMD and PCV (p<0.001. Then we overexpressed wild-type ARMS2 and ARMS2 A69S mutation (rs10490924 in RF/6A cells and RPE cells as in vitro study model. Cell proliferation, attachment, migration and tube formation were analyzed for the first time. Compare with wild-type ARMS2, A69S mutation resulted in a significant increase in proliferation and attachment but inhibited cell migration. Moreover, neither wild-type ARMS2 nor A69S mutation affected tube formation of RF/6A cells. There is a strong and consistent association of the ARMS2/HTRA1 locus with both nAMD and PCV, suggesting the two disorders share, at least partially, similar molecular mechanisms. Neither wild-type ARMS2 nor A69S mutation had direct association with neovascularisation in the pathogenesis of AMD.

  16. Choroid plexus papillomas: advances in molecular biology and understanding of tumorigenesis.

    Science.gov (United States)

    Safaee, Michael; Oh, Michael C; Bloch, Orin; Sun, Matthew Z; Kaur, Gurvinder; Auguste, Kurtis I; Tihan, Tarik; Parsa, Andrew T

    2013-03-01

    Choroid plexus papillomas are rare, benign tumors originating from the choroid plexus. Although generally found within the ventricular system, they can arise ectopically in the brain parenchyma or disseminate throughout the neuraxis. We sought to review recent advances in our understanding of the molecular biology and oncogenic pathways associated with this disease. A comprehensive PubMed literature review was conducted to identify manuscripts discussing the clinical, molecular, and genetic features of choroid plexus papillomas. Articles concerning diagnosis, treatment, and long-term patient outcomes were also reviewed. The introduction of atypical choroid plexus papilloma as a distinct entity has increased the need for accurate histopathologic diagnosis. Advances in immunohistochemical staining have improved our ability to differentiate choroid plexus papillomas from other intracranial tumors or metastatic lesions using combinations of key markers and mitotic indices. Recent findings have implicated Notch3 signaling, the transcription factor TWIST1, platelet-derived growth factor receptor, and the tumor necrosis factor-related apoptosis-inducing ligand pathway in choroid plexus papilloma tumorigenesis. A combination of commonly occurring chromosomal duplications and deletions has also been identified. Surgical resection remains the standard of care, although chemotherapy and radiotherapy may be considered for recurrent or metastatic lesions. While generally considered benign, these tumors possess a complex biology that sheds insight into other choroid plexus tumors, particularly malignant choroid plexus carcinomas. Improving our understanding of the molecular biology, genetics, and oncogenic pathways associated with this tumor will allow for the development of targeted therapies and improved outcomes for patients with this disease.

  17. A case of choroidal osteoma in a 10-year-old child

    Directory of Open Access Journals (Sweden)

    Behera M

    2015-11-01

    Full Text Available Madhusmita Behera,1 Manmath Kumar Das2 1Rotary Narayana Nethralaya, Kolkata, India; 2Vitreo-Retina Services, CL Gupta Eye Institute, Moradabad, India Abstract: Choroidal osteoma is a rare, benign tumor, usually diagnosed in healthy adult women in their second or third decade of life. Though its etiology and pathogenesis are unclear, it is usually diagnosed due to its typical clinical features of yellowish-orange colored subretinal lesion at posterior pole and a dense echogenic plaque persisting even in lower gains on B-scan ultrasonography. Mostly unilateral (79%, the median age of diagnosis is 26 years. It is relatively rare in children. We report a case of choroidal osteoma in a 10-year-old boy. Keywords: choroidal osteoma, choroidal osseous choristoma, choroidal tumor

  18. Shaggy Photoreceptors with Subfoveal Fluid Associated with a Distant Choroidal Melanoma

    Directory of Open Access Journals (Sweden)

    Ann Q. Tran

    2015-01-01

    Full Text Available Purpose. To describe the enhanced depth imaging optical coherence tomography (EDI-OCT findings in a patient with an extra macula choroidal melanoma before and after treatment. Methods. Observational case report. Results. A 45 year-old Caucasian male patient was referred to retina clinic for management of choroidal melanoma. Examination revealed a nasal choroidal melanoma while EDI-OCT illustrated subfoveal fluid pocket with elongated shaggy photoreceptors distant and separate from the tumor. The patient was treated with plaque brachytherapy and intravitreal bevacizumab. One week after plaque removal, there was a dramatic reduction in the shaggy photoreceptors. Conclusion. Choroidal melanomas have effects that are not localized to the area of the tumor. This loculated pocket of subretinal fluid and coinciding changes to photoreceptor morphology may be related to global changes in choroidal function or release of tumor related cytokines.

  19. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

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    Cham A

    2016-06-01

    Full Text Available Abdourahman Cham,1,2 Mayank Bansal,3 Himanshu K Banda,4 Young Kwon,1 Paul S Tlucek,1 Alexander G Bassuk,5 Stephen H Tsang,6,7 Warren M Sobol,8 James C Folk,1 Steven Yeh,4 Vinit B Mahajan1,2 1Department of Ophthalmology and Visual Sciences, 2Omics Laboratory, University of Iowa, Iowa City, IA, USA; 3Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 4Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, 5Department of Pediatrics, University of Iowa, Iowa City, IA, 6Barbara and Donald Jonas Laboratory of Stem Cells and Regenerative Medicine and Bernard and Shirlee Brown Glaucoma Laboratory, Department of Pathology and Cell Biology, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, 7Edward S Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, 8Retina Physicians & Surgeons, Inc., Dayton, OH, USA Objective: The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV, a hereditary autoimmune uveitis due to mutations in CAPN5. Patients and methods: A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP, visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT were also analyzed. Results: Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5 required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser

  20. The role of biomaterial properties in peri-implant neovascularization

    Science.gov (United States)

    Raines, Andrew Lawrence

    An understanding of the interactions between orthopaedic and dental implant surfaces with the surrounding host tissue is critical in the design of next generation implants to improve osseointegration and clinical success rates. Critical to the process of osseointegration is the rapid establishment of a patent neovasculature in the peri-implant space to allow for the delivery of oxygen, nutrients, and progenitor cells. The central aim of this thesis is to understand how biomaterials regulate cellular and host tissue response to elicit a pro-angiogenic microenvironment at the implant/tissue interface. To address this question, the studies performed in this thesis aim to (1) determine whether biomaterial surface properties can modulate the production and secretion of pro-angiogenic growth factors by cells, (2) determine the role of integrin and VEGF-A signaling in the angiogenic response of cells to implant surface features, and (3) to determine whether neovascularization in response to an implanted biomaterial can be modulated in vivo. The results demonstrate that biomaterial surface microtopography and surface energy can increase the production of pro-angiogenic growth factors by osteoblasts and that these growth factors stimulate the differentiation of endothelial cells in a paracrine manner and the results suggest that signaling through specific integrin receptors affects the production of angiogenic growth factors by osteoblast-like cells. Further, using a novel in vivo model, the results demonstrate that a combination of a rough surface microtopography and high surface energy can improve bone-to-implant contact and neovascularization. The results of these studies also suggest that VEGF-A produced by osteoblast-like cells has both an autocrine and paracrine effect. VEGF-A silenced cells exhibited reduced production of both pro-angiogenic and osteogenic growth factors in response to surface microtopgraphy and surface energy, and conditioned media from VEGF

  1. The association between Neovascular Age-related Macular Degeneration and Regulatory T cells in peripheral blood

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Falk, Mads; Sørensen, Torben Lykke

    2015-01-01

    PURPOSE: To investigate regulatory T cells (Tregs) and subsets of the Treg population in patients with neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Twenty-one neovascular AMD cases and 12 age-matched controls without retinal pathology were selected. Patients were recr...... were found in the percentages of CD4(+) lymphocytes, CD25(high)CD127(low) Tregs, CD45RA(+) naïve Tregs, or CD31(+) recent thymic emigrant Tregs. CONCLUSION: Our data does not indicate an altered state of systemic Treg cells in neovascular AMD....

  2. Pelvis metastasis from primary choroidal melanoma: a case report

    Directory of Open Access Journals (Sweden)

    Xiong Y

    2014-11-01

    Full Text Available Yan Xiong, Yun Lang, Chongqi Tu, Hong Duan Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China Abstract: The patient, a 16-year-old girl, was admitted to our hospital with complaints of right hip pain and claudication. Her past medical history indicated that 2 years earlier she had undergone enucleation of her left eye for a primary choroidal melanoma. Imaging studies revealed a osteolytic destruction with soft tissue mass involving the right hemipelvis (zone I–II. Single-photon emission computed tomography (SPECT and positron emission tomography–computed tomography (PET–CT showed no other sites of metastases. Consequently, the patient underwent hemipelvic prosthesis reconstruction after tumor resection. Postoperative pathological diagnosis was metastatic malignant melanoma. Thirty months after treatment, imaging studies indicated no evidence of recurrence, and functional recovery was excellent. To our knowledge, the literature does not reveal any previously reported cases of ocular choroidal melanoma that metastasized to pelvis, meanwhile was carried out hemipelvic prosthesis reconstruction after pelvic tumor resection. Keywords: melanoma, metastasis, pelvis, tumor, reconstruction

  3. Role of echography in diagnostic dilemma in choroidal masses

    Directory of Open Access Journals (Sweden)

    Kopal N Mithal

    2014-01-01

    Full Text Available Purpose: To evaluate the role of echography in diagnosis and management of a diverse array of choroidal masses. Materials and Methods: Sixty-two cases of clinically suspected choroidal masses were prospectively analyzed with B-scan (10 Hz, A-scan, and ultrasound biomicroscopy (UBM (50 Hz after a meticulous history and ocular examination. Ancillary investigations and systemic evaluation were also done. Results: Based on clinical suspicion, acoustic features, response to treatment, and other ancillary tests combined together, the various masses were differentiated. The cases included in the study were as follows: n = 10 malignant melanomas, n = 16 metastasis and infiltrations, n = 9 hemangioma, n = 7 tuberculoma, n = 8 nonspecific inflammatory masses, n = 2 disciform plaques, n = 4 macular cysts or retinoschisis, n = 2 Coat′s disease, n = 1 melanocytoma, and n = 2 osteomas. Ultrasonography (USG alone could identify n = 51 lesions, while UBM in combination with USG was needed in remaining 11 masses. Conclusion: Standardized echography is an important adjunct in the diagnosis and management of eyes with intraocular masses. A better understanding of the clinicopathological and echographic picture of the diverse lesions can help in detection, differentiation, diagnosis, proposing a therapeutic approach, and also monitoring response to treatment. Echography is essential to evaluate tumors for extrascleral and anterior segment extension.

  4. Implementation studies of ranibizumab for neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi

    2013-01-01

    , and type 2 CNV lesions, which have penetrated the RPE and evolve within the subretinal space. The natural course of neovascular AMD leads to visual disability in a majority of cases within the first years after onset, primarily caused by the development of subfoveal fibrous tissue and atrophy of the RPE......The pathogenesis of AMD is associated with age changes plus pathological changes involving oxidative stress and an altered inflammatory response leading to injury of retinal pigment epithelial cells and the adjacent choroidea and photoreceptor cells. AMD is divided into early, intermediate...... and advanced AMD. The advanced form of AMD is further divided into non-neovascular AMD and neovascular AMD. The diagnosis of neovascular AMD is based on FA and clinical characteristics of the eyes. The CNV lesions are by their growth pattern divided into type 1 CNV lesions, which grow primarily beneath the RPE...

  5. Combination verteporfin photodynamic therapy ranibizumab-dexamethasone in choroidal neovascularization due to age-related macular degeneration: results of a phase II randomized trial

    Science.gov (United States)

    Gallemore, Ron P; Wallsh, Josh; Hudson, Henry L; Ho, Allen C; Chace, Richard; Pearlman, Joel

    2017-01-01

    Purpose To assess whether combination therapy (CT) reduces retreatments when compared to ranibizumab monotherapy (RM), while safely maintaining similar vision outcomes. Methods In this 24-month trial, patients with age-related macular degeneration (AMD) were randomized to 1) quarter-fluence or 2) half-fluence triple therapy (verteporfin photodynamic therapy [vPDT] + ranibizumab + dexamethasone), 3) half-fluence double therapy (vPDT + ranibizumab), or 4) RM. The primary outcomes were number of retreatment visits and change from baseline in visual acuity (VA) at 12 months. Results One hundred sixty-two subjects enrolled. There were 4.0 (P=0.02), 3.2 (P<0.001), 4.1 (P=0.03), and 5.7 retreatment visits through month 12, and 5.9 (P=0.03), 4.3 (P<0.001), 5.9 (P=0.02) and 8.7 through month 24, in groups 1, 2, 3, and 4, respectively (P-value comparing with RM). Month 12 VA score change from baseline (95% confidence interval) was +3.6 (−0.9 to +8.1), +6.8 (+2.4 to +11.1), +5.0 (+0.6 to +9.3), and +6.5 (+1.7 to +11.4), respectively. Conclusion CT resulted in significantly fewer retreatment visits than a RM regimen at months 12 and 24. VA results appeared similar although wide confidence intervals preclude conclusions regarding vision outcomes. PMID:28182161

  6. Management of neovascular Age-related macular degeneration: A review on landmark randomized controlled trials

    OpenAIRE

    Aniruddha Agarwal; Kanika Aggarwal; Vishali Gupta

    2016-01-01

    In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have...

  7. Choroid plexus of the fourth ventricle: Review and anatomic study highlighting anatomical variations.

    Science.gov (United States)

    Tubbs, R Shane; Shoja, Mohammadali M; Aggarwal, Anjali; Gupta, Tulika; Loukas, Marios; Sahni, Daisy; Ansari, Shaheryar F; Cohen-Gadol, Aaron A

    2016-04-01

    Relatively few studies have been performed that analyze the morphology of the choroid plexus of the fourth ventricle. Due to the importance of this tissue as a landmark on imaging and during surgical intervention of the fourth ventricle, the authors performed a cadaveric study to better characterize this important structure. The choroid plexus of the fourth ventricle of 60 formalin fixed adult human brains was examined and measured. The horizontal distance from the midline to the lateral most point of the protruding tip of the horizontal limbs was measured. In the majority of the 60 brain specimens, right and left horizontal limbs of the choroid plexus were seen extending from the midline and protruding out of their respective lateral apertures of the fourth ventricle and into the subarachnoid space. However, on 3.3% of sides, there was absence of an extension into the foramen of Luschka and in one specimen, this lack of extension into the foramen of Luschka was bilateral. On two sides, there was discontinuity between the midline choroid plexus and the tuft of choroid just outside the foramen of Luschka. For specimens in which the choroid plexus did protrude through the foramen of Luschka (96.7%), these tufts were located anterior to the flocculus and inferolateral to the facial/vestibulocochlear nerve complex and posterosuperior to the glossopharyngeal/vagal/accessory complex. A thorough understanding of the normal and variant anatomy of the fourth ventricular choroid plexus is necessary for those who operate in, or interpret imaging of, this region.

  8. Spectral domain-optical coherence tomography analysis of choroid osteoma%脉络膜骨瘤的频域光相干断层扫描观察

    Institute of Scientific and Technical Information of China (English)

    薛康; 钱江; 张勇进; 黄欣; 黎蕾

    2013-01-01

    -OCT),and to explore their relationship with visual acuity.Methods The records and SD-OCT images of 14 patients (18 eyes) diagnosed with choroidal osteoma at this hospital were reviewed retrospectively.All patients received examinations of best corrected visual acuity (BCVA),direct or indirect ophthalmoscope,slit lamp ophthalmoscope,fundus fluorescein angiography,B scan and/or computerized tomography.Subtle structure changes of the retina and choroidal osteoma were observed by four lines of the horizontal,the vertical scanning lines through the foveal and the tumor basal diameter under the model of five Line Raster.The correlation between the retinal and choroidal morphology and visual acuity was evaluated.Results The choroidal features of SD-OCT image of choroidal osteoma can be categorized into hyper-reflective in six eyes (33.3 %),isoreflective in five eyes (27.8%),hypo-reflective in three eyes (16.7%) and mixing-reflective in four eyes (22.2%).The foveal thickness ranged from 50.2 to 245.1 μm,and the average foveal thickness was (130.2±58.3) μm.The horizontal and vertical diameters of choroidal osteoma ranged from 5.6 to 15.8 mm and 4.6 to 12.8 mm respectively.The average horizontal and vertical diameters of choroidal osteoma were (7.8 ± 2.9) mm and (6.5 ±2.5) mm respectively.The statistical analysis revealed that BCVA was not related to the horizontal,vertical diameters of choroidal osteoma or the foveal thickness (r =0.262,0.229,0.137; P =0.284,0.294,0.362).BCVA was related to the involvement of fovea and the integrity of photoreceptor inner/ outer segment junction (IS/OS) (r=-3.838,-4.559; P=0.001 5,0.000 3),but not related to macular choroidal neovascularization (CNV) or serous retinal detachment (r=-0.144,0.411; P=0.684,0.687).Conclusions The main SD-OCT image characteristics of eyes with choroidal osteoma was hyper-reflective and isoreflective.BCVA was not related to the horizontal,the vertical diameters of choroidal osteoma,the foveal thickness

  9. Slit2 signaling through Robo1 and Robo2 is required for retinal neovascularization.

    Science.gov (United States)

    Rama, Nicolas; Dubrac, Alexandre; Mathivet, Thomas; Ní Chárthaigh, Róisín-Ana; Genet, Gael; Cristofaro, Brunella; Pibouin-Fragner, Laurence; Ma, Le; Eichmann, Anne; Chédotal, Alain

    2015-05-01

    Ocular neovascular diseases are a leading cause of blindness. Vascular endothelial growth factor (VEGF) blockade improves vision, but not all individuals respond to anti-VEGF treatment, making additional means to prevent neovascularization necessary. Slit-family proteins (Slits) are ligands of Roundabout (Robo) receptors that repel developing axons in the nervous system. Robo1 expression is altered in ocular neovascular diseases, and previous in vitro studies have reported both pro- and anti-angiogenic effects of Slits. However, genetic evidence supporting a role for Slits in ocular neovascularization is lacking. Here we generated conditional knockout mice deficient in various Slit and Robo proteins and found that Slit2 potently and selectively promoted angiogenesis via Robo1 and Robo2 in mouse postnatal retina and in a model of ocular neovascular disease. Mechanistically, Slit2 acting through Robo1 and Robo2 promoted the migration of endothelial cells. These receptors are required for both Slit2- and VEGF-induced Rac1 activation and lamellipodia formation. Thus, Slit2 blockade could potentially be used therapeutically to inhibit angiogenesis in individuals with ocular neovascular disease.

  10. Cathepsin L is required for endothelial progenitor cell-induced neovascularization

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    Urbich, Carmen; Heeschen, Christopher; Aicher, Alexandra; Sasaki, Ken-ichiro; Bruhl, Thomas; Hofmann, Wolf K.; Peters, Christoph; Reinheckel, Thomas; Pennacchio, Len A.; Abolmaali, Nasreddin D.; Chavakis, Emmanouil; Zeiher, Andreas M.; Dimmeler, Stefanie

    2004-01-15

    Infusion of endothelial progenitor cells (EPCs), but not of mature endothelial cells (ECs), promotes neovascularization after ischemia. We performed a gene expression profiling of EPCs and ECs to identify genes, which might be important for the neovascularization capacity of EPCs. Intriguingly, the protease cathepsin L (CathL) was highly expressed in EPCs as opposed to ECs and is essential for matrix degradation and invasion by EPCs in vitro. CathL deficient mice showed impaired functional recovery after hind limb ischemia supporting the concept for an important role of CathL in postnatal neovascularization. Infused CathL deficient progenitor cells failed to home to sites of ischemia and to augment neovascularization. In contrast, over expression of CathL in mature ECs significantly enhanced their invasive activity and induced their neovascularization capacity in vivo. Taken together, CathL plays a crucial role for the integration of circulating EPCs into the ischemic tissue and is required for neovascularization mediated by EPCs.

  11. Imaging evidence of diabetic choroidopathy in vivo: angiographic pathoanatomy and choroidal-enhanced depth imaging.

    Directory of Open Access Journals (Sweden)

    Rui Hua

    Full Text Available PURPOSE: To describe the pathoanatomy of diabetic choroidopathy (DC in pre-diagnosed diabetic retinopathy (DR cases and to provide angiographic and optical evidence for DC using indocyanine green angiography (ICGA and enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT. METHODS: A retrospective analysis of 80 eyes from 40 DR patients was conducted. In Group One, choroidal vascular abnormalities were evaluated by comparing angiographic findings from simultaneous ICGA with those from fundus fluorescein angiography (FFA. In Group Two, EDI SD-OCT was used to evaluate the subfoveal choroidal thickness (SFCT and define the choroid boundary in order to acquire the bilateral and symmetric choroidal area (CA. Data were then analyzed by Image Pro Plus 6.0. RESULTS: In Group One, choroidal abnormalities that were evident using ICGA but not FFA included early hypofluorescent spots in 47 eyes (75.81%, late hyperfluorescent spots in 37 eyes (59.68%, and late choroidal non-perfusion regions in 32 eyes (51.61%. In particular, a significant difference between proliferative DR (PDR in 17 of 23 eyes (73.91% and non-PDR in 16 of 39 eyes (41.03% was observed in late choroidal non-perfusion regions. Eighteen of 31 eyes (58.06% also exhibited "inverted inflow phenomena." In Group Two, both the SFCT and CA of eyes with diabetic macular edema and serous macular detachment were significantly greater than those in the other eyes. The CA in panretinal photocoagulation (PRP treated cases was also greater than that in non-PRP treated cases. CONCLUSIONS: Early hypofluorescent spots, late choroidal non-perfusion regions, inverted inflow phenomena, higher SFCT, and larger CA are qualitative and quantitative indexes for DC. Moreover, the late choroidal non-perfusion region is a risk factor for DC with DR. Our study suggests that the supplemental use of ICGA and EDI SD-OCT with FFA is a better choice for DR patients.

  12. Presence of bilateral limbal dermoids and choroidal osteomas in a family with inherited limbal dermoids.

    Science.gov (United States)

    Magli, A; De Marco, R; Capasso, L

    1999-06-01

    We report a case of bilateral limbal dermoids and bilateral choroidal osteomas in a 14-year-old girl with no extraocular anomalies. Histopathological examination of a limbal lesion confirmed the clinical diagnosis of dermoid. Computerized tomography and ultrasonography were compatible with a diagnosis of choroidal osteoma. Limbal dermoids were present in the patient's mother, in a brother with Down syndrome, and in an aunt with no choroidal osteoma. The present pedigree is compatible with autosomal dominant inheritance of bilateral limbal dermoids. The same gene may be involved in the pathogenesis of ocular choristomas in same patients.

  13. Optical Coherence Tomography Imaging of Choroidal Abnormalities in Neurofibromatosis Type 1

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    Shinji Makino

    2013-01-01

    Full Text Available We report a case of neurofibromatosis type 1 (NF1 examined by infrared fundus autofluorescence (IR-FAF and optical coherence tomography (OCT to characterize the associated choroidal abnormalities. The conventional ophthalmoscopic findings were unremarkable. However, IR-FAF revealed multiple bright patchy lesions in the choroid of the posterior pole, in both eyes. OCT demonstrated irregular hyperreflectivity at the sites of these lesions. Patients with NF1 may have typical choroidal lesions that are visible on IR-FAF, which can be confirmed through OCT.

  14. Choroid plexus papilloma originating in the sella turcica--case report.

    Science.gov (United States)

    Sameshima, Tetsuro; Tanikawa, Rokuya; Sugimura, Toshihide; Izumi, Naoto; Seki, Toshitaka; Maeda, Takahiro; Tsuboi, Toshiyuki; Hashimoto, Masaaki; Kimura, Teruo; Nabeshima, Kazuki

    2010-01-01

    A 51-year-old female presented with a rare case of choroid plexus papilloma originating in the sella turcica manifesting as headaches that was not readily distinguishable preoperatively from pituitary adenoma. Head magnetic resonance imaging revealed a tumor extending from the sella turcica to the suprasellar cistern. The tumor was removed via an endonasal transsphenoidal approach. Histological examination indicated a papillary structure covered with a layer of columnar epithelial cells that resembled normal choroid plexus. These findings, together with immunohistochemistry, led to a diagnosis of choroid plexus papilloma.

  15. Choroid plexus tumors: An institutional series of 25 patients

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    Menon Girish

    2010-01-01

    Full Text Available Purpose : Choroid plexus tumors (CPT are rare neoplasms that pose considerable treatment challenges. This study reviews a single institute′s experience with 25 patients of CPT and attempts to contribute to the general body of knowledge on CPT. Materials and Methods : A retrospective analysis of the case records of 25 patients operated for CPT since January 1998 and having a minimum of 1 year follow-up. Results : The study group included 12 (48% cases of choroid plexus papilloma (CPP, 09 (36% cases of choroid plexus carcinoma (CPC and 4 cases of atypical CPP. The mean age at presentation was 18.6 years (range, 6 months to 54 years; SD, 18.7 and a male preponderance was noted (17:8. Raised intracranial pressure was the commonest presenting symptom (72%. The tumors were distributed as follows: lateral ventricle (16; 64%, fourth ventricle (5; 20%, fourth ventricle with cerebellopontine angle extension (3; 12%, and third ventricle (1; 4%. A complete surgical excision was achieved in 11 cases of CPP and 8 cases of CPC. Operative complications include pneumocephalus (40%, focal deficits (36%, subdural effusion (32%, and persistent hydrocephalus requiring shunt (24%. All patients with CPP had a good outcome at the end of a mean follow-up of 5.4 years, whereas the median survival for patients with CPCs who underwent a subtotal resection with adjuvant therapy was 36 months. Conclusion : CPTs include a spectra ranging from CPP to CPC. Radiologic and histologic characterization of these tumors is difficult and newer immunohistochemical and genetic studies should be done to differentiate them from each other. Total excision offers a good prognosis and should be attempted for all forms of CPTs. CPPs carry a good prognosis, and adjuvant therapy is not indicated even after partial excision. CPCs and atypical CPCs carry a poor prognosis, and adjuvant therapy improves survival marginally after total excision. Spinal drop metastases are common for CPC and

  16. The Pediatric Choroidal and Ciliary Body Melanoma Study

    DEFF Research Database (Denmark)

    Al-Jamal, Rana'a T; Cassoux, Nathalie; Desjardins, Laurence

    2016-01-01

    PURPOSE: To collect comprehensive data on choroidal and ciliary body melanoma (CCBM) in children and to validate hypotheses regarding pediatric CCBM: children younger than 18 years, males, and those without ciliary body involvement (CBI) have more favorable survival prognosis than young adults 18...... entered through a secure website and were reviewed centrally. Survival was analyzed using Kaplan-Meier analysis and Cox proportional hazards regression. MAIN OUTCOME MEASURES: Proportion of females, tumor-node-metastasis (TNM) stage, cell type, and melanoma-related mortality. RESULTS: Cumulative frequency...... type, known for 35% of tumors, and TNM stage (I in 22% and 21%, II in 49% and 52%, III in 30% and 28%, respectively) were comparable for children and young adults. Melanoma-related survival was 97% and 90% at 5 years and 92% and 80% at 10 years for children compared with young adults, respectively (P...

  17. Proton beam irradiation and hyperthermia. Effects on experimental choroidal melanoma

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    Riedel, K.G.; Svitra, P.P.; Seddon, J.M.; Albert, D.M.; Gragoudas, E.S.; Koehler, A.M.; Coleman, D.J.; Torpey, J.; Lizzi, F.L.; Driller, J.

    1985-12-01

    Ultrasonically induced hyperthermia (4.75 MHz) and proton irradiation (160 meV) were evaluated alone and combined to treat experimental choroidal melanoma in 58 rabbit eyes. Threshold tumoricidal doses were established for each modality. Therapy was performed combining subthreshold doses of heat and radiation. Focused ultrasonic energy via an external beam was found to deliver well-localized heat to an intraocular tumor. Ectopic temperature elevations due to soft-tissue-bone interfaces were alleviated by modifying beam alignment. The results indicate that hyperthermia (43 degrees C for one hour) potentiated the tumoricidal effects of radiation, while sparing normal ocular structures. Therefore, we believe that experimental hyperthermia is suitable as an adjuvant treatment modality. This shows that ultrasound hyperthermia has the potential to increase the efficacy of proton irradiation by lowering radiation doses and thus decreasing posttreatment ocular morbidity in human intraocular malignancies.

  18. Choroidal thickness profile in inherited retinal diseases in Indian subjects

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    Jay Chhablani

    2015-01-01

    Full Text Available Purpose: To evaluate changes in choroidal thickness (CT in inherited retinal diseases and its relationship with age, spherical equivalent, visual acuity, and macular thickness. Methods: Retrospective analysis of 51 eyes with features of retinal dystrophy of 26 subjects, who underwent enhanced depth imaging using spectral domain (SD optical coherence tomography (OCT, were included. The CT measurements were made at the fovea and at 5 points with an interval of 500 microns in both directions, nasal and temporal from the fovea and were compared with age-matched healthy subjects. Step-wise regression was used to find the relationship between age, spherical equivalent, best-corrected visual acuity (BCVA, central macular thickness (CMT, and subfoveal CT. Results: Disease distribution was as follows: Stargardt′s disease 18 eyes (9 subjects; Best disease 5 eyes (3 subjects; cone-rod dystrophy 26 eyes (13 subjects; and Bietti′s crystalline dystrophy 2 eyes (1 subject. Mean subfoveal CT was 266.33 ± 76 microns. On regression analysis, no significant correlation was found between subfoveal CT and any other variable such as age (P = 0.9, gender (P = 0.5, CMT (P = 0.1, spherical equivalent (P = 0.3 and BCVA (P = 0.6. While comparing with age-matched healthy subjects, no significant statistical difference was noted (P < 0.05 among all age groups. Conclusion: Our study reports quantitative changes in CT in various common inherited retinal diseases seen in Indian populations. To validate changes in choroid, a longitudinal study with larger sample size is warranted.

  19. Multifocal choroiditis following simultaneous hepatitis A, typhoid, and yellow fever vaccination

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    Escott S

    2013-02-01

    Full Text Available Sarah Escott, Ahmad B Tarabishy, Frederick H DavidorfHavener Eye Institute, The Ohio State University, Columbus, OH, USAAbstract: The paper describes the first reported case of multifocal choroiditis following simultaneous hepatitis-A, typhoid, and yellow fever vaccinations. A 33-year-old male developed sudden onset of flashing lights and floaters in his right eye 3 weeks following hepatitis A, typhoid, and yellow fever vaccinations. Fundus examination and angiography confirmed the presence of multiple peripheral chorioretinal lesions. These lesions demonstrated characteristic morphologic changes over a period of 8 weeks which were consistent with a diagnosis of self-resolving multifocal choroiditis. Vaccine-induced intraocular inflammation has been described infrequently. We demonstrate the first case of self-resolving multifocal choroiditis following simultaneous administration of hepatitis A, yellow fever, and typhoid immunizations.Keywords: multifocal choroiditis, vaccination, hepatitis A, typhoid, yellow fever

  20. Sturge-Weber Syndrome Associated with Early Diffuse Choroidal Hemangiaoma:A Case Report

    Institute of Scientific and Technical Information of China (English)

    Changzheng Chen; Yunxian Yu; Hongmei Zhen

    2004-01-01

    Purpose:To report indocyanine green angiography (ICGA) findings in one patient of diffuse choroidal hemangioma associated with Struge-Weber syndrome.Methods:Color fundus photography, fluorescein angiography (FA) and ICGA were performed in a patient with diffuse choroidal hemangioma associated with Sturge-Weber syndrome.Results: Three findings were unveiled by ICGA: rapid filling of diffuse choroidal hemangio's vascular network in the early stages; diffuse hyperfluorescence visual up to the late phase; no "wash-out" phenomenon was observed in the late phase.Conclusion:Indocyanine green angiography can provide information that is not detected by clinical or fluorescence angiographic examination in the patient with Sturge-Weber syndrome. ICGA may be important and sensitive in detecting the diffuse choroidal hamangioma associated with Sturge-Weber syndrome.

  1. Choroidal thickness in relation to birth parameters in 11- to 12-year-old children

    DEFF Research Database (Denmark)

    Li, Xiao Q; Munkholm, Anja; Larsen, Michael;

    2015-01-01

    to -1] μm, P = 0.04) compared with appropriate for gestation children. Longer birth length was associated with a thicker subfoveal choroid (2 [1-4] μm/cm, P = 0.005). Macular choroidal thickness at 16 extrafoveal locations was measured in a subset of children and found to have the same associations......PURPOSE: To examine choroidal thickness in a population-based child cohort in relation to birth parameters. METHODS: The Copenhagen Child Cohort 2000 Eye Study examined 1406 children aged 11 to 12 years using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), ocular...... biometry and measurement of height, weight, refraction, and self-reported pubertal development status. Birth parameters were obtained from the Danish Medical Birth Registry. RESULTS: The subfoveal choroid in low birth weight children (

  2. Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Pryds, Anders; Larsen, Michael

    2012-01-01

    Purpose: To evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC). Methods: Choroidal thickness was measured with enhanced depth imaging- optical coherence tomography (EDI-OCT) before and after verteporfin PDT...... (full-dose verteporfin, half-light dose) in 16 eyes in 16 patients with serous detachment of the fovea secondary to extrafoveal angiographic fluorescein leakage. Treatment was confined to the area of leakage, whereas choroidal thickness before and after treatment was assessed over a larger area...... of the fundus using OCT. Results: Complete resolution of the serous detachment was seen in all 16 eyes within 1 month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 µm [mean; 95% confidence interval (CI(95) ) 356-458 µm] to 349 µm (mean; CI(95) 300-399 µm; p...

  3. Automated choroid segmentation based on gradual intensity distance in HD-OCT images.

    Science.gov (United States)

    Chen, Qiang; Fan, Wen; Niu, Sijie; Shi, Jiajia; Shen, Honglie; Yuan, Songtao

    2015-04-06

    The choroid is an important structure of the eye and plays a vital role in the pathology of retinal diseases. This paper presents an automated choroid segmentation method for high-definition optical coherence tomography (HD-OCT) images, including Bruch's membrane (BM) segmentation and choroidal-scleral interface (CSI) segmentation. An improved retinal nerve fiber layer (RNFL) complex removal algorithm is presented to segment BM by considering the structure characteristics of retinal layers. By analyzing the characteristics of CSI boundaries, we present a novel algorithm to generate a gradual intensity distance image. Then an improved 2-D graph search method with curve smooth constraints is used to obtain the CSI segmentation. Experimental results with 212 HD-OCT images from 110 eyes in 66 patients demonstrate that the proposed method can achieve high segmentation accuracy. The mean choroid thickness difference and overlap ratio between our proposed method and outlines drawn by experts was 6.72µm and 85.04%, respectively.

  4. A comparison of two methods to measure choroidal thickness by enhanced depth imaging optical coherence tomography

    DEFF Research Database (Denmark)

    Lundberg, Lars Kristian; Vestergaard, Anders Højslet; Vergmann, Anna Stage

    Introduction The choroid is believed to be involved in the pathophysiology of several vision threatening diseases such as age-related macular degeneration, central serous chorioretinopathy, inflammatory disorders and myopic macular degeneration. Enhanced depth imaging spectral-domain optical...... coherence tomography (EDI-SD OCT) has made it possible to visualize the choroid, and it is generally accepted that Heidelberg Spectralis OCT provides valid measurements of choroidal thickness (CT), although no fully automated software is commercially available. Two methods for CT-measurement are available...... millimeter in each direction of fovea. Only the horizontal and vertical sections were selected for analysis. A total of 9 targets per eye that represented anatomically different choroidal locations were analysed for every subject. We used 2 different methods from the Heidelberg Explorer software to measure...

  5. A Case of Expansion of Traumatic Choroidal Rupture with Delayed-Developed Outer Retinal Changes

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    Kun Moon

    2013-08-01

    Full Text Available Background: This study aims to report the expansion of a choroidal rupture site caused by blunt ocular trauma using scanning laser ophthalmoscope-optical coherence tomography. Case Report: The clinical course of a 15-year-old girl with a traumatic ocular injury after being hit in the eye by an elbow was evaluated. Upon the first examination, the best-corrected visual acuity was 16/20. The findings were subretinal pigment epithelial hemorrhage and vertical choroidal rupture. Three weeks after the trauma, the patient's visual acuity was reduced to counting fingers at 30 cm. On fundus examination and fluorescein angiography subretinal pigment epithelial hemorrhage decreased, while the choroidal rupture expanded; on optical coherence tomography outer retinal changes in the adjacent area were detected. Discussion: This study reveals that the delayed expansion of a choroidal rupture site and the delayed change of the adjacent outer retina improved.

  6. Anterior segment changes following intravitreal bevacizumab injection for treatment of neovascular glaucoma

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    Canut MI

    2011-05-01

    Full Text Available MI Canut1, A Alvarez2, J Nadal3, R Abreu4, JA Abreu5, JS Pulido61Glaucoma Section, 2Barraquer Ophthalmology Centre, 3Retina and Vitreous Unit, Macula Section, Institut Universitari Barraquer, Universidad Autonoma de Barcelona, Barcelona, Spain; 4Retina and Vitreous Unit, University Hospital of La Candelaria, Tenerife 5Glaucoma Section, University Hospital of the Canary Islands, Tenerife, Spain; 6Retina and Vitreous Unit, Ophthalmology Department, Mayo Clinic, Rochester, MN, USABackground: The purpose of this study was to describe anterior segment changes in a prospective, interventional, noncomparative case series of patients with neovascular glaucoma secondary to proliferative diabetic retinopathy treated with intravitreal bevacizumab.Methods: Five consecutive patients with neovascular glaucoma and a refractory, symptomatic elevation of intraocular pressure and pronounced anterior segment congestion received intravitreal bevacizumab 1.25 mg/0.05 mL. Follow-up examinations were performed at 4–16 weeks by the same specialists, with testing performed at hour 48, week 1, and months 1, 3, and 6 after intravitreal bevacizumab.Results: We observed a significant difference (P = 0.021 between initial and mean neovascularization at three months in all the quadrants. At three months, median intraocular pressure was 19 ± 5.38 (range 12–26 mmHg. In three of the five cases, diode laser cyclophotocoagulation was required, and in one case a trabeculectomy was performed. One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.Conclusion: Intravitreal bevacizumab achieves complete regression of neovascularization in neovascular glaucoma secondary to proliferative diabetic retinopathy, and this regression is stable when associated with treatment of the underlying disease and should be investigated more thoroughly as an adjunct in the management of neovascular

  7. Optical coherence tomography and multifocal electroretinography of patients with advanced neovascular age-related macular degeneration before, during, and after treatment with ranibizumab

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    Izabela Negrão Frota de Almeida

    2015-04-01

    Full Text Available Purpose: To evaluate retinal morphology and function of patients with advanced neovascular age-related macular degeneration (AMD before, during, and after treatment with ranibizumab. Methods: Twenty-one eyes diagnosed with advanced AMD were studied with optical coherence tomography (OCT and multifocal electroretinography (mfERG. Three intravitreal injections of ranibizumab were administered at 1-month intervals. Evaluations were performed before the first injection (D0 and at 30 (D30, 60 (D60, and 90 days (D90 after the first injection and compared to an age-matched control group (n=21 eyes. Results: The thickness of macular retinal layers increased before treatment due to the presence of intraretinal fluid. A thick retinal pigment epithelium-choriocapillaris complex (RPE-CC suggested the presence of choroidal neovascular membrane. Intraretinal edema decreased after treatment (P<0.01, but persisting RPE-CC thickness resulted in a subretinal scar. Three different annular retinal areas were studied with mfERG (from center to periphery: rings R1, R2, and R3. The amplitude of the first negative component (N1 decreased in R1, R2, and R3 at D30, D60, and D90 when compared with that in controls (P<0.05; the N1 implicit time was delayed in R3 at D30 (P<0.05. The amplitude of the first positive component (P1 was reduced in R1 and R2 at D30, D60, and D90 when compared with that in controls (P<0.01; the P1 implicit time was delayed in R1 at D0 and D60 (P<0.05, in R2 at D0, D30, and D90 (P<0.01, and in R3 at D30 and D60 (P<0.05. Conclusion: Ranibizumab reduces intraretinal edema, even in advanced cases. Central macular activity appeared to increase after the initiation of treatment, improving over time.

  8. Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-li; WEI Wen-bin; LI Dong-jun

    2012-01-01

    Background Choroidal melanoma is the most common intraocular malignant tumor in adults.It threatens not only the visual function but also the patient's life.Therefore,it is important to find a non-traumatic,quantitative and repetitive diagnostic method.This study investigated the value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of choroidal melanoma.Methods CEUS were performed in 51 cases of choroidal melanoma,which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma.The characteristics of the time-intensity curve of the contrast agent were analyzed.For the quantitative analysis,the following parameters of the contrast agent in the lesion were included:rising time (RT),time to peak (TTP),maximum intensity (MI) and the mean transit time (MTT).Results Choroidal melanoma had the following characteristics on CEUS:Choroidal lesions were completely filled with contrast agent.The typical filling pattern was centripetal,with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion.In some cases,areas with contrast agent filling defect were obseved in the lesions.The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion.Quantitative analysis showed that in choroidal melanoma,MI of contrast agent (191.31%±146.90%) was significantly more than that of the normal tissue (100.00%±0.00%) (P <0.05) and MTT ((63.56±26.04) seconds) was significanly less than that of the normal tissue ((149.87±182.68)seconds) (P <0.05).TTP (22.80±9.85) was less than that of the normal tissue ((29.57±24.76) seconds) and RT ((18.52±7.09) seconds) was less than that of the normal tissue ((26.45±21.83) seconds).Both the differences of TTP and RT were not statistically significant though.Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT

  9. Overload and neovascularization of shoulder tendons in volleyball players

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    Notarnicola Angela

    2012-08-01

    Full Text Available Abstract Background In overhead sports like volleyball, the onset of a rotator cuff tendinopathy due to functional overload is a common observation. An angiofibroblastic etiopathogenesis has been hypothesized, whereby a greater anaerobic metabolism occurs in critical zones of the tendon with a lower degree of vascularization; this would induce collagen and extracellular matrix degradation, that could then trigger a compensatory neovascularization response. We performed a clinical observational study of 80 elite volleyball players, monitoring the perfusion values of the supraspinatus tendons by oximetry. Results No statistically significant differences were found between the oximetry data and age, sex or years of sports activity, nor when comparing the right and left arm or the dominant and non-dominant arm. A statistically significant difference was found for the dominant arm values in relation to the competitive role, higher values being obtained in outside hitters (62.7% than middle hitters (53.7% (p = 0.01, opposite hitters (55.5% (p = 0.02 and libero players (54.4% (p = 0.008, whereas there were no differences in setters (56.2% (p > 0.05. Conclusions The different tendon vascularization values found in players with different roles in the team may be attributed to a response to the specific biomechanical demands posed by the different overhead throwing roles.

  10. Neovascularization in canine mammary carcinoma – a case report

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    Alexandra Irimie

    2016-11-01

    Full Text Available The frequency of mammary tumors in canines is three times higher than in women. Contrast enhanced ultrasonography (CEUS is a noninvasive clinical method, that uses special contrast agents (CAs, their role being to layout the microvasculature of different lesions. The aim of this particular method, in this case, was to establish if we can evaluate the malignancy of a mass, given the fact that neovascularization is a malignancy marker. The case is represented by a Silky Terrier breed female dog, 5 years old, that was presented initially with an enlarged polycystic mammary gland and a nervous lactation. The female was initially diagnosed with polycystic mastosis. After 2 more months the mass became denser and enlarged. Before the ovariohisterectomy and unilateral mastectomy surgeries have taken place, a B-Mode standard ultrasound, CEUS and a pulmonary X-ray were performed. Our results integrate this case in “fast in” and “slow in” (type 2 curve. The histological diagnosis was established as a simple cystic papillary carcinoma with a malignancy grade 2. The mean value of the MVD was 13.75 which is a low MVD. We cannot determine a correlation between CEUS and a tumor’s malignancy, and so further studies are needed.

  11. Intravitreal ranibizumab as adjuvant treatment for neovascular glaucoma

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    Flavia Gazze Ticly

    2013-04-01

    Full Text Available The purpose of this study was to describe a prospective case series of 5 eyes treated with intravitreal ranibizumab injection for neovascular glaucoma (NVG. Five patients with clinically uncontrolled NVG secondary to proliferative diabetic retinopathy (4 patients and central retinal vein occlusion (1 patient, non-responsive to maximal tolerable medication and panretinal photocoagulation, received intravitreal ranibizumab injection (0.5 mg. Patients were seen at 1st, 3rd and 7th day after the ranibizumab injection and when it was necessary. Success was defined as intraocular pressure (IOP 21, despite maximal tolerable medication, underwent trabeculectomy with 0.5mg/ml mitomycin C (MMC for 1 minute. Failure was defined as IOP > 21 mmHg, phthisis bulbi, loss of light perception or additional glaucoma surgery. The primary outcome was 6-month IOP control. Mean IOP before the ranibizumab injection was 37 mmHg (7 mmHg SD. Two out of five eyes underwent only ranibizumab injection, having an IOP control after the procedure. Three patients were submitted to trabeculectomy with MMC on the 7th day after the injection. At 6-month follow-up, the mean IOP was 12mmHg (3 mmHg SD. All eyes showed regression of rubeosis iridis and IOP control. Visual acuity improved in 2 eyes worsened in 1 eye, and remained stable in 2 eyes. These data suggest that intravitreal ranibizumab injection may be a useful tool in the treatment of NVG.

  12. PRIMARY CHOROIDAL MALIGNANT LYMPHOMA:REPORT OF A CASE AND REVIEW OF LITERATURE

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    F. Asadi Amoli

    2006-06-01

    Full Text Available Non-Hodgkin lymphoma (NHL is one of the masquerade syndromes of malignant melanoma that can occur with two main patterns of presentations in the eye: metastatic involvement of uveal tract, and primary involvement of retina. We report ophthalmic, imaging and histopathological findings in the first case diagnosed as primary choroidal NHL without central nervous system or systemic involvement. A 37-year-old woman presented with the complaint of severe visual loss in her right eye. Significant ocular finding included light perception of vision (LP, 2+ APD, 2+ cells in vitreous and intraocular pressure of 46 mmHg. Fundoscopic examination revealed exudative retinal detachment. Ocular echography showed choroidal thickening in addition to retinal detachment. MRI showed semilunar shape lesion in the posterior right globe suggesting choroidal melanoma. Systemic work-up could not reveal any underlying cause. The patient underwent enucleation with clinical suggestion of choroidal melanoma. Result of histological examination showed NHL (diffuse large Bcell type of choroid. Immunohistochemical staining showed negative staining for HMB-45 and CD3, positive staining for LCA, and CD20. Multiple periodic lumbar puncture, bone marrow biopsies and MRI were unremarkable. No recurrence of tumor in systemic work-up was noted during the 36-months follow-up. Primary choroidal NHL is one of the causes of generalized thickening of choroid and should be considered in differential diagnosis of malignant melanoma. It is recommended to perform fine needle biopsy before performing surgery in any patient who has had an atypical malignant melanoma. This is, so far as we know, the first case diagnosed as primary choroidal NHL.

  13. A Second New Choroidal Osteoma in the Same Eye: Differences between Them with New Imaging Techniques

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    Javier Sambricio

    2015-01-01

    Full Text Available The authors introduce a 42-year-old woman with a choroidal osteoma. After 10 years the patient presented a second choroidal osteoma in the same eye; this osteoma has been growing in the last years. New tests that were unavailable during the first diagnosis were performed such as Fundus Autofluorescence or Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT. These tests show characteristics of the tumors and allow us to realize a visual prognosis for the patient.

  14. Choroidal thickness and retinal abnormalities by optical coherence tomography in endogenous Cushing’s syndrome

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    Maria Fernanda Abalem

    2016-12-01

    Full Text Available Context: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes. Objective: To compare choroidal thickness measurements using optical coherence tomography (OCT in patients with endogenous active Cushing’s syndrome and to evaluate the occurrence of retinal abnormalities in the same group of patients. Design: Cross-sectional study.Setting: Outpatient clinic.Patients: Eleven female patients with Cushing’s syndrome in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24h, no suppression of cortisol with low dose dexamethasone suppression test and nocturnal salivary cortisol levels and 12 healthy controls.Methods: Choroidal and retinal morphology was assessed using OCT. Main outcome measures: Choroidal thickness measurements and the presence of retinal changes. Results: The mean subfoveal choroidal thickness was 372.96 ± 73.14 μm in the patients with Cushing’s syndrome and 255.63 ± 50.70 μm in the control group, (p<0.001. One patient (9.09% presented with central serous chorioretinopathy and one patient (9.09% with pachychoroid pigment epitheliopathy. Conclusions: Choroidal thickness is increased in the eyes of patients with active Cushing’s syndrome compared to healthy and matched control. Also, 18.18% of patients presented with macular changes, possibly secondary to choroidal thickening. While further studies are necessary to confirm our findings excess corticosteroid levels seems to have a significant effect on the choroid and might be associated with secondary retinal diseases.

  15. Atypical presentation of ocular toxoplasmosis: A Case report of exudative retinal detachment and choroidal Ischemia

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    Yahya A Al-Zahrani

    2016-01-01

    Full Text Available A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

  16. Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia.

    Science.gov (United States)

    Al-Zahrani, Yahya A; Al-Dhibi, Hassan A; Al-Abdullah, Abdulelah A

    2016-01-01

    A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

  17. Choroidal Thickness Analysis in Patients with Usher Syndrome Type 2 Using EDI OCT.

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    Colombo, L; Sala, B; Montesano, G; Pierrottet, C; De Cillà, S; Maltese, P; Bertelli, M; Rossetti, L

    2015-01-01

    To portray Usher Syndrome type 2, analyzing choroidal thickness and comparing data reported in published literature on RP and healthy subjects. Methods. 20 eyes of 10 patients with clinical signs and genetic diagnosis of Usher Syndrome type 2. Each patient underwent a complete ophthalmologic examination including Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), axial length (AL), automated visual field (VF), and EDI OCT. Both retinal and choroidal measures were measured. Statistical analysis was performed to correlate choroidal thickness with age, BCVA, IOP, AL, VF, and RT. Comparison with data about healthy people and nonsyndromic RP patients was performed. Results. Mean subfoveal choroidal thickness (SFCT) was 248.21 ± 79.88 microns. SFCT was statistically significant correlated with age (correlation coefficient -0.7248179, p < 0.01). No statistically significant correlation was found between SFCT and BCVA, IOP, AL, VF, and RT. SFCT was reduced if compared to healthy subjects (p < 0.01). No difference was found when compared to choroidal thickness from nonsyndromic RP patients (p = 0.2138). Conclusions. Our study demonstrated in vivo choroidal thickness reduction in patients with Usher Syndrome type 2. These data are important for the comprehension of mechanisms of disease and for the evaluation of therapeutic approaches.

  18. Choroidal Thickness Analysis in Patients with Usher Syndrome Type 2 Using EDI OCT

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    L. Colombo

    2015-01-01

    Full Text Available To portray Usher Syndrome type 2, analyzing choroidal thickness and comparing data reported in published literature on RP and healthy subjects. Methods. 20 eyes of 10 patients with clinical signs and genetic diagnosis of Usher Syndrome type 2. Each patient underwent a complete ophthalmologic examination including Best Corrected Visual Acuity (BCVA, intraocular pressure (IOP, axial length (AL, automated visual field (VF, and EDI OCT. Both retinal and choroidal measures were measured. Statistical analysis was performed to correlate choroidal thickness with age, BCVA, IOP, AL, VF, and RT. Comparison with data about healthy people and nonsyndromic RP patients was performed. Results. Mean subfoveal choroidal thickness (SFCT was 248.21±79.88 microns. SFCT was statistically significant correlated with age (correlation coefficient −0.7248179, p<0.01. No statistically significant correlation was found between SFCT and BCVA, IOP, AL, VF, and RT. SFCT was reduced if compared to healthy subjects (p<0.01. No difference was found when compared to choroidal thickness from nonsyndromic RP patients (p=0.2138. Conclusions. Our study demonstrated in vivo choroidal thickness reduction in patients with Usher Syndrome type 2. These data are important for the comprehension of mechanisms of disease and for the evaluation of therapeutic approaches.

  19. Defining the proteome of human iris, ciliary body, retinal pigment epithelium, and choroid.

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    Zhang, Pingbo; Kirby, David; Dufresne, Craig; Chen, Yan; Turner, Randi; Ferri, Sara; Edward, Deepak P; Van Eyk, Jennifer E; Semba, Richard D

    2016-04-01

    The iris is a fine structure that controls the amount of light that enters the eye. The ciliary body controls the shape of the lens and produces aqueous humor. The retinal pigment epithelium and choroid (RPE/choroid) are essential in supporting the retina and absorbing light energy that enters the eye. Proteins were extracted from iris, ciliary body, and RPE/choroid tissues of eyes from five individuals and fractionated using SDS-PAGE. After in-gel digestion, peptides were analyzed using LC-MS/MS on an Orbitrap Elite mass spectrometer. In iris, ciliary body, and RPE/choroid, we identified 2959, 2867, and 2755 nonredundant proteins with peptide and protein false-positive rates of body, and RPE/choroid. Four "missing proteins" were identified in ciliary body based on ≥2 proteotypic peptides. The mass spectrometric proteome database of the human iris, ciliary body, and RPE/choroid may serve as a valuable resource for future investigations of the eye in health and disease. The MS proteomics data have been deposited to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifiers PXD001424 and PXD002194.

  20. Unusual case of extradural choroid plexus papilloma of the sacral canal. Case report.

    Science.gov (United States)

    Kurtkaya-Yapicier, Ozlem; Scheithauer, Bernd W; Van Peteghem, Karl Peter; Sawicki, John E

    2002-07-01

    An unusual case of a sacral, extradural choroid plexus papilloma involving the S1-3 level is described. This 50-year-old woman presented with a 4-month history of pain involving her right buttock, perineum, and leg. Contrast-enhanced magnetic resonance (MR) imaging of the spine revealed a well-defined, mildly enhancing sacral canal mass at the S1-3 level; its appearance was consistent with that of a benign tumor. Intraoperatively, the lesion was found to be extradural in location and was entwined among nerve roots in the sacral canal. Microscopic examination of the gross totally resected tumor revealed typical features of a choroid plexus papilloma. Despite performing a thorough neuroimaging workup (craniospinal contrast-enhanced MR imaging) for an intracranial or spinal primary mass, none was found. The choroid plexus appeared entirely normal; however, both a cavum septum pellucidum and a cavum vergae were noted. Extraneural choroid plexus papilloma, specifically intrasacral, extradural choroid plexus papilloma has not been previously reported. The present example is thought to have arisen either from ectopic choroid plexus tissue or perhaps by metaplasia from ependymal rests.

  1. Correlations between choroidal abnormalities, Lisch nodules, and age in patients with neurofibromatosis type 1

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    Makino S

    2014-01-01

    Full Text Available Shinji Makino, Hironobu Tampo, Yusuke Arai, Hiroto ObataDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanAbstract: To evaluate correlations between choroidal abnormalities, Lisch nodules, and age in patients with neurofibromatosis type 1 (NF1, we examined ten cases with NF1 using near-infrared reflectance imaging. Patients ranged in age from 4 to 39 years. The angle used for near-infrared reflectance imaging was 55°. We counted the total number of choroidal abnormalities in an area within a 55° angle centered on the fovea and the total number of Lisch nodules on the iris by slit-lamp examination. No positive correlation was found between the number of Lisch nodules and patient age (Spearman's rank correlation coefficient ρ=0.117, P=0.7414. Choroidal abnormalities tended to increase with age (ρ=0.6150, but this difference was not statistically significant (P=0.0650. A positive correlation was found between the number of choroidal abnormalities and Lisch nodules (ρ=0.783, P=0.0267. In conclusion, choroidal abnormalities tend to increase with patient age and are correlated with the number of Lisch nodules.Keywords: neurofibromatosis type 1, near-infrared reflectance, choroidal abnormality, Lisch nodule, age

  2. Automatic segmentation of the choroid in enhanced depth imaging optical coherence tomography images.

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    Tian, Jing; Marziliano, Pina; Baskaran, Mani; Tun, Tin Aung; Aung, Tin

    2013-03-01

    Enhanced Depth Imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid in vivo, and hence is used in many clinical studies. However, the quantification of the choroid depends on the manual labelings of two boundaries, Bruch's membrane and the choroidal-scleral interface. This labeling process is tedious and subjective of inter-observer differences, hence, automatic segmentation of the choroid layer is highly desirable. In this paper, we present a fast and accurate algorithm that could segment the choroid automatically. Bruch's membrane is detected by searching the pixel with the biggest gradient value above the retinal pigment epithelium (RPE) and the choroidal-scleral interface is delineated by finding the shortest path of the graph formed by valley pixels using Dijkstra's algorithm. The experiments comparing automatic segmentation results with the manual labelings are conducted on 45 EDI-OCT images and the average of Dice's Coefficient is 90.5%, which shows good consistency of the algorithm with the manual labelings. The processing time for each image is about 1.25 seconds.

  3. Tumor seeding after diagnostic vitrectomy for choroidal metastasis in breast cancer.

    Science.gov (United States)

    Kung, Ya-Hsin; Wu, Tsung-Tien; Lin, Chia-Shian

    2012-09-01

    Choroidal metastasis is the most common type of intraocular tumor in adults, and in females the most common primary site is the breast. We report a case of unilateral choroidal metastasis with exudative retinal detachment as the initial presentation of recurrent breast cancer, and subsequent ophthalmic metastasis following diagnostic vitrectomy. A 49-year-old woman with a 7-year-history of well-treated bilateral breast cancer had been suffering from blurred vision in the left eye for 1 week. Ocular examination was normal except for superotemporal retinal detachment in the left eye. Neither retinal break nor choroidal mass was seen. The patient received scleral buckling and pneumatic retinopexy without significant improvement. Fluorescein angiography revealed a suspected choroidal metastasis in the left eye, but ocular ultrasonography did not show a visible choroidal mass. Two consecutive diagnostic vitrectomies with cytology could not confirm malignancy. A systemic workup was also negative. Six months later, two tumor masses were noted over two of the sclerotomy wounds of the left eye. Pathology showed adenocarcinoma compatible with invasive ductal carcinoma of the breast. Ocular metastasis may present as infiltrative choroidal lesions with exudative retinal detachment without a visible mass. Invasive procedures, such as fine-needle aspiration biopsy and diagnostic vitrectomy, may risk tumor seeding.

  4. Measurement and clinical implications of choroidal thickness in patients with inflammatory bowel disease

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    Ibrahim Koral Onal

    2015-10-01

    Full Text Available ABSTRACTPurpose:Ocular inflammation is a frequent extraintestinal manifestation of inflammatory bowel disease (IBD and may parallel disease activity. In this study, we evaluated the utility of a choroidal thickness measurement in assessing IBD activity.Methods:A total of 62 eyes of 31 patients with IBD [Crohn's disease (CD, n=10 and ulcerative colitis (UC, n=21] and 104 eyes of 52 healthy blood donors were included in this study. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography. The Crohn's disease activity index (CDAI and the modified Truelove Witts score were used to assess disease activity in CD and UC, respectively.Results:No significant differences in mean subfoveal, nasal 3000 μm, or temporal 3000 μm choroidal thickness measurements (P>0.05 for all were observed between IBD patients and healthy controls. Age, smoking, CD site of involvement (ileal and ileocolonic involvement, CDAI, CD activity, and UC endoscopic activity index were all found to be significantly correlated with choroidal thickness by univariate analysis (P<0.05. Smoking (P<0.05 and the CD site of involvement (P<0.01 were the only independent parameters associated with increased choroidal thickness at all measurement locations.Conclusions:Choroidal thickness is not a useful marker of disease activity in patients with IBD but may be an indicator of ileal involvement in patients with CD.

  5. OB protein binds specifically to the choroid plexus of mice and rats.

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    Devos, R; Richards, J G; Campfield, L A; Tartaglia, L A; Guisez, Y; van der Heyden, J; Travernier, J; Plaetinck, G; Burn, P

    1996-05-28

    Binding studies were conducted to identify the anatomical location of brain target sites for OB protein, the ob gene product. 125I-labeled recombinant mouse OB protein or alkaline phosphatase-OB fusion proteins were used for in vitro and in vivo binding studies. Coronal brain sections or fresh tissue from lean, obese ob/ob, and obese db/db mice as well as lean and obese Zucker rats were probed to identify potential central OB protein-binding sites. We report here that recombinant OB protein binds specifically to the choroid plexus. The binding of OB protein (either radiolabeled or the alkaline phosphatase-OB fusion protein) and its displacement by unlabeled OB protein was similar in lean, obese ob/ob, and obese db/db mice as well as lean and obese Zucker rats. These findings suggest that OB protein binds with high affinity to a specific receptor in the choroid plexus. After binding to the choroid plexus receptor, OB protein may then be transported across the blood-brain barrier into the cerebrospinal fluid. Alternatively, binding of OB protein to a specific receptor in the choroid plexus may activate afferent neural inputs to the neural network that regulates feeding behavior and energy balance or may result in the clearance or degradation of OB protein. The identification of the choroid plexus as a brain binding site for OB protein will provide the basis for the construction of expression libraries and facilitate the rapid cloning of the choroid plexus OB receptor.

  6. Implementation studies of ranibizumab for neovascular age-related macular degeneration.

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    Bloch, Sara Brandi

    2013-11-01

    The pathogenesis of AMD is associated with age changes plus pathological changes involving oxidative stress and an altered inflammatory response leading to injury of retinal pigment epithelial cells and the adjacent choroidea and photoreceptor cells. AMD is divided into early, intermediate and advanced AMD. The advanced form of AMD is further divided into non-neovascular AMD and neovascular AMD. The diagnosis of neovascular AMD is based on FA and clinical characteristics of the eyes. The CNV lesions are by their growth pattern divided into type 1 CNV lesions, which grow primarily beneath the RPE, and type 2 CNV lesions, which have penetrated the RPE and evolve within the subretinal space. The natural course of neovascular AMD leads to visual disability in a majority of cases within the first years after onset, primarily caused by the development of subfoveal fibrous tissue and atrophy of the RPE. The prognosis of visual acuity in neovascular AMD has been markedly improved by the introduction of an intravitreal administered VEGF inhibitor (ranibizumab) given on a monthly basis. Treatment with ranibizumab for neovascular AMD was introduced in Denmark in 2006 under a fully reimbursed national healthcare plan. Treatment with ranibizumab is given in a variable dosing regimen that varies from the monthly dosing regimen administered in the studies that led to the approval of ranibizumab for neovascular AMD in Europe. The main objectives of this PhD thesis were to evaluate and potentially improve treatment with ranibizumab in a variable OCT guided regimen for neovascular AMD. Another intension of this PhD thesis was to prepare the conditions for future research to further improve the visual prognosis in neovascular AMD treated with anti-VEGF agents. The first study revealed that vision was improved in eyes with active neovascular AMD treated for 1 year in a variable ranibizumab treatment regimen as compared to PDT and the natural course of the disease. We assumed by

  7. The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy

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    Raza Syed A

    2009-12-01

    Full Text Available Abstract Background Shoulder dysfunction is common and pathology of the rotator cuff tendons and subacromial bursa are considered to be a major cause of pain and morbidity. Although many hypotheses exist there is no definitive understanding as to the origin of the pain arising from these structures. Research investigations from other tendons have placed intra-tendinous neovascularity as a potential mechanism of pain production. The prevalence of neovascularity in patients with a clinical diagnosis of rotator cuff tendinopathy is unknown. As such the primary aim of this pilot study was to investigate if neovascularity could be identified and to determine the prevalence of neovascularity in the rotator cuff tendons and subacromial bursa in subjects with unilateral shoulder pain clinically assessed to be rotator cuff tendinopathy. The secondary aims were to investigate the association between the presence of neovascularity and pain, duration of symptoms, and, neovascularity and shoulder function. Methods Patients with a clinical diagnosis of unilateral rotator cuff tendinopathy referred for a routine diagnostic ultrasound (US scan in a major London teaching hospital formed the study population. At referral patients were provided with an information document. On the day of the scan (on average, at least one week later the patients agreeing to participate were taken through the consent process and underwent an additional clinical examination prior to undergoing a bilateral grey scale and colour Doppler US examination (symptomatic and asymptomatic shoulder using a Philips HDI 5000 Sono CT US machine. The ultrasound scans were performed by one of two radiologists who recorded their findings and the final assessment was made by a third radiologist blinded both to the clinical examination and the ultrasound examination. The findings of the radiologists who performed the scans and the blinded radiologist were compared and any disagreements were resolved

  8. Bilateral Hypertensive Retinopathy Complicated with Retinal Neovascularization: Panretinal Photocoagulation or Intravitreal Anti-VEGF Treatment

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    Odysseas Georgiadis

    2014-07-01

    Full Text Available Purpose: To present the case of a patient with bilateral hypertensive retinopathy complicated with retinal neovascularization who received anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP in the fellow eye. Methods: A 33-year-old male patient presented with gradual visual loss in both eyes for the last 5 months. At that time, he was examined by an ophthalmologist and occlusive retinopathy due to malignant systematic hypertension was diagnosed. He was put on antihypertensive treatment but no ophthalmic treatment was undertaken. At presentation, 5 months later, best-corrected visual acuity (BCVA was 0.1 in the right eye (RE and 0.9 in the left eye (LE. Fundus examination was compatible with hypertensive retinopathy complicated with retinal neovascularization. Fluorescein angiography (FFA revealed macular ischemia mainly in the RE and large areas of peripheral retinal ischemia and neovascularization with vascular leakage in both eyes. The patient was treated with two anti-VEGF (ranibizumab injections with 2 months interval in the RE and PRP laser in the LE. Results: Follow-up examination after 12 months showed mild improvement in BCVA, and FFA documented regression of retinal neovascularization in both eyes. Conclusion: Hypertensive retinopathy can be rarely complicated with retinal neovascularization. Treatment with PRP can be undertaken. In our case, the use of an intravitreal anti-VEGF agent seemed to halt its progression satisfactorily.

  9. Placental Growth Factor Promotes Cardiac Muscle Repair via Enhanced Neovascularization

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    Jianfeng Zhang

    2015-06-01

    Full Text Available Background/Aims: Transplantation of mesenchymal stem cells (MSCs improves post-injury cardiac muscle repair using ill-defined mechanisms. Recently, we have shown that production and secretion of placental growth factor (PLGF by MSCs play a critical role in the MSCs-mediated post-injury cardiac muscle repair. In this study, we addressed the underlying molecular mechanisms, focusing specifically on the interactions between MSCs, macrophages and endothelial cells. Methods: We isolated macrophages (BM-MΦ from mouse bone-marrow derived cells based on F4/80 expression by flow cytometry. BM-MΦ were treated with different doses of PLGF. Cell number was analyzed by a MTT assay. Macrophage polarization was examined based on CD206 expression by flow cytometry. PLGF levels in macrophage subpopulations were analyzed by RT-qPCR and ELISA. Effects of macrophages on vascularization were evaluated by a collagen gel assay using Human umbilical vein endothelial cells (HUVECs co-cultured with PLGF-treated macrophages. Results: PLGF did not increase macrophage number, but dose-dependently polarized macrophages into a M2 subpopulation. M2 macrophages expressed high levels of PLGF. PLGF-polarized M2 macrophages significantly increased tubular structures in the collagen gel assay. Conclusion: Our data suggest that MSCs-derived PLGF may induce macrophage polarization into a M2 subpopulation, which in turn releases more PLGF to promote local neovascularization for augmenting post-injury cardiac muscle repair. This study thus sheds novel light on the role of PLGF in cardiac muscle regeneration.

  10. Modified Vitreous Surgery for Subretinal Neovascularization and Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    LinLu; LezhengWU

    1995-01-01

    Purpose:To modify vitreous surgery for subretinal neovascularization(SRNV)and to detrmine the effects of this operation.Methods:Six patients with SRNV were performed with this operation,The meth-ods of examination before and after operation included;testing the best-corrected visual acuity before operation and 1,3or6months after operation;30degrees and visual acuity before operation and 1,3or6months after operation;30degrees and macular 10degrees Humphrey visual field examination:FFA examination preop-eratively and 1,3or6months postoperatiely.Modified surgery procedureis;a preventive buckling;pars plana vitrectomy;peeling the vitreous cortical;no in-traocular diathermy;small retinotomy;subretinal surgery;air-fluid exchang.Results:SRNV was taken off in4cases.Subretinal hemorrhage was washed in2cases.After4to7months follow-up,the visual acuity was improved in 4cases,unchanged in 2cases.The visual field was improved in 4cases.unchanged in 1case,decraesed in 1case,The complications included macular hole due to surgery in lcase and subretinal hemorrage in 1case.Conclusion;The surgery criteria were:1)massive subretinal hemorrhage;2)some patients of SRN V included;FFA evidence they showed the membrane is beneath fovea,the bestV.Ais20/100orlower.and can't be treated by laser and the pa-tient consent.This modified subretinal operation is safe,and effective for massive hemorrhage and some SRNVS.

  11. The Active Metabolite of Leflunomide A771726 Inhibits Corneal Neovascularization

    Institute of Scientific and Technical Information of China (English)

    Mingchang ZHANG; Nian HAO; Fang BIAN

    2008-01-01

    The effects of A771726, the active metabolite of leflunomide, on experimental rat corneal neovascularization (NV) in vivo and on cultured human umbilical vein endothelial cells in vitro were studied. The corneal NV was induced by alkali burn in 40 SD rats. The rats were randomly divided into 4 groups with 10 rats in each group. Group A was treated with 0.9% sodium chloride (control group), and group B, group C and group D were given different concentrations of A771726 eye drops (0.5%,l.0%,2.0% respectively) 4 times daily during days 0-28. The occurrence and development of corneal NV were observed at 4,7,14,21 and 28 day after alkali burn by a slit lamp microscope. The cultured human umbilical vein endothelial cells (ECV-304) were incubated with A771726 solution at different concentrations (20,40,80,160,320μmol/L) for 36h. The proliferation of cells was assessed by methyl thiazolyl tetrazolium (MTT), and the expression of proliferating cell nuclear antigen (PCNA) in cells was detected by using immunofluorescence under the laser confocal microscope. The rat model showed that the onset of corneal NV was delayed and progression of corneal NV was inhibited in the groups C and D. The corneal NV areas in groups C and D were significantly smaller than in groups A and B (P0.05). A771726 solution (≥40μmol/L) could inhibit proliferation of human umbilical vein endothelial cells and decrease the expression of PCNA in cells significantly. A771726, as the active metabolite of leflunomide, strongly prevented corneal NV induced by alkali burn in the in vivo model, and inhibited proliferation of human umbilical vein endothelial cells in the in vitro model. Therefore, A771726 may serve as an angiogenic inhibitor in the treatment of corneal NV.

  12. A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.

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    Chui Ming Gemmy Cheung

    Full Text Available OBJECTIVE: To study the treatment patterns and visual outcome over one year in Asian patients with choroidal neovascular membrane secondary to age-related macular degeneration (AMD-CNV and polypoidal choroidal vasculopathy (PCV. DESIGN: Prospective cohort, non-interventional study. METHODS: 132 treatment-naïve patients who received treatment for AMD-CNV and PCV were included. All patients underwent standardized examination procedures including retinal imaging at baseline and follow-up. AMD-CNV and PCV were defined on fundus fluorescein angiography and indocyanine green angiography at baseline. Patients were treated according to standard of care.We report the visual acuity (VA and optical coherence tomography (OCT measurements at baseline, month 3 and month 12 The factors influencing month 12 outcomes were analyzed. MAIN OUTCOME MEASURE: Type of treatment, number of Anti-vascular endothelial growth factor (VEGF treatments, visual outcome over one year. RESULTS: Anti-VEGF monotherapy was the initial treatment in 89.1% of AMD-CNV, but only 15.1% of PCV. The mean number of anti-VEGF injections up to month 12 was 3.97 (4.51 AMD-CNV, 3.43 PCV, p = 0.021. Baseline OCT, month 3 OCT and month 3 VA were significant in determining continuation of treatment after month 3. At month 12, mean VA improved from 0.82 (∼20/132 at baseline to 0.68 (∼20/96 at month 12 (mean gain 6.5 ETDRS letters, p = 0.002. 34.2% of eyes (38/113 eyes gained ≥15 ETDRS letters and 14.4% (16/113 eyes lost ≥15 ETDRS letters. There were no significant differences in visual outcome between AMD-CNV and PCV (p = 0.51. Factors predictive of month 12 visual outcome were baseline VA, baseline OCT central macular thickness, month 3 VA and age. CONCLUSIONS: There is significant variation in treatment patterns in Asian eyes with exudative maculopathy. There is significant visual improvement in all treatment groups at one year. These data highlight the need for high quality

  13. [The origin of papillary neovascularization in patients with proliferative diabetic retinopathy].

    Science.gov (United States)

    Sdobnikova, S V; Mazurina, N K

    2004-01-01

    The case study covers examinations of 63 patients with diabetes mellitus (DM), type 1, and with proliferative diabetic retinopathy (PDR). According to the results of fluorescence angiography, the patients were shared between 3 groups: Group 1--early contrasting of papillary vascular neoplasms; Group 2--late contrasting; and Group 3--mixed contrasting. We explained the available differences by that the vascular neoplasms of the optic nerve disk (OND) originate from 2 main blood supply basins, i.e. choroidal and retinal ones. They reflect, with respect to the above stated, the hemodynamic properties of the choroidal mycocirculation, which is characterized by a higher hemodynamic load and a higher intravascular pressure, or the retinal hemomicrocirculation. The pathological signs of diabetic retinopathy in the choroidal system may fail to correlate with changes in the retinal vascular system itself. Therefore, the findings of fluorescence angiography do not always represent the genuine scope of pathological manifestations occurring in the hemomicrocirculation system in case of PDR.

  14. Treatment of Neovascular Glaucoma Using Trabeculectomy Combined with Implantation of Silicon Rubber Slice

    Institute of Scientific and Technical Information of China (English)

    Weizhong Yang; Fengang Deng

    2001-01-01

    Purpose: To observe clinical effect of treatment for neovascular glaucoma using trabeculectomy combined with implantation of silicon rubber slice. Methods: 28 cases(28 eyes)with neovascular glaucoma were performed trabeculectomy combined with a piece of 3 × 5 mm silicon rubber implantation, and their lowing intraocular pressure effect was observed.Results: All patients were follow-up for 9 ~ 24 months (mean: 18.3 months). The average intraocular pressure at last visit was 21.65 mmHg (rang: 17.30 ~ 28.97 mmHg , 1mmHg = 0. 133 kPa). The symptom of eye pain was disappeared after surgery.Conclusion: Trabeculectomy with a piece of silicon rubber implantation is ideal therapy for neovascular glaucoma.

  15. Disinhibition of neurons of the nucleus of solitary tract that project to the superior salivatory nucleus causes choroidal vasodilation: Implications for mechanisms underlying choroidal baroregulation.

    Science.gov (United States)

    Li, Chunyan; Fitzgerald, Malinda E C; Del Mar, Nobel; Reiner, Anton

    2016-10-28

    Preganglionic neurons in the superior salivatory nucleus (SSN) that mediate parasympathetic vasodilation of choroidal blood vessels receive a major excitatory input from the baroresponsive part of the nucleus of the solitary tract (NTS). This input appears likely to mediate choroidal vasodilation during systemic hypotension, which prevents decreases in choroidal blood flow (ChBF) due to reduced perfusion pressure. It is uncertain, however, how low blood pressure signals to NTS from the aortic depressor nerve (ADN), which fires at a low rate during systemic hypotension, could yield increased firing in the NTS output to SSN. The simplest hypothesis is that SSN-projecting NTS neurons are under the inhibitory control of ADN-receptive GABAergic NTS neurons. As part of evaluating this hypothesis, we assessed if SSN-projecting NTS neurons, in fact, receive prominent inhibitory input and if blocking GABAergic modulation of them increases ChBF. We found that SSN-projecting NTS neuronal perikarya identified by retrograde labeling are densely coated with GABAergic terminals, but lightly coated with excitatory terminals. We also found that, infusion of the GABA-A receptor antagonist GABAzine into NTS increased ChBF. Our results are consistent with the possibility that low blood pressure signals from the ADN produce vasodilation in choroid by causing diminished activity in ADN-receptive NTS neurons that tonically suppress SSN-projecting NTS neurons.

  16. A prospective pilot study comparing combined intravitreal ranibizumab and half-fluence photodynamic therapy with ranibizumab monotherapy in the treatment of neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Williams PD

    2012-09-01

    -tailed t-test (P = 0.2. Due to the presence of outliers in each group, a Mann–Whitney U test was performed to confirm the results (U = 325; P = 0.28. The mean optical coherence tomography foveal thickness improved 92.5 microns and 106.7 microns in the ranibizumab alone and the combined group, respectively. The difference was not significant based on a two-tailed t-test (P = 0.6. The ranibizumab alone group received an average of 6.8 injections, while the combined group received an average of three injections. This difference was not significant based on a chi-square test (P = 0.11.Conclusion: The groups appeared similar based on statistical analysis, but larger studies are needed to determine possible small differences between combination therapy and monotherapy.Keywords: ranibizumab, macular degeneration, photodynamic therapy, verteporfin, choroidal neovascularization, anti-vegf

  17. Associations of prenatally detected choroid plexus cysts with biochemical risk for congenital disorders

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    Danielius Serapinas

    2014-06-01

    Full Text Available Introduction: C horoid plexus cysts are one of the foetus ultrasonography findings that raise parents’ concerns about their child’s health. Usually cysts are found in an estimated 1% all performed ultrasonographies. Aim of the research: To evaluate the risk of Down syndrome, Edward’s syndrome and neural tube defect when choroid plexus cysts are found. Material and methods : The risks of Down syndrome, Edward’s syndrome and neural tube defect were calculated by using second-trimester biomarkers (a-fetoprotein, human choriongonadotropin, unconjugated estriol for patients with choroid plexus cysts. A control group was selected randomly with calculated risks and without any abnormal ultrasonography findings. These risks were compared between the two groups. Results: Twelve pregnancies with diagnosed choroid plexus cysts were included in this study during the year 2012. Choroid plexus cyst findings during this case/control study have shown that only one case from the test group had progressed to more serious foetal aberrations (Edward’s syndrome; nonetheless, this progression did not influence statistically significant changes in the test and control groups. No statistically significant changes between the risks of disorders according the PRISCA method were observed in the appearance of Down syndrome or neural tube defect.  Conclusions : There is no data that choroid plexus cysts increase the risk of Down syndrome, Edward’s syndrome and neural tube defect.

  18. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease.

    Science.gov (United States)

    Kur, Joanna; Newman, Eric A; Chan-Ling, Tailoi

    2012-09-01

    We review the cellular and physiological mechanisms responsible for the regulation of blood flow in the retina and choroid in health and disease. Due to the intrinsic light sensitivity of the retina and the direct visual accessibility of fundus blood vessels, the eye offers unique opportunities for the non-invasive investigation of mechanisms of blood flow regulation. The ability of the retinal vasculature to regulate its blood flow is contrasted with the far more restricted ability of the choroidal circulation to regulate its blood flow by virtue of the absence of glial cells, the markedly reduced pericyte ensheathment of the choroidal vasculature, and the lack of intermediate filaments in choroidal pericytes. We review the cellular and molecular components of the neurovascular unit in the retina and choroid, techniques for monitoring retinal and choroidal blood flow, responses of the retinal and choroidal circulation to light stimulation, the role of capillaries, astrocytes and pericytes in regulating blood flow, putative signaling mechanisms mediating neurovascular coupling in the retina, and changes that occur in the retinal and choroidal circulation during diabetic retinopathy, age-related macular degeneration, glaucoma, and Alzheimer's disease. We close by discussing issues that remain to be explored.

  19. Single-Chain Antibody Fragment VEGF Inhibitor RTH258 for Neovascular Age-Related Macular Degeneration

    DEFF Research Database (Denmark)

    Holz, Frank G; Dugel, Pravin U; Weissgerber, Georges

    2016-01-01

    PURPOSE: To assess the safety and efficacy of different doses of RTH258 applied as single intravitreal administration compared with ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration (AMD). DESIGN: Six-month, phase 1/2, prospective, multicenter, double-masked, random...

  20. Calpain inhibitors reduce retinal hypoxia in ischemic retinopathy by improving neovascular architecture and functional perfusion.

    Science.gov (United States)

    Hoang, Mien V; Smith, Lois E H; Senger, Donald R

    2011-04-01

    In ischemic retinopathies, underlying hypoxia drives abnormal neovascularization that damages retina and causes blindness. The abnormal neovasculature is tortuous and leaky and fails to alleviate hypoxia, resulting in more pathological neovascularization and retinal damage. With an established model of ischemic retinopathy we found that calpain inhibitors, when administered in moderation, reduced architectural abnormalities, reduced vascular leakage, and most importantly reduced retinal hypoxia. Mechanistically, these calpain inhibitors improved stability and organization of the actin cytoskeleton in retinal endothelial cells undergoing capillary morphogenesis in vitro, and they similarly improved organization of actin cables within new blood vessels in vivo. Hypoxia induced calpain activity in retinal endothelial cells and severely disrupted the actin cytoskeleton, whereas calpain inhibitors preserved actin cables under hypoxic conditions. Collectively, these findings support the hypothesis that hyper-activation of calpains by hypoxia contributes to disruption of the retinal endothelial cell cytoskeleton, resulting in formation of neovessels that are defective both architecturally and functionally. Modest suppression of calpain activity with calpain inhibitors restores cytoskeletal architecture and promotes formation of a functional neovasculature, thereby reducing underlying hypoxia. In sharp contrast to "anti-angiogenesis" strategies that cannot restore normoxia and may aggravate hypoxia, the therapeutic strategy described here does not inhibit neovascularization. Instead, by improving the function of neovascularization to reduce underlying hypoxia, moderate calpain inhibition offers a method for alleviating retinal ischemia, thereby suggesting a new treatment paradigm based on improvement rather than inhibition of new blood vessel growth.

  1. Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins.

    Science.gov (United States)

    Vashist, M G; Singhal, Nitin; Verma, Manish; Sen, Jyotsana

    2015-12-01

    Varicose veins have a high recurrence rate following surgery. Besides poor surgical technique, majority of these recurrences are attributable to neovascularization after both primary and repeat surgery. Authors have studied the effectiveness of a polytetrafluoroethylene (PTFE) patch interposition between the ligated vein stump and the overlying soft tissue at saphenofemoral junction in decreasing recurrence of varicose veins after initial surgery. Study was conducted on 50 patients of varicose veins with saphenofemoral junction incompetence. Patients were randomly divided into two groups, group A and group B alternately. In group A, standard surgical procedure was done followed by PTFE patch application. In group B, same surgical procedure was applied as in group A, with the exception of PTFE patch application. Patients in both groups were given similar postoperative care. A full venous duplex ultrasound assessment was performed in all the patients postoperatively. Neovascularization was observed in five patients (20 %) of group B, while it was not seen in any of the patients in group A at 1-year follow-up. This difference in neovascularization across the two groups was found to be statistically significant with a p value of 0.0251. Hence, authors concluded that patch saphenoplasty helps in reducing recurrence in varicose veins by decreasing neovascularization at saphenofemoral junction.

  2. Predicting Non-response to Ranibizumab in Patients with Neovascular Age-related Macular Degeneration

    NARCIS (Netherlands)

    Asten, F. van; Rovers, M.M.; Lechanteur, Y.T.E.; Smailhodzic, D.; Muether, P.S.; Chen, J.; Hollander, A.I. den; Fauser, S.; Hoyng, C.B.; Wilt, G.J. van der; Klevering, B.J.

    2014-01-01

    Abstract Purpose: To validate known and determine new predictors of non-response to ranibizumab in patients with neovascular age-related macular degeneration (AMD) and to incorporate these factors into a prediction rule. METHODS: This multicenter, observational cohort study included 391 patients tre

  3. Bilateral Choroidal Metastases as Presentation of Dissemination of Cutaneous Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    S. Fernandez-Perez

    2012-01-01

    Full Text Available Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.

  4. Aging. Aging-induced type I interferon response at the choroid plexus negatively affects brain function.

    Science.gov (United States)

    Baruch, Kuti; Deczkowska, Aleksandra; David, Eyal; Castellano, Joseph M; Miller, Omer; Kertser, Alexander; Berkutzki, Tamara; Barnett-Itzhaki, Zohar; Bezalel, Dana; Wyss-Coray, Tony; Amit, Ido; Schwartz, Michal

    2014-10-03

    Aging-associated cognitive decline is affected by factors produced inside and outside the brain. By using multiorgan genome-wide analysis of aged mice, we found that the choroid plexus, an interface between the brain and the circulation, shows a type I interferon (IFN-I)-dependent gene expression profile that was also found in aged human brains. In aged mice, this response was induced by brain-derived signals, present in the cerebrospinal fluid. Blocking IFN-I signaling within the aged brain partially restored cognitive function and hippocampal neurogenesis and reestablished IFN-II-dependent choroid plexus activity, which is lost in aging. Our data identify a chronic aging-induced IFN-I signature, often associated with antiviral response, at the brain's choroid plexus and demonstrate its negative influence on brain function, thereby suggesting a target for ameliorating cognitive decline in aging.

  5. Newborn with Prenatally Diagnosed Choroidal Fissure Cyst and Panhypopituitarism and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ritu Chitkara

    2011-12-01

    Full Text Available Little has been reported on fetal diagnosis of choroidal fissure cysts and prediction of the clinical complications that can result. We describe the case of a near-term male infant with prenatally diagnosed choroidal fissure cyst and bilateral clubfeet. His prolonged course in the neonatal intensive care nursery was marked by severe panhypopituitarism, late-onset diabetes insipidus, placement of a cystoperitoneal shunt, and episodes of sepsis. Postnatal genetic evaluation also revealed an interstitial deletion involving most of band 10q26.12 and the proximal half of band 10q26.13. The patient had multiple readmissions for medical and surgical indications and died at 6 months of age. This case represents the severe end of the spectrum of medical complications for children with choroidal fissure cysts. It highlights not only the importance of comprehensive evaluation and multidisciplinary management and counseling in such cases, but also the need for heightened vigilance in these patients.

  6. Age-related structural abnormalities in the human retina-choroid complex revealed by two-photon excited autofluorescence imaging.

    Science.gov (United States)

    Han, Meng; Giese, Guenter; Schmitz-Valckenberg, Steffen; Bindewald-Wittich, Almut; Holz, Frank G; Yu, Jiayi; Bille, Josef F; Niemz, Markolf H

    2007-01-01

    The intensive metabolism of photoreceptors is delicately maintained by the retinal pigment epithelium (RPE) and the choroid. Dysfunction of either the RPE or choroid may lead to severe damage to the retina. Two-photon excited autofluorescence (TPEF) from endogenous fluorophores in the human retina provides a novel opportunity to reveal age-related structural abnormalities in the retina-choroid complex prior to apparent pathological manifestations of age-related retinal diseases. In the photoreceptor layer, the regularity of the macular photoreceptor mosaic is preserved during aging. In the RPE, enlarged lipofuscin granules demonstrate significantly blue-shifted autofluorescence, which coincides with the depletion of melanin pigments. Prominent fibrillar structures in elderly Bruch's membrane and choriocapillaries represent choroidal structure and permeability alterations. Requiring neither slicing nor labeling, TPEF imaging is an elegant and highly efficient tool to delineate the thick, fragile, and opaque retina-choroid complex, and may provide clues to the trigger events of age-related macular degeneration.

  7. Small interference RNA targeting vascular endothelial growth factor gene effectively attenuates retinal neovascularization in mice model

    Institute of Scientific and Technical Information of China (English)

    KONG Yi-chun; SUN Bei; ZHAO Kan-xing; HAN Mei; WANG Yu-chuan

    2013-01-01

    Background The mechanism of retinal neovascularization is not understood completely.Many growth factors are involved in the process of retinal neovascularization,such as vascular endothelial growth factor (VEGF) and pigment epithelium-deprived factor (PEDF),which are the representatives of angiogenic and antiangiogenic molecules respectively.Oxygen induced retinopathy (OIR) is a useful model to investigate retinal neovascularization.The present study was conducted to investigate the feasibility of small interference RNA (siRNA) targeting VEGF gene in attenuating oxygen induced retinopathy (OIR) by regulating VEGF to PEDF ratio (VEGF/PEDF).Methods In vitro,cultured EOMA cells were transfected with VEGF-siRNA (psi-HITM/EGFPNEGF siRNA) and LipofectamineTM 2000 for 24,48,and 72 hours,respectively.Expression of VEGF mRNA was evaluated by real time polymerase chain reaction (PCR) and the level of VEGF protein was analyzed by Western blotting.In vivo,OIR model mice were established,the mice (C57BL/6J) received an intra-vitreal injection of 1 μl of mixture of psi-HITM/EGFPNEGF siRNA and Lipofectamine 2000.Expressions of retinal VEGF and PEDF protein were measured by Western blotting,retinal neovascularization was observed by fluorescein angiography,and quantified.Results In vitro psi-HITM/EGFP/VEGF siRNA treatment significantly reduced VEGF mRNA and protein expression.In vivo,with decreased VEGF and VEGF-PEDF ratio,significant attenuation of neovascular tufts,avascular regions,tortuous,and dilated blood vessels were observed in the interfered animals.Conclusions VEGF plays an important role in OIR,and the transfection of VEGF-siRNA can effectively downregulate VEGF expression in vivo,accompanied by the downregulation of VEGF-PEDF ratio,and simultaneous attenuation of retinal neovascularization was also observed.These findings suggest that VEGF/PEDF may serve as a potential target in the treatment of retinal neovascularization and RNA interference targeting VEGF expression

  8. Effect of DLL4 siRNA on proliferation, migration and tube formation of choroid-retinal endothelial cells under hypoxic conditions

    Institute of Scientific and Technical Information of China (English)

    HE Hua; LI Bin; ZHANG Hong; XIANG Nan; LI Gui-gang

    2011-01-01

    Background Delta-like 4 (DLL4) is an endothelium specific Notch ligand and has been shown to function as a regulating factor during physiological and pathological angiogenesis. It has been reported that the DLL4-Notch signaling pathway is regulated by hypoxia and may prevent excessive angiogenesis through the inhibition of angiogenic branching and by triggering vessel maturation. Choroidal neovascularization (CNV) is a pathological form of angiogenesis in which hypoxia is thought to play an important role. This study was aimed to evaluate the role of DLL4 in the development of CNV.Methods We utilized chemical hypoxia induced by 200 μmol/L CoCl2 to observe the expression of DLL4 in choroid-retinal endothelial cells (RF/6A cells), which are the primary cells involved in CNV. After transfection of a DLL4 small interfering RNA (siRNA), mRNA and protein expression of DLL4 and key downstream genes, including HES1 and HEY1, in hypoxic RF/6A cells were investigated by RT-PCR, real-time PCR, and Western blotting analysis. Three controls were used: one without transfection, one with transfection reagent, and one with scrambled negative control siRNA. The effects of the DLL4 siRNA on the biological function of hypoxic RF/6A cells during angiogenesis, including cell proliferation, migration and tube formation, were investigated.Results The results showed that hypoxic conditions led to upregulation of DLL4 expression in RF/6A cells in vitro. After transfection, siRNA-duplex1 targeting DLL4 depleted the DLL4 mRNA levels by as much as 91.4% compared with the scrambled siRNA control, and DLL4 protein expression was similarly effected. There was no significant difference in DLL4 expression among the blank control, transfection reagent control, and scrambled siRNA groups. In addition, after transfection of hypoxic RF/6A cells with the DLL4 siRNA-duplex1, the mRNA levels of HES1 and HEY1, which function downstream of DLL4-Notch signaling, were lowered by 75.1% and 86

  9. Choroidal atrophy in a patient with paraneoplastic retinopathy and anti-TRPM1 antibody

    Directory of Open Access Journals (Sweden)

    Ueno S

    2014-02-01

    Full Text Available Shinji Ueno,1 Yasuki Ito,1 Ruka Maruko,1 Mineo Kondo,2 Hiroko Terasaki1 1Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 2Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan Abstract: The purpose of this paper is to report choroidal atrophy in a patient with cancer-associated retinopathy who had autoantibodies against the transient receptor potential cation channel, subfamily M, member 1 (TRPM1. A 69-year-old man visited our clinic in July 2010 with complaints of blurred vision and night blindness in both eyes. The full-field electroretinograms were negative type, indicating ON bipolar cell dysfunction. General physical examination revealed small cell carcinoma of the lung, and Western blot of the patient's serum showed autoantibodies against TRPM1. We diagnosed this patient with cancer-associated retinopathy and retinal ON bipolar dysfunction due to anti-TRPM1 autoantibody. We followed him for more than 2 years from the initial visit and his symptoms have not changed. However, consistent with the choroidal hypopigmentation of the fundus, spectral domain optical coherence tomography showed a decrease in choroidal thickness of about one third over a 2-year follow-up period. We suggest that this case of gradually progressive choroidal atrophy was caused by the autoantibody against TRPM1 directly, because TRPM1 is expressed not only on ON bipolar cells but also on melanocytes. These findings indicate that we should be aware of choroidal thickness in patients with paraneoplastic retinopathy who have retinal ON bipolar dysfunction with the anti-TRPM1 antibody. Keywords: choroidal thickness, melanocyte, TRPM1, cancer-associated retinopathy, paraneoplastic retinopathy

  10. Choroidal Vascularity Index (CVI--A Novel Optical Coherence Tomography Parameter for Monitoring Patients with Panuveitis?

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    Full Text Available To compute choroidal vascularity index (CVI using an image binarization tool on enhanced depth imaging (EDI-optical coherence tomography (OCT scans as a non-invasive optical tool to monitor progression in panuveitis and to investigate the utility of volumetric data from EDI-OCT scans using custom image analysis software.In this retrospective cohort study, segmented EDI-OCT scans of both eyes in 19 patients with panuveitis were taken at baseline and at 3-month follow-up and were compared with EDI-OCT scans of normal eyes. Subfoveal choroidal area was segmented into luminal (LA and stromal interstitial area (SA. Choroidal vascularity index (CVI was defined as the proportion of LA to the total circumscribed subfoveal choroidal area (TCA.The mean choroidal thickness was 265.5±100.1μm at baseline and 278.4±102.6μm at 3 months follow up (p = 0.06. There was no statistically significant difference in TCA between study and control eyes (p = 0.08. CVI in the control group was 66.9±1.5% at baseline and 66.4±1.5% at follow up. CVI was 74.1±4.7% at baseline and 69.4±4.8% at 3 months follow up for uveitic eyes (p<0.001. The % change in CVI was 6.2 ±3.8 (4.3 to 8.0 for uveitic eyes, which was significantly higher from % change in CVI for control eyes (0.7±1.1, 0.2 to 1.3, p<0.001.The study reports composite OCT-derived parameters and CVI as a possible novel tool in monitoring progression in panuveitis. CVI may be further validated in larger studies as a novel optical tool to quantify choroidal vascular status.

  11. Homeostatic capabilities of the choroid plexus epithelium in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Duncan John

    2004-12-01

    Full Text Available Abstract As the secretory source of vitamins, peptides and hormones for neurons, the choroid plexus (CP epithelium critically provides substances for brain homeostasis. This distributive process of cerebrospinal fluid (CSF volume transmission reaches many cellular targets in the CNS. In ageing and ageing-related dementias, the CP-CSF system is less able to regulate brain interstitial fluid. CP primarily generates CSF bulk flow, and so its malfunctioning exacerbates Alzheimers disease (AD. Considerable attention has been devoted to the blood-brain barrier in AD, but more insight is needed on regulatory systems at the human blood-CSF barrier in order to improve epithelial function in severe disease. Using autopsied CP specimens from AD patients, we immunocytochemically examined expression of heat shock proteins (HSP90 and GRP94, fibroblast growth factor receptors (FGFr and a fluid-regulatory protein (NaK2Cl cotransporter isoform 1 or NKCC1. CP upregulated HSP90, FGFr and NKCC1, even in end-stage AD. These CP adjustments involve growth factors and neuropeptides that help to buffer perturbations in CNS water balance and metabolism. They shed light on CP-CSF system responses to ventriculomegaly and the altered intracranial pressure that occurs in AD and normal pressure hydrocephalus. The ability of injured CP to express key regulatory proteins even at Braak stage V/VI, points to plasticity and function that may be boosted by drug treatment to expedite CSF dynamics. The enhanced expression of human CP 'homeostatic proteins' in AD dementia is discussed in relation to brain deficits and pharmacology.

  12. Subfoveal choroidal thickness and glaucoma. The Beijing Eye Study 2011.

    Directory of Open Access Journals (Sweden)

    Ya Xing Wang

    Full Text Available To examine subfoveal choroidal thickness (SFCT in eyes with glaucoma, using enhanced depth imaging spectral domain optical coherence tomography.The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years (range: 50-93 years. A detailed ophthalmic examination was performed including spectral-domain optical coherence tomography (SD-OCT with enhanced depth imaging for measurement of SFCT, and assessment of fundus photographs for presence of glaucoma. In addition, the group of patients with chronic angle-closure glaucoma (ACG from the Beijing Eye Study (n = 37 was merged with a group of patients with chronic ACG from the Tongren hospital (n = 52.Assessments of SFCT and glaucoma were available for 3232 (93.2% subjects. After adjusting for age, axial length, gender, anterior chamber and lens thickness, SFCT was not significantly associated with presence of glaucoma (P = 0.08; regression coefficient B:-15.7. As a corollary, in logistic regression analysis with adjustment for age, axial length and intraocular pressure, presence of glaucoma was not significantly associated with SFCT (P = 0.20. If only open-angle glaucoma was considered, multivariate analysis revealed no significant association between SFCT and presence of open-angle glaucoma (P = 0.44. As a corollary, in logistic regression analysis, open-angle glaucoma was not significantly associated with SFCT (P = 0.91. In a similar manner if only ACG was taken into account, SFCT was not significantly associated with the presence of ACG (P = 0.27 in multivariate analysis. As a corollary in binary regression analysis, presence of ACG was not significantly associated with SFCT (P = 0.27.In multivariate analysis with adjustment for age, axial length, gender, anterior chamber and lens thickness, neither OAG nor ACG was associated with an abnormal SFCT.

  13. Photodynamic therapy in the treatment of subfoveal choroidal neovascularisation.

    Science.gov (United States)

    Harding, S

    2001-06-01

    Subfoveal choroidal neovascularisation (CNV) is a major cause of visual disability, with age-related macular degeneration (AMD) the commonest cause. Confluent laser to CNV significantly reduces severe visual loss but the profound visual loss after treatment of subfoveal lesions and the high recurrence rate has meant its restriction to extrafoveal lesions. Developed initially as a treatment for cancers, photodynamic therapy (PDT) has been shown to successfully close CNV in the eye. Large international randomised placebo-controlled studies of the safety and efficacy of PDT with verteporfin are under way. The Treatment of Age-related Macular Degeneration with Photodynamic Therapy (TAP) study has demonstrated a reduction of visual loss in treated patients with any classic CNV. Subgroup analysis showed a greater benefit in predominantly classic lesions (p AMD (VIP) trial, but no benefit in pure occult lesions. Further research is required to establish cost-effectiveness and appropriate referral patterns in the UK and optimise treatment strategies. Further data are awaited from TAP/VIP. At present verteporfin PDT is indicated in eyes with subfoveal predominantly classic CNV secondary to AMD with visual acuity of 6/60 or better and lesions < 5,400 microm in diameter. Juxtafoveal lesions meeting the above criteria and CNV secondary to pathological myopia should also be considered for treatment. The efficacy of treatment of larger lesions, juxtapapillary CNV, occult/no classic with high-risk characteristics (HRC) and CNV from other causes remains unclear. The treatment of minimally classic lesions and those with occult/no classic without HRC is not indicated.

  14. Angiographic leakage of polypoidal choroidal vasculopathy on indocyanine angiography

    Institute of Scientific and Technical Information of China (English)

    ZUO Cheng-guo; WEN Feng; HUANG Shi-zhou; LUO Guang-wei; YAN Hong; WU Wei-ju; WU De-zheng

    2010-01-01

    Background There is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy (PCV)lesions on indocyanine green (ICG) angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography.Methods One hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms.Results In all 144 eyes, 110 eyes showed angiographic leakage (leakage group) on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) <0.1 and old subretinal hemorrhages were 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes)respectively, compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) of regression group (P <0.001). The history of regression group was significantly longer (P <0.001).Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

  15. Honokiol inhibits pathological retinal neovascularization in oxygen-induced retinopathy mouse model

    Energy Technology Data Exchange (ETDEWEB)

    Vavilala, Divya Teja [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States); O’Bryhim, Bliss E. [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Ponnaluri, V.K. Chaithanya [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States); White, R. Sid; Radel, Jeff [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Symons, R.C. Andrew [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Ophthalmology Department, Royal Melbourne Hospital, University of Melbourne, Victoria (Australia); Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Victoria (Australia); Mukherji, Mridul, E-mail: mukherjim@umkc.edu [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States)

    2013-09-06

    Highlights: •Aberrant activation of HIF pathway is the underlying cause of ischemic neovascularization. •Honokiol has better therapeutic index as a HIF inhibitor than digoxin and doxorubicin. •Daily IP injection of honokiol in OIR mouse model reduced retinal neovascularization. •Honokiol also prevents vaso-obliteration, the characteristic feature of the OIR model. •Honokiol enhanced physiological revascularization of the retinal vascular plexuses. -- Abstract: Aberrant activation of the hypoxia inducible factor (HIF) pathway is the underlying cause of retinal neovascularization, one of the most common causes of blindness worldwide. The HIF pathway also plays critical roles during tumor angiogenesis and cancer stem cell transformation. We have recently shown that honokiol is a potent inhibitor of the HIF pathway in a number of cancer and retinal pigment epithelial cell lines. Here we evaluate the safety and efficacy of honokiol, digoxin, and doxorubicin, three recently identified HIF inhibitors from natural sources. Our studies show that honokiol has a better safety to efficacy profile as a HIF inhibitor than digoxin and doxorubicin. Further, we show for the first time that daily intraperitoneal injection of honokiol starting at postnatal day (P) 12 in an oxygen-induced retinopathy (OIR) mouse model significantly reduced retinal neovascularization at P17. Administration of honokiol also prevents the oxygen-induced central retinal vaso-obliteration, characteristic feature of the OIR model. Additionally, honokiol enhanced physiological revascularization of the retinal vascular plexuses. Since honokiol suppresses multiple pathways activated by HIF, in addition to the VEGF signaling, it may provide advantages over current treatments utilizing specific VEGF antagonists for ocular neovascular diseases and cancers.

  16. Potential anti-angiogenic role of Slit2 in corneal neovascularization.

    Science.gov (United States)

    Han, Xi; Zhang, Ming-Chang

    2010-06-01

    Slits are large secreted proteins critical for axon guidance and neuronal precursor cell migration in nervous system. Evidence suggests that classical neuronal guidance cues also regulate vascular development. Our objective was to investigate whether neuronal guidance cue Slit2 and Roundabout (Robo) receptors are involved in corneal neovascularization (NV). Corneal NV model in rats was induced by implantation of agarose-coated gelfoam pellets containing basic fibroblast growth factor (bFGF) into corneal stroma. Differential expression of Slit2 and Robo1-4 between normal and neovascularized cornea was detected by real-time RT-PCR and visualized by immunohistochemistry and in situ hybridization. Primary human umbilical vein endothelial cells (HUVECs) were harvested and their expression of Robo1-4 was detected by RT-PCR. Recombinant human Slit2 protein was prepared and the effect of it on the migration of vascular endothelial cells was examined using cell migration assay. Agarose-coated gelfoam pellets were able to induce well-localized and reproducible corneal NV model. A significant down-regulation of Slit2 and a strong up-regulation of Robo1 and Robo4 were seen in neovascularized cornea when compared with normal cornea (P Slit2, Robo1 and Robo4 were throughout the epithelium in normal cornea and markedly weak or absent in epithelium in neovascularized cornea, with Robo1 and Robo4 being prominent in vascular endothelial cells invading the stroma. Primary HUVECs were confirmed to express both Robo1 and Robo4 receptors and their migration was inhibited by Slit2 (P Slit2 and corneal NV. Our findings suggest that the interaction of Slit2 with Robo1 and Robo4 receptors plays an essential role in inhibiting pathological neovascular processes of the cornea and may represent a new therapeutic target for corneal NV.

  17. Treatment of neovascular age-related macular degeneration in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Michael Cummings

    2008-06-01

    Full Text Available Michael Cummings1, José Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB. Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with

  18. Circulating monocytes and B-lymphocytes in neovascular age-related macular degeneration

    Science.gov (United States)

    Hector, Sven Magnus; Sørensen, Torben Lykke

    2017-01-01

    Background Individuals with neovascular age-related macular degeneration (AMD) have altered number and distribution of retinal macrophages and show changes in circulating antibodies. We wanted to investigate the corresponding precursors, with subpopulations. We therefore measured monocyte and B-lymphocyte populations in individuals with neovascular AMD. Design This was an observational case–control study. Participants or samples A total of 31 individuals with neovascular AMD and 30 healthy age-matched controls were included. Methods Patients and controls were interviewed, and ophthalmological examination included visual acuity assessment using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, spectral domain optical coherence tomography (SD-OCT), slit-lamp examination and fundus photography. Moreover, venous blood was drawn and prepared for flow cytometry. Cells were gated and measured for surface markers. Main outcome measures Relative amounts of monocytes and B-lymphocytes with subsets, as well as selected surface markers, were measured. Results The two groups did not significantly differ in age, smoking history, body mass index, physical activity or C-reactive protein (CRP). Total monocytes (percentage of all leukocytes) were lower in the neovascular AMD group (median 5.5%) compared with the level in the control group (6.5%; P-value: 0.028). The percentage of intermediate monocytes positive for cluster of differentiation 11b (CD11b) was lower for AMD patients (99.4%) compared with 100% for the control group (P-value: 0.032). Conclusion We observed lower numbers of monocytes, which show a potentially impaired ability to migrate across the endothelial wall in patients with neovascular AMD. These subtle changes could potentially lead to an imbalance in the recruitment of macrophages into the retina during disease development. PMID:28176950

  19. COMPARATIVE ESTIMATION OF QUALITY OF LIFE IN PATIENTS WITH CHOROIDAL MELANOMA AFTER DIFFERENT TREATMENT OPTIONS

    Directory of Open Access Journals (Sweden)

    I. Ye. Panova

    2012-01-01

    Full Text Available The paper analyzes quality-of-life indicators in patients with choroidal melanoma after organ-removing and organ-saving treatments. Their quality of life after different treatments was found to have no statistically significant differences. Enucleation in patients with choroidal melanoma ensured higher values in the block of emotional well-being after surgery. After organ-saving treatment, the patients showed a significant reduction in quality of life as a total score in the late follow-up period. 

  20. Neuroendoscopic assessment of choroid plexus coagulation to release ventricular catheter: note on the seldinger technique.

    Science.gov (United States)

    Nishikuni, Koshiro; Freitas, Luiz R M; Oliveira, Matheus F; Leme, Ricardo J A

    2013-01-01

    Shunting is fundamental in neurosurgical practice and a large number of patients experience shunt dysfunction throughout life. The Seldinger technique seems to be a valuable tool in the management of dysfunctions and consists of coagulating the choroid plexus before shunt removal. We report the unique case of a neuroendoscopic view of choroid plexus coagulation by the Seldinger technique in a 7-year-old child with shunt dysfunction submitted to endoscopic third ventriculostomy and previous shunt removal. We reinforce the security and efficacy of the Seldinger technique with a direct neuroendoscopic view of the coagulation process.

  1. Open-source algorithm for automatic choroid segmentation of OCT volume reconstructions

    Science.gov (United States)

    Mazzaferri, Javier; Beaton, Luke; Hounye, Gisèle; Sayah, Diane N.; Costantino, Santiago

    2017-02-01

    The use of optical coherence tomography (OCT) to study ocular diseases associated with choroidal physiology is sharply limited by the lack of available automated segmentation tools. Current research largely relies on hand-traced, single B-Scan segmentations because commercially available programs require high quality images, and the existing implementations are closed, scarce and not freely available. We developed and implemented a robust algorithm for segmenting and quantifying the choroidal layer from 3-dimensional OCT reconstructions. Here, we describe the algorithm, validate and benchmark the results, and provide an open-source implementation under the General Public License for any researcher to use (https://www.mathworks.com/matlabcentral/fileexchange/61275-choroidsegmentation).

  2. Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2007-01-01

    Full Text Available We report successful surgical management of a circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy (TTT. A 33-year-old man with symptomatic serous macular detachment in the left eye (Snellen acuity: 20/200 secondary to a paramacular choroidal hemangioma was treated with TTT. The nonresponsive detachment was subsequently managed by vitrectomy, endophotocoagulation and silicon-oil tamponade. It resulted in complete resolution of the tumor and the detachment. Silicon oil was removed at four months. Visual acuity improved to 20/80 by the last follow-up visit at 10 months without any recurrence.

  3. Prophylactic effect of topical silica nanoparticles as a novel antineovascularization agent for inhibiting corneal neovascularization following chemical burn

    Directory of Open Access Journals (Sweden)

    Mehrdad Mohammadpour

    2015-01-01

    Conclusions: SiNPs is an effective modality for inhibiting corneal neovascularization following chemical burn in an experimental model. Further investigations are suggested for evaluation of its safety and efficacy in human eyes.

  4. A 4-Year Longitudinal Study of 555 Patients Treated with Ranibizumab for Neovascular Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Rasmussen, Annette; Bloch, Sara B; Fuchs, Josefine;

    2013-01-01

    To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years....

  5. Choroid plexus carcinomas in children: MRI features and patient outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Steven P. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Radiology, Rochester, NY (United States); University of Rochester Medical Center, Department of Radiology, 601 Elmwood Avenue, P.O. Box 648, Rochester, NY (United States); Khademian, Zarir P.; Zimmerman, Robert A. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chuang, Sylvester H. [Hospital for Sick Children, Department of Radiology, Toronto, ON (Canada); Pollack, Ian F. [Children' s Hospital of Pittsburgh, Department of Pediatric Neurosurgery, Pittsburgh, PA (United States); Korones, David N. [University of Rochester School of Medicine, Strong Memorial Hospital, Department of Pediatrics, Rochester, NY (United States)

    2004-09-01

    Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms usually occurring in young children. The objectives of this study were to characterize the preoperative MRI features of CPC, determine the frequency of disseminated disease in the CNS at diagnosis, and assess patient outcomes. The preoperative cranial MR images of 11 patients with CPC were retrospectively reviewed for lesion location, lesion size, un-enhanced and enhanced MRI signal characteristics, and presence of disseminated intracranial tumor. Postoperative cranial and spinal MRI images were reviewed for residual, recurrent, and/or disseminated tumor. The study group included six male and five female patients ranging in age from 5 months to 5.3 years (median=1.8 years). CPC were located in the lateral (n=8), fourth (n=1), and third (n=1) ventricles, and foramen of Luschka (n=1). Mean tumor size was 5.2cm x 4.9cm x 5.0 cm. On short-TR images, CPC had heterogeneous, predominantly intermediate signal with foci of high signal in 45% of lesions from areas of hemorrhage. On long-TR/long-TE images, solid portions of CPC typically had heterogeneous, intermediate-to-slightly-high signal. Small zones of low signal on long-TR/long-TE images were seen in 55% of the lesions secondary to areas of hemorrhage and/or calcifications. Tubular flow voids representing blood vessels were seen in 55% of the lesions. Zones of high signal comparable to CSF were seen in 64% of CPC secondary to cystic/necrotic zones. All CPC showed prominent contrast enhancement. Irregular enhancing margins suggesting subependymal invasion were seen in 73% of the lesions. Findings consistent with edema in the brain adjacent to the enhancing lesions were seen in 73% of CPC. CPC caused hydrocephalus in 82% of patients at diagnosis. Two patients died from hemorrhagic complications from surgical biopsies. Disseminated tumor in the leptomeninges was present in 45% of patients at diagnosis and was associated with a poor prognosis. The 1

  6. Unknown syndrome: peculiar face, severe hypodontia of permanent teeth, and precocious choroid calcifications.

    OpenAIRE

    Pallotta, R; Fusilli, P

    1998-01-01

    We describe a mother and her twin daughters affected with severe hypodontia of the permanent teeth, precocious calcification of the choroid plexus, and minor digital anomalies. The presence of inner telecanthus, broad and flattened nasal bridge, mild ocular proptosis, small nose with anteverted nostrils, and slight microretrognathia gives them an unusual appearance. All three affected persons are of normal intelligence.

  7. Membrane-bound proteases of the gerbil subfornical organ and choroid plexus: an enzyme histochemical study.

    Science.gov (United States)

    Mitro, A; De Bault, L E

    1994-03-01

    Using enzyme-histochemical methods, the membrane-bound peptidases, gamma-glutamyl transpeptidase (gamma-GTP), microsomal alanyl aminopeptidase (mAAP), glutamyl aminopeptidase (EAP), and dipeptidyl peptidase IV (DPP IV), were studied in microvessels of the gerbil subfornical organ (SFO), choroid plexus adjacent to the SFO, and the ependyma of brain ventricle walls in the vicinity of the SFO. Vessels and microvessels of gerbil SFO and choroid plexus were positive for gamma-GTP, mAAP, and EAP, but negative for DPP IV. Blood-brain barrier (BBB) microvessels in the surrounding brain tissue also showed positive reactions for gamma-GTP, mAAP, and EAP but a negative reaction for DPP IV. Both epithelial cells of the choroid plexus and ependymal cells of the ventricle walls were negative for all four studied enzymes. It is suggested that blood-borne peptide hormones which can be substrates for these membrane-bound proteases can be modulated by gamma-GTP, mAAP, and EAP, but not by DPP IV, when they come in contact with the plasma membrane of the endothelial cells of the vessels in gerbil SFO, choroid plexus, and surrounding brain tissue.

  8. Evaluation of peripapillary choroidal and retinal nerve fiber layer thickness in eyes with tilted optic disc

    Directory of Open Access Journals (Sweden)

    Muammer Ozcımen

    2014-12-01

    Full Text Available Purpose: This study was performed to evaluate the retinal nerve fiber layer (RNFL and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT. Methods: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. Results: SD-OCT indicated significantly lower superotemporal (p<0.001, superonasal (p=0.001, and global (p=0.005 RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001. Conclusion: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups.

  9. Prognostic value of nucleolar size and size pleomorphism in choroidal melanomas

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Gamel, J W; Jensen, O A;

    1993-01-01

    Morphometric estimates of nucleolar size have been shown to possess a high prognostic value in patients with uveal melanomas. The authors investigated various quantitative estimators of the mean size and pleomorphism of nucleoli in choroidal melanomas from a consecutive series of 95 Danish patien...

  10. Subfoveal choroidal thickness in 1323 children aged 11-12 years and association with puberty

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Jeppesen, Pia; Larsen, Michael;

    2014-01-01

    Purpose: To investigate subfoveal choroidal thickness and ocular and systemic associated factors in a population-based cohort of children. Methods: Cross-sectional, observational study where 1323 healthy 11 and 12 year-old children were examined with enhanced-depth imaging spectral domain optical...

  11. Choroidal melanoma with massive retinal fibrosis and spontaneous regression of retinal detachment.

    Science.gov (United States)

    Pitts, R E; Awan, K J; Yanoff, M

    1976-01-01

    An unusual case of choroidal malignant melanoma with heterochromia iridis, massive subretinal hemorrhage and fibrosis, spontaneously resolving retinal detachment, and subretinal seeding is reported. Clinical and pathological findings are presented and discussed. The unusual aspects of the case are further considered by Drs. Andrew Ferry and Mark Tso.

  12. Retinal vessel caliber, choroidal thickness and ocular pulse amplitude measurements in essential thrombocythemia

    Directory of Open Access Journals (Sweden)

    Gökhan Pekel

    2016-01-01

    Conclusions: Our results indicate that choroidal thickness and pulsatile blood flow are not significantly affected in ET and under high blood platelet counts. Retinal arteriolar and venular calibers are thinner in ET when compared to age.sex matched healthy controls.

  13. [Ultrastructure of melanocytes from retina and choroid of the Pacific salmon].

    Science.gov (United States)

    Zagal'skaia, E O

    2001-01-01

    The ultrastructure of the retina and choroid cells in three species of the Pacific salmon, Oncohrynchus gorbuscha, O. keta and O. masou, was studied. The structure of retina pigment cells is similar in all the three species, only a small difference was found in the percentage of lengthened and rounded forms of melanosomes. Melanocytes of the masu salmon differ also in the structure of their nuclei. The pigment cells of choroid differ from those of retina by a more extended form of melanosomes and by the presence of less rounded melanosomes. In the chum salmon retina we found electron lucent "contact vesicles", whose assignment is open to discussion. In retina pigment cells of the masu salmon smolts ready for migration, the activity of Golgi appararus rises, mitochondria and mature melanosomes increase in number. The choroid pigment cells are slightly swollen, their processes more often and deeper penetrate into the walls of vessels, down to the endothelium. Results of the experiment with the application of an artificial magnetic field (AMF) have shown that the retina and choroid pigment cells in the masu salmon fry react to the field of a certain direction. The phenomenon of magnetosensitivity of pigment cells is discussed in addition to their possible involvement in magnetoreception.

  14. Magnetic nanoparticles: a strategy to target the choroidal layer in the posterior segment of the eye

    Science.gov (United States)

    Giannaccini, Martina; Pedicini, Lucia; De Matienzo, Guglielma; Chiellini, Federica; Dente, Luciana; Raffa, Vittoria

    2017-01-01

    Despite the higher rate of blindness due to population aging, minimally invasive and selective drug delivery to the eye still remains an open challenge, especially in the posterior segment. The retina, the retinal pigment epithelium (RPE) and the choroid are posterior segment cell layers, which may be affected by several diseases. In particular, damages to the choroid are associated with poor prognosis in the most severe pathologies. A drug delivery approach, able to target the choroid, is still missing. Recently, we demonstrated that intravitreally injected magnetic nanoparticles (MNP) are able to rapidly and persistently localise within the RPE in an autonomous manner. In this work we functionalised the MNP surface with the vascular endothelial growth factor, a bioactive molecule capable of transcytosis from the RPE towards more posterior layers. Such functionalisation successfully addressed the MNPs to the choroid, while MNP functionalised with a control polypeptide (poly-L-lysine) showed the same localisation pattern of the naked MNP particles. These data suggest that the combination of MNP with different bioactive molecules could represent a powerful strategy for cell-specific targeting of the eye posterior segment. PMID:28256525

  15. Single spot PDT in patients with circumscribed choroidal haemangioma and near normal visual acuity

    NARCIS (Netherlands)

    F.D. Verbraak; R.O. Schlingemann; M.D. de Smet; J.E.E. Keunen

    2006-01-01

    Background: In circumscribed choroidal hemangiomas (CCH) a long observation period and decreased visual acuity before treatment are risk factors for poor visual outcome. Therefore, we studied the use of limited, single spot photodynamic therapy (PDT) with Visudyne for the timely treatment of CCH. Me

  16. Single spot PDT in patients with circumscribed choroidal haemangioma and near normal visual acuity.

    NARCIS (Netherlands)

    Verbraak, F.D.; Schlingemann, R.O.; Smet, M.D. de; Keunen, J.E.E.

    2006-01-01

    BACKGROUND: In circumscribed choroidal hemangiomas (CCH) a long observation period and decreased visual acuity before treatment are risk factors for poor visual outcome. Therefore, we studied the use of limited, single spot photodynamic therapy (PDT) with Visudyne for the timely treatment of CCH. ME

  17. Influence of intraoperative course on visual outcome after an RPE-choroid translocation

    NARCIS (Netherlands)

    K.J.M. Maaijwee (Kristel Johanna Maria); T. Missotten (Tom); P.G.H. Mulder (Paul); J.C. van Meurs (Jan)

    2008-01-01

    textabstractPurpose. In a previous study, preoperative variables were correlated with postoperative visual outcome after the translocation of a free RPE- choroid graft. The present study was conducted to investigate whether the intraoperative course was an independent factor influencing visual outco

  18. Defining response to anti-VEGF therapies in neovascular AMD.

    Science.gov (United States)

    Amoaku, W M; Chakravarthy, U; Gale, R; Gavin, M; Ghanchi, F; Gibson, J; Harding, S; Johnston, R L; Kelly, S P; Kelly, S; Lotery, A; Mahmood, S; Menon, G; Sivaprasad, S; Talks, J; Tufail, A; Yang, Y

    2015-06-01

    The introduction of anti-vascular endothelial growth factor (anti-VEGF) has made significant impact on the reduction of the visual loss due to neovascular age-related macular degeneration (n-AMD). There are significant inter-individual differences in response to an anti-VEGF agent, made more complex by the availability of multiple anti-VEGF agents with different molecular configurations. The response to anti-VEGF therapy have been found to be dependent on a variety of factors including patient's age, lesion characteristics, lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles. Furthermore, a proportion of eyes with n-AMD show a decline in acuity or morphology, despite therapy or require very frequent re-treatment. There is currently no consensus as to how to classify optimal response, or lack of it, with these therapies. There is, in particular, confusion over terms such as 'responder status' after treatment for n-AMD, 'tachyphylaxis' and 'recalcitrant' n-AMD. This document aims to provide a consensus on definition/categorisation of the response of n-AMD to anti-VEGF therapies and on the time points at which response to treatment should be determined. Primary response is best determined at 1 month following the last initiation dose, while maintained treatment (secondary) response is determined any time after the 4th visit. In a particular eye, secondary responses do not mirror and cannot be predicted from that in the primary phase. Morphological and functional responses to anti-VEGF treatments, do not necessarily correlate, and may be dissociated in an individual eye. Furthermore, there is a ceiling effect that can negate the currently used functional metrics such as >5 letters improvement when the baseline VA is good (ETDRS>70 letters). It is therefore important to use a combination of both the parameters in determining the response.The following are proposed definitions: optimal (good) response is defined as when there

  19. Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis

    Science.gov (United States)

    Mehta, H; Sim, D A; Keane, P A; Zarranz-Ventura, J; Gallagher, K; Egan, C A; Westcott, M; Lee, R W J; Tufail, A; Pavesio, C E

    2015-01-01

    Aim The aim of this study is to characterise the choroidal features of patients diagnosed with sarcoid- and tuberculosis (TB)-associated granulomatous uveitis using spectral domain optical coherence tomography (OCT). Methods Twenty-seven patients (27 eyes) diagnosed with sarcoid- (13 eyes) and TB (14 eyes)-related uveitis were included in this retrospective, cross-sectional study. Over a six-month period, patients diagnosed with sarcoid and TB granulomatous uveitis were scanned using enhanced depth imaging OCT. Clinical and demographical characteristics were recorded, including the method of diagnosis, disease activity, site of inflammation (anterior or posterior), treatments, and visual acuity (VA). Manual segmentation of the choroidal layers was performed using custom image analysis software. Results The main outcome measure was OCT-derived thickness measurements of the choroid and choroidal sublayers (Haller's large vessel and Sattler's medium vessel layers) at the macula region. The ratio of Haller's large vessel to Sattler's medium vessel layer was significantly different at the total macula circle in eyes diagnosed with TB uveitis (1.47 (=140.71/95.72 μm)) compared with sarcoid uveitis (1.07 (=137.70/128.69 μm)) (P=0.001). A thinner choroid was observed in eyes with a VA ≥0.3 LogMAR (Snellen 6/12; 198.1 μm (interquartile range (IQR)=147.0–253.4 μm) compared with those with VA <0.3 LogMAR (292.4 μm (IQR=240.1–347.6 μm)) at the total macula circle (P=0.004). At the foveal central subfield, the median choroidal thickness was 336.8 μm (IQR=272.3–375.4 μm) in active compared with 239.3 μm (IQR=195.3–330.9 μm) in quiescent disease (P=0.04). Conclusion A disproportionately enlarged Sattler's layer may indicate a diagnosis of sarcoid-related uveitis, and choroidal thickening may be a feature of active granulomatous uveitis. PMID:26021867

  20. Enhanced-Depth Imaging Optical Coherence Tomography of the Human Choroid In Vivo Compared With Histology After Enucleation

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Heegaard, Steffen; Kiilgaard, Jens Folke;

    2016-01-01

    PURPOSE: This study compared in vivo enhanced-depth imaging optical coherence tomography (EDI-OCT) with ex vivo histology of the choroid in human eyes. METHODS: Three eyes in three patients with advanced iris melanoma without posterior segment involvement underwent EDI-OCT less than 24 hours prior...... such as retinal vessel, the foveal depression, ciliary arteries, drusen, and nevi. RESULTS: Intra- and interindividual variations in relative choroidal thickness were comparable between the two modalities. After histologic fixation of the three melanoma eyes, the fullness of the choroidal vessels was reduced...

  1. A pilot quantitative study of topographic correlation between reticular pseudodrusen and the choroidal vasculature using en face optical coherence tomography.

    Directory of Open Access Journals (Sweden)

    Dilraj S Grewal

    Full Text Available PURPOSE: To analyze the topographic correlation between reticular pseudodrusen (RPD visualized on infrared reflectance (IR and choroidal vasculature using en-face volumetric spectral-domain optical coherence tomography (SD-OCT. METHODS: A masked observer marked individual RPD on IR images using ImageJ (NIH, Bethesda, MD. Using the macular volume scan (Cirrus, Carl Zeiss Meditec Inc, Dublin, CA, the RPE slab function was used to generate a C-scan of the most superficial choroidal vasculature. An independent masked grader created a topographic binary map of the choroidal vasculature by thresholding the en-face image, which was overlaid onto the IR map of RPD. For each IR image, ImageJ was used to generate a random set of dots as "control lesions". RESULTS: 17 eyes of 11 patients (78±13.7 years with RPD were analyzed. The average number of RPD lesions identified on IR images was 414±71.5, of which 49.6±4.3% were located overlying the choroidal vasculature, compared to 45.4±4.0% in controls (p = 0.014. 50.4±4.3% of lesions overlay the choroidal stroma, of which 76.5±3.1% were ≤3 pixels from the choroidal vessels. The percentage of RPD lesions located within ≤3 pixels from the choroidal vasculature was significantly greater than the percentage located ≥7 pixels away. (p<0.0001. Compared to controls (71.6±3.8%, RPD were more likely to be located ≤3 pixels away from choroidal vessels (p = 0.014. In contrast, control lesions were more likely to be ≥7 pixels away from choroidal vessels than RPD (9.1±1.9% vs. 4.8±1.2%, respectively, p = 0.002. CONCLUSIONS: Our analysis shows that RPD lesions follow the underlying choroidal vasculature. Approximately half the RPD directly overlay the choroidal vessels and the majority of the remaining lesions were ≤3 pixels (≤30 microns from the vessel edge, supporting the hypothesis that RPD maybe related to pathologic changes at the choroidal level.

  2. Choroid plexus tumors: review of three cases. Carcinoma de plexos coroideos: revision a proposito de 3 casos

    Energy Technology Data Exchange (ETDEWEB)

    Zuazo Ojeda, A.; Ereo Ealo, M.J.; Mateos Goi, B.; Larrea Rementeria, F.; Pastor Cordoba, A.

    1994-01-01

    Choroid plexus tumors are rare, constituting approximately 0.5-0.6% of all intracranial neoplasms. Choroid plexus carcinomas are even more infrequent. We report three cases of choroid plexus carcinoma, the first signs of which were increased of head size or neurological disorders. The ultrasound (US) study demonstrated the existence of an highly echogenic intraventricular mass. One of the cases was studied by MR: on T1-weighted images the tumor was isointense to gray matter, and of intermediate signal intensity with T2-weighting. CT findings include intense homogeneous enhancement of the solid portions. (Author)

  3. In Vivo Monitoring of Neovascularization in Tumour Angiogenesis by Photoacoustic Tomography

    Institute of Scientific and Technical Information of China (English)

    XIANG Liang-Zhong; XING Da; GU Huai-Min; ZHOU Fei-Fan; YANG Di-Wu; ZENG Lv-Ming; YANG Si-Hua

    2007-01-01

    Photoacoustic tomography (PAT) is presented to in vivo monitor neovascularization in tumout angiogenesis with high resolution and high contrast images in a rat. With a circular scan system, the photoacoustic signal, generated by laser pulses at a wavelength of 532nm from a Q-switched Nd:YAG laser, is captured by a hydrophone with a diameter of 1 mm and a sensitivity of 850nV/Pa. The vascular structure around the rat tumour is imaged clearly, with optimal contrast, because blood has strong absorption near this wavelength. Serial noninvasive photoacoustic images of neovascularization in tumour angiogenesis are also obtained consecutively from a growing tumour implanted under the skin of a rat over a period of two weeks. This work demonstrates that PAT can potentially provide a powerful tool for tumour angiogenesis detection in cancer research. It will bring us closer to clinical applications for tumour diagnosis and treatment monitoring.

  4. Multilayered pigment epithelial detachment in neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Rahimy, Ehsan; Freund, K Bailey; Larsen, Michael

    2014-01-01

    PURPOSE: To describe the spectral domain optical coherence tomography findings in eyes with chronic fibrovascular pigment epithelial detachment (PED) receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. METHODS: Retrospective observational case series of patients...... over a mean of 36.9 months (median, 37.5; range, 6-84). A fusiform, or spindle-shaped, complex of highly organized layered hyperreflective bands was noted within each PED. Nineteen eyes demonstrated heterogenous, dilated, irregular neovascular tissue adherent to the undersurface of the retinal pigment......, hyperreflective bands, termed a "multilayered PED," which is often seen in conjunction with neovascular tissue adherent to the undersurface of the retinal pigment epithelium monolayer. On the basis of previous histopathologic correlations, these bands may represent a fibrous tissue complex with contractile...

  5. Inhibitory effects of polysaccharide extract from Spirulina platensis on corneal neovascularization

    OpenAIRE

    Yang, LingLing; Wang, Yao; Zhou, Qingjun; Chen, Peng; Wang, Yiqiang; Wang, Ye; Liu, Ting; Xie, Lixin

    2009-01-01

    Purpose To assess the effects of polysaccharide extract from Spirulina platensis (PSP) on corneal neovascularization (CNV) in vivo and in vitro. Methods PSP was extracted from dry powder of Spirulina platensis. Its anti-angiogenic activity was evaluated in the mouse corneal alkali burn model after topical administration of PSP four times daily for up to seven days. Corneal samples were processed for histochemical, immunohistochemical, and gene expression analyses. The effects of PSP on prolif...

  6. Smooth muscle progenitor cells from peripheral blood promote the neovascularization of endothelial colony-forming cells

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Hyung Joon; Seo, Ha-Rim [Department of Cardiology, Cardiovascular Center, College of Medicine, Korea University, Seoul (Korea, Republic of); Jeong, Hyo Eun [Department of Mechanical Engineering, Korea University, Seoul (Korea, Republic of); Choi, Seung-Cheol; Park, Jae Hyung; Yu, Cheol Woong; Hong, Soon Jun [Department of Cardiology, Cardiovascular Center, College of Medicine, Korea University, Seoul (Korea, Republic of); Chung, Seok [Department of Mechanical Engineering, Korea University, Seoul (Korea, Republic of); Lim, Do-Sun, E-mail: dslmd@kumc.or.kr [Department of Cardiology, Cardiovascular Center, College of Medicine, Korea University, Seoul (Korea, Republic of)

    2014-07-11

    Highlights: • Two distinct vascular progenitor cells are induced from adult peripheral blood. • ECFCs induce vascular structures in vitro and in vivo. • SMPCs augment the in vitro and in vivo angiogenic potential of ECFCs. • Both cell types have synergistic therapeutic potential in ischemic hindlimb model. - Abstract: Proangiogenic cell therapy using autologous progenitors is a promising strategy for treating ischemic disease. Considering that neovascularization is a harmonized cellular process that involves both endothelial cells and vascular smooth muscle cells, peripheral blood-originating endothelial colony-forming cells (ECFCs) and smooth muscle progenitor cells (SMPCs), which are similar to mature endothelial cells and vascular smooth muscle cells, could be attractive cellular candidates to achieve therapeutic neovascularization. We successfully induced populations of two different vascular progenitor cells (ECFCs and SMPCs) from adult peripheral blood. Both progenitor cell types expressed endothelial-specific or smooth muscle-specific genes and markers, respectively. In a protein array focused on angiogenic cytokines, SMPCs demonstrated significantly higher expression of bFGF, EGF, TIMP2, ENA78, and TIMP1 compared to ECFCs. Conditioned medium from SMPCs and co-culture with SMPCs revealed that SMPCs promoted cell proliferation, migration, and the in vitro angiogenesis of ECFCs. Finally, co-transplantation of ECFCs and SMPCs induced robust in vivo neovascularization, as well as improved blood perfusion and tissue repair, in a mouse ischemic hindlimb model. Taken together, we have provided the first evidence of a cell therapy strategy for therapeutic neovascularization using two different types of autologous progenitors (ECFCs and SMPCs) derived from adult peripheral blood.

  7. Caregiver Burden in Patients Receiving Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

    OpenAIRE

    Rishma Gohil; Roxanne Crosby-Nwaobi; Angus Forbes; Ben Burton; Phil Hykin; Sobha Sivaprasad

    2015-01-01

    Purpose To assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD). Methods This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA). Objective caregiver burden was determined by the caregiver tasks and level of ...

  8. Economic Burden of Bilateral Neovascular Age-Related Macular Degeneration: Multi-Country Observational Study

    OpenAIRE

    Alan F. Cruess; Gergana Zlateva; Xiao Xu; Gisele Soubrane; Daniel Pauleikhoff; Andrew Lotery; Jordi Mones; Ronald Buggage; Caroline Schaefer; Tyler Knight; Goss, Thomas F

    2008-01-01

    Background: There is limited previous research examining the healthcare costs of neovascular age-related macular degeneration (NV-AMD), which constrains our understanding of the economic impact of this condition. With aging populations, this leading cause of rapid vision loss in Western countries is expected to become a pressing health predicament, requiring decision makers to evaluate alternative treatment strategies for AMD. Objective: To document the economic burden of bilateral NV-AMD, th...

  9. Ethyl Pyruvate Inhibits Retinal Pathogenic Neovascularization by Downregulating HMGB1 Expression

    Directory of Open Access Journals (Sweden)

    Yun Mi Lee

    2013-01-01

    Full Text Available Retinal pathogenic angiogenesis in the eyes is a causative factor in retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration. This study was designed to examine the pathogenic role of the high-mobility group box-1 (HMGB1 protein and the inhibitory effect of ethyl pyruvate (EP, a well-known antioxidant substance, in retinal pathogenic angiogenesis in mice with oxygen-induced retinopathy (OIR, one of the animal models of proliferative ischemic retinopathy. The OIR mouse model was used for our in vivo studies. The mice were exposed to 75% oxygen from postnatal day 7 (P7 to P11, after which the mice were brought to room air and intraperitoneally injected with EP (50 mg/kg, or 100 mg/kg for five days. At P17, the mice were perfused with fluorescein isothiocyanate-dextran, and flat-mounted retinas were used to measure nonperfused and neovascular tufts. In OIR mice, an intraperitoneal injection of EP reduced the nonperfused retinal area in the treatment group and significantly reduced the retinal neovascular tufts. In addition, EP inhibited the overexpression of HMGB1 in the retinas of OIR mice. These data suggest that EP could serve as an innovative pharmaceutical agent to prevent retinal neovascularization through inhibiting HMGB1 expression.

  10. Ethyl pyruvate inhibits retinal pathogenic neovascularization by downregulating HMGB1 expression.

    Science.gov (United States)

    Lee, Yun Mi; Kim, Junghyun; Jo, Kyuhyung; Shin, So Dam; Kim, Chan-Sik; Sohn, Eun Jin; Kim, Seon Gi; Kim, Jin Sook

    2013-01-01

    Retinal pathogenic angiogenesis in the eyes is a causative factor in retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration. This study was designed to examine the pathogenic role of the high-mobility group box-1 (HMGB1) protein and the inhibitory effect of ethyl pyruvate (EP), a well-known antioxidant substance, in retinal pathogenic angiogenesis in mice with oxygen-induced retinopathy (OIR), one of the animal models of proliferative ischemic retinopathy. The OIR mouse model was used for our in vivo studies. The mice were exposed to 75% oxygen from postnatal day 7 (P7) to P11, after which the mice were brought to room air and intraperitoneally injected with EP (50 mg/kg, or 100 mg/kg) for five days. At P17, the mice were perfused with fluorescein isothiocyanate-dextran, and flat-mounted retinas were used to measure nonperfused and neovascular tufts. In OIR mice, an intraperitoneal injection of EP reduced the nonperfused retinal area in the treatment group and significantly reduced the retinal neovascular tufts. In addition, EP inhibited the overexpression of HMGB1 in the retinas of OIR mice. These data suggest that EP could serve as an innovative pharmaceutical agent to prevent retinal neovascularization through inhibiting HMGB1 expression.

  11. Structural modeling of a novel CAPN5 mutation that causes uveitis and neovascular retinal detachment.

    Directory of Open Access Journals (Sweden)

    Alexander G Bassuk

    Full Text Available CAPN5 mutations have been linked to autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV, a blinding autoimmune eye disease. Here, we link a new CAPN5 mutation to ADNIV and model the three-dimensional structure of the resulting mutant protein. In our study, a kindred with inflammatory vitreoretinopathy was evaluated by clinical eye examinations, DNA sequencing, and protein structural modeling to investigate the disease-causing mutation. Two daughters of an affected mother demonstrated symptoms of stage III ADNIV, with posterior uveitis, cystoid macular edema, intraocular fibrosis, retinal neovascularization, retinal degeneration, and cataract. The women also harbored a novel guanine to thymine (c.750G>T, p.Lys250Asn missense mutation in exon 6 of CAPN5, a gene that encodes a calcium-activated cysteine protease, calpain-5. Modeling based on the structures of all known calpains revealed the mutation falls within a calcium-sensitive flexible gating loop that controls access to the catalytic groove. Three-dimensional modeling placed the new mutation in a region adjacent to two previously identified disease-causing mutations, all three of which likely disrupt hydrogen bonding within the gating loop, yielding a CAPN5 with altered enzymatic activity. This is the third case of a CAPN5 mutation leading to inherited uveitis and neovascular vitreoretinopathy, suggesting patients with ADNIV features should be tested for CAPN5 mutations. Structural modeling of novel variants can be used to support mechanistic consequences of the disease-causing variants.

  12. Management of Neovascular Age-related Macular Degeneration: A Review on Landmark Randomized Controlled Trials.

    Science.gov (United States)

    Agarwal, Aniruddha; Aggarwal, Kanika; Gupta, Vishali

    2016-01-01

    In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have led to substantial improvements in the outcome of these patients. The introduction of anti-vascular endothelial growth factor agents has resulted in improvement of visual outcomes and has had a positive impact on the quality of life among elderly population. While the contemporary management of neovascular AMD has been successful in tremendously reducing the visual morbidity, the financial burden of therapy has increased exponentially. To overcome these challenges, newer pharmacologic agents are evaluated for their efficacy and safety in AMD. Ground-breaking advances in bench to bedside research have led to discovery of new pathways that appear to be viable targets for preventing visual loss in AMD. In this review, study designs and results of landmark clinical trials in AMD from the past decade have been summarized.

  13. Management of neovascular Age-related macular degeneration: A review on landmark randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Aniruddha Agarwal

    2016-01-01

    Full Text Available In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age.related macular degeneration (AMD. These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have led to substantial improvements in the outcome of these patients. The introduction of anti.vascular endothelial growth factor agents has resulted in improvement of visual outcomes and has had a positive impact on the quality of life among elderly population. While the contemporary management of neovascular AMD has been successful in tremendously reducing the visual morbidity, the financial burden of therapy has increased exponentially. To overcome these challenges, newer pharmacologic agents are evaluated for their efficacy and safety in AMD. Ground.breaking advances in bench to bedside research have led to discovery of new pathways that appear to be viable targets for preventing visual loss in AMD. In this review, study designs and results of landmark clinical trials in AMD from the past decade have been summarized.

  14. Angiogenin expression in burn blister fluid: implications for its role in burn wound neovascularization.

    Science.gov (United States)

    Pan, Shin-Chen; Wu, Li-Wha; Chen, Chung-Lin; Shieh, Shyh-Jou; Chiu, Haw-Yen

    2012-01-01

    Deep partial thickness burn (DPTB) wound fluids have a greater propensity for establishing neovascularization than did superficial partial thickness burn (SPTB) wound fluids in our previous study. To investigate the factors responsible for this activity, cytokine array and enzyme-linked immunosorbent assay were used to perform an expression analysis of angiogenic factors in burn fluid. Although present in approximately equal amounts in both SPTB and DPTB blister fluids from burn patients, angiogenin does appear to be involved in the ability of DPTB blister fluid to promote neovascularization in vitro and in vivo. Angiogenin alone was sufficient to induce endothelial differentiation of circulating angiogenic cells (CAC) without vascular endothelial growth factor A involvement. In addition, angiogenin was positively associated with CAC differentiation in the burn blister fluid. Blocking the effect of angiogenin in burn blister fluids resulted in a significant reduction of endothelial cell proliferation, CAC differentiation, and new blood vessels formation in vivo. Moreover, immunohistochemistry revealed that high angiogenin expression colocalizes with high vascularity in human burn wounds at day 7, further supporting our hypothesis that angiogenin is involved in burn wound neovascularization.

  15. Role of Pigment Epithelium-Derived Factor in Stem/Progenitor Cell-Associated Neovascularization

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    Jung-Tung Liu

    2012-01-01

    Full Text Available Pigment epithelium-derived factor (PEDF was first identified in retinal pigment epithelium cells. It is an endogenously produced protein that is widely expressed throughout the human body such as in the eyes, liver, heart, and adipose tissue; it exhibits multiple and varied biological activities. PEDF is a multifunctional protein with antiangiogenic, antitumorigenic, antioxidant, anti-inflammatory, antithrombotic, neurotrophic, and neuroprotective properties. More recently, PEDF has been shown to be the most potent inhibitor of stem/progenitor cell-associated neovascularization. Neovascularization is a complex process regulated by a large, interacting network of molecules from stem/progenitor cells. PEDF is also involved in the pathogenesis of angiogenic eye disease, tumor growth, and cardiovascular disease. Novel antiangiogenic agents with tolerable side effects are desired for the treatment of patients with various diseases. Here, we review the value of PEDF as an important endogenous antiangiogenic molecule; we focus on the recently identified role of PEDF as a possible new target molecule to influence stem/progenitor cell-related neovascularization.

  16. Predictors of Visual Response to Intravitreal Bevacizumab for Treatment of Neovascular Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Kai Fang

    2013-01-01

    Full Text Available Purpose. To identify the predictors of visual response to the bevacizumab treatment of neovascular age-related macular degeneration (AMD. Design. A cohort study within the Neovascular AMD Treatment Trial Using Bevacizumab (NATTB. Methods. This was a multicenter trial including 144 participants from the NATTB study. Visual outcomes measured by change in visual acuity (VA score, proportion gaining ≥15 letters, and change in central retinal thickness (CRT were compared among groups according to the baseline, demographic, and ocular characteristics and genotypes. Results. Mean change in the VA score was 9.2 ± 2.3 SD letters with a total of 46 participants (31.9% gaining ≥15 letters. Change in median CRT was −81.5 μm. Younger age, lower baseline VA score, shorter duration of neovascular AMD, and TT genotype in rs10490924 were significantly associated with greater VA score improvement (P=0.028, P<0.001, P=0.02, and P=0.039, resp.. Lower baseline VA score and TT genotype in rs10490924 were significantly associated with a higher likelihood of gaining ≥15 letters (P=0.028, and P=0.021, resp.. Conclusions. Baseline VA and genotype of rs10490924 were both important predictors for visual response to bevacizumab at 6 months. This trial is registered with the Registration no. NCT01306591.

  17. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report.

    Science.gov (United States)

    Erol, Muhammet Kazim; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet

    2013-01-01

    The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.

  18. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

    Directory of Open Access Journals (Sweden)

    Muhammet Kazim Erol

    2013-06-01

    Full Text Available The authors present enhanced depth imaging optical coherence tomography (EDI OCT and fundus autofluorescence (FAF characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.

  19. Delayed presentation of a metastatic choroidal melanoma to the liver: The latency of an elective metastatic localization

    Directory of Open Access Journals (Sweden)

    Antonio Pesce

    2015-01-01

    Conclusion: Patients with gastrointestinal symptoms and a history of choroidal melanoma should be investigated for the presence of gastrointestinal or liver metastases, although the original primary malignancy was diagnosed years before the patient’s presentation.

  20. Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Erol, Muhammet Kazim; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet, E-mail: muhammetkazimerol@gmail.com [Kazim Erol. Antalya Training and Research Hospital, Ophthalmology Department, Antalya (Turkey)

    2013-11-01

    The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. (author)

  1. OPTICAL COHERENCE TOMOGRAPHY–BASED CORRELATION BETWEEN CHOROIDAL THICKNESS AND DRUSEN LOAD IN DRY AGE-RELATED MACULAR DEGENERATION

    Science.gov (United States)

    KO, ASHLEY; CAO, SIJIA; PAKZAD-VAEZI, KAIVON; BRASHER, PENELOPE M.; MERKUR, ANDREW B.; ALBIANI, DAVID A.; KIRKER, ANDREW W.; CUI, JING; MATSUBARA, JOANNE; FOROOGHIAN, FARZIN

    2014-01-01

    Purpose Spectral domain optical coherence tomography can be used to measure both choroidal thickness and drusen load. The authors conducted an exploratory study using spectral domain optical coherence tomography to determine if a correlation between choroidal thickness and drusen load exists in patients with dry age-related macular degeneration. Methods Forty-four patients with dry age-related macular degeneration were recruited. The drusen area and volume were determined using the automated software algorithm of the spectral domain optical coherence tomography device, and choroidal thickness was measured using enhanced depth imaging. Correlations were determined using multivariable and univariable analyses. Results The authors found an inverse correlation between choroidal thickness and drusen load (r = −0.35, P = 0.04). Drusen load was also correlated with visual acuity (r = 0.32, P = 0.04). A correlation between choroidal thickness and visual acuity was suggested (r = −0.22, P = 0.21). Conclusion Spectral domain optical coherence tomography can be used to assess the correlation between drusen load and choroidal thickness, both of which show a relationship with visual acuity. The measurement of these outcomes may serve as important outcome parameters in routine clinical care and in clinical trials for patients with dry age-related macular degeneration. PMID:23474546

  2. Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions

    Institute of Scientific and Technical Information of China (English)

    Lukas; Reznicek; Carmen; Stumpf; Florian; Seidensticker; Anselm; Kampik; Aljoscha; S; Neubauer; Marcus; Kernt

    2014-01-01

    ·AIM:Toevaluatethe diagnostic properties of wide-field fundus autofluorescence(FAF) scanning laser ophthalmoscope(SLO) imaging for differentiating choroidal pigmented lesions.·METHODS: A consecutive series of 139 patients were included, 101 had established choroidal melanoma with13 untreated lesions and 98 treated with radiotherapy.Thirty-eight had choroidal nevi. All patients underwent a full ophthalmological examination, undilated wide-field imaging, FAF and standardized US examination. FAF images and imaging characteristics from SLO were correlated with the structural findings in the two patient groups.·RESULTS: Mean FAF intensity of melanomas was significantly lower than the FAF of choroidal nevi. Only 1out of 38 included eyes with nevi touched the optic disc compared to 31 out of 101 eyes with melanomas. In 18 out of 101 melanomas subretinal fluid was seen at the pigmented lesion compared to none seen in eyes with confirmed choroidal nevi. In "green laser separation", a trend towards more mixed FAF appearance of melanomas compared to nevi was observed. The mean maximal and minimal transverse and longitudinal diameters of melanomas were significantly higher than those of nevi.·CONCLUSION: Wide-field SLO and FAF imaging may be an appropriate non-invasive diagnostic screening tool to differentiate benign from malign pigmented choroidal lesions.

  3. Choroidal metastases in testicular choriocarcinoma, successful treatment with chemo- and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Guber Ivo

    2011-12-01

    Full Text Available Abstract Background Choriocarcinoma is a very rare cause of ocular metastasis. Only 18 male patients have been reported on, 4 of whom survived, but with significant loss of vision. Case presentation A 26-year-old Caucasian man, suffering from testicular choriocarcinoma with pulmonary, cerebral, renal, hepatic and osseous metastases, underwent left radical orchiectomy. While being treated with chemotherapy, he presented with loss of vision in the left eye. Ophthalmoscopy revealed bilateral non-pigmented, hemorrhagic choroidal tumours, compatible with secondary lesions. Continued chemotherapy and stereotactic radiotherapy of the skull and spine lead to full remission with excellent vision, after more than 4 years of follow up. Conclusion Testicular choriocarcinoma is an exceptional cause of choroidal metastasis, potentially asymptomatic and with specific clinical features. Radiotherapy can complement radical orchiectomy and chemotherapy, to achieve full remission and maintain good vision.

  4. Induction of Chemokine Secretion and Monocyte Migration by Human Choroidal Melanocytes in Response to Proinflammatory Cytokines

    DEFF Research Database (Denmark)

    Jehs, Tina; Faber, Carsten; Udsen, Maja S.

    2016-01-01

    Purpose: To determine to which extent inflammatory cytokines affect chemokine secretion by primary human choroidal melanocytes (HCMs), their capacity to attract monocytes, and whether HCMs are able to influence the proliferation of activated T cells. Methods: Primary cultures of HCMs were...... established from eyes of 13 donors. Human choroidal melanocytes were stimulated with IFN-γ and TNF-α or with supernatant from activated T cells (T-cell–conditioned media [TCM]). Gene expression analysis was performed by using microarrays. Protein levels were quantified with ELISA or cytometric bead array....... Supernatants of HCMs were assessed for the capability to attract monocytes in a transwell plate. Proliferation of activated T cells was assessed in a direct coculture with HCMs by a [3H]-thymidine incorporation assay. Results: Stimulation of HCMs with TCM or IFN-γ and TNF-α resulted in increased expression...

  5. Photodynamic Therapy for Diffuse Choroidal Hemangioma in Sturge-Weber Syndrome

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    Sílvia Monteiro

    2014-01-01

    Full Text Available Purpose. To report the treatment outcome of photodynamic therapy with verteporfin (PDT for exudative retinal detachment (RD associated with diffuse choroidal hemangioma in Sturge-Weber syndrome (SWS. Methods. An interventional case report of a 10-year-old girl with SWS who developed an exudative RD (visual acuity hand motions that was treated with PDT. She was treated with a first session of multispot PDT. Posteriorly, a choroidotomy for drainage of subretinal fluid was created, combined with an intravitreal injection of gas (SF6 and cryoapplication. Finally, a second session of PDT was applied. Results. Subretinal fluid resolved over a period of one year and visual acuity increased to 20/125. Conclusions. PDT is an effective therapeutic option for exudative RD associated with diffuse choroidal hemangioma.

  6. Gene Therapy with Endogenous Inhibitors of Angiogenesis for Neovascular Age-Related Macular Degeneration: Beyond Anti-VEGF Therapy

    Directory of Open Access Journals (Sweden)

    Selwyn M. Prea

    2015-01-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of substantial and irreversible vision loss amongst elderly populations in industrialized countries. The advanced neovascular (or “wet” form of the disease is responsible for severe and aggressive loss of central vision. Current treatments aim to seal off leaky blood vessels via laser therapy or to suppress vessel leakage and neovascular growth through intraocular injections of antibodies that target vascular endothelial growth factor (VEGF. However, the long-term success of anti-VEGF therapy can be hampered by limitations such as low or variable efficacy, high frequency of administration (usually monthly, potentially serious side effects, and, most importantly, loss of efficacy with prolonged treatment. Gene transfer of endogenous antiangiogenic proteins is an alternative approach that has the potential to provide long-term suppression of neovascularization and/or excessive vascular leakage in the eye. Preclinical studies of gene transfer in a large animal model have provided impressive preliminary results with a number of transgenes. In addition, a clinical trial in patients suffering from advanced neovascular AMD has provided proof-of-concept for successful gene transfer. In this mini review, we summarize current theories pertaining to the application of gene therapy for neovascular AMD and the potential benefits when used in conjunction with endogenous antiangiogenic proteins.

  7. Retinal and choroidal findings in oxalate retinopathy using EDI-OCT.

    Science.gov (United States)

    Roth, Bryan M; Yuan, Alex; Ehlers, Justis P

    2012-01-01

    A 55-year-old woman with extensive retinal crystalline deposition secondary to primary hyperoxaluria presented with bilateral loss of vision secondary to oxalate retinopathy. Enhanced depth imaging optical coherence tomography revealed intraretinal, subretinal, and intraretinal and subretinal pigment epithelium, and choroidal focal hyperreflective structures consistent with both neurosensory and uveal deposition of oxalate crystals. Serial optical coherence tomography revealed continued crystalline deposition with progressive retinal atrophy.

  8. Profile of serpiginous choroiditis in a tertiary eye care centre in eastern India

    Directory of Open Access Journals (Sweden)

    Kumar Saurabh

    2013-01-01

    Full Text Available Purpose: To study the clinical profile of serpiginous choroiditis in eastern India. Materials and Methods: Ninety-one eyes of 54 patients with serpiginous choroiditis presenting to a tertiary care centre in eastern India between January 2006 and December 2010 were included in the study. Clinical presentation, treatment given, and visual outcome of the eyes were studied. Results: Thirty-five (64.8% patients were male and 19 (35.2% were female in the age group of 13-62 years (mean age: 34.1 μ 18.7 years. Blurring of vision (71; 78% and floaters (36; 39.5% were commonest symptoms. In 75 (82.4% eyes, choroiditis started from optic nerve head and spreading centrifugally. Overall, 38 (41.75% eyes had macular involvement at first visit. Mantoux test reading was 10 mm or more (Group A in 12 (22.22% patients and less than 10 mm (Group B in 42 (77.77% patients. Difference between Groups A and B in macular involvement at first visit (10; 50% vs. 28; 39.4% and rate of recurrence (3; 15% vs. 14; 19.7% was not statistically significant (P = 0.37 and 0.68. Oral steroid (51; 94.4% was the commonest mode of treatment. Fifty-one (56% eyes had two lines or more improvement in vision. Conclusions: The present study details the clinical presentation, treatment, and visual outcome of serpiginous choroiditis. Mantoux test reading does not affect the clinical presentation or the treatment outcome in these eyes.

  9. Carcinoma lung presenting with choroidal metastasis as initial presentation: A rarity

    Directory of Open Access Journals (Sweden)

    Tapesh Bhattacharyya

    2013-01-01

    Full Text Available Diminished vision due to choroidal metastasis as the primary symptom of lung cancer is very uncommon. Here, we report such a presentation in a 54-year-old male patient of small cell lung cancer. The outcome is usually dismal with this kind of presentation. The patient received systemic chemotherapy as well as intravitreal bevacizumab but with no improvement in vision. The patient had been given external beam radiotherapy and showed subjective improvement in his ocular symptoms.

  10. Optic coherence tomography measurement of choroidal and retinal thicknesses after uncomplicated YAG laser capsulotomy

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    İsa Yuvacı

    2015-12-01

    Full Text Available ABSTRACT Purpose: Optic coherence tomography (OCT evaluation of the choroid, retina, and retinal nerve fiber layer after uncomplicated yttrium-aluminum-garnet (YAG laser capsulotomy. Methods: OCT analysis of retinal and choroidal structures was performed in 28 eyes of 28 patients following routine examinations before and 24 h, 72 h, 2 weeks, 4 weeks, and 12 weeks after YAG laser capsulotomy. Data were analyzed using the SPSS software. Results: Data collected before YAG capsulotomy and at the above mentioned follow-up visits are summarized as follows. Mean central subfoveal choroidal thickness before YAG capsulotomy was 275.85 ± 74.78 µm; it was 278.46 ± 83.46 µm, 283.39 ± 82.84 µm, 280.00 ± 77.16 µm, 278.37 ± 76.95 µm, and 278.67 ± 76.20 µm after YAG capsulotomy, respectively. Central macular thickness was 272.14 ± 25.76 µm before YAG capsulotomy; it was 266.53 ± 26.47 µm, 269.14 ± 27.20 µm, 272.17 ± 26.97 µm, 270.91 ± 26.79 µm, and 273 ± 26.63 µm after YAG capsulotomy, respectively. Mean retinal nerve fiber layer thickness before YAG was 99.89 ± 7.61 µm; it was 98.50 ± 8.62 µm, 98.14 ± 8.69 µm, 99.60 ± 8.39 µm, 99.60 ± 8.39 µm, and 99.60 ± 8.35 µm after YAG capsulotomy, respectively. No observed change was statistically significant. No significant changes were observed with regard to mean intraocular pressure. Conclusions: After YAG laser capsulotomy, no statistically significant changes were found in choroidal, retinal, and optical nerve fiber layer thicknesses, although slight thickness changes in these structures were observed, particularly during the first days.

  11. Acute triventricular hydrocephalus caused by choroid plexus cysts: a diagnostic and neurosurgical challenge.

    Science.gov (United States)

    Spennato, Pietro; Chiaramonte, Carmela; Cicala, Domenico; Donofrio, Vittoria; Barbarisi, Manlio; Nastro, Anna; Mirone, Giuseppe; Trischitta, Vincenzo; Cinalli, Giuseppe

    2016-11-01

    OBJECTIVE Intraventricular choroid plexus cysts are unusual causes of acute hydrocephalus in children. Radiological diagnosis of intraventricular choroid plexus cysts is difficult because they have very thin walls and fluid contents similar to CSF and can go undetected on routine CT studies. METHODS This study reports the authors' experience with 5 patients affected by intraventricular cysts originating from the choroid plexus. All patients experienced acute presentation with rapid neurological deterioration, sometimes associated with hypothalamic dysfunction, and required urgent surgery. In 2 cases the symptoms were intermittent, with spontaneous remission and sudden clinical deteriorations, reflecting an intermittent obstruction of the CSF pathway. RESULTS Radiological diagnosis was difficult in these cases because a nonenhanced CT scan revealed only triventricular hydrocephalus, with slight lateral ventricle asymmetry in all cases. MRI with driven-equilibrium sequences and CT ventriculography (in 1 case) allowed the authors to accurately diagnose the intraventricular cysts that typically occupied the posterior part of the third ventricle, occluding the aqueduct and at least 1 foramen of Monro. The patients were managed by urgent implantation of an external ventricular drain in 1 case (followed by endoscopic surgery, after completing a diagnostic workup) and by urgent endoscopic surgery in 4 cases. Endoscopic surgery allowed the shrinkage and near-complete removal of the cysts in all cases. Use of neuronavigation and a laser were indispensable. All procedures were uneventful, resulting in restoration of normal neurological conditions. Long-term follow-up (> 2 years) was available for 2 patients, and no complications or recurrences occurred. CONCLUSIONS This case series emphasizes the necessity of an accurate and precise identification of the possible causes of triventricular hydrocephalus. Endoscopic surgery can be considered the ideal treatment of choroid plexus

  12. Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer’s Type Dementia

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    Mehmet Bulut

    2016-01-01

    Full Text Available Aim. To asses both choroidal thickness differences among Alzheimer’s type dementia (ATD patients, mild cognitive impairment (MCI patients, and healthy control (C subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT. Detailed neurological examination including mini mental state examination (MMSE test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p<0.05. The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3±1.8, 24.8±0.9, and 27.6±1.2 in ATD, MCI, and healthy controls, respectively (p<0.001. There were also significant correlation between MMSE score and choroidal thickness at each location (p<0.05. Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients.

  13. Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer's Type Dementia

    Science.gov (United States)

    Bulut, Mehmet; Yaman, Aylin; Erol, Muhammet Kazim; Kurtuluş, Fatma; Toslak, Devrim; Doğan, Berna; Turgut Çoban, Deniz; Kaya Başar, Ebru

    2016-01-01

    Aim. To asses both choroidal thickness differences among Alzheimer's type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p < 0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3 ± 1.8, 24.8 ± 0.9, and 27.6 ± 1.2 in ATD, MCI, and healthy controls, respectively (p < 0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p < 0.05). Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients. PMID:26925259

  14. INTRAVITREAL ANTI-VEGF TREATMENT IN EYES WITH COMBINED CHOROIDAL NEOVASCULARISATION AND VITREOMACULAR TRACTION SYNDROME

    OpenAIRE

    Rotsos, Tryfon; Sagoo, Mandeep; da Cruz, Lyndon; Andrews, Richard; Dowler, Jonathan

    2010-01-01

    Abstract Purpose: To report the effect of intravitreal anti VEGF injections (IVI) on visual acuity (VA) in eyes with choroidal neovascularisation (CNVM) and coexistent vitreomacular traction (VMT) or when VMT has developed during the course of treatment. Methods: Retrospective interventional case series of 7 eyes in 7 patients. VMT was monitored with serial optical coherence tomography scans. Results: The aetiology of the CNVM was wet age-related macular degeneration in 5 e...

  15. Rare and Unusual Choroidal Abnormalities in a Patient with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Shinji Makino

    2013-08-01

    Full Text Available Purpose: To report a case of rare and unusual choroidal abnormalities in a 42-year-old woman with systemic lupus erythematosus (SLE. Methods: Images were obtained using fundus photography, fluorescein angiography, near-infrared reflectance (NIR imaging, and optical coherence tomography (OCT. Results: The patient had a history of SLE and central retinal artery occlusion in her right eye. Fundus examination showed no specific retinochoroidal abnormalities, with the exception of optic disc atrophy in her right eye and a peripapillary small hemorrhage in her left eye. However, NIR revealed multiple bright patchy lesions in the choroid of the posterior pole and the mid-periphery of the fundus in both eyes. OCT demonstrated irregular hyperreflectivity at the lesion sites. Conclusions: The observed choroidal abnormalities are highly specific findings and therefore indicative of neurofibromatosis type 1 (NF1. Since the coexistence of SLE and NF1 is extremely rare, this case provided the chance to examine the relationship between SLE and NF1.

  16. Regulation Effect of Vascular Endothelial Growth Factor on Human Fetal Choroid Vascularization

    Institute of Scientific and Technical Information of China (English)

    JinsongZhao; YiWang; 等

    2002-01-01

    Purpose:To investigate the spatial and temporal regulation effect of vascular endothelial growth factor(VEGF) on human fetal choroids vascularization.Methods:The eyeballs of 54 human fetuses from the 9th week to the 40th week due to accidental abortion were studied by immunohistochemically stainin for the expression of VEGF and proliferation cell nuclear antigen (PCNA).Results: (1)The distribution of VEGF expression in the retinal pigment epithelium (RPE) decreased with the incrase of age,the peak of which was between the 9th and 14th week.(2)PCNA immunoreactivity was localized within choriocapillaris endothelium .The expression level decreased alone with fetus age.In this period the choriocapillaris endothelium kept proliferation,differentiation,canalization and remodeled to form the choroids vessels(3)Statistically significant correlations were shown between the expression of VEGF in the PRE and that of PCNA in choriocapillaris endothelium(r=0.933,P<0.01).Couclusin:VEGF expression in PRE was positively involved in modulating human fetal choroids vascularization .Eye Science 2000;16:11-14.

  17. Regulation Effect of Vascular Endothelial Growth Factor on Human Fetal Choroid Vascularization

    Institute of Scientific and Technical Information of China (English)

    Jinsong Zhao; Yue Song; Yi Wang; Xiaoguang Zhang

    2000-01-01

    Purpose: To investigate the spatial and temporal regulation effect of vascular endothelial growth factor(VEGF) on human fetal choroid vascularization. Methods: The eyeballs of 54 human fetuses from the 9th week to the 40th week due to accidental abortion were studied by immunohistochemically staining for the expression of VEGF and proliferation cell nuclear antigen (PCNA). Results: (1) The distribution of VEGF expression in the retinal pigment epithelium (RPE) decreased with the increase of age, the peak of which was between the 9th and 14th week. (2) PCNA immunoreactivity was localized within choriocapillaris endothelium. The expression level decreased alone with fetus age. In this period the choriocapillaris endothelium kept proliferation, differentiation, canalization and remodelled to form the choroid vessels. (3)Statistically significant correlations were shown between the expression of VEGF in the PRE and that of PCNA in choriocapillaris endothelium(r =0. 933, P < 0. 01). Conclusion: VEGF expression in RPE was positively involved in modulating human fetal choroid vascularization. Eye Science 2000; 16:11 ~ 14.

  18. Clinical course of focal choroidal excavation in Vogt–Koyanagi–Harada disease

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    Nishikawa Y

    2014-12-01

    Full Text Available Yuko Nishikawa,1–3,* Kaoru Fujinami,1,2,4,5,* Ken Watanabe,1,2 Toru Noda,1,2 Kazushige Tsunoda,1,2 Kunihiko Akiyama1,2 1Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan; 2Laboratory of Visual Physiology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan; 3Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan; 4Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 5UCL Institute of Ophthalmology, London, UK*These authors contributed equally to this workAbstract: We describe focal choroidal excavation (FCE in a case of Vogt–Koyanagi–Harada (VKH disease and compare the findings with different chorioretinal conditions. A 55-year-old man was diagnosed with VKH based on panuveitis and exudative retinal detachments. Spectral-domain optical coherence tomography demonstrated a dome-shaped protrusion with a nonconforming pattern at the fovea, which had been detected as a conforming pattern 1 year before the onset. The FCE pattern returned into a conforming pattern following corticosteroid therapy. These findings suggest that the natively existent FCE could be affected by pathophysiological changes of VKH as well as other chorioretinal conditions.Keywords: choroidal excavation, focal choroidal excavation, Vogt–Koyanagi–Harada disease, optical coherence tomography

  19. Lesões expansivas do plexo coróide Choroid plexus mass lesions

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    Ernesto Lima Araújo Melo

    2003-12-01

    Full Text Available As lesões expansivas do plexo coróide constituem um grupo bastante amplo e heterogêneo de doenças e seus simuladores. Tumores, infecções, anomalias congênitas, hemorragias, cistos e fenômenos degenerativos são alguns dos exemplos de causas de lesões expansivas do plexo coróide. No presente trabalho fizemos revisão da literatura pertinente, descrevendo os achados de imagem e ilustrando-os com alguns casos do nosso serviço. Apesar de não existir na literatura descrição de sinais patognomônicos, a avaliação criteriosa e sistemática das características das lesões pode sugerir determinada etiologia.Choroid plexus mass lesions encompass a broad and heterogeneous group of diseases and their simulators. Tumors, infections, congenital anomalies, hemorrhage, cysts and degenerative diseases are some examples of mass lesions affecting the choroid plexus. In this article we review the current literature, describing the imaging findings and illustrating choroid plexus mass lesions with some cases diagnosed at our facility. Despite the inexistence of pathognomonic signs, a careful and systematic evaluation of the imaging characteristics may suggest many etiologies.

  20. CFH Y402H and ARMS2 A69S Polymorphisms and Oral Supplementation with Docosahexaenoic Acid in Neovascular Age-Related Macular Degeneration Patients: The NAT2 Study.

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    Bénédicte M J Merle

    Full Text Available Genetic susceptibility could be modified by environmental factors and may also influence differential responses to treatments for age-related macular degeneration (AMD. We investigated whether genotype could influence response to docosahexaenoic acid (DHA-supplementation in the occurrence of choroidal new vessels (CNV.The Nutritional AMD Treatment 2 (NAT2 study was a randomized, placebo-controlled, double-blind, parallel, comparative study, including 250 patients aged 55 to 85 years with early lesions of age-related maculopathy, visual acuity better than 0.4 Logarithm of Minimum Angle of Resolution units in the study eye and neovascular AMD in the fellow eye. Patients were randomized at baseline to receive either 3 daily fish-oil capsules, each containing 280 mg DHA, 90 mg EPA and 2 mg Vitamin E, or placebo.Patients carrying the risk allele (C for CFH Y402H had no statistically significant increased risk for developing CNV in the study eye (Hazard Ratio (HR=0.97; 95% Confidence Interval (CI: 0.54-1.76 for heterozygous and HR=1.29; 95%CI: 0.69-2.40 for homozygous. Patients carrying the risk allele (T for ARMS2 A69S had no statistically significant increased risk for developing CNV in the study eye (HR=1.68; 95%CI: 0.91-3.12 for heterozygous and HR=1.78; 95%CI: 0.90-3.52 for homozygous. A significant interaction was observed between CFH Y402H and DHA-supplementation (p=0.01. We showed a protective effect of DHA-supplementation among homozygous non-risk patients. Among these patients, occurrence of CNV was 38.2% in placebo group versus 16.7% in DHA group (p=0.008.These results suggest that a genetic predisposition to AMD conferred by the CFH Y402H variant limits the benefit provided by DHA supplementation.ISRCTN registry 98246501.

  1. Evaluation of the siRNA PF-04523655 versus ranibizumab for the treatment of neovascular age-related macular degeneration (MONET Study)

    DEFF Research Database (Denmark)

    Nguyen, Quan Dong; Schachar, Ronald A; Nduaka, Chudy I;

    2012-01-01

    To evaluate the efficacy of different dosing paradigms of PF-04523655 (PF) versus ranibizumab (comparator) in subjects with neovascular age-related macular degeneration (AMD).......To evaluate the efficacy of different dosing paradigms of PF-04523655 (PF) versus ranibizumab (comparator) in subjects with neovascular age-related macular degeneration (AMD)....

  2. Accelerated reendothelialization, increased neovascularization and erythrocyte extravasation after arterial injury in BAMBI-/- mice.

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    Nicolas Guillot

    Full Text Available BACKGROUND: Intimal injury rapidly activates TGFβ and enhances vascular repair by the growth of endothelial (EC and vascular smooth muscle cells (VSMC. The response to the TGFβ family of growth factors can be modified by BAMBI (BMP, Activin, Membrane Bound Inhibitor acting as a non-signaling, competitive antagonist of TGFβ type I receptors such as ALK 1 and 5. In vivo the effect of BAMBI will depend on its cell-specific expression and of that of the ALK type receptors. We recently reported EC restricted BAMBI expression and genetic elimination of BAMBI resulting in an in vitro and in vivo phenotype characterized by endothelial activation and proliferation involving alternative pathway activation by TGFβ through ALK 1. METHODOLOGY/PRINCIPAL FINDINGS: To test the hypothesis that BAMBI modulates arterial response to injury via its effects on endothelial repair and arterial wall neovascularization we used a model of femoral arterial denudation injury in wild type (WT and BAMBI(-/- mice. Arterial response was evaluated at 2 and 4 weeks after luminal endothelial denudation of femoral arteries. The BAMBI(-/- genotype mice showed accelerated luminal endothelial repair at 2 weeks and a highly unusual increase in arterial wall neovascularization compared to WT mice. The exuberant intimal and medial neovessel formation with BAMBI(-/- genotype was also associated with significant red blood cell extravasation. The bleeding into the neointima at 2 weeks transiently increased it's area in the BAMBI(-/-genotype despite the faster luminal endothelial repair in this group. Vascular smooth muscle cells were decreased at 2 weeks in BAMBI(-/- mice, but comparable to wild type at 4 weeks. CONCLUSIONS/SIGNIFICANCE: The absence of BAMBI results in a highly unusual surge in arterial wall neovascularization that surprisingly mimiks features of intra-plaque hemorrhage of advanced atheroma in a mechanical injury model. This suggests important effects of BAMBI on

  3. Incidence and Clinical Features of Neovascularization of the Iris following Acute Central Retinal Artery Occlusion

    Science.gov (United States)

    Jung, Young Ho; Ahn, Seong Joon; Hong, Jeong-Ho; Park, Kyu Hyung; Han, Moon-Ku; Jung, Cheolkyu

    2016-01-01

    Purpose To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients with NVI following acute central retinal artery occlusion (CRAO). Methods A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital between January 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excluding patients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, or NVI detected before CRAO attack. Fluorescein angiography (FA) was applied until retinal arterial reperfusion was achieved, typically within 1 to 3 months. Results The incidence of NVI was 10.9% (12 out of 110 patients). Neovascular glaucoma was found in seven patients (6.4%). The mean time to NVI diagnosis after CRAO events was 3.0 months (range, 1 week to 15 months). The cumulative incidence was 5.5% at 3 months, 7.3% at 6 months, and 10.9% at 15 months. Severely narrowed ipsilateral carotid arteries were observed in only three patients (27.3%). The other nine patients (75.0%) showed no predisposing conditions for NVI, such as proliferative diabetic retinopathy or central retinal vein occlusion. Reperfusion rate and prevalence of diabetes were significantly different between patients with NVI and patients without NVI (reperfusion: 0% [NVI] vs. 94.7% [no NVI], p < 0.001; diabetes: 50.0% [NVI] vs. 17.3% [no NVI], p = 0.017). Conclusions CRAO may lead to NVI and neovascular glaucoma caused by chronic retinal ischemia from reperfusion failure. Our results indicate that follow-up fluorescein angiography is important to evaluate retinal artery reperfusion after acute CRAO events, and that prophylactic treatment such as panretinal photocoagulation should be considered if retinal arterial perfusion is not recovered. PMID:27729755

  4. Effect of endothelial progenitor cells in neovascularization and their application in tumor therapy

    Institute of Scientific and Technical Information of China (English)

    DONG Fang; HA Xiao-qin

    2010-01-01

    Objective To review the effect of endothelial progenitor cells in neovascularization as well as their application to the therapy of tumors.Data sources The data used in this review were mainly from PubMed for relevant English language articles published from 1997 to 2009. The search term was "endothelial progenitor cells".Study selection Articles regarding the role of endothelial progenitor cells in neovascularization and their application to the therapy of tumors were selected.Results Endothelial progenitor cells isolated from bone marrow, umbilical cord blood and peripheral blood can proliferate, mobilize and differentiate into mature endothelial cells. Experiments suggest endothelial progenitor cells take part in forming the tumor vascular through a variety of mechanisms related to vascular endothelial growth factor, matrix metalloproteinases, chemokine stromal cell-derived factor 1 and its receptor C-X-C receptor-4, erythropoietin, Notchsignal pathway and so on. Evidence demonstrates that the number and function change of endothelial progenitor cells in peripheral blood can be used as a biomarker of the response of cancer patients to anti-tumor therapy and predict the prognosis and recurrence. In addition, irradiation temporarily increased endothelial cells number and decreased the endothelial progenitor cell counts in animal models. Meanwhile, in preclinical experiments, therapeutic gene-modified endothelial progenitor cells have been approved to attenuate tumor growth and offer a novel strategy for cell therapy and gene therapy of cancer.Conclusions Endothelial progenitor cells play a particular role in neovascularization and have attractively potential prognostic and therapeutic applications to malignant tumors. However, a series of problems, such as the definitive biomarkers of endothelial progenitor cells, their interrelationship with radiotherapy and their application in cell therapy and gene therapy of tumors, need further investigation.

  5. A novel xenograft model in zebrafish for high-resolution investigating dynamics of neovascularization in tumors.

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    Chengjian Zhao

    Full Text Available Tumor neovascularization is a highly complex process including multiple steps. Understanding this process, especially the initial stage, has been limited by the difficulties of real-time visualizing the neovascularization embedded in tumor tissues in living animal models. In the present study, we have established a xenograft model in zebrafish by implanting mammalian tumor cells into the perivitelline space of 48 hours old Tg(Flk1:EGFP transgenic zebrafish embryos. With this model, we dynamically visualized the process of tumor neovascularization, with unprecedented high-resolution, including new sprouts from the host vessels and the origination from VEGFR2(+ individual endothelial cells. Moreover, we quantified their contributions during the formation of vascular network in tumor. Real-time observations revealed that angiogenic sprouts in tumors preferred to connect each other to form endothelial loops, and more and more endothelial loops accumulated into the irregular and chaotic vascular network. The over-expression of VEGF165 in tumor cells significantly affected the vascularization in xenografts, not only the number and size of neo-vessels but the abnormalities of tumor vascular architecture. The specific inhibitor of VEGFR2, SU5416, significantly inhibited the vascularization and the growth of melanoma xenografts, but had little affects to normal vessels in zebrafish. Thus, this zebrafish/tumor xenograft model not only provides a unique window to investigate the earliest events of tumoral neoangiogenesis, but is sensitive to be used as an experimental platform to rapidly and visually evaluate functions of angiogenic-related genes. Finally, it also offers an efficient and cost-effective means for the rapid evaluation of anti-angiogenic chemicals.

  6. Phacoemulsification Surgery in Eyes with Neovascular Age-Related Macular Degeneration

    Science.gov (United States)

    Papavasileiou, Evangelia; Kumar, Balakrishna Vineeth; Prasad, Som

    2014-01-01

    Purpose. To evaluate the visual outcomes and effect of phacoemulsification surgery on the progression of neovascular age-related macular degeneration (AMD). Methods. Retrospective, noncomparative, and interventional case series. Thirty eyes from 29 subjects with neovascular AMD treated with intravitreal antivascular endothelial growth factor (VEGF) injections who underwent phacoemulsification and had a postsurgery follow-up of 6 months were included. LogMAR best corrected visual acuity (BCVA) was assessed preoperatively; 1 month, 3 months, and 6 months postoperatively; and finally at the last visit. The frequency of anti-VEGF therapy, calculated as the number of intravitreal injections per month, and central macular thickness (CMT) before and after cataract surgery were determined. Results. Median (range) logMAR BCVA was 0.69 (0.16 to 1.32) preoperatively; 0.55 (−0.04 to 1.32) at 1 month, 0.52 (−0.1 to 1.32) at 3 months, and 0.50 (0.0 to 1.32) at 6 months postoperatively; and 0.6 (0.0 to 1.4) at final visit (P = 0.0011). There was no difference in the frequency of anti-VEGF injections between the immediate 6 months before and after phacoemulsification, which was equal to 0.1667 injections per month (P = 0.6377). Median CMT measured 203 μm preoperatively, which temporarily increased to 238 μm at 1 month after surgery (P = 0.0093) and then spontaneously returned to baseline, measuring 212.5 μm at 3 months postoperatively (P = 0.3811). Conclusion. Phacoemulsification surgery significantly improved vision in patients with neovascular AMD, with no increased need for anti-VEGF injections to keep the macula dry postoperatively. PMID:24719771

  7. A Chinese 2-herb formula (NF3) promotes hindlimb ischemia-induced neovascularization and wound healing of diabetic rats.

    Science.gov (United States)

    Tam, Jacqueline Chor-Wing; Ko, Chun-Hay; Lau, Kit-Man; To, Ming-Ho; Kwok, Hin-Fai; Chan, Yuet-Wa; Siu, Wing-Sum; Etienne-Selloum, Nelly; Lau, Ching-Po; Chan, Wai-Yee; Leung, Ping-Chung; Fung, Kwok-Pui; Schini-Kerth, Valérie B; Lau, Clara Bik-San

    2014-01-01

    Diabetic foot ulcer is closely associated with peripheral vascular disease. Enhancement of tissue oxidative stress, reduction of nitric oxide (NO) and angiogenic growth factors, and abnormal matrix metalloproteinase (MMP) activity are pathophysiological factors in post-ischemic neovascularization and diabetic wound healing. Our previous study demonstrated that the Chinese 2-herb formula, NF3, showed significant wound healing effects on diabetic foot ulcer rats. A novel rat diabetic foot ulcer with hindlimb ischemia model was established in order to strengthen our claims on the diabetic wound healing and post-ischemic neovascularization effects of NF3. Our results demonstrate that NF3 can significantly reduce the wound area of the diabetic foot ulcer rat with hindlimb ischemia by 21.6% (poxidative stress of ischemic muscles (p<0.001). NF3 significantly stimulated MMP activity involved in angiogenesis. Our study shows, for the first time, the beneficial effects of NF3 in wound healing and post-ischemic neovascularization in diabetes.

  8. Effect of Uveal Melanocytes on Choroidal Morphology in Rhesus Macaques and Humans on Enhanced-Depth Imaging Optical Coherence Tomography

    Science.gov (United States)

    Yiu, Glenn; Vuong, Vivian S.; Oltjen, Sharon; Cunefare, David; Farsiu, Sina; Garzel, Laura; Roberts, Jeffrey; Thomasy, Sara M.

    2016-01-01

    Purpose To compare cross-sectional choroidal morphology in rhesus macaque and human eyes using enhanced-depth imaging optical coherence tomography (EDI-OCT) and histologic analysis. Methods Enhanced-depth imaging–OCT images from 25 rhesus macaque and 30 human eyes were evaluated for choriocapillaris and choroidal–scleral junction (CSJ) visibility in the central macula based on OCT reflectivity profiles, and compared with age-matched histologic sections. Semiautomated segmentation of the choriocapillaris and CSJ was used to measure choriocapillary and choroidal thickness, respectively. Multivariate regression was performed to determine the association of age, refractive error, and race with choriocapillaris and CSJ visibility. Results Rhesus macaques exhibit a distinct hyporeflective choriocapillaris layer on EDI-OCT, while the CSJ cannot be visualized. In contrast, humans show variable reflectivities of the choriocapillaris, with a distinct CSJ seen in many subjects. Histologic sections demonstrate large, darkly pigmented melanocytes that are densely distributed in the macaque choroid, while melanocytes in humans are smaller, less pigmented, and variably distributed. Optical coherence tomography reflectivity patterns of the choroid appear to correspond to the density, size, and pigmentation of choroidal melanocytes. Mean choriocapillary thickness was similar between the two species (19.3 ± 3.4 vs. 19.8 ± 3.4 μm, P = 0.615), but choroidal thickness may be lower in macaques than in humans (191.2 ± 43.0 vs. 266.8 ± 78.0 μm, P morphology on EDI-OCT in rhesus macaque and human eyes. Racial differences in pigmentation may affect choriocapillaris and CSJ visibility, and may influence the accuracy of choroidal thickness measurements. PMID:27792810

  9. Contractility studies on isolated bovine choroidal small arteries: determination of the active and passive wall tension-internal circumference relation.

    Science.gov (United States)

    Delaey, C; Boussery, K; Van de Voorde, J

    2002-09-01

    Studies on isolated choroidal arteries could help to understand the regulatory mechanisms in the choroidal circulation. The aim of the present study was therefore to assess whether contractility studies on isolated choroidal arteries were feasible and to determine the active and passive wall tension-internal circumference relation of these arteries. This relation is essential for reliable further pharmacodynamic studies on these vessels. Isolated choroidal arteries were mounted on a wire myograph for isometric tension recording. After the vessel was mounted, the L(100) (the circumference of the vessel at a transmural pressure of 100 mmHg) was determined. Then the passive and active wall tension-internal circumference relation of the choroidal vessels was obtained by stepwise increasing the internal circumference. The changes in the internal circumference were expressed as a percentage of L(100). After each increase in circumference, the passive tone (in a calcium free medium), the spontaneous tone (in a Krebs--Ringer bicarbonate solution) and the active tone (in a solution containing K(+) 120 mM and prostaglandin F(2 alpha) 30 microM) was measured. The passive tone of the vessel increased exponentially with the circumference of the vessel. Both the spontaneous tone and the active tone also increased when the vessel was stretched. They peaked when the internal circumference approached 90% of the L(100) and diminished again when the circumference was further increased. The peak value of the active tension curve averaged 2.24+/-0.47 Nm(-1) (n=10). The passive tension was 0.57+/-0.08 Nm(-1) (n=10) at this circumference. The peak value of the spontaneous tension curve averaged 0.37+/-0.08 Nm(-1) (n=10). It can be concluded that in vitro contractility studies on isolated choroidal arteries are feasible. The optimal length or preload of the choroidal arteries is attained when the internal circumference of the artery is set to 90% of the L(100).

  10. Melanopsin Phototransduction Contributes to Light-Evoked Choroidal Expansion and Rod L-Type Calcium Channel Function In Vivo

    Science.gov (United States)

    Berkowitz, Bruce A.; Schmidt, Tiffany; Podolsky, Robert H.; Roberts, Robin

    2016-01-01

    Purpose In humans, rodents, and pigeons, the dark → light transition signals nonretinal brain tissue to increase choroidal thickness, a major control element of choroidal blood flow, and thus of photoreceptor and retinal pigment epithelium function. However, it is unclear which photopigments in the retina relay the light signal to the brain. Here, we test the hypothesis that melanopsin (Opn4)-regulated phototransduction modulates light-evoked choroidal thickness expansion in mice. Methods Two-month-old C57Bl/6 wild-type (B6), 4- to 5-month-old C57Bl/6/129S6 wild-type (B6 + S6), and 2-month-old melanopsin knockout (Opn4−/−) on a B6 + S6 background were studied. Retinal anatomy was evaluated in vivo by optical coherence tomography and MRI. Choroidal thickness in dark and light were measured by diffusion-weighted MRI. Rod cell L-type calcium channel (LTCC) function in dark and light (manganese-enhanced MRI [MEMRI]) was also measured. Results Opn4−/− mice did not show the light-evoked expansion of choroidal thickness observed in B6 and B6 + S6 controls. Additionally, Opn4−/− mice had lower than normal rod cell and inner retinal LTCC function in the dark but not in the light. These deficits were not due to structural abnormalities because retinal laminar architecture and thickness, and choroidal thickness in the Opn4−/− mice were similar to controls. Conclusions First time evidence is provided that melanopsin phototransduction contributes to dark → light control of murine choroidal thickness. The data also highlight a contribution in vivo of melanopsin phototransduction to rod cell and inner retinal depolarization in the dark. PMID:27727394

  11. A pilot study of morphometric analysis of choroidal vasculature in vivo, using en face optical coherence tomography.

    Directory of Open Access Journals (Sweden)

    Mahsa Sohrab

    Full Text Available PURPOSE: To study the ability of volumetric spectral domain optical coherence tomography (SD-OCT to perform quantitative measurement of the choroidal vasculature in vivo. METHODS: Choroidal vascular density and vessel size were quantified using en face choroidal scans from various depths below the retinal pigment epithelium (RPE in 58 eyes of 58 patients with either epiretinal membranes (ERM, early age-related macular degeneration (AMD, or reticular pseudo-drusen (RPD. For each patient, we used the macular volume scan (6×6 mm cube for vessel quantification, while high-definition (HD cross-section raster scans were used to qualitatively assess vascularity of the choroidal sub-layers, and measure choroidal thickness. RESULTS: Of the 58 patients, more were female (66% versus 34% male, of whom 14 (24% had ERM, 11 (19% early AMD, and 33 (57% RPD. Compared to intact choriocapillaris in all ERM (100%, none of the RPD and only 5/11 (45% early AMD eyes had visible choriocapillaris on either cross section or C-scans (p-value<0.001. When comparing select regions from the most superficial C-scans, early AMD group had lowest vascular density and RPD had highest (p-value 0.04. Qualitative evaluation of C-scans from all three groups revealed a more granular appearance of the choriocapillaris in ERM versus increased stroma and larger vessels in the RPD eyes. CONCLUSIONS: SD-OCT can be used to qualitatively and quantitatively assess choroidal vascularity in vivo. Our findings correlate to previously reported histopathologic studies. Lack of choriocapillaris on HD cross-sections or C-scans in all RPD and about half of early AMD eyes suggests earlier choroidal involvement in AMD and specifically, RPD.

  12. Posterior capsule opacification and neovascularization treated with intravitreal bevacizumab and Nd:YAG capsulotomy

    Science.gov (United States)

    Sánchez-Castro, Grimelda Yuriana; Hitos-Fájer, Alejandra; Mendoza-Schuster, Erick; Velez-Montoya, Raul; Velasco-Barona, Cecilio Francisco

    2008-01-01

    We reported a 75-year-old diabetic man, who developed opacification and neovascularization of the posterior capsule after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient was treated with two injections of 2.5 mg of intravitreal bevacizumab. The treatment produced an important regression of the posterior capsular new vessels, allowing us to perform a successful Nd:YAG capsulotomy, clearing the visual axis and improving the visualization of the posterior pole. Even though, best corrected visual acuity was 20/200 due to diabetic macular edema. PMID:19668770

  13. Decellularized matrix from tumorigenic human mesenchymal stem cells promotes neovascularization with galectin-1 dependent endothelial interaction

    DEFF Research Database (Denmark)

    Burns, Jorge S; Kristiansen, Malthe; Kristensen, Lars P

    2011-01-01

    . Histological analysis showed that cells of the most vascularized tumorigenic clone, -BD11 had a pericyte-like alpha smooth muscle actin (ASMA+) and CD146+ positive phenotype. Upon serum withdrawal in culture, -BD11 cells formed cord-like structures mimicking capillary morphogenesis. In contrast, cells...... of the poorly tumorigenic clone, -BC8 did not stain for ASMA, tumours were less vascularized and serum withdrawal in culture led to cell death. By exploring the heterogeneity in hMSC-TERT20 clones we aimed to understand molecular mechanisms by which mesenchymal stem cells may promote neovascularization....

  14. Role of intravitreal Bevacizumab Injection for Management of Neovascular Age Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Neha K Desai

    2016-06-01

    Full Text Available Background: Age related macular degeneration ( ARMD is the major cause of severe visual loss in older adults. Different treatment modalities are available such as: Laser photocoagulation, photodynamic therapy,transpupillary thermotherapy,submacular surgery and anti-veg. Aims and Objectives: The aim of our study was to evaluate the efficacy and safety of intravitreally administered Bevacizumab a humanized monoclonal anti and ndash;VEGF in Neovascular Age related Macular Degeneration. Methodology: This non randomized, prospective study was carried out on 75 eyes of 75 patients attending the OPD at M and J Institute Of Ophthalmology and diagnosed as having Neovascular ARMD confirmed on FFA and SD-OCT . After taking written informed consent all patients were injected with intravitreal Bevacizumab 1.25 mg/0.05 ml. Follow up visits were scheduled one week, one month post procedure and every monthly thereafter. Results: 75 eyes of 75 patients were included in this non randomized prospective study. and 29.33% patients required 2 injections. Visual acuity is improved more than 3 lines from baseline in 21.33% patient, 64% patient have 2-3 lines gain and 6.66% patients showed 0-1 line gain in snellen's visual acuity. 5.33% patients have a loss of 1 line from baseline and 2.66% patients showed loss of 2-3 lines. Central foveal thickness decreased more than 200 microns from baseline in 52% patients, 28% patients have decreased of 100-200 microns and 20% patients have decreased of less than 100 microns. Discussion: Approximately 10 % of ARMD patients manifest the neovascular form of the disease. 12 weeks. Our study showed that 80% patients had decrease in central foveal thickness more than 100 microns from baseline at the end of one year. 85% patients had gain of 2 or more lines on Snellen's visual acuity chart from baseline.No patient had any serious local or systemic adverse reactions.Limitations of our study is small number of patients,ICG not done

  15. Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Cvetkova NP

    2016-06-01

    Full Text Available Nadezhda P Cvetkova, Kristina Hölldobler, Philipp Prahs, Viola Radeck, Horst Helbig, David Märker Department of Ophthalmology, University of Regensburg, Regensburg, Germany Purpose: Our aim was to evaluate an optical coherence tomography (OCT and visual acuity (VA-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD from 2007 to 2012. Design: This was a retrospective clinical study of 5 years follow-up in a tertiary eye center. Patients and methods: In this study, 66 patients with neovascular AMD (mean age of 74 years, SD 8.7 years were included. We investigated the development of best-corrected visual acuity (BCVA, the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis over 5 years of intravitreal treatment. Results: The mean number of intravitreal ranibizumab injections over 5 years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR. After 5 years of therapy, the mean BCVA was 0.6 logMAR. In all, 16% of treated patients had stable VA over 5 years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295 µm; after 5 years of treatment, the mean central retinal thickness was 315 µm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion: Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8 injections over 5 years. In OCT, an increase in central retinal thickness over 5 years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of

  16. Subfoveal Choroidal Thickness after Panretinal Photocoagulation with Red and Green Laser in Bilateral Proliferative Diabetic Retinopathy Patients: Short Term Results

    Science.gov (United States)

    Roohipoor, Ramak; Dantism, Sina; Karkhaneh, Reza; Zarei, Mohammad; Ghasemi, Fariba

    2016-01-01

    Purpose. To compare subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness after panretinal photocoagulation (PRP) with red and green laser in diabetic patients. Study Design. Randomized clinical trial. Methods. A total of 50 patients with bilateral proliferative diabetic retinopathy and no diabetic macular edema underwent PRP. One eye was randomly assigned to red or green laser. Subfoveal choroidal, central retinal, and RNFL thicknesses were evaluated at baseline and 6 weeks after treatment. Results. The mean subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness increased significantly in each eye 6 weeks after PRP (P values in red laser group: <0.01, 0.03, and <0.01, resp., and in green laser group <0.01, <0.01, and <0.01). There was no difference between red and green laser considering subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness increase after PRP (P values: 0.184, 0.404, and 0.726, resp.). Conclusion. Both red and green lasers increased mean subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness significantly 6 weeks after PRP, but there is no difference between these two modalities in this regard. PMID:27595017

  17. [Dynamics of changes in the thickness of the choroid in patients with stenosis of the internal carotid artery].

    Science.gov (United States)

    Ivashina, A I; Ioffe, D I; Zolotarevskiĭ, A V; Mikhaĭlova, G D; Kuntsevich, G I

    1989-01-01

    Thirty-five patients suffering from atherosclerosis with carotid artery stenosis of varying severity have been examined. The thickness of the choroid has been paramacularly measured by the ultrasonic methods. The studies have revealed a significant decrease of the choroid thickness in both eyes of patients with bilateral hemodynamically significant stenoses of the carotid arteries and with bilateral stenoses on the point of occlusion. Of the 12 patients with hemodynamically insignificant stenoses, the choroid thickness has reduced only in 3. Surgical treatment (vascular restoration operations on the carotid arteries) has resulted in recovery of the choroid thickness in all the patients. This has lead the authors to a conclusion that isolated measurements of the choroid thickness in patients with impaired arterial extracranial blood stream cannot serve the diagnostic ophthalmologic test for the detection of patients with carotid insufficiency, but such measurements carried out by ultrasonic techniques, combined with other functional ophthalmologic methods, give valuable information on the time course of changes in the eyeball blood content.

  18. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer.

    Science.gov (United States)

    Okuma, Yusuke; Tanaka, Yuichiro; Kamei, Tina; Hosomi, Yukio; Okamura, Tatsuru

    2015-01-01

    Choroidal metastasis is rare in cancer patients. Small molecules of molecular targeted agents for lung cancer with actionable mutations were reported to be palliated for symptoms caused by choroidal metastasis. Visual disturbance by choroidal metastasis significantly decreases quality of life during the patient's remaining lifespan; therefore, radiotherapy or laser photocoagulation is proposed with consensus. However, improvement in survival with matched molecular targeted agents for oncogenic driver mutations reminds us to also be concerned with late treatment toxicities. A 30-year-old female patient previously treated with crizotinib harboring ALK rearranged non-small cell lung cancer complained of visual disturbance, fever, and bone pains undergoing anti-PD-1 antibody treatment. A decreased proportion of ALK fusion was demonstrated by fluorescence in situ hybridization in liver metastasis compared to the primary site in a chemo-naïve state. She was diagnosed with low vision, choroidal metastasis and retinal detachment. Therefore, she started alectinib treatment and both her ocular and systemic symptoms were palliated in a week. Later, she temporarily discontinued alectinib because of skin rash although the choroidal metastasis and retinal detachment resolved and she regained low vision completely at 2 weeks. She obtained partial response with alectinib for more than 5 months after recovering from skin rash.

  19. Progress of anti-vascular endothelial growth factor therapy for ocular neovascular disease: benefits and challenges

    Institute of Scientific and Technical Information of China (English)

    Xu Jianjiang; Li Yimin; Hong Jiaxu

    2014-01-01

    Objective This review aims to summarize the progress of current clinical studies in ocular angiogenesis treated with antivascular endothelial growth factor (VEGF) therapy and to discuss the benefits and challenges of the treatment.Data sources Pubmed,Embase and the Cochrane Library were searched with no limitations of language and year of publication.Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed.Results Anti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization,though some of them are still used as off-label drugs.Intravitreal injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications,and intimate monitoring in both adult and pediatric population are warranted.Future directions should be focused on carrying out more well-designed large-scale controlled trials,promoting sustained duration of action,developing safer and more efficient generation of anti-VEGF agents.Conclusions Anti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases.However,more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.

  20. Quantitative proteomic analysis of mice corneal tissues reveals angiogenesis-related proteins involved in corneal neovascularization.

    Science.gov (United States)

    Shen, Minqian; Tao, Yimin; Feng, Yifan; Liu, Xing; Yuan, Fei; Zhou, Hu

    2016-07-01

    Corneal neovascularization (CNV) was induced in Balb/c mice by alkali burns in the central area of the cornea with a diameter of 2.5mm. After fourteen days, the cornea from one eye was collected for histological staining for CNV examination, while the cornea from the other eye of the same mouse was harvested for proteomic analysis. The label-free quantitative proteomic approach was applied to analyze five normal corneal tissues (normal group mice n=5) and five corresponding neovascularized corneal tissues (model group mice n=5). A total of 2124 proteins were identified, and 1682 proteins were quantified from these corneal tissues. Among these quantified proteins, 290 proteins were significantly changed between normal and alkali burned corneal tissues. Of these significantly changed proteins, 35 were reported or predicted as angiogenesis-related proteins. Then, these 35 proteins were analyzed using Ingenuity Pathway Analysis Software, resulting in 26 proteins enriched and connected to each other in the protein-protein interaction network, such as Lcn-2, αB-crystallin and Serpinf1 (PEDF). These three significantly changed proteins were selected for further Western blotting validation. Consistent with the quantitative proteomic results, Western blotting showed that Lcn-2 and αB-crystallin were significantly up-regulated in CNV model, while PEDF was down-regulated. This study provided increased understanding of angiogenesis-related proteins involved in corneal vascular development, which will be useful in the ophthalmic clinic of specifically target angiogenesis.

  1. Possibility of enhanced risk of retinal neovascularization in repeated blood donors: blood donation and retinal alteration

    Directory of Open Access Journals (Sweden)

    Rastmanesh R

    2011-09-01

    Full Text Available Reza RastmaneshDepartment of Clinical Nutrition and Dietetics, Shahid Beheshti University of Medical Sciences, National Nutrition and Food Technology Research Institute, Tehran, IranAbstract: Repeated blood donors manifest clinical, subclinical, and biochemical signs of iron deficiency anemia, have significantly higher erythropoietin and vascular endothelial growth factor (VEGF concentrations, and decreased tissue oxygen saturation, oxygenated tissue hemoglobin, and regional cerebral oxygen saturation. Erythropoietin and VEGF are potent retinal angiogenic factors which may initiate and promote the retinal angiogenesis process independently or simultaneously. Increases in circulating levels of erythropoietin and VEGF are proportionate to the levels of hematocrit, hypoxemia, and tissue hypoxia. It is suggested that higher erythropoietin production following iron deficiency anemia-induced chronic hypoxemia/hypoxia may, hypothetically, enhance the risk of retinal angiogenesis and/or neovascularization, possibly by inducing hypoxia inducible factor-1 alpha, which consequently upregulates genes stimulating angiogenesis, resulting in formation of a new vasculature, possibly by modulation of signal transducer and activator of transcription 3 signaling in the retina. Implications of this hypothesis cover erythropoietin doping, chronic hypoxia, and hypoxemic situations, such as angiogenesis-related cardiac and pulmonary diseases.Keywords: repeated blood donation, erythropoietin, retinal neovascularization, vascular endothelial growth factor, hypoxia

  2. Posterior capsule opacification and neovascularization treated with intravitreal bevacizumab and Nd:YAG capsulotomy

    Directory of Open Access Journals (Sweden)

    Grimelda Yuriana Sánchez-Castro

    2008-10-01

    Full Text Available Grimelda Yuriana Sánchez-Castro1, Alejandra Hitos-Fájer1, Erick Mendoza-Schuster1, Raul Velez-Montoya2, Cecilio Francisco Velasco-Barona11Asociación para Evitar la Ceguera en México. Hospital “Dr. Luis Sánchez Bulnes”, México, D.F. Ophthalmology Department – Anterior Segment; 2Asociación para Evitar la Ceguera en México. Hospital “Dr. Luis Sánchez Bulnes”, México, D.F. Ophthalmology Department – Retina departmentAbstract: We reported a 75-year-old diabetic man, who developed opacification and neovascularization of the posterior capsule after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient was treated with two injections of 2.5 mg of intravitreal bevacizumab. The treatment produced an important regression of the posterior capsular new vessels, allowing us to perform a successful Nd:YAG capsulotomy, clearing the visual axis and improving the visualization of the posterior pole. Even though, best corrected visual acuity was 20/200 due to diabetic macular edema.Keywords: posterior capsule opacification, posterior capsule neovascularization, cataract surgery, postoperative complications, intravitreal bevacizumab

  3. Neocellularization and neovascularization of nanosized bioactive glass-coated decellularized trabecular bone scaffolds

    KAUST Repository

    Gerhardt, Lutz Christian

    2012-09-11

    In this study, the in vivo recellularization and neovascularization of nanosized bioactive glass (n-BG)-coated decellu-larized trabecular bone scaffolds were studied in a rat model and quantified using stereological analyses. Based on the highest amount of vascular endothelial growth factor (VEGF) secreted by human fibroblasts grown on n-BG coatings (0-1.245 mg/cm 2), decellularized trabecular bone samples (porosity: 43-81%) were coated with n-BG particles. Grown on n-BG particles at a coating density of 0.263 mg/cm2, human fibroblasts produced 4.3 times more VEGF than on uncoated controls. After 8 weeks of implantation in Sprague-Dawley rats, both uncoated and n-BG-coated samples were well infiltrated with newly formed tissue (47-48%) and blood vessels (3-4%). No significant differences were found in cellularization and vascularization between uncoated bone scaffolds and n-BG-coated scaffolds. This finding indicates that the decellularized bone itself may exhibit growth-promoting properties induced by the highly interconnected pore microarchitecture and/or proteins left behind on decellularized scaffolds. Even if we did not find proangiogenic effects in n-BG-coated bone scaffolds, a bioactive coating is considered to be beneficial to impart osteoinductive and osteoconductive properties to decellularized bone. n-BG-coated bone grafts have thus high clinical potential for the regeneration of complex tissue defects given their ability for recellularization and neovascularization. © 2012 Wiley Periodicals, Inc.

  4. Gemcitabine-induced CXCL8 expression counteracts its actions by inducing tumor neovascularization

    Energy Technology Data Exchange (ETDEWEB)

    Song, Yao; Baba, Tomohisa [Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-1192 (Japan); Li, Ying-Yi [Cancer Research Institute, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai (China); Furukawa, Kaoru; Tanabe, Yamato [Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-1192 (Japan); School of Natural System Bioengineering Course, College of Science and Engineering, Kanazawa University, Kanazawa, Ishikawa (Japan); Matsugo, Seiichi [School of Natural System Bioengineering Course, College of Science and Engineering, Kanazawa University, Kanazawa, Ishikawa (Japan); Sasaki, Soichiro [Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-1192 (Japan); Mukaida, Naofumi, E-mail: mukaida@staff.kanazawa-u.ac.jp [Division of Molecular Bioregulation, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-1192 (Japan)

    2015-03-06

    Patients with pancreatic ductal adenocarcinoma (PDAC) are frequently complicated with metastatic disease or locally advanced tumors, and consequently need chemotherapy. Gemcitabine is commonly used for PDAC treatment, but with limited efficacy. The capacity of gemcitabine to generate reactive oxygen species (ROS) in human pancreatic cancer cells, prompted us to examine its effects on the expression of pro-inflammatory cytokines and chemokines. We observed that gemcitabine enhanced selectively the expression of CXCL8 in human pancreatic cancer cells through ROS generation and NF-κB activation. In vitro blocking of CXCL8 failed to modulate gemcitabine-mediated inhibition of cell proliferation in human pancreatic cancer cells. Gemcitabine also enhanced CXCL8 expression in pancreatic cancer cells in xenografted tumor tissues. Moreover, anti-CXCL8 antibody treatment in vivo attenuated tumor formation as well as intra-tumoral vascularity in nude mice, which were transplanted with Miapaca-2 cells and treated with gemcitabine. Thus, gemcitabine-induced CXCL8 may counteract the drug through inducing neovascularization. - Highlights: • Gemcitabine induced CXCL8 expression in human pancreatic cancer cells. • CXCL8 expression required ROS generation and NF-κB activation. • CXCL8 did not affect in vitro proliferation of human pancreatic cancer cells. • CXCL8 in vivo counteracted gemcitabine by inducing neovascularization.

  5. Pathological alteration in the choroid plexus of Alzheimer´s disease: implication for new therapy approaches

    Directory of Open Access Journals (Sweden)

    Agnieszka eKrzyzanowska

    2012-05-01

    Full Text Available Morphological alterations of choroid plexus in Alzheimer´s disease (AD have been extensively investigated. These changes include epithelial atrophy, thickening of the basement membrane and stroma fibrosis. As a result, synthesis, secretory, and transportation functions are significantly altered resulting in decreased cerebrospinal fluid (CSF turnover. Recent studies discuss the potential impacts of these changes, including the possibility of reduced resistance to stress insults and slow clearance of toxic compounds from CSF with specific reference to the amyloid peptide. Here, we review new evidences for AD-related changes in the choroid plexus. The data suggest that the significantly altered functions of the choroid plexus contribute to the multiparametric pathogenesis of late-onset AD.

  6. Increased Expression of CD200 on Circulating CD11b+ Monocytes in Patients with Neovascular Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Singh, Amardeep; Falk, Mads K; Hviid, Thomas V F

    2013-01-01

    was found to be increased in patients with neovascular AMD compared with controls with healthy eyes. This novel finding supports the notion that altered regulation of the inflammatory response plays an integral role in the pathogenesis of AMD. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary...... or commercial interest in any materials discussed in this article....

  7. The SECURE study: long-term safety of ranibizumab 0.5 mg in neovascular age-related macular degeneration

    NARCIS (Netherlands)

    Silva, R. de; Axer-Siegel, R.; Eldem, B.; Guymer, R.; Kirchhof, B.; Papp, A.; Seres, A.; Gekkieva, M.; Nieweg, A.; Pilz, S.; Hoyng, C.B.

    2013-01-01

    OBJECTIVE: To evaluate long-term safety of intravitreal ranibizumab 0.5-mg injections in neovascular age-related macular degeneration (nAMD). DESIGN: Twenty-four-month, open-label, multicenter, phase IV extension study. PARTICIPANTS: Two hundred thirty-four patients previously treated with ranibizum

  8. Year 2 efficacy results of 2 randomized controlled clinical trials of pegaptanib for neovascular age-related macular degeneration.

    NARCIS (Netherlands)

    Chakravarthy, U.; Adamis, A.P.; Cunningham Jr, E.T.; Goldbaum, M.; Guyer, D.R.; Katz, B.; Patel, M.

    2006-01-01

    OBJECTIVE: To evaluate the efficacy of a second year of pegaptanib sodium therapy in patients with neovascular age-related macular degeneration (AMD). DESIGN: Two concurrent, multicenter, randomized, double-masked, sham-controlled studies (V.I.S.I.O.N. [Vascular Endothelial Growth Factor Inhibition

  9. Influx mechanisms in the embryonic and adult rat choroid plexus: a transcriptome study

    Directory of Open Access Journals (Sweden)

    Norman Ruthven Saunders

    2015-04-01

    Full Text Available The transcriptome of embryonic and adult rat lateral ventricular choroid plexus, using a combination of RNA-Sequencing and microarray data, was analysed by functional groups of influx transporters, particularly solute carrier (SLC transporters. RNA-Seq was performed at embryonic day (E 15 and adult with additional data obtained at intermediate ages from microarray analysis. The largest represented functional group in the embryo was amino acid transporters (twelve with expression levels 2-98 times greater than in the adult. In contrast, in the adult only six amino acid transporters were up-regulated compared to the embryo and at more modest enrichment levels (<5-fold enrichment above E15. In E15 plexus five glucose transporters, in particular Glut-1, and only one monocarboxylate transporter were enriched compared to the adult, whereas only two glucose transporters but six monocarboxylate transporters in the adult plexus were expressed at higher levels than in embryos. These results are compared with earlier published physiological studies of amino acid and monocarboxylate transport in developing rodents. This comparison shows correlation of high expression of some transporters in the developing brain with higher amino acid transport activity reported previously. Data for divalent metal transporters are also considered. Immunohistochemistry of several transporters (e.g. Slc16a10, a thyroid hormone transporter gene products was carried out to confirm translational activity and to define cellular distribution of the proteins. Overall the results show that there is substantial expression of numerous influx transporters in the embryonic choroid plexus, many at higher levels than in the adult. This, together with immunohistochemical evidence and data from published physiological transport studies suggests that the choroid plexus in embryonic brain plays a major role in supplying the developing brain with essential nutrients.

  10. Standardization of choroidal thickness measurements using enhanced depth imaging optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    Nattapon; Boonarpha; Yalin; Zheng; Alexandros; N.Stangos; Huiqi; Lu; Ankur; Raj; Gabriela; Czanner; Simon; P.Harding; Jayashree; Nair-Sahni

    2015-01-01

    AIM: To describe and evaluate a standardized protocol for measuring the choroidal thickness(Ch T) using enhanced depth imaging optical coherence tomography(EDI OCT).METHODS: Single 9 mm EDI OCT line scans across the fovea were used for this study. The protocol used in this study classified the EDI OCT images into four groups based on the appearance of the choroidal-scleral interface and suprachoroidal space. Two evaluation iterations of experiments were performed: first, the protocol was validated in a pilot study of 12 healthy eyes. Afterwards, the applicability of the protocol was tested in 82 eyes of patients with diabetes. Inter-observer and intra-observer agreements on image classifications were performed using Cohen’s kappa coefficient(κ). Intraclass correlation coefficient(ICC) and Bland-Altman’s methodology were used for the measurement of the Ch T.RESULTS: There was a moderate(κ=0.42) and perfect(κ =1) inter- and intra-observer agreements on image classifications from healthy eyes images and substantial(κ =0.66) and almost perfect(κ =0.86) agreements from diabetic eyes images. The proposed protocol showed excellent inter- and intra-observer agreements for the Ch T measurements on both, healthy eyes and diabetic eyes(ICC >0.90 in all image categories). The Bland-Altman plot showed a relatively large Ch T measurement agreement in the scans that contained less visible choroidal outer boundary. CONCLUSION: A protocol to standardize Ch T measurements in EDI OCT images has been developed;the results obtained using this protocol show that the technique is accurate and reliable for routine clinical practice and research.

  11. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Okuma Y

    2015-06-01

    Full Text Available Yusuke Okuma,1,2 Yuichiro Tanaka,3 Tina Kamei,1 Yukio Hosomi,1 Tatsuru Okamura1 1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 2Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan Abstract: Choroidal metastasis is rare in cancer patients. Small molecules of molecular targeted agents for lung cancer with actionable mutations were reported to be palliated for symptoms caused by choroidal metastasis. Visual disturbance by choroidal metastasis significantly decreases quality of life during the patient’s remaining lifespan; therefore, radiotherapy or laser photocoagulation is proposed with consensus. However, improvement in survival with matched molecular targeted agents for oncogenic driver mutations reminds us to also be concerned with late treatment toxicities. A 30-year-old female patient previously treated with crizotinib harboring ALK rearranged non-small cell lung cancer complained of visual disturbance, fever, and bone pains undergoing anti-PD-1 antibody treatment. A decreased proportion of ALK fusion was demonstrated by fluorescence in situ hybridization in liver metastasis compared to the primary site in a chemo-naïve state. She was diagnosed with low vision, choroidal metastasis and retinal detachment. Therefore, she started alectinib treatment and both her ocular and systemic symptoms were palliated in a week. Later, she temporarily discontinued alectinib because of skin rash although the choroidal metastasis and retinal detachment resolved and she regained low vision completely at 2 weeks. She obtained partial response with alectinib for more than 5 months after recovering from skin rash. Keywords: lung cancer, ALK rearrangement, alectinib, choroidal metastasis, molecular targeted

  12. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  13. Cellular Specificity of the Blood-CSF Barrier for Albumin Transfer across the Choroid Plexus Epithelium

    DEFF Research Database (Denmark)

    Liddelow, Shane A; Dzięgielewska, Katarzyna M; Møllgård, Kjeld

    2014-01-01

    in albumin transport into developing brain, however the exact mechanism remains unknown. We postulate that SPARC is a docking site for albumin, mediating its uptake and transfer by choroid plexus epithelial cells from blood into cerebrospinal fluid (CSF). We used in vivo physiological measurements...... the mouse blood-CSF barrier to the same extent as endogenous mouse albumin, confirming results from in situ PLA. During postnatal development Sparc gene expression was higher in early postnatal ages than in the adult and changed in response to altered levels of albumin in blood plasma in a differential...

  14. Cortical blindness and choroidal metastases secondary to metastatic breast carcinoma in a male patient.

    Science.gov (United States)

    Palejwala, Neal; Yeh, Steven; Grossniklaus, Hans E; Bergstrom, Chris

    2013-01-01

    Male breast carcinoma is a rare entity that often goes undiagnosed until advanced stages. The authors describe the case of a patient with profound vision loss who was found to have bilateral choroidal metastases as well as advanced cerebral metastatic disease. Further medical work-up revealed widespread infiltrative ductal breast carcinoma. Given the presence of large occipital lobe lesions, the etiology of the patient's vision loss was thought to be cortical blindness. Prompt diagnosis and neurologic evaluation with this presentation is crucial because it can be associated with significant morbidity and mortality.

  15. NADPH oxidase-derived overproduction of reactive oxygen species impairs postischemic neovascularization in mice with type 1 diabetes.

    Science.gov (United States)

    Ebrahimian, Téni G; Heymes, Christophe; You, Dong; Blanc-Brude, Olivier; Mees, Barend; Waeckel, Ludovic; Duriez, Micheline; Vilar, José; Brandes, Ralph P; Levy, Bernard I; Shah, Ajay M; Silvestre, Jean-Sébastien

    2006-08-01

    We hypothesized that diabetes-induced oxidative stress may affect postischemic neovascularization. The response to unilateral femoral artery ligation was studied in wild-type or gp91(phox)-deficient control or type 1 diabetic mice or in animals treated with the anti-oxidant N-acetyl-l-cysteine (NAC) or with in vivo electrotransfer of a plasmid encoding dominant-negative Rac1 (50 microg) for 21 days. Postischemic neovascularization was reduced in diabetic mice in association with down-regulated vascular endothelial growth factor-A protein levels. In diabetic animals vascular endothelial growth factor levels and postischemic neovascularization were restored to nondiabetic levels by the scaven