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Sample records for desprendimiento seroso macular

  1. Desprendimiento seroso macular asociado a foseta papilar congénita y coloboma de papila: ¿Qué opciones terapéuticas tenemos?

    Directory of Open Access Journals (Sweden)

    Caridad Chiang Rodríguez

    Full Text Available La foseta papilar es una rara anomalía congénita que forma parte del espectro de las anormalidades congénitas del disco óptico. Se trata de invaginaciones intrapapilares que suelen localizarse en el margen del disco óptico. La mayoría se localiza a nivel temporal; en torno al 20 % son de localización central seguidas por las fosetas superiores, inferiores o nasales. La bilateralidad se estima en un 10-15 % y su incidencia se ha establecido en torno al 0,19 %. Suelen ser asintomáticas, aunque en aproximadamente el 50 % de los casos se produce afectación macular por el paso de fluido procedente desde la foseta papilar hacia las diferentes capas retinianas, lo que afecta secundariamente la agudeza visual y es, por tanto, el motivo de consulta. Hasta el momento se han descrito múltiples alternativas terapéuticas para el tratamiento de los desprendimientos de retina serosos asociados a foseta de papila, pero ninguna de estas alternativas se ha impuesto sobre el resto. El tratamiento de esta enfermedad consiste en cerrar la comunicación entre la foseta y el espacio subretiniano con diversas opciones terapéuticas como: la fotocoagulación láser, la neumoretinopexia, la indentación escleral posterior, la fenestración del nervio óptico, la vitrectomía o alguna combinación de las anteriores. La actual revisión bibliográfica se propone profundizar en el tema, sobre la base de pacientes en consulta con dicha afección retiniana.

  2. Cistoadenoma seroso benigno de ovario

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    Héctor Martín Aguirre

    2014-11-01

    Full Text Available Los quistes de ovario constituyen una serie de procesos de este órgano con un crecimiento exagerado y representan un desafío diagnóstico y terapéutico. Se presenta un caso de cistoadenoma seroso benigno de gran tamaño, en una paciente en la séptima década de su vida, con evolución prolongada, desde hace diez años, acompañado de nauseas, vómitos y dolor abdominal. Al examen físico se palpa una tumoración que ocupa casi todo el abdomen, de consistencia firme, poco movible y ultrasonograficamente se demuestra una imagen quística gigante y multitabicada. Se practica laparotomía exploratoria, en la cual se encuentra un quiste gigante de ovario derecho, que ocupa todo el abdomen con pedículo no torcido, dimensiones de 53x33x21cm y un peso de 24,04Kg, por lo que se realizó histerectomía total abdominal con doble anexectomía. La facies ovárica, los trastornos menstruales, la leucorrea, las molestias urinarias y rectales no estuvieron presentes en esta paciente. Después de la intervención evolucionó satisfactoriamente, sin presentar complicaciones y actualmente se encuentra asintomática

  3. Desprendimiento de retina

    Directory of Open Access Journals (Sweden)

    L. Jaime Claramunt, Dr.

    2010-11-01

    Full Text Available El desprendimiento de retina (DR consiste en la separación entre la retina neurosensorial y el epitelio pigmentario subyacente. Su forma más frecuente es el DR regmatógeno, causado por una rotura en la retina. Se manifiesta generalmente como un defecto en el campo visual o mala visión. Si se pesquisa y trata oportunamente tiene buenas posibilidades de éxito. No obstante, sigue siendo una causa importante de mala visión y ceguera, por lo que su prevención tiene un rol fundamental.

  4. Resultados funcionales y anatómicos de la cirugía del desprendimiento de retina recurrente por vitreorretinopatía proliferativa

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    Ailen Garcés Fernández

    Full Text Available Objetivos: evaluar los resultados funcionales y anatómicos de la cirugía de desprendimiento de retina recurrente por vitreorretinopatía proliferativa. Métodos: estudio observacional descriptivo retrospectivo en una serie de casos de 17 ojos diagnosticados de desprendimiento de retina recurrente por vitreorretinopatía proliferativa, que fueron intervenidos en el período comprendido entre enero 2010 y diciembre 2011. Los pacientes fueron seguidos hasta un mínimo de tres meses posteriores a la última intervención. Los resultados funcionales se evaluaron con la agudeza visual mejor corregida y los anatómicos a través del grado de readaptación retiniana y macular. Resultados: fueron realizadas un total de 25 reintervenciones, rango 13. Se realizaron retinotomía/retinectomía en el 52 % de las cirugías, la mayoría con una extensión menor de 180º (84,6 %. El taponador que con mayor frecuencia se utilizó fue el aceite de silicona (23,92 %. La media de la agudeza visual mejor corregida posoperatoria fue de 1,28 logMAR, que mejoró en el 58,8 % de los ojos y fue inferior a 1,5 logMAR en el 90 % de ellos. El éxito de readaptación retiniana fue del 82,3 % (14 ojos. La readaptación macular se consiguió en el 100 % de los ojos. Conclusiones: el tratamiento quirúrgico del desprendimiento de retina recurrente por proliferación vítreorretinal requiere la realización de diferentes opciones quirúrgicas para que resulte en reaplicación retiniana final y mejoría de la visión en los casos de alta complejidad.

  5. Estudo do reparo do ferimento de colon com o lado seroso da parede de jejuno, utilizando cianoacrilato e cola de fibrina

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    Carlos Edmundo Rodrigues Fontes

    Full Text Available OBJETIVO: Comparar o efeito do cianoacrilato e da cola de fibrina como adesivo das bordas do ferimento de cólon reparado com o lado seroso da parede de jejuno. MÉTODO: Foram utilizados 45 ratos wistar adultos jovens, machos , com peso médio de 260 gramas procedentes do Biotério Central da Universidade Estadual de Maringá.Os animais foram submetidos a procedimento operatório sob sedação com thiopental para produção de ferimento pradonizado de 0,5 cm distante caudalmente a 2 cm do ceco que foi reparado no grupo I pelo lado seroso da parede de jejuno e sutura, no grupo II, pelo lado seroso da parede de jejuno e cola de fibrina, e o grupo III pelo lado seroso da parede de jejuno e cianoacrilato. No 4º dia de pós-operatório os animais foram submetidos a um enema opaco, para estudo o de estenose. No 7º dia de pós-operatório os animais foram submetidos a laparotomia sob sedação para estudo macroscópico da cavidade , e coleta dos segmentos que foram processados para análise microscópica. RESULTADOS: A cola de fibrina teve uma tendência de ser melhor reparadora, estimulando a proliferação de fibras de colágeno a partir da borda da ferida. CONCLUSÃO: O experimento demonstrou que o ferimento em cólon de rato pode ser reparado pelo lado seroso da parede de jejuno colado às bordas da ferida por cola de fibrina ou cianoacrilato.

  6. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular Edema Sections What Is Macular Edema? What Causes Macular Edema? Macular Edema Symptoms Macular Edema Diagnosis ... particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would ...

  7. Desprendimiento de retina exudativo como primera manifestación de una preeclampsia grave

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    Antonio Ramos Suárez

    Full Text Available El desprendimiento de retina exudativo es una causa poco común de pérdida visual en la preeclampsia. Su patogenia no es del todo conocida, aunque la isquemia coroidea pudiera jugar un papel fundamental. Existen pocos casos reportados en la literatura y la mayoría hace referencia a casos aislados o series cortas de casos. Presentamos el caso de una primigesta de 34 años en el tercer trimestre de embarazo con un desprendimiento de retina exudativo bilateral. La sintomatología visual fue la primera manifestación de una preeclampsia que terminó en cesárea de urgencia. La clínica oftalmológica se resolvió de forma espontánea a las dos semanas de la cesárea.

  8. Pigmentos maculares Macular pigments

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    Renata Canovas

    2009-12-01

    Full Text Available A luteína e a zeaxantina são pigmentos amarelos que se localizam na mácula. Devido à sua localização, diminuem e filtram a quantidade de luz principalmente azul que chega aos fotorreceptores, atuam como antioxidantes e podem melhorar a qualidade visual. Esta é uma revisão do seu mecanismo de incorporação, ação, possíveis aplicações e conhecimento científico a respeito.Lutein and Zeaxanthin are yellow pigments located at the macula. Because of your location macular pigments decrease and filter the amount of blue light that reach photoreceptors, protect the outer retina from oxidative stress and may improve the vision quality. This is a review regarding incorporation mechanism, function and knowledge update.

  9. Macular degeneration (image)

    Science.gov (United States)

    Macular degeneration is a disease of the retina that affects the macula in the back of the eye. ... see fine details. There are two types of macular degeneration, dry and wet. Dry macular degeneration is more ...

  10. American Macular Degeneration Foundation

    Science.gov (United States)

    ... Policy Disclaimer Contact Us Donate Store The American Macular Degeneration Foundation The American Macular Degeneration Foundation (AMDF) is ... Ed Asner Video Clip An Inspiring Her-story Macular Degeneration is the leading cause of vision loss, affecting ...

  11. Evaluación y conducta recomendada en presencia de precursores vítreorretinianos del desprendimiento de retina

    Directory of Open Access Journals (Sweden)

    Ceija Molina Cisneros

    Full Text Available Los cambios y las variaciones anatómicas vítreorretinianas predisponen al desprendimiento de retina regmatógeno, por lo que su conocimiento es de vital importancia para el tratamiento adecuado de los pacientes. Por ello se decidió realizar una revisión acerca de los elementos más importantes al respecto, con el objetivo de actualizar los conocimientos existentes sobre el tema. Estos precursores comprenden tres entidades que, por su fisiopatología, pueden estar presentes en la historia natural de esta afección: Desprendimiento de vítreo posterior, degeneraciones periféricas y desgarro de retina (sintomáticos y asintomáticos. Además, algunas situaciones de riesgo como la cirugía de catarata, la capsulotomía posterior con YAG-láser, los traumatismos y la miopía alta pueden favorecer también al desprendimiento de retina. Estos precursores, por lo general, se hacen más evidentes después de los 40 años, sin predilección por sexo o características raciales y están muy relacionadas con cambios vítreos o su licuefacción. El conocimiento básico y actualizado de estas entidades, así como de los factores de riesgo asociados al desprendimiento de retina es importante para el adecuado manejo y el control de las complicaciones. En la revisión se describen con claridad los pilares fundamentales para el diagnóstico y tratamiento de este tipo de situaciones clínicas.

  12. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers ...

  13. Técnica de Lindner-Guist: lo impensable en cirugía de desprendimiento de retina

    OpenAIRE

    Hernández Da Mota, Sergio E.

    2015-01-01

    Múltiples han sido las técnicas empleadas para el tratamiento del desprendimiento de la retina a lo largo de la historia sobre todo después de la descrita por Gonin que representa un parteaguas en el tratamiento de esta enfermedad. Una de las más curiosas y cruentas que se han descrito es la de Lindner-Guist, que se realizó en la década de los treinta del siglo pasado. Lo que más llama la atención de esta técnica es que para lograr crear la cicatriz coriorretiniana alrededor de las lesione...

  14. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Edema Symptoms Macular Edema Diagnosis Macular Edema Treatment ... macula is a very small area at the center of the retina—a thin layer of light-sensitive tissue that lines the back of the eye. Light ...

  15. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, ... common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  16. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 Macular edema is ... Follow The Academy Professionals: ... Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  17. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 ...

  18. What Is Macular Edema?

    Medline Plus

    Full Text Available ... remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. Next What Causes Macular ... Compares Eylea, Lucentis and Avastin for Diabetic Macular Edema Jul 17, 2015 Top 5 Risk ...

  19. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué es un edema macular? Dec. 01, 2010 ...

  20. What Is Macular Edema?

    Medline Plus

    Full Text Available ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  1. What Is Macular Edema?

    Science.gov (United States)

    ... diabetes—particularly if it is left untreated. Next What Causes Macular Edema? Related Ask an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  2. [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.

  3. Efecto del desprendimiento de las biopelículas formadas en una red de acueducto sobre la calidad del agua

    Directory of Open Access Journals (Sweden)

    Juan Camilo Rueda Ariza

    2013-12-01

    Full Text Available El objetivo de esta investigación fue determinar el efecto del desprendimiento de las biopelículas formadas en una red de distribución de agua potable sobre la calidad del agua que llega a los hogares, ya que esta puede afectar la calidad de vida y la salud de las personas. Se realizaron análisis de pH, turbiedad, concentración de metales y microbiológicos en una red de acueducto para evaluar el efecto de las biopelículas sobre la calidad del agua, encontrando altos niveles de aluminio y de microorganismos esporulados que dificultan su control y representan un potencial problema de salud para la población.

  4. Técnica de Lindner-Guist: lo impensable en cirugía de desprendimiento de retina

    Directory of Open Access Journals (Sweden)

    Sergio E. Hernández Da Mota

    2015-10-01

    Lo que más llama la atención de esta técnica es que para lograr crear la cicatriz coriorretiniana alrededor de las lesiones se empleaban trepanaciones en la esclera, dentro de las cuales se vertía una solución de sosa o potasa cáustica. Por lo cruento y las obvias complicaciones que producía este método entre las que se contaba la consecuente quemadura química del ojo, pronto se abandonó. Representa sin embargo un procedimiento anecdótico en la historia de la cirugía del desprendimiento retiniano.

  5. What Is Macular Edema?

    Medline Plus

    Full Text Available ... an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 Can Prolensa drops help a ...

  6. What Is Macular Edema?

    Medline Plus

    Full Text Available ... an Ophthalmologist Answers Would a macular wrinkle cause black streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, 2016 After a person develops ocular ...

  7. Delayed Macular Hole Closure

    Directory of Open Access Journals (Sweden)

    Peter Distelmaier

    2014-04-01

    Full Text Available Purpose: The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods: We present an interventional case report and a short review of the pertinent literature. Results: We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions: So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible.

  8. What Is Macular Edema?

    Medline Plus

    Full Text Available ... the brain and interpreted as the images you see. It is the macula that is responsible for ... 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan ...

  9. What Is Macular Edema?

    Medline Plus

    Full Text Available ... the most common form of vision loss for people with diabetes—particularly if it is left untreated. ... a macular hole? Jan 11, 2016 After a person develops ocular histoplasmosis, is it common that years ...

  10. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left untreated. Next What ...

  11. What Is Macular Edema?

    Medline Plus

    Full Text Available ... streaks in my vision? Oct 05, 2017 When will I be able to see after vitrectomy surgery for a macular hole? Jan 24, ... Answers Free Newsletter Get ophthalmologist-reviewed tips and information about ...

  12. Desprendimiento de retina y subluxación de cristalino por traumatismo ocular autoinfligido en el síndrome de Cornelia de Lange

    Directory of Open Access Journals (Sweden)

    Norma Aide Castro-Santana

    2014-07-01

    Se presenta el caso de un paciente femenino de 10 años de edad con síndrome de Cornelia de Lange que comienza a los 8 años de edad con actitud retraída, caídas constantes y cese de actividades cotidianas, con antecedente de trauma ocular autoinfligido, en el cual después de la valoración clínica integral se detectan complicaciones oftalmológicas tales como subluxación de cristalino y desprendimiento de retina, por lo que se decide instaura plan quirúrgico y preventivo.

  13. Desprendimiento de la membrana de Descemet como complicación intraquirúrgica de la cirugía de la catarata

    Directory of Open Access Journals (Sweden)

    Andrea Díaz

    2014-10-01

    Discusión: El DMD es una condición infrecuente asociada a una amplia variedad de patologías. La causa más común es un desprendimiento localizado durante la cirugía de la catarata. La intervención mediante la inyección de hexafluoruro de azufre en cámara anterior es una terapia segura y efectiva para la rápida reducción del edema corneal en un ojo con DMD.

  14. Desprendimiento de la membrana de Descemet como complicación intraquirúrgica de la cirugía de la catarata

    OpenAIRE

    Díaz, Andrea; Vicente, M. Pilar; Tarragó, Emilia; Pascual, Javier; Almela, Miguel Angel

    2014-01-01

    Caso clínico: Mujer de 75 años presenta un desprendimiento de la membrana de Descemet (DMD) tipo no planar (> 1 mm) durante la cirugía de la catarata del ojo derecho. Se trató mediante aire en cámara anterior. Debido a que la paciente presentaba edema corneal y una agudeza visual de movimiento de manos se realizó una OCT Visante® y se apreció un DMD planar (

  15. 168 Intervenciones de Desprendimiento de Retina: La Exploración Clínica en la Indicación Quirúrgica y en los Resultados.

    OpenAIRE

    Ortiz García, Ramón

    2017-01-01

    Históricamente, el tratamiento del Desprendimiento de Retina puede ser dividido en dos épocas: la anterior a Gonin y otra después de Gonin. En los años en que Gonin (1925-1928) hablo de una técnica operatoria para la oclusión de los desgarros y agujeros retinianos por la formación de una adhesión coriorretiniana, había poca o ninguna esperanza de tratamiento feliz. Como suele ocurrir en estas circunstacnias, un gran númer...

  16. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with diabetes—particularly if it is left ... Studies Show Zika Virus May Cause More Serious Eye ...

  17. [Pathopshysiological mechanisms in macular edema].

    Science.gov (United States)

    Turlea, Cristian; Zolog, Ileana; Blăjan, Codruta; Roşca, C; Turlea, Magdalena; Munteanu, Mihnea; Boruga, Ovidiu

    2014-01-01

    The treatment of diabetic macular edema has known a fast development in the last 5 years where the transition from laser monotherapy to intravitreal pharmacotherapy is becoming standard practice. Intravitreal injections therapy is in a continuous development with promising positive results. The use of intratvitreal devices in the treatment of macular edema of vascular cause has become a viable alternative also in treating diabetic macular edema. Several clinical studies have revealed the superiority of intravitreal treatment versus laser monotherapy. This article is evaluating and reviewing present and future treatments used to combat diabetic macular edema. [corrected].

  18. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...

  19. Determinación experimental de los factores que controlan el desprendimiento de polvos en el conformado de chapas de acero recubiertas con Zn-Ni

    Directory of Open Access Journals (Sweden)

    Cárcel, A. C.

    1995-04-01

    Full Text Available Powder detachment from coatings during press forming of Zn-Ni precoated steel sheets increases die wear and maintenance costs. Experimental design helped to establish that powder detachment rises by increasing coating thickness or bath temperature. Otherwise, the use of high flow rates and the presence of an intermediate layer of nickel help to reduce powdering. Temperature and flow rate affect the alloy composition. In the range 10 to 15 % Ni, powdering increases as the alloy becomes richer in nickel. This behaviour is attributed to changes in structure and ductility of the alloy.

    El desprendimiento de polvos del recubrimiento durante la embutición constituye uno de los principales problemas en las líneas de prensas que emplean chapas de acero recubiertas con aleaciones Zn-Ni. El uso de técnicas de diseño de experiencias permitió determinar que la cantidad de polvos aumenta al incrementarse el espesor del depósito y la temperatura del baño, y disminuye al aplicar un flash intermedio de níquel o al aumentar la velocidad relativa cátodo-electrólito. Los efectos de la velocidad y de la temperatura afectan a la composición de la aleación. En el rango comprendido entre el 10-15 % Ni, el desprendimiento aumenta con el contenido en níquel, lo que se atribuye a los cambios de estructura y de ductilidad de la aleación.

  20. Achondroplasia and Macular Coloboma.

    Science.gov (United States)

    Ahoor, M H; Amizadeh, Y; Sorkhabi, R

    2015-01-01

    Achondroplasia is an autosomal dominant congenital disorder of enchondral ossification. It is clinically characterized by low stature, craniofacial deformity, and vertebral malformation. Associated ophthalmic features include telecanthus, exotropia, angle anomalies, and cone-rod dystrophy. A 24-year-old male presented with decreased vision bilaterally and typical achondroplasia. The best corrected visual acuity was 20/70 in both eyes. Anterior segment examination was normal. Fundus examination revealed a well-demarcated circular paramacular lesion in both eyes. As macular coloboma and achondroplasia are developmental disorders, the funduscopic examination is required in patients with achondroplasia.

  1. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian....... Smoking is probably also a risk factor. Preventive strategies using macular laser photocoagulation are under investigation, but their efficacy in preventing visual loss is as yet unproven. There is no treatment with proven efficacy for geographic atrophy. Optimal treatment for exudative AMD requires...

  2. Dominantly inherited cystoid macular edema.

    Science.gov (United States)

    Fishman, G A; Goldberg, M F; Trautmann, J C

    1979-01-01

    Four patients of Greek ancestry had dominantly inherited cystoid macular edema. Characteristics of this syndrome include the following: an early onset and prolonged course of cystoid changes in the macula, followed by atrophy of the macula in later stages. Some patients also show leakage of fluorescein from the optic disc capillaries, subnormal EOG Lp/Dt ratios, elevated rod dark adaptation thresholds, red-green and blue-yellow color deficiencies, normal ERG findings, hyperopia, peripheral pigmentary retinopathy, and vitreous opacities. Dominantly inherited cystoid macular edema is a distinct genetic trait among the dominantly inherited macular dystrophies.

  3. Datación mediante liquenometría de los desprendimientos rocosos asociados a la sismicidad histórica en Lorca (Murcia, SE de España)

    OpenAIRE

    Pérez-López, R.; Martín-González, F.; Martínez Díaz, José J.; Rodríguez-Pascua, M.A.

    2012-01-01

    El terremoto de Lorca (Murcia, SE de España) del año 2011 (Mw 5,2, profundidad 4 km) provocó una serie de caídas de rocas con un volumen total inferior a los 2000 m3. Estos desprendimientos de origen sísmico se localizan principalmente en la Sierra de las Estancias y en la Sierra de La Tercia, ambos relieves formados por calizas tortonienses con escarpes superiores a 30 metros de altura, así como con diferentes orientaciones. En estos mismos sitios se han encontrado evidencias de antiguas caí...

  4. Progressive macular hypomelanosis: an overview

    NARCIS (Netherlands)

    Relyveld, Germaine N.; Menke, Henk E.; Westerhof, Wiete

    2007-01-01

    Progressive macular hypomelanosis (PMH) is a common skin disorder that is often misdiagnosed. Various authors have written about similar skin disorders, referring to them by different names, but we believe that all these similar disorders are part of the same entity.PMH is characterized by

  5. Age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Wanjiku Mathenge

    2014-12-01

    Full Text Available Age-related macular degeneration (AMD is a disease of the retina that usually develops in people aged 60 years and older. It affects about 8.7% of the world’s population and is the leading cause of blindness among people aged 50 and older in industrialised countries.

  6. Age-Related Macular Degeneration.

    Science.gov (United States)

    Mehta, Sonia

    2015-09-01

    Age-related macular degeneration (AMD) is the leading cause of vision loss in the elderly. AMD is diagnosed based on characteristic retinal findings in individuals older than 50. Early detection and treatment are critical in increasing the likelihood of retaining good and functional vision. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Incidencia del desprendimiento de retina en operados de catarata, 1990-1997 Incidence of retina detachment in patients operated on of cataract, 1990-1997

    Directory of Open Access Journals (Sweden)

    Eneida Pérez Candelaria

    2002-06-01

    Full Text Available Se presenta el estudio realizado en pacientes operados de catarata, en el Centro de Microcirugía Ocular en Serie (CMOS en el período comprendido entre 1990 y 1997, con la técnica de extracción extracapsular del cristalino (incisión amplia que después presentaron desprendimiento de retina (DR. De un total de 17 762 pacientes operados de catarata solo 42 de ellos presentaron DR, lo que representó una tasa de 2,4 por cada mil operados (tasa muy baja. Se analizaron diferentes variables que pudieran estar incidiendo en la aparición de esta entidad, entre ellas: edad, sexo, antecedentes de enfermedades oculares, antecedentes de enfermedades sistémicas, complicaciones transquirúrgicas, complicaciones posquirúrgicas y capsulotomía posterior; el atrapamiento de Lente Intraocular (LIO fue la complicación posquirúrgica que mayor tasa presentó, seguida de los antecedentes de enfermedades sistémicas y la salida de vítreo.The study conducted in patients operated on of cataract at the Center of Serial Ocular Microsurgery (CSOM by using the extracapsular crystallyne lens extraction (wide incision from 1990 to 1997, and that after surgery had retinal detachment (RD, is presented. Of a total of 17 762 patients operated on of cataract, only 42 of them had RD, which represented a rate of 2.4 per one thousand patients operated on (very low rate. Different variables that could have some incidence on the appearance of this entity, such as age, sex, history of ocular diseases, history of systemic diseases, transsurgical complications, postsurgical complications and posterior capsulotomy, were analyzed. The Intraocular Lens (IOL entrapment was the postsurgical complication with the highest rate, followed by the history of systemic diseases and the vitreous loss.

  8. [Therapeutic approach in persistent diabetic macular edema].

    Science.gov (United States)

    Brănişteanu, Daniel; Moraru, Andreea

    2014-01-01

    Terminology of persistent diabetic macular edema has been initially reserved to cases unresponsive to conventional laser photocoagulation according to ETDRS criteria. While knowledge about pathophysiology of macular edema evolved and new drugs became available, the terminology of persistent diabetic macular edema expanded to include resistance to most current therapies. The purpose of this paper is to review medical and surgical options in the treatment of such difficult cases according to literature data and personal experience.

  9. Age-related macular degeneration

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    cause of blindness among Caucasian individuals in developed countries. Blindness resulting from AMD rarely occurs before age 70, and most cases occur after age 80. The age-standardised 1-year incidence of legal blindness resulting from AMD is 212 cases per million. Two-thirds of AMD cases have CNV......Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...... individuals than in pigmented races. In predominantly Caucasian populations, the age-standardised prevalence of AMD in at least one eye is 7760 cases per million. The age-standardised cumulated 1-year incidence of AMD in at least one eye is 1051 cases per million individuals. AMD is the most important single...

  10. Dimensionamiento del refuerzo a flexión con laminados de polímeros reforzados con fibras (FRP evitando su desprendimiento prematuro

    Directory of Open Access Journals (Sweden)

    Oller, E.

    2013-12-01

    Full Text Available According to the available experimental research related to structures flexurally strengthened by bonding fiber reinforced polymer (FRP laminates, the laminate debonds in a brittle manner in most tests. This debonding failure usually initiates in the most loaded regions due the effect of intermediate cracks (intermediate crack debonding. From the beginning of this technique, several models have been developed to avoid this premature failure. However, some of them present a significant scatter in relation to the experimental data. This paper presents a comparative analysis of the existing formulations through a database of tests compiled by the authors. Afterwards, a design procedure based on a shear-bending moment interaction diagram related to intermediate crack debonding is presented. This interaction diagram depends on the maximum shear force between crack discontinuities. Finally, the proposed method is compared to the rest of the models obtaining satisfactory results when predicting the failure load.La investigación experimental de elementos de hormigón reforzados a flexión mediante la adhesión de laminados de polímeros reforzados con fibras (FRP muestra que en la mayor parte de ensayos, el laminado se desprende de forma prematura iniciándose normalmente el fallo en las regiones más solicitadas debido al efecto de las fisuras intermedias. Desde los inicios de esta técnica de refuerzo, se han desarrollado modelos para evitar este tipo de rotura, la mayoría de los cuales presentan una dispersión considerable comparando sus resultados con los experimentales. En este artículo se presenta un análisis comparativo de diferentes formulaciones existentes a partir de una base de datos de ensayos recopilada por los autores. Posteriormente, se propone un método de dimensionamiento basado en un diagrama de interacción cortante-flexión asociado al desprendimiento del refuerzo, que depende de la máxima fuerza rasante transmitida entre

  11. Macular thickness and macular volume measurements using spectral domain optical coherence tomography in normal Nepalese eyes

    Directory of Open Access Journals (Sweden)

    Pokharel A

    2016-03-01

    Full Text Available Amrit Pokharel,1 Gauri Shankar Shrestha,2 Jyoti Baba Shrestha2 1Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, 2B P Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal Purpose: To record the normative values for macular thickness and macular volume in normal Nepalese eyes. Methods: In all, 126 eyes of 63 emmetropic subjects (mean age: 21.17±6.76 years; range: 10–37 years were assessed for macular thickness and macular volume, using spectral domain-optical coherence tomography over 6×6 mm2 in the posterior pole. A fast macular thickness protocol was employed. Statistics such as the mean, median, standard deviation, percentiles, and range were used, while a P-value was set at 0.05 to test significance. Results: Average macular thickness and total macular volume were larger in males compared to females. With each year of increasing age, these variables decreased by 0.556 µm and 0.0156 mm3 for average macular thickness and total macular volume, respectively. The macular thickness was greatest in the inner superior section and lowest at the center of the fovea. The volume was greatest in the outer nasal section and thinnest in the fovea. The central subfield thickness (r=-0.243, P=0.055 and foveal volume (r=0.216, P=0.09 did not correlate with age. Conclusion: Males and females differ significantly with regard to macular thickness and macular volume measurements. Reports by other studies that the increase in axial length reduced thickness and volume, were negated by this study which found a positive correlation among axial length, thickness, and volume. Keywords: macular thickness, macular volume, optical coherence tomography, Nepal

  12. Precursors of Age-Related Macular Degeneration

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Linneberg, Allan; Larsen, Michael

    2013-01-01

    PURPOSE: To investigate associations of small, hard macular drusen and larger macular drusen with obesity-related risk factors. METHODS: Cross-sectional study of 888 subjects aged 30-60 years characterized using anthropometric measurements and blood sample analyses. Physical activity was assessed...

  13. CASE REPORT Moebius syndrome with macular hyperpigmentation ...

    African Journals Online (AJOL)

    Bilateral macular hyperpigmentation was detected in our patient on fundus examination which was not reported previously in Moebius syndrome cases. In addition there is hypoplasia of the right pectoralis major muscle. KEYWORDS Moebius syndrome; Macular hyperpigmentation; Pectoralis major muscle; Cranial nerves; ...

  14. Correlations Between Macular, Skin, and Serum Carotenoids

    Science.gov (United States)

    Conrady, Christopher D.; Bell, James P.; Besch, Brian M.; Gorusupudi, Aruna; Farnsworth, Kelliann; Ermakov, Igor; Sharifzadeh, Mohsen; Ermakova, Maia; Gellermann, Werner; Bernstein, Paul S.

    2017-01-01

    Purpose Ocular and systemic measurement and imaging of the macular carotenoids lutein and zeaxanthin have been employed extensively as potential biomarkers of AMD risk. In this study, we systematically compare dual wavelength retinal autofluorescence imaging (AFI) of macular pigment with skin resonance Raman spectroscopy (RRS) and serum carotenoid levels in a clinic-based population. Methods Eighty-eight patients were recruited from retina and general ophthalmology practices from a tertiary referral center and excluded only if they did not have all three modalities tested, had a diagnosis of macular telangiectasia (MacTel) or Stargardt disease, or had poor AFI image quality. Skin, macular, and serum carotenoid levels were measured by RRS, AFI, and HPLC, respectively. Results Skin RRS measurements and serum zeaxanthin concentrations correlated most strongly with AFI macular pigment volume under the curve (MPVUC) measurements up to 9° eccentricity relative to MPVUC or rotationally averaged macular pigment optical density (MPOD) measurements at smaller eccentricities. These measurements were reproducible and not significantly affected by cataracts. We also found that these techniques could readily identify subjects taking oral carotenoid-containing supplements. Conclusions Larger macular pigment volume AFI and skin RRS measurements are noninvasive, objective, and reliable methods to assess ocular and systemic carotenoid levels. They are an attractive alternative to psychophysical and optical methods that measure MPOD at a limited number of eccentricities. Consequently, skin RRS and MPVUC at 9° are both reasonable biomarkers of macular carotenoid status that could be readily adapted to research and clinical settings. PMID:28728169

  15. Association of age-related macular degeneration and reticular macular disease with cardiovascular disease.

    Science.gov (United States)

    Rastogi, Neelesh; Smith, R Theodore

    2016-01-01

    Age-related macular degeneration is the leading cause of adult blindness in the developed world. Thus, major endeavors to understand the risk factors and pathogenesis of this disease have been undertaken. Reticular macular disease is a proposed subtype of age-related macular degeneration correlating histologically with subretinal drusenoid deposits located between the retinal pigment epithelium and the inner segment ellipsoid zone. Reticular lesions are more prevalent in females and in older age groups and are associated with a higher mortality rate. Risk factors for developing age-related macular degeneration include hypertension, smoking, and angina. Several genes related to increased risk for age-related macular degeneration and reticular macular disease are also associated with cardiovascular disease. Better understanding of the clinical and genetic risk factors for age-related macular degeneration and reticular macular disease has led to the hypothesis that these eye diseases are systemic. A systemic origin may help to explain why reticular disease is diagnosed more frequently in females as males suffer cardiovascular mortality at an earlier age, before the age of diagnosis of reticular macular disease and age-related macular degeneration. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. [Laser scotometry in macular diseases].

    Science.gov (United States)

    Makabe, R

    1986-02-01

    Retinal sensitivity is examined by projecting the aiming beam of an argon krypton laser photocoagulator onto the fundus through a contact lens. Even at normal intensity the brightness of the projected aiming on the retina is much greater than the maximum-intensity light target in ordinary scotometry. The discrepancy between scotomata when comparing the results of ordinary and laser scotometry suggests a potential for recovery of visual function, especially in macular diseases. This examination is practicable even if there is slight opacity of the media. By setting the laser beam at sufficiently low intensity, relative scotomata can be detected.

  17. PHOTODYNAMIC THERAPY OF MACULAR DEGENERATION

    Directory of Open Access Journals (Sweden)

    Davorin Sevšek

    2004-05-01

    Full Text Available Background. University Eye Clinic in Ljubljana began to perform a photodynamic therapy (PDT in July 2002. Up to September 2003 there were 51 PDT interventions on 36 eyes. Almost half of the eyes had one or more reinterventions. PDT was used on 29 eyes with age related macular degeneration (AMD. Just before the treatment all of them had visual acuity (VA 6/60 or better and there were predominantly classical or classical choroidal neovascular (CNV membranes. Most VA did not changed significantly in follow-up visits but diameter of CNV membranes was obviously reduced. In macular degeneration due to pathologic myopia (MMD, photodynamic therapy was performed on 7 eyes with mainly occult CNV and VA was 12/60 or better. VA was mostly better in follow-up visits than before treatment with PDT.Conclusions. There were no serious complications during and after PDT interventions. Two patients had back pain during the infusion of Verteporfin but there was no need to stop the intervention.

  18. Age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Querques G

    2011-05-01

    Full Text Available Giuseppe Querques¹, Fernando Onofrio Avellis1,2, Lea Querques1,3, Francesco Bandello³, Eric H Souied¹ ¹Service d'Ophtalmologie, Centre Hospitalier Intercommunal Créteil, Université Paris-Est Créteil, Créteil, France; ²Parma Eye Clinic University Hospital, Università degli Studi di Parma, Parma, Italy; ³Department of Ophthalmology, Università Vita-Salute San Raffaele Milano, Milano, Italy Date of preparation: March 3, 2011 Conflict of interest: None declaredClinical question: Is there any new knowledge about the pathogenesis and treatment of age-related macular degeneration (AMD?Results: We now understand better the biochemical and pathological pathways involved in the genesis of AMD. Treatment of exudative AMD is based on intravitreal injection of new antivascular endothelial growth factor drugs for which there does not yet exist a unique recognized strategy of administration. No therapies are actually available for atrophic AMD, despite some experimental new pharmacological approaches.Implementation: strategy of administration, safety of intravitreal injectionKeywords: age-related macular degeneration, antivascular endothelial growth factor, choroidal neovascularization, drusen, geographic atrophy

  19. Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema

    Energy Technology Data Exchange (ETDEWEB)

    Saraiva, Fabio Petersen; Costa, Patricia Grativol; Inomata, Daniela Lumi; Melo, Carlos Sergio Nascimento; Helal Junior, John; Nakashima, Yoshitaka [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Oftalmologia]. E-mail: fabiopetersen@yahoo.com.br

    2007-07-01

    Objectives: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. Introduction: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. Methods: The study recruited diabetic patients without clinically evident retinopathy (control group) and with diffuse macular edema (case group). Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. Results: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. Discussion: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. Conclusions: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema. (author)

  20. What Is Age-Related Macular Degeneration?

    Science.gov (United States)

    ... Qué es la degeneración macular relacionada con la edad? Written By: Kierstan Boyd Reviewed By: Robert H ... Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American Academy of Ophthalmology 2018 ...

  1. The Frequency of Serous Macular Detachment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Onur Yaya

    2015-05-01

    Full Text Available Objectives: To investigate the epidemiology and frequency of serous macular detachment (SMD in patients diagnosed with diabetic macular edema (DME. Materials and Methods: Hundred and forty-three eyes of 104 patients with DME were examined retrospectively. According to the results of OCT, the patients were separated into two groups; patients diagnosed with SMD and DME (group 1 and patients diagnosed with DME (group 2. They were assessed based on demographic characteristics, average age, duration of diabetes mellitus (DM, hypertension (HT history, best-corrected visual acuity, and diabetic retinopathy stages. Results: The average age of the patients was 61±8.7 years. Forty-three patients (41.3% were female and 61 patients (58.7% were male. Fifty-four of 104 patients (51.9% had DME with SMD. 21 (38.8% patients had bilateral SMD. In group 1, 31 patients were male (57.4% and 23 patients were female (42.6%. In group 2, 30 (60% patients were male and 20 (40% patients were female. In group 1, average age was 60.2±9.6 and the average duration of DM was 12.2±7.0 years, whereas the average age was 61.9±7.6 and the average duration of DM was 14.06±6.8 years in group 2. Forty-two patients in group 1 (77.8% and 30 patients (60% in group 2 had history of HT. Before the treatment, the average best-corrected visual acuity was found to be 0.30±0.24 in group 1 and 0.32±0.25 in group 2. Conclusion: Today, it is thought that diabetic maculopathy is the leading cause of SMD and it is a determining factor of treatment applications. In our study, we aimed at investigating the frequency of SMD in DME and the risk factors for the development of SMD. Although there were some differences between the factors, only the history of HT was found statistically higher in patients with SMD (p=0.04. (Turk J Ophthalmol 2015; 45: 92-96

  2. Intravitreal triamcinolone for diffuse diabetic macular oedema.

    LENUS (Irish Health Repository)

    Gibran, S K

    2012-02-03

    AIM: To evaluate the efficacy of intravitreal triamcinolone (IVTA) for the treatment of diffuse diabetic macular oedema (DME) refractory to conventional argon macular laser therapy. METHODS: A prospective, consecutive, and noncomparative case series was undertaken involving 38 eyes of 38 patients with refractory DME. Triamcinolone acetonide (4 mg) in 0.1 ml was injected intravitreally. LogMar visual acuity (VA) and macular thickness measured by ocular coherence tomography (OCT) were assessed preoperatively and postoperatively at 1, 3, and 6 months. RESULTS: All patients completed 6 months of follow up. VA (mean+\\/-SD) improved from 0.905+\\/-0.23 to 0.605+\\/-0.28, 0.555+\\/-0.29, and 0.730+\\/-0.30 at 1, 3, and 6 months, respectively. Macular thickness baseline (mean+\\/-SD) on OCT was 418.7+\\/-104.2 microm and this decreased to 276.9+\\/-72.6 microm, 250.6+\\/-53.1 microm, and 308.8+\\/-87.3 microm at 1, 3, and 6 months, respectively. CONCLUSIONS: IVTA may be a potential temporary treatment for refractory DME. It is effective in decreasing macular thickness and improving VA but the effect lasts approximately for 6 months in the majority of patients. Further investigations are required to establish the safety of IVTA for the treatment of DME.

  3. Spontaneously resolving macular cyst in an infant

    Directory of Open Access Journals (Sweden)

    Anuradha Ganesh

    2013-01-01

    Full Text Available The purpose of this study is to describe transient macular cysts in an infant and correlate their occurrence with normal development events. A newborn Caucasian girl presented with a protruding corneal mass in her left eye at birth. She underwent a complete ophthalmic examination. A keratinized staphylomatous malformation involving the entire cornea and precluding further visualization of the anterior and posterior segment was observed in the left eye. Spectral domain optical coherence tomography (SD-OCT of the right eye performed when the child was approximately 6-week-old had revealed an unexpected finding of macular cysts involving the inner nuclear and outer retinal layers. Corneal transplant in the left eye was performed a month later. Ocular examination under anesthesia just prior to surgery revealed normal intraocular pressure, anterior segment and retina in the right eye. SD-OCT was normal in both eyes and showed complete resolution of the cysts in the right eye. The patient had not been on any medications at that time. Although clinical retinal examination might be unremarkable, SD-OCT may reveal cystic spaces in the macula. In the absence of conditions known to be associated with macular edema, transient macular cysts may arise due to a developmental incompetence of the blood-retinal barrier or may represent transient spaces created during normal migration of retinal cells. Further study is warranted to delineate the entity of transient macular cysts in infancy.

  4. Corticosteroid Treatment in Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Burcu Nurözler Tabakcı

    2017-06-01

    Full Text Available Diabetic macular edema is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of macular edema is complex and multifactorial. For many years, laser photocoagulation has been considered the standard therapy for the treatment of diabetic macular edema; however, few patients achieve significant improvements in visual acuity. Today the intravitreal administration of anti-inflammatory or anti-angiogenic agents together with the use of laser photocoagulation represents the standard of care for the treatment of this complication. The intravitreal route of administration minimizes the systemic side effects of corticosteroids. Steroid-related ocular side effects are elevated intraocular pressure and cataract, while injection-related complications include endophthalmitis, vitreous hemorrhage, and retinal detachment. In order to reduce the risks and complications, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated injections for the management of diabetic macular edema. In this review, the efficacy, safety, and therapeutic potential of intravitreal corticosteroids in diabetic macular edema are discussed with a review of recent literature.

  5. MACULAR CHOROIDAL VOLUME CHANGES AFTER INTRAVITREAL BEVACIZUMAB FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Palkovits, Stefan; Seidel, Gerald; Pertl, Laura; Malle, Eva M; Hausberger, Silke; Makk, Johanna; Singer, Christoph; Osterholt, Julia; Herzog, Sereina A; Haas, Anton; Weger, Martin

    2017-12-01

    To evaluate the effect of intravitreal bevacizumab on the macular choroidal volume and the subfoveal choroidal thickness in treatment naïve eyes with exudative age-related macular degeneration. The macular choroidal volume and the subfoveal choroidal thickness were measured using enhanced depth imaging optical coherence tomography. After a screening examination, each patient received 3 monthly intravitreal injections of 1.25 mg bevacizumab. One month after the third injection was a final assessment. Forty-seven patients with a mean age of 80 ± 6.4 years were included. The macular choroidal volume decreased significantly from median 4.1 mm (interquartile range 3.4-5.9) to median 3.9 mm (interquartile range 3.1-5.6) between the baseline and final examination (difference -0.46 mm, 95% confidence interval: -0.57 to 0.35, P macular choroidal volume at baseline and subfoveal choroidal thickness at baseline were not associated with the response to treatment. The macular choroidal volume and the subfoveal choroidal thickness decreased significantly after 3 monthly bevacizumab injections for exudative age-related macular degeneration.

  6. Quantitative analysis of macular retinal thickness and macular volume in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Ying Zhao

    2017-12-01

    Full Text Available AIM: To evaluate and characterize the macular thickness and macular volume in patients of different stages of diabetic retinopathy with special-domain optical coherence tomography(SD-OCT. METHODS: Totally 40 patients(78 eyeswith diabetic retinopathy were recruited in the study from January 2016 to January 2017 in our hospital. According to the international clinical classification of diabetic retinopathy, 20 cases(40 eyeswere categorized as non-proliferative diabetic retinopathy(NPDRgroup and 20 cases proliferative diabetic retinopathy(PDRgroup(38 eyes. All subjects were examined and analyzed with Early Treatment Diabetic Retinopathy Study(ETDRSsubfields, which were embedded in HS(Haag-Streitwith diameter of 1, 3 and 6mm.The changes of retinal thickness and volume of the macular center were measured. RESULTS: The thickness of macular foveolar in NPDR group and PDR group were 252.57±31.36μm, 362.47±20.81μm. The retinal thickness of inner superior subfield(ISMand inner nasal subfield(INMwere the thickest; that of inner inferior subfield(IIMwas next to ISM and INM, and that of inner temporal subfield was the thinnest. Of the outer subfields, the retinal thickness of outer superior subfield(OSMwas the thickest; that of outer nasal subfield(ONMwas next to OSM, and that of outer temporal subfield(OTMand outer inferior subfield(OIMwas the thinnest. The value of macular central concave thickness and retinal thickness in each quadrant of the NPDR group were less than those of the PDR group, the difference was statistically significant(P3, 0.28±0.16mm3, the upper and nasal sides of the middle part of the partition were the largest, the inferior and the temporal side were the smallest. The nasal side of the outer loop was the largest, the upper was the second, the temporal side and the inferior were the smallest. The volume of macular central fovea and the retinal volume in each quadrant of the NPDR group were smaller than those of the PDR group, the

  7. Long-term changes of macular retinal thickness after idiopathic macular hole surgery

    Directory of Open Access Journals (Sweden)

    Yan Yang

    2014-12-01

    Full Text Available AIM:To determine the changes of regional macular retinal thickness(RTwith spectral domain optical coherence tomography(SD-OCTafter successful pars plana vitrectomy(PPVsurgery with inner limiting membrane(ILMpeeling in patients with idiopathic macular hole.METHODS:A non-randomized retrospective case study on 17 patients(17 eyeswho were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with ILM peeling and short-term gas tamponade. In the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3~5wk after the surgery(stage A, 2~3mo after the surgery(stage B, and >6mo after the surgery(stage C.RESULTS:In stage A, the macular RT of operated eyes in the areas of C, IS, II, IN, OS, OI, ON(263.00±39.48, 313.92±18.35, 311.00±18.02, 335.67±19.91, 280.83±33.74, 269.92±23.32, 307.00±28.40were significantly thicker than the corresponding areas of the normal fellow eyes(220.51±23.94, 292.08±21.93, 282.50±20.30, 288.33±20.76, 251.25±17.60, 247.75±21.48, 265.17±24.76μm(PP>0.01. In Stage B, the macular RT in the areas of II, IN, OS(335.67±19.20,319.75±19.20, 273.50±16.89μmwere significantly thicker than the corresponding areas of the normal fellow eyes(286.33±20.46, 293.42±17.64, 252.50±16.32μm(PP> 0.01. In Stage C, the macular RT of operated eyes with the areas of IN(321.17±19.71μmwere significantly thicker than the corresponding areas of the normal fellow eyes(296.25±19.57μm(PP>0.01. Moreover, the macular RT of operated eyes in the areas of ON, IT(307.00±28

  8. [New aspects in age related macular degeneration].

    Science.gov (United States)

    Turlea, C

    2012-01-01

    Being the leading cause of blindness in modern world Age Related Macular Degeneration has beneficiated in the last decade of important progress in diagnosis, classification and the discovery of diverse factors who contribute to the etiology of this disease. Treatments have arised who can postpone the irreversible evolution of the disease and thus preserve vision. Recent findings have identified predisposing genetic factors and also inflamatory and imunological parameters that can be modified trough a good and adequate prevention and therapy This articole reviews new aspects of patology of Age Related Macular Degeneration like the role of complement in maintaining inflamation and the role of oxidative stress on different structures of the retina.

  9. Assessment of Macular Function during Vitrectomy: New Approach Using Intraoperative Focal Macular Electroretinograms.

    Directory of Open Access Journals (Sweden)

    Celso Soiti Matsumoto

    Full Text Available To describe a new technique to record focal macular electroretinograms (FMERGs during vitrectomy to assess macular function.Intraoperative FMERGs (iFMERGs were recorded in ten patients (10 eyes who undergo vitrectomy. iFMERGs were elicited by focal macular stimulation. The stimulus light was directed to the macular area through a 25 gauge (25G glass fiber optic bundle. Background light was delivered through a dual chandelier-type light fiber probe. Focal macular responses elicited with combinations of stimulus and background luminances were analyzed.A stimulus luminance that was approximately 1.75 log units brighter than the background light was able to elicit focal macular responses that were not contaminated by stray light responses. Thus, a stimulus luminance of 160 cd/m2 delivered on a background of 3 cd/m2 elicited iFMEGs from only the stimulated area. This combination of stimulus and background luminances did not elicit a response when the stimulus was projected onto the optic nerve head. The iFMERGs elicited by a 10° stimulus with a duration of 100 ms and an interstimulus interval of 150 ms consisted of an a-, b-, and d-waves, the oscillatory potentials, and the photopic negative response (PhNR.Focal ERGs with all components can be recorded from the macula and other retinal areas during vitreous surgery. This new technique will allow surgeons to assess the function of focal areas of the retina intraoperatively.

  10. The relationship between fundus fluorescein angiographic findings and serous macular detachment in diabetic macular edema.

    Science.gov (United States)

    Gungel, Hulya; Altan, Cigdem

    2013-10-01

    To investigate whether the serous macular detachment (SMD) shown by optical coherence tomography is associated with types of maculopathy, severity of retinopathy, the effect of macular and retinal photocoagulation, and retinal circulation times in diabetic macular edema. Patients were grouped as SMD+ (Group 1) and SMD- (Group 2). Fundus photography and fluorescein angiography were evaluated regarding the type of maculopathy; severity of retinopathy and also arm-retina time, arteriovenous transit time, and venous filling time; and the applied macular and panretinal laser treatment. Diffuse maculopathy was seen more frequently in eyes with SMD, whereas ischemic maculopathy was more frequent in eyes without SMD. There was no significant difference regarding severity of retinopathy and retinal circulation times between groups. The frequency of patients with complete panretinal photocoagulation and grid laser photocoagulation was found to be higher in Group 2. Serous macular detachment can occur in eyes with increased vascular permeability in macula. Serous macular detachment may be an important finding in terms of the possible existence of diffuse maculopathy and the need of additional panretinal photocoagulation, but absence of SMD may point at ischemic maculopathy.

  11. Macular Amyloidosis and Epstein-Barr Virus

    Directory of Open Access Journals (Sweden)

    Yalda Nahidi

    2016-01-01

    Full Text Available Background. Amyloidosis is extracellular precipitation of eosinophilic hyaline material of self-origin with special staining features and fibrillar ultrastructure. Macular amyloidosis is limited to the skin, and several factors have been proposed for its pathogenesis. Detection of Epstein-Barr virus (EBV DNA in this lesion suggests that this virus can play a role in pathogenesis of this disease. Objective. EBV DNA detection was done on 30 skin samples with a diagnosis of macular amyloidosis and 31 healthy skin samples in the margin of removed melanocytic nevi by using PCR. Results. In patients positive for beta-globin gene in PCR, BLLF1 gene of EBV virus was positive in 23 patients (8 patients in case and 15 patients in the control group. There was no significant difference in presence of EBV DNA between macular amyloidosis (3.8% and control (23.8% groups (P=0.08. Conclusion. The findings of this study showed that EBV is not involved in pathogenesis of macular amyloidosis.

  12. Precursors of age-related macular degeneration

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Toft, Ulla; Linneberg, Allan

    2016-01-01

    -sectional study of 848 subjects aged 30-60 years from the Inter99 Eye Study. Daily intake of vitamins and minerals was estimated from a 198-item food frequency questionnaire. Digital fundus photographs were recorded in red-free illumination and graded for macular drusen >63 μm and numerous (>20) small hard...

  13. Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

    African Journals Online (AJOL)

    To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however persisted.

  14. Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however ...

  15. Moebius syndrome with macular hyperpigmentation, skeletal ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-11-08

    Nov 8, 2014 ... Moebius syndrome with macular hyperpigmentation, skeletal anomalies, and hypoplasia of pectoralis major muscle in an Egyptian child. Rabah M. Shawky a, ... examination which was not reported previously in Moebius syndrome cases. .... or absence of middle cerebellar peduncles, depression of the.

  16. Correlation between choroidal thickness and macular hole

    Directory of Open Access Journals (Sweden)

    Li-Li Wang

    2018-01-01

    Full Text Available AIM:To explore the correlation between choroidal thickness and macular hole, and to provide a theoretical basis for diagnosis and treatment of macular hole. METHODS: This study included 40 cases of monocular idiopathic macular hole patients who were treated in ophthalmology of our hospital from June 2015 to June 2016 and 40 cases of healthy people. Sicked eyes of idiopathic macular hole patients(40 eyeswere set as the Group A, uninjured side eyes(40 eyeswere set as the Group B, eyes of 40 cases of healthy people(40 normal eyeswere set as the Group C. Choroidal thickness of macular fovea, macular fovea 1mm, 3mm at 9 points, 4 directions in the upper, lower, nasal and temporal regions were measured through coherent optical tomography of enhanced deep imaging(enhanced depth image optical coherence tomography, EDI-OCT. They were recorded as SFCT, SCT1mm, SCT3mm, ICT1mm, ICT3mm, NCT1mm, NCT3mm, TCT1mm, TCT3mm, and correlation analysis between SFCT and age was analyzed. RESULTS: Average SFCT of Group A, B had no significant difference, data of the Group C was significantly higher than those of the Group A, B, there was statistical significance(P1mm, SCT3mm, ICT1mm, ICT3mm, NCT1mm, NCT3mm, TCT1mm, TCT3mm of the Group A, B had no significant difference(P>0.05, and choroidal thickness at each point of the Group C was significantly higher than that of Group A and B, there was statistical significance(Pr=-0.065, P=0.148; r=-0.057, P=0.658, SFCT of the Group C was negatively correlated with age(r=-0.343, P=0.041. CONCLUSION: The pathogenesis of idiopathic macular hole may be related to the sharp decrease of choroidal thickness, choroidal thickness of uninjured side eyes reduces more sharply than normal population and choroidal vascular metabolism reduces may be pathogenic.

  17. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment......ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment...

  18. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment......ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment...

  19. Origen y desarrollo de la cirugía del desprendimiento de retina con implantes esclerales y su introducción en Cuba Origin and development of retina detachment surgery with scleral implants and its introduction in Cuba

    Directory of Open Access Journals (Sweden)

    Roberto Alejandro Guerra García

    2011-06-01

    Full Text Available Se realizó una revisión bibliográfica con el objetivo de conocer los orígenes del tratamiento quirúrgico del desprendimiento regmatógeno de retina, el desarrollo de la técnica quirúrgica mediante implantes esclerales y su introducción en Cuba, así como su utilización hasta nuestros días. Son abordados tópicos como la creación del primer servicio de retina en el Hospital "Ramón Pando Ferrer", la visita de Charles Schepens a La Habana y la labor de importantes profesores vinculados al desarrollo de la especialidad en Cuba. Se consultó una bibliografía que abarca un período de varios años hasta el presente para conocer los resultados de la utilización de esta técnica quirúrgica en la actualidad y demostrar, de esa forma, su vigencia.A bibliographic review was conducted to know the origins of the surgical treatment of the retina regmatogen detachment, the development of the surgical technique using scleral transplantations, as well as its introduction in Cuba and its use until nowadays. Subjects like the creation of our first Retina Service, the visit of Charles Schepens to La Habana and the work of important professors linked with development of the specialty in Cuba were approached. The bibliography covering a period of some years until now was looked up to know the results of the use of such surgical technique in present time and to demonstrate its validity.

  20. Clinical and tomographic aspects of macular microholes

    International Nuclear Information System (INIS)

    Novelli, Fernando Jose de; Maia Junior, Otacilio de Oliveira; Garrido Neto, Theodomiro; Takahashi, Walter Yukihiko

    2009-01-01

    Purpose: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. Methods: Seven patients were assessed (8 eyes) with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. Results: Ages ranged from 26 to 69 years. Six patients were female (85.7%) and five of them had microhole in the right eye. The presenting symptom was decrease in visual acuity (71.3%) and central scotoma in (14.3%). Five eyes (71.4%) had no defects shown by fluorescent angiography. A defect in the outer retina was demonstrated in all eyes on optical coherence tomography. The lesions were nonprogressive. Conclusion: Macular microholes are small lamellar defects in the outer retina. The condition is nonprogressive, generally unilateral and compatible with good visual acuity. Fundus biomicroscopy associated with an optical coherence tomography are the main elements in the diagnosis and study of this pathology. (author)

  1. Current Treatments of Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Wei-Chun Chan

    2011-12-01

    Full Text Available Diabetic macular edema (DME is a major cause of visual impairment in diabetic patients. Laser photocoagulation is the standard management strategy for macular edema, but its results remain unsatisfactory. Several clinical trials of new treatment modalities for DME have been conducted over the past 10 years. We performed a literature search of English articles, published between 2000 and 2010, by using the PubMed database. The keywords searched included “diabetic macular edema and treatment” with limits set to include only clinical trials and review articles, over 50 articles were reviewed. Among the newer treatment modalities reviewed, therapy with anti-vascular endothelial growth factor (VEGF antibodies showed significantly better efficacy, with level I evidence. However, multiple injections were required to maintain its efficacy. Therefore, the associated complications and cost implications are the major limitations of this treatment. Several combinations of different modalities have been evaluated in the literature, but none are more efficacious than monotherapy with anti-VEGF antibodies. Since DME is a multifactorial disease, further studies involving combinations of modalities or new treatments modalities may be needed to reduce the number of injections required or improve the visual outcomes in case of DME.

  2. LONG-TERM EVOLUTION OF DOME-SHAPED MACULA: Increased Macular Bulge is Associated With Extended Macular Atrophy.

    Science.gov (United States)

    Soudier, Guillaume; Gaudric, Alain; Gualino, Vincent; Massin, Pascale; Nardin, Mathieu; Tadayoni, Ramin; Speeg-Schatz, Claude; Gaucher, David

    2016-05-01

    Dome-shaped macula (DSM) may cause impaired vision. This study analyzed the long-term evolution of DSM, most particularly macular changes: serous retinal detachment, retinal pigment epithelium atrophy, and DSM bulge increase. Twenty-nine eyes presenting with DSM were retrospectively studied. Clinical data, color photographs, fluorescein angiographs, and optical coherence tomography examinations were reviewed. Patients were followed up from 6 months to 111 months (mean, 37.89 months). The height of the macular bulge, the size of retinal pigment epithelium macular atrophy, and serous retinal detachment progression were studied. Other macular changes were noted. Mean vision remained stable. Dome-shaped macula height increased significantly from 338.9 μm to 364.3 μm (P = 0.007). Serous retinal detachment was present initially in 15 of 29 eyes; it increased in 4 cases and resolved spontaneously in 7. Macular retinal pigment epithelium atrophy correlated with the bulge height (P = 0.015), and it enlarged during follow-up (1.12 vs. 1.34, P = 0.04). Other macular anomalies were present initially or appeared during follow-up: macular pucker, choroidal neovascularization (CNV), subretinal pigmentary clumps, and flat irregular pigmented epithelium detachment. A few treatments were proven in serous retinal detachment cases but were ineffective in restoring vision. In DSM, vision may be stable for years while macular changes progress: the macular bulge increases as does retinal pigment epithelium atrophy.

  3. Macular morphology and visual acuity after macular hole surgery with or without internal limiting membrane peeling

    DEFF Research Database (Denmark)

    Christensen, U.C.; Kroyer, K.; Sander, B.

    2010-01-01

    Aim: To examine postoperative macular morphology and visual outcome after 12 months in relation to internal limiting membrane (ILM) peeling versus no peeling, indocyanine green (ICG) staining and re-operation in eyes that achieved macular hole closure after surgery. Methods: Seventy-four eyes...... tomography was used to assess central foveal thickness, central photoreceptor layer thickness (CPRT), central photoreceptor layer discontinuity (PRD) and relative reflectivity of the outer nuclear layer. Outcomes were correlated with best corrected visual acuity (BCVA) 12 months after surgery. Results: BCVA...

  4. Recovery of the neurosensory retina after macular translocation surgery is independent of preoperative macular sensitivity in neovascular age-related macular degeneration.

    Science.gov (United States)

    Mettu, Priyatham S; Sarin, Neeru; Stinnett, Sandra S; Toth, Cynthia A

    2011-09-01

    To directly assess the recovery of the retina overlying choroidal neovascularization in neovascular age-related macular degeneration and to understand the relationship between macular sensitivity and visual functional measures and retinal structural alterations as predictive factors for outcome among eyes undergoing macular translocation surgery (MT360). In a prospective, consecutive case series of 55 patients with subfoveal choroidal neovascularization undergoing MT360, we explored the relationship between macular sensitivity on the Nidek microperimeter-1 with pathologic features on optical coherence tomography and with distance and near visual acuity, reading speed, contrast sensitivity, color vision, and National Eye Institute Visual Function Questionnaire-25 composite quality-of-life (QOL) score, both before and at 1 year after MT360. On average, there was improvement in all measures of visual function, macular sensitivity, and QOL after MT360. Preoperative median retinal sensitivity score did not predict postoperative measures of visual function, macular sensitivity, and vision-related QOL. Correlation between preoperative median retinal sensitivity score and preoperative measures of visual function and vision-related QOL was generally poor, excepting modest correlation for contrast sensitivity and color vision. However, correlation between postoperative median retinal sensitivity score and postoperative measures of visual function and vision-related QOL was uniformly modest, and change in median retinal sensitivity score correlated modestly with change in most measures of visual function and QOL. Among optical coherence tomography morphologic features, preoperative retinal pigment epithelium elevation predicted reduced postoperative contrast sensitivity (P = 0.04), while preoperative epiretinal membrane or vitreomacular traction predicted increased postoperative contrast sensitivity (P = 0.05). Preoperative cystoid macular edema, subretinal fluid, and

  5. [Macular hole--a rare complication of toxocariasis].

    Science.gov (United States)

    Voinea, Liliana; Podoleanu, Elena; Ion, Daniela; Grădinaru, Sînziana; Ungureanu, E; Covaliu, Nicoleta; Tecuceanu, Andreea; Alexandrescu, Cristina; Simionescu, Ruxandra; Popescu, Viorela; Panca, Aida; Dascalu, Ana Maria; Vrapciu, Alexandra; Voicu, Mădălina

    2007-01-01

    Macular hole is a condition that characterizes older patients, being rare in adolescent patients and exceptionally at children. The etiopathogenic mechanism of most macular holes in children and adolescent is idiopathic. The suggested etiopathogenic mechanism is vitreoretinal traction due to a toxocara granuloma for a 9 years old girl.

  6. Age-related macular degeneration: epidemiology and optimal treatment

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...

  7. Prevalence of age-related macular degeneration in elderly Caucasians

    DEFF Research Database (Denmark)

    Erke, Maja G; Bertelsen, Geir; Peto, Tunde

    2012-01-01

    To describe the sex- and age-specific prevalence of drusen, geographic atrophy, and neovascular age-related macular degeneration (AMD).......To describe the sex- and age-specific prevalence of drusen, geographic atrophy, and neovascular age-related macular degeneration (AMD)....

  8. The molecular genetic basis of age-related macular degeneration ...

    Indian Academy of Sciences (India)

    Keywords. AMD; epidemiology; genes; polymorphism; risk. Abstract. Age-related macular degeneration (AMD) is a complex disorder of the eye and the third leading cause of blindness worldwide. With a multifactorial etiology, AMD results in progressive loss of central vision affecting the macular region of the eye in elderly.

  9. Effect of acute postural variation on diabetic macular oedema

    DEFF Research Database (Denmark)

    Vinten, Martin; la Cour, Morten; Lund-Andersen, Henrik

    2010-01-01

    This study aimed to study the pathophysiology of diabetic macular oedema (DMO) by analysis of concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), and retinal artery and vein diameters in response to acute postural changes in patients with DMO...

  10. ILM peeling in nontractional diabetic macular edema: review and metanalysis.

    Science.gov (United States)

    Rinaldi, M; dell'Omo, R; Morescalchi, F; Semeraro, F; Gambicorti, E; Cacciatore, F; Chiosi, F; Costagliola, C

    2017-10-31

    To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema. PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary.

  11. Quantification of metamorphopsia in patients with macular hole

    DEFF Research Database (Denmark)

    Kroyer, K.; Christensen, U.; Larsen, M.

    2008-01-01

    .001). CONCLUSIONS. The level of metamorphopsia declined as a function of eccentricity and affected the central 10 of visual field. Macular hole size had an independent effect on interocular disparity. These results confirm reports that visuospatial distortion in the presence of macular hole is primarily the result...

  12. Visual and anatomical outcome after macular buckling for macular hole with associated foveoschisis in highly myopic eyes.

    Science.gov (United States)

    Burés-Jelstrup, Anniken; Alkabes, Micol; Gómez-Resa, Maria; Rios, Jose; Corcóstegui, Borja; Mateo, Carlos

    2014-01-01

    Macular hole (MH) with associated foveoschisis is very specific to highly myopic eyes with a pronounced posterior staphyloma. A high axial length increases the risk of foveoschisis, MH formation and retinal detachment secondary to a macular hole (MHRD). These highly myopic MH show poor surgical outcomes after vitrectomy and internal limiting membrane peeling compared with non-myopic MH. The posterior staphyloma seems to play an important role, and thus macular buckling could prove useful to improve both visual and anatomical results. Sixteen highly myopic eyes with MH and associated foveoschisis that underwent macular buckling were studied. Vitrectomy combined with macular buckling was performed in all 16 eyes. Optical coherence tomography was performed to confirm MH closure in all cases. Combined vitrectomy and macular buckling resulted in MH closure in all patients. Best-corrected visual acuity (BCVA) improved in 13 out of 16 eyes (81.25%), remained stable in 2 eyes (12.5%) and worsened in 1 eye (6.25%). Mean preoperative BCVA was 20/125, whereas mean postoperative BCVA was 20/50. Combined vitrectomy and macular buckling is a safe and effective approach to achieve primary closure of MH in eyes with posterior staphyloma and associated foveoschisis. Eyes with a high axial length show a less favourable prognosis, which can be partially overcome by means of macular buckling.

  13. Efficacy of intravitreal ranibizumab injection combined with macular grid photocoagulation for diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Hu-Lin Jiang

    2014-07-01

    Full Text Available AIM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema(DME.METHODS:Totally 60 eyes(60 patientswith DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity(BCVA, central macular thickness(CMTmeasured by optical coherence tomography(OCTand postoperative complications were observed.RESULTS:In simple injection group, the BCVA after operation were separately 0.390±0.075(4wk, 0.367±0.088(8wkand 0.319±0.064(12wk,the CMT after operation were separately 221.63±112.34μm(4wk, 337.73±99.56μm(8wkand 432.92±100.46μm(12wk, which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. In combined treatment group, the BCVA after operation were separately 0.385±0.036(4wk, 0.382±0.079(8wkand 0.377±0.097(12wk,the CMT after operation were separately 249.77±106.55μm(4wk, 270.40±92.88μm(8wkand 275.84±97.34μm(12wk, which were satisfactory and steady during follow-up, better than simple injection group(PCONCLUSION:Intravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.

  14. Outcomes of chronic macular hole surgical repair

    Directory of Open Access Journals (Sweden)

    Shripaad Y Shukla

    2014-01-01

    Full Text Available Purpose: To report visual and anatomic outcomes of chronic macular hole surgery, with analysis of pre-operative OCT-based hole size and post-operative closure type. Settings and Design: An IRB-approved, retrospective case series of 26 eyes of 24 patients who underwent surgery for stage 3 or 4 idiopathic chronic macular holes at a tertiary care referral center. Statistical Analysis: Student′s t-test. Results: Nineteen of 26 eyes (73% had visual improvement after surgery on most recent exam. Twenty-one of 26 eyes (81% achieved anatomic closure; 16 of 26 eyes (62% achieved type 1, and five of 26 eyes (19% achieved type 2 closure. Post-operative LogMAR VA for type 1 closure holes (0.49 was significantly greater than for type 2 closure and open holes (1.26, P < 0.003 and 1.10, P < 0.005, respectively, despite similar pre-operative VA (P = 0.51 and 0.68, respectively. Mean pre-operative hole diameter for eyes with type 1 closure, type 2 closure, and holes that remained open were 554, 929, and 1205 microns, respectively. Mean pre-operative hole diameter was significantly larger in eyes that remained open as compared to eyes with type 1 closure (P = 0.015. Conclusion: Vitrectomy to repair chronic macular holes can improve vision and achieve long-term closure. Holes of greater than 3.4 years duration were associated with a greater incidence of remaining open and type 2 closure. Larger holes (mean diameter of 1205 microns were more likely to remain open after repair.

  15. Macular thickness and volume in the elderly

    DEFF Research Database (Denmark)

    Subhi, Yousif; Forshaw, Thomas; Sørensen, Torben Lykke

    2016-01-01

    Ageing leads to a number of changes in the body including the macula. Detailed imaging using optical coherence tomography have enabled in vivo studies of how macula changes with age. Here we systematically review 49 studies (9115 participants and 11,577 eyes) to provide an overview of how ageing...... manifests in the macula of the elderly focusing on clinical relevant measures that are thicknesses and volumes of different macular areas. Ageing seems to increase center point foveal thickness. Ageing does not seem to change the center subfield thickness significantly. Ageing decreases the inner and outer...

  16. Acute Macular Neuroretinopathy Associated With Chikungunya Fever.

    Science.gov (United States)

    Pang, Claudine E; Navajas, Eduardo V; Warner, Simon J; Heisler, Morgan; Sarunic, Marinko V

    2016-06-01

    A 47-year-old man with recent travel to the Caribbean was admitted with acute febrileillness associated with arthralgia and skin rash followed by sudden onset of bilateral visual field defects. Funduscopy revealed subtle bilateral paracentral dark lesions nasal to the fovea best seen on near infrared imaging as hyporeflective, wedge-shaped, paracentral macular lesions. Spectral-domain optical coherence tomography (SD-OCT) through the lesions revealed hyperreflective bands at the level of the outer plexiform layer and outer nuclear layer (ONL), with concomitant attenuation of the underlying external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ). Neither fluorescein angiography nor speckle variance OCT angiography (sv-OCTA) showed any defects in retinal circulation. Work up revealed positive Immunoglobulin M for Chikungunya virus (CHIKV). Six months later, the patient had persistent scotomas, although reduced in size. SD-OCT showed subtle ONL thinning and restoration of the ELM, although EZ and IZ remained disrupted. Chikungunya fever may manifest as bilateral acute macular neuroretinopathy (AMN). Clinicians should be aware of possible systemic associations of AMN. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:596-599.]. Copyright 2016, SLACK Incorporated.

  17. Management of pseudophakic cystoid macular edema.

    Science.gov (United States)

    Guo, Suqin; Patel, Shriji; Baumrind, Ben; Johnson, Keegan; Levinsohn, Daniel; Marcus, Edward; Tannen, Brad; Roy, Monique; Bhagat, Neelakshi; Zarbin, Marco

    2015-01-01

    Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. [Physiopathology of macular edema in central vein occlusion].

    Science.gov (United States)

    Stanca, Horia T; Manea, Georgiana

    2012-01-01

    Retinal Vein Occlusions are vascular diseases affecting the Central Retinal Vein and its branches causing decreased retinal drainage resulting in significant clinical and functional pathological changes. RVO determines the increase of vascular permeability, with edema and hemorrhage and development of collateral vessels in a few weeks. Among the serious consequences of venous occlusion is the installation of macular edema to which depends long-term visual prognosis. Macular Edema is the accumulation of intraretinal serous fluid in the macular area caused by the breakdown of blood-retinal barrier.

  19. Clinical and tomographic aspects of macular microholes; Aspectos clinicos e tomograficos dos microburacos maculares

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, Fernando Jose de [Hospital de Olhos Sadalla Amin Ghanem, Joinville, SC (Brazil)], e-mail: Fernando.novelli@gmail.com; Maia Junior, Otacilio de Oliveira [Fundacao Monte Tabor, Salvador, BA (Brazil). Hospital Sao Rafael; Nobrega, Mario Junqueira [Universidade da Regiao de Joinville (UNIVILLE), Joinville, SC (Brazil); Garrido Neto, Theodomiro [Universidade do Estado do Amazonas (UEA), Manaus, AM (Brazil); Takahashi, Walter Yukihiko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Oftalmologia

    2009-07-01

    Purpose: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. Methods: Seven patients were assessed (8 eyes) with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. Results: Ages ranged from 26 to 69 years. Six patients were female (85.7%) and five of them had microhole in the right eye. The presenting symptom was decrease in visual acuity (71.3%) and central scotoma in (14.3%). Five eyes (71.4%) had no defects shown by fluorescent angiography. A defect in the outer retina was demonstrated in all eyes on optical coherence tomography. The lesions were nonprogressive. Conclusion: Macular microholes are small lamellar defects in the outer retina. The condition is nonprogressive, generally unilateral and compatible with good visual acuity. Fundus biomicroscopy associated with an optical coherence tomography are the main elements in the diagnosis and study of this pathology. (author)

  20. LASER PHOTOCOAGULATION IN DIABETIC MACULAR EDEMA: EFFECTS ON VISUAL ACUITY AND MACULAR EDEMA

    Directory of Open Access Journals (Sweden)

    M.H. Dehghan

    1999-06-01

    Full Text Available Due to the importance of clinically significant macular edema in diabetic patients, this study is aimed to determine if laser photocoagulation is effective in the treatment of clinically significant diabetic macular edema. In addition, the effects of risk factors arc surveyed* This is an existing data study considering patients with clinically significant diabetic macular edema, treated with argon-green laser photocoagulation in Labbafinejad hospital, department of lasertherapy, from 1995 to 1997. in 60 (42.6% eyes the treatment method was focal, in 22 (15.6% eyes grid, and in 59 (41.84 modified grid laser photocoagulation was performed. The results are based upon deterioration of visual acuity, occurance of moderate visual loss and improvement or persistence of CSME. We studied 114 eyes from 87 patients. Two years after initial treatment, visual acuity improved in 19.1% of eyes, unchanged in 9.5% and worsened in 71.4% of eyes. After this period the rate of moderate visual loss was 28.6% and CSME was improved in 23.8% of eyes. According to our study, baseline visual acuity and retinopathy severity were two important intervening factors in response to lasertherapy. Comparing our results with natural course of diabetic macular edema, indicates that in assessing visual outcome laser photocoagulation is an effective modality in treatment of CSME, but it is not effective in maintaining or improving visual acuity, which is due to patients delay in visiting ophthalmologists and paying not enough attention to follow-up visits.

  1. Ultrastructural findings in progressive macular hypomelanosis indicate decreased melanin production

    NARCIS (Netherlands)

    Relyveld, G. N.; Dingemans, K. P.; Menke, H. E.; Bos, J. D.; Westerhof, W.

    2008-01-01

    BACKGROUND: The pathogenesis of progressive macular hypomelanosis (PMH) is unknown. Recently, Westerhof et al. (Arch Dermatol 2004; 140: 210-214) hypothesized that Propionibacterium acnes produces a depigmenting factor that interferes with melanogenesis in the skin, resulting in hypopigmented spots.

  2. Acute macular edema following intracorporeal prostaglandin injection for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Asahi MG

    2015-07-01

    Full Text Available Masumi G Asahi, Calvin Chou, Ron P Gallemore Retina Macula Institute, Torrance, CA, USA Purpose: We aimed to describe the first case of macular edema following intracorporeal injection of alprostadil, a prostaglandin E1. Methods: This was a retrospective case report followed with optical coherence tomography, fundus photos, and fluorescein angiography images. Results: A patient developed bilateral cystoid macular edema following intracorporeal injection of alprostadil, a prostaglandin E1 for treatment of erectile dysfunction. The edema resolved following treatment with nonsteroidal anti-inflammatory drugs (NSAIDs and corticosteroids, with subsequent recovery in visual acuity. Discussion: Systemic prostaglandin administration can cause macular edema and vision loss, indicating that elevated systemic prostaglandin levels may affect visual function. This has potential implications for other systemic disorders and treatments that could affect macular function. Keywords: alprostadil, inflammation

  3. Quantification of retinal layer thickness changes in acute macular neuroretinopathy

    DEFF Research Database (Denmark)

    Munk, Marion R; Beck, Marco; Kolb, Simone

    2017-01-01

    PURPOSE: To quantitatively evaluate retinal layer thickness changes in acute macular neuroretinopathy (AMN). METHODS: AMN areas were identified using near-infrared reflectance (NIR) images. Intraretinal layer segmentation using Heidelberg software was performed. The inbuilt ETDRS -grid was moved ...

  4. [Depression in Patients with Age-Related Macular Degeneration].

    Science.gov (United States)

    Narváez, Yamile Reveiz; Gómez-Restrepo, Carlos

    2012-09-01

    Age-related macular degeneration is a cause for disability in the elderly since it greatly affects their quality of life and increases depression likelihood. This article discusses the negative effect depression has on patients with age-related macular degeneration and summarizes the interventions available for decreasing their depression index. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Pathology of Macular Foveoschisis Associated with Degenerative Myopia

    Directory of Open Access Journals (Sweden)

    Johnny Tang

    2010-01-01

    Full Text Available This is a clinicopathological paper on the histologic findings in myopia-associated macular foveoschisis. The findings on ophthalmic pathological study of a 73-year-old woman with high myopia are reviewed. Multiple retinoschisis cavities involving both the macula and retinal periphery were disclosed. Our paper offers tissue evidence and supports recent ocular coherence tomography reports of eyes with high myopia and associated macular foveoschisis.

  6. Bilateral coexistence of keratoconus and macular corneal dystrophy

    Directory of Open Access Journals (Sweden)

    Ghazi Al-Hamdan

    2009-01-01

    The authors hereby report a 21-year-old female who presented with the typical signs and topographic evidence of keratoconus in association with macular corneal dystrophy. Histopathologic evaluation from the excised corneal button after corneal transplant confirmed the diagnosis. To our knowledge, there is only one previous report in the literature linking the association of keratoconus and macular corneal dystrophy in the same eye bilaterally.

  7. Prevention of Age-Related Macular Degeneration.

    Science.gov (United States)

    Singh, Niharika; Srinivasan, Sangeetha; Muralidharan, Vinata; Roy, Rupak; V, Jayprakash; Raman, Rajiv

    2017-01-01

    Age-related macular degeneration (AMD) compromises quality of life. However, the available therapeutic options are limited. This has led to the identification of modifiable risk factors to prevent the development or alter the natural course and prognosis of AMD. The identification and modification of risk factors has the potential for greater public health impact on reducing morbidity from AMD. Likewise, identifying the imaging clues and genetic clues could serve as a guide to recognizing the propensity for progression to severe and end stages of the disease. Several attempts, both successful and unsuccessful, have been made for interventions that could delay the progression of AMD. Of these, pharmacological interventions have shown promising results. The Age-Related Eye Disease Study 1 and 2 have shown the beneficial role of antioxidants in a selected group of patients. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  8. Perceptual learning in patients with macular degeneration

    Directory of Open Access Journals (Sweden)

    Tina ePlank

    2014-10-01

    Full Text Available Patients with age-related macular degeneration (AMD or hereditary macular dystrophies (JMD rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT at their preferred retinal locus (PRL used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later took part in three functional magnetic resonance imaging (fMRI sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p=.001 in the stimulus onset asynchrony (SOA between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p=.014. The following trends were observed: (i Improvement in Vernier acuity for an eccentric line-bisection task; (ii positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r=0.531; (iii positive correlation between the increase in task performance and initial fixation stability (r=0.730. The first two trends were non-significant, whereas the third trend was significant at p=.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex.

  9. [Macular Edema in Uveitis - Steroids or VEGF Inhibitors?

    Science.gov (United States)

    Heinz, Carsten; Heiligenhaus, Arnd

    2017-06-09

    Macular edema in uveitis patients is certainly the most frequent complication leading to a permanent and irreversible reduction in vision during the course of the disease. Thanks to optical coherence tomography (OCT) technology and fluorescein angiography (FAG), significantly more macular edemas are detected. Macular edema can be found in various uveitis varieties and can show different clinical patterns. All macular edema should be treated. Macular edema with active inflammation usually reacts very well to general uveitis treatment. In the case of eyes without visible inflammation, however, the response to such therapy is usually less effective. According to the latest treatment recommendations, dexamethasone implants should be used as the first intravitreal therapy. Vascular endothelial growth factor inhibitors (VEGF inhibitors) are second-line treatment regimens. The choice of therapy is, therefore, primarily based on the degree of inflammation and the individual complications, such as glaucoma, lens situation or previous increase in IOP after steroid administration. These individual complications may allow using VEGF inhibitors as first line treatment. An improvement in the macular edema can be achieved with both groups of active substances. Georg Thieme Verlag KG Stuttgart · New York.

  10. Photocoagulation treatment for clinically significant radiation macular oedema

    Energy Technology Data Exchange (ETDEWEB)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M. [Washington Univ., Seattle, WA (United States)

    1995-02-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author).

  11. Photocoagulation treatment for clinically significant radiation macular oedema

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M.

    1995-01-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author)

  12. [Macular surgery in a new point of view].

    Science.gov (United States)

    Branişteanu, D; Moraru, Andreea

    2014-01-01

    To reveal the differences in anatomical and functional results following standard 20-gauge vitrectomy and modern transconjunctival sutureless vitrectomy in macular surface pathology. Retrospective, interventional, comparative evaluation of macular pathology cases operated by standard 20-gauge vitrectomy and transconjunctival 23 G sutureless vitrectomy. In evaluation were included a comparable number of epiretinal membranes (both idiopathic and secondary) and stage 3 and 4 macular holes. A postoperative anatomical and functional analysis was performed and also the incidence of pre-and postoperative complications was noted. Transconjunctival sutureless vitrectomy was associated with a shorter operating time and quicker anatomical and functional results. If in epiretinal membranes there was no significant difference in final results, in macular holes anatomical and functional results were better with sutureless vitrectomy. These results confirm the efficacy and safety of both surgical procedures in macular surface pathology. Better anatomical and functional results in macular holes and quicker functional rehabilitation in all cases promote sutureless vitrectomy as new standard procedure in these cases.

  13. MACULAR DETACHMENT ASSOCIATED WITH INTRACHOROIDAL CAVITATION IN NONPATHOLOGICAL MYOPIC EYES.

    Science.gov (United States)

    Ando, Yoshimasa; Inoue, Makoto; Ohno-Matsui, Kyoko; Kusumi, Yumi; Iida, Tomohiro; Hirakata, Akito

    2015-10-01

    To report the characteristics of a macular detachment associated with peripapillary intrachoroidal cavitation (ICC) and the outcomes of vitrectomy. The medical records of 69 eyes of 61 patients who underwent vitrectomy for macular detachment or macular retinoschisis but without vitreomacular traction or optic disc pit were reviewed. Optical coherence tomography was used to determine the morphology of the ICC. The outcomes of vitrectomy including the creation of a posterior vitreous detachment and internal limiting membrane peeling were evaluated. An ICC was detected in 3 of 3 eyes without pathologic myopia but none in 66 eyes with pathologic myopia (P detachment in all eyes. Optical coherence tomography detected a connection between the vitreous cavity and the ICC in two eyes with pit-like splitting and between the subretinal space and the ICC in two eyes. The macular detachment was resolved 5 months to 6 months postoperatively with improvement of vision. A macular detachment with ICC can be present in nonpathological myopic eyes. Vitreous surgery to create a posterior vitreous detachment with internal limiting membrane peeling may help resolve the macular detachment.

  14. Macular micropseudocysts in early stages of diabetic retinopathy.

    Science.gov (United States)

    Tremolada, Gemma; Pierro, Luisa; de Benedetto, Umberto; Margari, Sergio; Gagliardi, Marco; Maestranzi, Gisella; Calori, Giliola; Lorenzi, Mara; Lattanzio, Rosangela

    2011-01-01

    To identify by noninvasive means early retinal abnormalities that may predict diabetic macular edema. The authors analyzed retrospectively data from consecutive patients with Type 1 (n = 16) or Type 2 (n = 23) diabetes who presented for routine follow-up of early retinopathy, had no clinical signs or symptoms of diabetic macular edema, and were evaluated with spectral-domain optical coherence tomography. Age- and gender-matched nondiabetic subjects provided normative data. Spectral-domain optical coherence tomography revealed in the macular region of diabetic patients small hyporeflective areas (median diameter, 55 μm) contained within discrete retinal layers that we named micropseudocysts (MPCs). Micropseudocysts are associated with vascular leakage. The patients showing MPCs had more frequently systemic hypertension and increased central foveal thickness than those without MPCs. The association with increased central foveal thickness was only in the patients with Type 2 diabetes. Macular MPCs in patients with mild diabetic retinopathy appear to reflect leakage and can precede macular thickening. The association of MPCs with increased central foveal thickness in patients with Type 2 diabetes, but not in patients with Type 1 diabetes, points to a greater tendency to retinal fluid accumulation in patients with Type 2 diabetes. Studies in larger cohorts will determine the usefulness of MPCs in strategies to abort diabetic macular edema.

  15. The Association Between Subretinal Drusenoid Deposits in Older Adults in Normal Macular Health and Incident Age-Related Macular Degeneration.

    Science.gov (United States)

    Huisingh, Carrie; McGwin, Gerald; Neely, David; Zarubina, Anna; Clark, Mark; Zhang, Yuhua; Curcio, Christine A; Owsley, Cynthia

    2016-02-01

    Subretinal drusenoid deposits (SDD) have been associated with the progression to late age-related macular degeneration (AMD). To determine whether SDD in eyes in normal macular health increases risk for early AMD, this study examined the association between presence of SDD at baseline in a cohort of older adults in normal macular health and incident AMD 3 years later. Subjects enrolled in the Alabama Study on Early Age-Related Macular Degeneration (ALSTAR) were assessed for the presence of SDD using color fundus photos, infrared reflectance and fundus autofluorescence images, and spectral-domain optical coherence tomography volumes. The study sample included 799 eyes from 455 participants in normal macular health per grading of color fundus photographs using the 9-step Age-Related Eye Disease Study (AREDS) classification system. Age-related macular degeneration was defined as eyes having an AREDS grade ≥2 at the 3-year follow-up. Twenty-five percent of participants had SDD in one or both eyes at baseline. At follow-up visit, 11.9% of eyes in the sample developed AMD. Compared to eyes without SDD, those with SDD were 2.24 (95% confidence interval [CI] 1.36-3.70) times more likely to have AMD at follow-up. After adjusting for age, C-reactive protein quartile, and family history of AMD, the association persisted. Results suggest that SDD in older eyes with normal macular health as defined by the AREDS scale is a risk factor for the development of early AMD. Older adults in seemingly normal macular health yet having SDD may warrant closer clinical monitoring for the possible onset of early AMD.

  16. Risk factors of age-related macular degeneration in Argentina

    Directory of Open Access Journals (Sweden)

    María Eugenia Nano

    2013-04-01

    Full Text Available PURPOSES: To assess the risk factors of age-related macular degeneration in Argentina using a case-control study. METHODS: Surveys were used for subjects' antioxidant intake, age/gender, race, body mass index, hypertension, diabetes (and type of treatment, smoking, sunlight exposure, red meat consumption, fish consumption, presence of age-related macular degeneration and family history of age-related macular degeneration. Main effects models for logistic regression and ordinal logistic regression were used to analyze the results. RESULTS: There were 175 cases and 175 controls with a mean age of 75.4 years and 75.5 years, respectively, of whom 236 (67.4% were female. Of the cases with age-related macular degeneration, 159 (45.4% had age-related macular degeneration in their left eyes, 154 (44.0% in their right eyes, and 138 (39.4% in both eyes. Of the cases with age-related macular degeneration in their left eyes, 47.8% had the dry type, 40.3% had the wet type, and the type was unknown for 11.9%. The comparable figures for right eyes were: 51.9%, 34.4%, and 13.7%, respectively. The main effects model was dominated by higher sunlight exposure (OR [odds ratio]: 3.3 and a family history of age-related macular degeneration (OR: 4.3. Other factors included hypertension (OR: 2.1, smoking (OR: 2.2, and being of the Mestizo race, which lowered the risk of age-related macular degeneration (OR: 0.40. Red meat/fish consumption, body mass index, and iris color did not have an effect. Higher age was associated with progression to more severe age-related macular degeneration. CONCLUSION: Sunlight exposure, family history of age-related macular degeneration, and an older age were the significant risk factors. There may be other variables, as the risk was not explained very well by the existing factors. A larger sample may produce different and better results.

  17. Single night postoperative prone posturing in idiopathic macular hole surgery.

    LENUS (Irish Health Repository)

    2012-02-01

    Purpose. To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. Methods. This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole. Intraocular gas tamponade (20% C2F6) was used in all cases with postoperative face-down posturing overnight and without specific posturing afterwards. LogMAR visual acuity, appearance by slit-lamp biomicroscopy, and ocular coherence tomography (OCT) scans were compared preoperatively and postoperatively to assess outcome. Results. Among 14 eyes recruited, all eyes were phakic; 50% of patients underwent concurrent phacoemulsification with IOL. The macular holes were categorized preoperatively by OCT appearance, 4 (28.57%) were stage 2, 7 (50%) were stage 3, and 3 (21.43%) were stage 4. Mean macular hole size was 0.35 disk diameters. Symptoms of macular hole had been present for an average of 6.5 months. All holes (100%) were closed 3 and 6 months postoperatively. Mean visual acuity (logMAR) was improved to 0.61 at 3 months and was stable at 6 months after the surgery. None of the eyes had worse vision postoperatively. Conclusions. Vitrectomy with ILM peeling and 20% C2F6 gas with a brief postoperative 1 night prone posturing regimen is a reasonable approach to achieve anatomic closure in idiopathic macular hole. Concurrent cataract extraction did not alter outcomes and was not associated with any additional complications.

  18. Macular xanthophylls, lipoprotein-related genes, and age-related macular degeneration1234

    Science.gov (United States)

    Koo, Euna; Neuringer, Martha; SanGiovanni, John Paul

    2014-01-01

    Plant-based macular xanthophylls (MXs; lutein and zeaxanthin) and the lutein metabolite meso-zeaxanthin are the major constituents of macular pigment, a compound concentrated in retinal areas that are responsible for fine-feature visual sensation. There is an unmet need to examine the genetics of factors influencing regulatory mechanisms and metabolic fates of these 3 MXs because they are linked to processes implicated in the pathogenesis of age-related macular degeneration (AMD). In this work we provide an overview of evidence supporting a molecular basis for AMD-MX associations as they may relate to DNA sequence variation in AMD- and lipoprotein-related genes. We recognize a number of emerging research opportunities, barriers, knowledge gaps, and tools offering promise for meaningful investigation and inference in the field. Overviews on AMD- and high-density lipoprotein (HDL)–related genes encoding receptors, transporters, and enzymes affecting or affected by MXs are followed with information on localization of products from these genes to retinal cell types manifesting AMD-related pathophysiology. Evidence on the relation of each gene or gene product with retinal MX response to nutrient intake is discussed. This information is followed by a review of results from mechanistic studies testing gene-disease relations. We then present findings on relations of AMD with DNA sequence variants in MX-associated genes. Our conclusion is that AMD-associated DNA variants that influence the actions and metabolic fates of HDL system constituents should be examined further for concomitant influence on MX absorption, retinal tissue responses to MX intake, and the capacity to modify MX-associated factors and processes implicated in AMD pathogenesis. PMID:24829491

  19. Age related macular degeneration and visual disability.

    Science.gov (United States)

    Christoforidis, John B; Tecce, Nicola; Dell'Omo, Roberto; Mastropasqua, Rodolfo; Verolino, Marco; Costagliola, Ciro

    2011-02-01

    Age-related macular degeneration (AMD) is the leading cause of central blindness or low vision among the elderly in industrialized countries. AMD is caused by a combination of genetic and environmental factors. Among modifiable environmental risk factors, cigarette smoking has been associated with both the dry and wet forms of AMD and may increase the likelihood of worsening pre-existing AMD. Despite advances, the treatment of AMD has limitations and affected patients are often referred for low vision rehabilitation to help them cope with their remaining eyesight. The characteristic visual impairment for both forms of AMD is loss of central vision (central scotoma). This loss results in severe difficulties with reading that may be only partly compensated by magnifying glasses or screen-projection devices. The loss of central vision associated with the disease has a profound impact on patient quality of life. With progressive central visual loss, patients lose their ability to perform the more complex activities of daily living. Common vision aids include low vision filters, magnifiers, telescopes and electronic aids. Low vision rehabilitation (LVR) is a new subspecialty emerging from the traditional fields of ophthalmology, optometry, occupational therapy, and sociology, with an ever-increasing impact on the usual concepts of research, education, and services for visually impaired patients. Relatively few ophthalmologists practise LVR and fewer still routinely use prismatic image relocation (IR) in AMD patients. IR is a method of stabilizing oculomotor functions with the purpose of promoting better function of preferred retinal loci (PRLs). The aim of vision rehabilitation therapy consists in the achievement of techniques designed to improve PRL usage. The use of PRLs to compensate for diseased foveae has offered hope to these patients in regaining some function. However, in a recently published meta-analysis, prism spectacles were found to be unlikely to be of

  20. Hyperautofluorescent ring in eyes with macular holes

    Directory of Open Access Journals (Sweden)

    Sato T

    2013-08-01

    Full Text Available Tatsuhiko Sato, Kazuyuki Emi, Yui Osawa, Hajime Bando Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, Sakai, Japan Background: Fundus autofluorescence studies in eyes with macular holes (MHs have shown a hyperautofluorescent spot corresponding to the hole and a hypoautofluorescent ring corresponding to the fluid cuff surrounding the hole. The purpose of this report is to present three cases of MH with a different fundus autofluorescence pattern. Case reports: Case 1 was a 62-year-old woman who did not know the duration of the MH in her left eye. Her decimal best-corrected visual acuity (BCVA was 0.08. The left eye had a one-half disc diameter MH with a depigmented ring surrounding the area of the fluid cuff. Fundus autofluorescence showed a hyperautofluorescent ring corresponding to the depigmented ring. After vitrectomy, fundus autofluorescence showed the same size hyperautofluorescent ring despite the decreased size of the opened MH. Case 2 was a 69-year-old woman who had been diagnosed with MH in the right eye 13 years earlier. Her decimal BCVA was 0.1. The right eye had a one-half disc diameter MH with a depigmented ring surrounding the area of the fluid cuff. Fundus autofluorescence showed a hyperautofluorescent ring corresponding to the depigmented ring. Postoperative fundus autofluorescence showed the same size hyperautofluorescent ring despite the hole being closed. The decimal BCVA was 0.2 in her right eye 6 months after vitrectomy. Case 3 was a 71-year-old woman who had been diagnosed with MH in the right eye 15 years earlier. Her decimal BCVA was 0.1. The right eye had a one-half disc diameter MH with a depigmented ring which corresponded with a hyperautofluorescent ring. Postoperative fundus autofluorescence showed the same size hyperautofluorescent ring despite the hole being closed. The decimal BCVA was 0.2 in her right eye 6 months after vitrectomy. Conclusion: Our findings suggest that a

  1. [Comparison of macular electroretinography and psychophysical tests in diabetic retinopathy with intraretinal edema].

    Science.gov (United States)

    Grounauer, P A; Balmer, A; Geinoz, J; Stress, S

    1978-01-01

    Short comparison between psychophysic and electrodiagnostic tests in 20 eyes with macular edema from diabetic retinopathy. De Lange's curve, the critical flicker frequency in central fixation and the macular ERG are compared with the classical EOG and global ERG data. The methodology is briefly described. It allows a new approach of the macula and the macular ERG responses confirms the clinical tests.

  2. The role of steroids in the management of uveitic macular edema

    NARCIS (Netherlands)

    de Smet, Marc D.; Julian, Karina

    2010-01-01

    Purpose. To review the role of steroids in the management of uveitic macular edema. Methods. Review of recent literature on the physiopathology of macular edema and clinical trials involving steroids as main treatment of uveitic macular edema. Results. The steroid-glucocorticoid receptor complex

  3. A Case of Diabetic Macular Edema with Prominent Chorioretinal Folds

    Directory of Open Access Journals (Sweden)

    Takaki Sato

    2017-03-01

    Full Text Available Purpose: To report a case of diabetic macular edema with prominent chorioretinal folds. Case Report: This study involved a 55-year-old male with untreated bilateral diabetic retinopathy who had undergone cataract surgery at another clinic. Following that surgery, diabetic macular edema rapidly exacerbated, accentuating marked cystoid macular edema and radial chorioretinal folds in the macula. Investigation of his medical history revealed that in addition to diabetes, he had uncontrolled hypertension and severe diabetic nephropathy. Vitreous surgery was performed on both eyes due to a resistance to a subtenon injection of triamcinolone acetonide or intravitreal injection of an antivascular endothelial growth factor agent. After surgery, the macular edema and chorioretinal folds showed a tendency towards improvement. Thereafter, kidney transplant surgery was performed for renal failure, and a mild tendency of chorioretinal folds was observed. Conclusion: In the case presented in this study, we observed remarkable cystoid macular edema in the fovea centralis and theorize that distortion with the surrounding tissue might have occurred, thus leading to the formation of chorioretinal folds around the macula.

  4. Intravitreal gas injection for the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    McHugh D

    2011-10-01

    Full Text Available Dominic McHugh, Bhaskar Gupta, Manzar Saeed King's College Hospital, Denmark Hill, London, England, UK Purpose: This study investigates the efficacy of an intravitreal gas injection in inducing a posterior vitreous detachment (PVD in patients with clinically significant diabetic macular edema refractory to laser therapy. Methods: A local ethics committee-approved technique of an intravitreal injection of pure perfluoropropane gas (C3F8 was performed for all participants. After a period of prone positioning, the patients underwent regular and detailed clinical review. Main outcome measures: The induction of a PVD, change in macular thickness, change in visual acuity. Results: A PVD was induced in all five eyes with subsequent signs of reduction in macular thickness and resolution of exudates. Mean visual improvement was 11 ETDRS (Early Treatment Diabetic Retinopathy Study letters (range 4–21. Apart from a transient vitreous hemorrhage in one eye, there were no significant treatment-related complications. Conclusion: The induction of a PVD by pneumatic retinopexy appears to have a significant influence on diabetic macular edema in eyes which have not successfully responded to macular laser therapy. A randomized clinical trial is justified on the basis of the initial promising data. Keywords: optical coherence tomography, OCT, posterior vitreous detachment, perfluoropropane

  5. Parainflammation, chronic inflammation, and age-related macular degeneration.

    Science.gov (United States)

    Chen, Mei; Xu, Heping

    2015-11-01

    Inflammation is an adaptive response of the immune system to noxious insults to maintain homeostasis and restore functionality. The retina is considered an immune-privileged tissue as a result of its unique anatomic and physiologic properties. During aging, the retina suffers from a low-grade chronic oxidative insult, which sustains for decades and increases in level with advancing age. As a result, the retinal innate-immune system, particularly microglia and the complement system, undergoes low levels of activation (parainflammation). In many cases, this parainflammatory response can maintain homeostasis in the healthy aging eye. However, in patients with age-related macular degeneration, this parainflammatory response becomes dysregulated and contributes to macular damage. Factors contributing to the dysregulation of age-related retinal parainflammation include genetic predisposition, environmental risk factors, and old age. Dysregulated parainflammation (chronic inflammation) in age-related macular degeneration damages the blood retina barrier, resulting in the breach of retinal-immune privilege, leading to the development of retinal lesions. This review discusses the basic principles of retinal innate-immune responses to endogenous chronic insults in normal aging and in age-related macular degeneration and explores the difference between beneficial parainflammation and the detrimental chronic inflammation in the context of age-related macular degeneration. © Society for Leukocyte Biology.

  6. New Computer Simulations of Macular Neural Functioning

    Science.gov (United States)

    Ross, Muriel D.; Doshay, D.; Linton, S.; Parnas, B.; Montgomery, K.; Chimento, T.

    1994-01-01

    We use high performance graphics workstations and supercomputers to study the functional significance of the three-dimensional (3-D) organization of gravity sensors. These sensors have a prototypic architecture foreshadowing more complex systems. Scaled-down simulations run on a Silicon Graphics workstation and scaled-up, 3-D versions run on a Cray Y-MP supercomputer. A semi-automated method of reconstruction of neural tissue from serial sections studied in a transmission electron microscope has been developed to eliminate tedious conventional photography. The reconstructions use a mesh as a step in generating a neural surface for visualization. Two meshes are required to model calyx surfaces. The meshes are connected and the resulting prisms represent the cytoplasm and the bounding membranes. A finite volume analysis method is employed to simulate voltage changes along the calyx in response to synapse activation on the calyx or on calyceal processes. The finite volume method insures that charge is conserved at the calyx-process junction. These and other models indicate that efferent processes act as voltage followers, and that the morphology of some afferent processes affects their functioning. In a final application, morphological information is symbolically represented in three dimensions in a computer. The possible functioning of the connectivities is tested using mathematical interpretations of physiological parameters taken from the literature. Symbolic, 3-D simulations are in progress to probe the functional significance of the connectivities. This research is expected to advance computer-based studies of macular functioning and of synaptic plasticity.

  7. Animal models of age related macular degeneration

    Science.gov (United States)

    Pennesi, Mark E.; Neuringer, Martha; Courtney, Robert J.

    2013-01-01

    Age related macular degeneration (AMD) is the leading cause of vision loss of those over the age of 65 in the industrialized world. The prevalence and need to develop effective treatments for AMD has lead to the development of multiple animal models. AMD is a complex and heterogeneous disease that involves the interaction of both genetic and environmental factors with the unique anatomy of the human macula. Models in mice, rats, rabbits, pigs and non-human primates have recreated many of the histological features of AMD and provided much insight into the underlying pathological mechanisms of this disease. In spite of the large number of models developed, no one model yet recapitulates all of the features of human AMD. However, these models have helped reveal the roles of chronic oxidative damage, inflammation and immune dysregulation, and lipid metabolism in the development of AMD. Models for induced choroidal neovascularization have served as the backbone for testing new therapies. This article will review the diversity of animal models that exist for AMD as well as their strengths and limitations. PMID:22705444

  8. Diabetic Macular Edema Pathophysiology: Vasogenic versus Inflammatory

    Directory of Open Access Journals (Sweden)

    Pedro Romero-Aroca

    2016-01-01

    Full Text Available Diabetic macular edema (DME can cause blindness in diabetic patients suffering from diabetic retinopathy (DR. DM parameters controls (glycemia, arterial tension, and lipids are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease. However, it still remains to be clarified whether angiogenesis following VEGF overexpression is a cause or a consequence of inflammation. This paper provides a review of the data currently available, focusing on VEGF, angiogenesis, and inflammation. Our analysis suggests that angiogenesis and inflammation act interdependently during the development of DME. Knowledge of DME etiology seems to be important in treatments with anti-VEGF or anti-inflammatory drugs. Current diagnostic techniques do not permit us to differentiate between both etiologies. In the future, diagnosing the physiopathology of each patient with DME will help us to select the most effective drug.

  9. NONSUPINE POSITIONING IN MACULAR HOLE SURGERY

    DEFF Research Database (Denmark)

    Alberti, Mark; la Cour, Morten

    2016-01-01

    PURPOSE: To determine whether nonsupine positioning (NSP) is noninferior to face-down positioning (FDP) in full-thickness macular hole (FTMH) surgery. METHODS: This is a single-center, open-label, randomized controlled trial. Between October 2013 and October 2014, pseudophakic participants...... positioning groups: 33/34 (97.1%; 95% confidence interval: 84.7-99.9). Closure rates in the ≥400-μm FTMH subgroup were similar, 93.8% and 100.0% in the FDP and NSP groups, respectively (P = 0.43). Final visual acuity did not differ significantly between the groups (P = 0.60). Median gas fill was 78% (range......: 57-86) in the FDP group and 76% (range: 56-85) in the NSP group (P = 0.51). Gas fill in closed FTMHs was significantly higher than in unclosed FTMHs (P = 0.02). CONCLUSION: Nonsupine positioning is noninferior to FDP in FTMH surgery. Furthermore, results suggest that the degree of gas fill affects...

  10. MACULAR ATROPHY FINDINGS BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY COMPARED WITH FUNDUS AUTOFLUORESCENCE IN TREATED EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Takasago, Yukari; Shiragami, Chieko; Kobayashi, Mamoru; Osaka, Rie; Ono, Aoi; Yamashita, Ayana; Tsujikawa, Akitaka; Hirooka, Kazuyuki

    2017-11-28

    To compare the areas of choriocapillaris (CC) nonperfusion and macular atrophy (MA) in treated exudative age-related macular degeneration. This was a prospective, observational, cross-sectional study. Forty-four eyes exhibiting MA (42 patients with age-related macular degeneration), with a dry macula, underwent fundus autofluorescence and optical coherence tomography angiography. The area of MA detected by fundus autofluorescence and CC nonperfusion detected by optical coherence tomography angiography was measured using image analysis software. The rates of concordance between the MA and CC nonperfusion areas were calculated. We qualitatively and quantitatively compared the areas of MA and CC nonperfusion in age-related macular degeneration eyes. The mean areas of MA and CC nonperfusion were 5.95 ± 4.50 mm and 10.66 ± 7.05 mm, respectively (paired t-test, P age-related macular degeneration.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  11. Radiation treatment for age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Tomoko; Mandai, Michiko; Honjo, Megumi; Matsuda, Naoko; Miyamoto, Hideki; Takahashi, Masayo; Ogura, Yuichiro; Sasai, Keisuke [Kyoto Univ. (Japan). Faculty of Medicine

    1996-11-01

    Fifteen eyes of age-related macular degeneration were treated by low-dose radiation. All the affected eyes had subfoveal neovascular membrane. Seventeen nontreated eyes with similar macular lesion served as control. Radiation was performed using photon beam at 6MV. Each eye received daily dose of 2 Gy for 5 consecutive days. When evaluated 9 to 12 months after treatment, the size of neovascular membrane had decreased in 47% of treated eyes and 7% of control eyes. The visual acuity improved by 2 lines or more in 13% of treated eyes and in none of control eyes. When the initial neovascular membrane was less than 1.5 disc diameter in size, the visual acuity had improved or remained stationary in 90% of treated eyes and in 36% of control eyes. The findings show the potential beneficial effect of radiation for age-related macular degeneration. (author)

  12. Cystoid Macular Edema Induced by Low Doses of Nicotinic Acid

    Directory of Open Access Journals (Sweden)

    Daniela Domanico

    2013-01-01

    Full Text Available Cystoid macular edema (CME is a condition that involves the macula, causing painless vision loss. In this paper, we report a case of niacin-induced bilateral cystoid macular edema (CME in a middle-age woman taking low dose of niacin (18 mg of nicotinic acid. Optical coherence tomography (OCT showed retinal thickening and cystoid spaces in both eyes, whereas fluorescein angiography (FA; HRA 2, Heidelberg Engineering revealed the absence of fluorescein leakage also in later phases. Four weeks after discontinuation of therapy there were a complete disappearance of macular edema at funduscopic examination and an improvement of visual acuity in both eyes. Furthermore OCT showed a normal retinal profile in both eyes. In our opinion considering the wide availability of niacin, medical monitoring and periodical examination should be considered during niacin administration. To our knowledge, this is the first report in the literature that described the very low-dose niacin-induced bilateral niacin maculopathy.

  13. Dexamethasone Intravitreal Implant for Diabetic Macular Edema During Pregnancy

    DEFF Research Database (Denmark)

    Concillado, Michael; Lund-Andersen, Henrik; Mathiesen, Elisabeth R

    2016-01-01

    PURPOSE: To describe the management of diabetic macular edema during pregnancy with the use of a dexamethasone slow-release intravitreal implant. DESIGN: Retrospective, observational, consecutive case series. METHODS: The study included 5 pregnant women who presented with diabetic macular edema...... during pregnancy in the period from 2011 to 2014. Review of charts and photographs comprised best-corrected visual acuity (BCVA), foveal center field thickness assessed by optical coherence tomography, blood pressure, glycated hemoglobin, medications, and changes in such parameters after implant...... injection. RESULTS: Diabetic macular edema involving the foveal center was observed between gestational weeks 9 and 23 in 10 eyes of 5 patients. Dexamethasone intravitreal implant injection was given 10 times in 9 eyes with a mean preinjection center field retinal thickness of 535 μm (range, 239-727 μm...

  14. Intravitreal triamcinolone for intraocular inflammation and associated macular edema

    Directory of Open Access Journals (Sweden)

    Steven M Couch

    2008-11-01

    Full Text Available Steven M Couch, Sophie J BakriMayo Clinic Department of Ophthalmology, Mayo Clinic, Rochester, MN, USAAbstract: Triamcinolone acetonide (TA is a corticosteroid that has many uses in the treatment of ocular diseases because of its potent anti-inflammatory and anti-permeability actions. Intraocular inflammation broadly referred to as uveitis can result from several causes, including the immune system and after ophthalmic surgery. One of the most common reasons for vision loss with uveitis is macular edema. TA has been used for many years as an intravitreal injection for the treatment of ocular diseases. Several case control studies have been reported showing the efficacy of TA in the treatment of intraocular inflammation and associated macular edema caused by Behcet’s disease, Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia and white dot syndromes. It has also been shown efficacious in cases of pars planitis and idiopathic posterior uveitis. Some authors have reported its use in postoperative cystoid macular edema. Many of the studies on the use of TA in controlling intraocular inflammation and concomitant macular edema showed its effect to be transient in many patients requiring reinjection. Complications can arise from intravitreal injection of TA including elevated intraocular pressure and cataract. Rarely, it can be associated with infectious and non-infectious endophthalmitis. TA may be useful as an adjuvant in the treatment of uveitis and its associated macular edema, especially in patients resistant or intolerant to standard treatment.Keywords: triamcinolone acetonide, Behcet’s disease, sympathetic ophthalmia, Vogt-Koyanagi-Harada syndrome, white dot syndromes, uveitis, cataract surgery, macular edema, endophthalmitis

  15. Spontaneous resolution of macular edema after silicone oil removal

    Directory of Open Access Journals (Sweden)

    Eyyup Karahan

    2014-12-01

    Full Text Available AIM:To investigate the macular changes in eyes filled with silicone oil (SO and course of these changes after SO removal.METHODS:A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS:Mean duration of SO tamponade was 3.6±1.0mo (range:3-7mo. Cystoid macular edema (CME was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal. Resolution of CME and submacular fluid was achieved 1mo after SO removal in all eyes. Mean best corrected visual acuity (BCVA was 1.15±0.65 (range, hand movement to 0.2 before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82±0.23, 0.76±0.21, and 0.70±0.19, all of which were significantly better than baseline (P=0.030, 0.017, 0.006 respectively. In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline (P=0.037.CONCLUSION:Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.

  16. Bilateral macular colobomata: Temporal dragging of optic disc

    Directory of Open Access Journals (Sweden)

    David J Mathew

    2015-01-01

    Full Text Available A 13-year-old male presented with decreased vision and squint from childhood. He had bilateral large colobomata at the macula in each eye, the one on the right being larger than the left. The disc was dragged temporally with straightening of the temporal retinal vessels. This is a case report of bilateral large macular coloboma and serves to report its association with a temporally dragged disc and straightened temporal retinal vessels. A dragged disc if present with a colobomatous defect at the macula may strengthen the case for diagnosis of macular coloboma and help exclude other differentials.

  17. Topical Nonsteroidal Anti-Inflammatory Drugs for Macular Edema

    Directory of Open Access Journals (Sweden)

    Andrea Russo

    2013-01-01

    Full Text Available Nonsteroidal anti-inflammatory drugs (NSAIDs are nowadays widely used in ophthalmology to reduce eye inflammation, pain, and cystoid macular edema associated with cataract surgery. Recently, new topical NSAIDs have been approved for topical ophthalmic use, allowing for greater drug penetration into the vitreous. Hence, new therapeutic effects can be achieved, such as reduction of exudation secondary to age-related macular degeneration or diabetic maculopathy. We provide an updated review on the clinical use of NSAIDs for retinal diseases, with a focus on the potential future applications.

  18. Topical nonsteroidal anti-inflammatory drugs for macular edema.

    Science.gov (United States)

    Russo, Andrea; Costagliola, Ciro; Delcassi, Luisa; Parmeggiani, Francesco; Romano, Mario R; Dell'Omo, Roberto; Semeraro, Francesco

    2013-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are nowadays widely used in ophthalmology to reduce eye inflammation, pain, and cystoid macular edema associated with cataract surgery. Recently, new topical NSAIDs have been approved for topical ophthalmic use, allowing for greater drug penetration into the vitreous. Hence, new therapeutic effects can be achieved, such as reduction of exudation secondary to age-related macular degeneration or diabetic maculopathy. We provide an updated review on the clinical use of NSAIDs for retinal diseases, with a focus on the potential future applications.

  19. Bilateral macular colobomata: Temporal dragging of optic disc.

    Science.gov (United States)

    Mathew, David J

    2015-04-01

    A 13-year-old male presented with decreased vision and squint from childhood. He had bilateral large colobomata at the macula in each eye, the one on the right being larger than the left. The disc was dragged temporally with straightening of the temporal retinal vessels. This is a case report of bilateral large macular coloboma and serves to report its association with a temporally dragged disc and straightened temporal retinal vessels. A dragged disc if present with a colobomatous defect at the macula may strengthen the case for diagnosis of macular coloboma and help exclude other differentials.

  20. Acute effect of pure oxygen breathing on diabetic macular edema

    DEFF Research Database (Denmark)

    Vinten, Carl Martin; La Cour, Morten; Lund-Andersen, Henrik

    2012-01-01

    Purpose. A small-scale pilot study of the pathophysiology of diabetic macular edema (DME) was made by assessing concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), retinal artery diameter (RAD), and retinal vein diameter (RVD) in response...... diameters by fundus photography, intraocular pressure by pulse-air tonometry, and arterial blood pressure by sphygmomanometry. Results. After initiation of pure oxygen breathing, reductions of 2.6% in RAD (p=0.04) and 11.5% reduction in RVD (p...

  1. Clinical observation on vitreous surgery in treating idiopathic macular hole

    Directory of Open Access Journals (Sweden)

    Min Liu

    2013-12-01

    Full Text Available AIM: To observe the surgical effect and influential factors of idiopathic macular hole(IMHtreated with vitrectomy and internal limiting membrane peeling combined with intravitreal gas tamponade.METHODS: The clinical data of 22 IMH patients(23 eyeswere retrospectively analyzed. All the patients were diagnosed with IMH by optical coherence tomography(OCTand their macular hole patterns were measured before and after surgery by OCT in addition to the routine examinations. All patients were treated with vitrectomy, internal limiting membrane peeling combined with gas injection(air or inert gas. The postoperative visual acuity, macular hole closure rate and the incidence of surgical complications were observed. The correlation between the patients' age, course of disease, preoperative best corrected visual acuity(BCVA, macular hole diameter, the type of vitreous cavity filling gas, the postoperative BCVA, and the macular hole closure rate was analyzed with SPSS 13.0 statistical software.RESULTS: Postoperative OCT examination results showed that the macular hole closure rate was 100%. The macular hole closure rate was 79%(11 eyes of 14 eyesafter the first intravitreal air injection and 100%(9 eyesafter fist intravitreal inert gas injection(100mL/L C3F8. There was no significant difference between the air injection and inert gas injection(χ2=2.1214, P>0.05. The mean preoperational BCVA was 0.11±0.05 and the mean postoperative BCVA 0.23±0.12; there was a statistically significant difference between them(t=4.023,Pt=3.92, PPr=-0.415, P=0.256, duration of disease(r=0.193, P= 0.498, preoperative VA(r=0.152, P=0.673had no significant influence on IMH visual outcomes.CONCLUSION: The vitrectomy combined with internal limiting membrane peeling and intravitreal gas tamponade is an effective treatment for IMH; the macular hole diameter is the major influence factor in the postoperative closure and visual prognosis of IMH; while the preoperative visual acuity

  2. Pathology of the macular hole rim in flat-mounted internal limiting membrane specimens.

    Science.gov (United States)

    Gandorfer, Arnd; Scheler, Renate; Haritoglou, Christos; Schumann, Ricarda; Nentwich, Martin; Kampik, Anselm

    2009-09-01

    The purpose of this study was to image the pathology of vitreoretinal adhesion and cellular proliferation at the macular hole rim for a better understanding of macular hole formation. Internal limiting membrane (ILM) peeling, ILM flat-mount preparation, phase contrast and interference microscopy, transmission electron microscopy, and immunocytochemistry of the macular hole rim were performed in 10 eyes with idiopathic macular holes. Phase contrast and interference microscopy showed cellular proliferation on the vitreal side of the ILM in all specimens. There were single cells in three eyes, cell clusters in six eyes, and continuous proliferation in one eye. Surrounding the macular hole, only a few cells were present. Cellular proliferation started at a distance of 80 mum to 940 mum from the macular hole edge. Transmission electron microscopy showed vitreous adhesion at the macular hole rim. In ultrastructural terms, there was a continuous insertion of vitreous collagen fibers into the ILM. Immunocytochemistry was positive for collagen type II, laminin, and fibronectin in the area of vitreous attachment. Cells were stained with markers for glial cells, retinal pigment epithelial cells, and hyalocytes. There is ultrastructural evidence that macular hole formation is caused by an insertion of the cortical vitreous into the foveal ILM. Vitreous collagen fibers may exert vitreofoveal traction, resulting in a foveal tear. Cellular proliferation is not continuously distributed surrounding the macular hole but separated from the macular hole edge and seems to originate from cell clusters forming centers of proliferation distant from the macular hole rim.

  3. Volcano like pattern in optical coherence tomography in chronic diabetic macular edema.

    Science.gov (United States)

    Pai, Sivakami A; Hussain, Nazimul; Hebri, Sudhira P; Lootah, Afra M; Dekhain, Moza A

    2014-04-01

    In this article we herein report an interesting vitreo-macular interface abnormality associated with chronic diabetic cystoid macular edema. It is an observational case study of three diabetic patients examined in the diabetic clinic. All the patients had proliferative diabetic retinopathy with chronic macular edema. A serial cross sectional OCT examination and tracking of both the longitudinal progression of macular thickening and vitreo-macular interface revealed cystoid macular edema with a characteristic hyperreflective vitreous shadow emerging from the vitreofoveal interface. All the patients had dehiscence of inner retinal layers. This particular morphological feature at the vitreo-foveolar interface, which we name as "volcano sign", has not been described earlier. The probable mechanism of such a finding probably could be due to slow progressive leakage of chronic cytoid fluid into the vitreous with condensation of the overlying vitreous. Vitreo-macular traction followed by posterior vitreous detachment probably would have contributed to such a morphological event.

  4. Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema

    DEFF Research Database (Denmark)

    Vujosevic, Stela; Varano, Monica; Egan, Catherine

    2015-01-01

    PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were......: A composite OCT grading of macular edema taking into account the retinal thickness changes in the inner and outer macular rings offers a simple way to characterize macular edema, with added clinical value....

  5. Aspectos atuais na fisiopatologia do edema macular diabético Recent aspects on physiopathology of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Mário Martins dos Santos Motta

    2008-02-01

    Full Text Available O edema macular é a principal causa de baixa visual em pacientes diabéticos. Seu mecanismo de formação é complexo e envolve alterações bioquímicas e estruturais. Os autores fazem uma revisão e atualização dos conceitos fisiopatológicos envolvidos na maculopatia diabética.Macular edema is the leading cause of poor vision in diabetic patients.The mechanism of edema formation is complex and involves biochemical and structural changes. The authors review and update the physiopathologic concepts related to diabetic maculopathy.

  6. Analysis of macular cone photoreceptors in a case of occult macular dystrophy

    Directory of Open Access Journals (Sweden)

    Tojo N

    2013-05-01

    Full Text Available Naoki Tojo Tomoko Nakamura Hironori Ozaki Miyako Oka Toshihiko Oiwake Atsushi HayashiDepartment of Ophthalmology, University of Toyama, Toyama, JapanPurpose: To investigate changes in cone photoreceptors with adaptive optics (AO fundus imaging and spectral domain optical coherence tomography (SD-OCT in a case of occult macular dystrophy (OMD.Patient and methods: Both eyes of a 42-year-old woman diagnosed with OMD were examined. We used an AO fundus camera to obtain images of cone photoreceptors in the macula of the OMD subject and five healthy control subjects. Correlations between the AO images and the SD-OCT images were examined. Cone photoreceptors in eight areas in the macula of OMD and healthy control subjects were analyzed and compared.Results: SD-OCT showed a loss of the cone outer-segment tips line outside of the fovea in both eyes of the subject with OMD. The left eye with decreased visual acuity showed a discontinuous photoreceptor inner-segment and outer-segment line and cone outer-segment tips line at the fovea in SD-OCT and loss of cone mosaics as a dark spot in the AO image. In panoramic AO images and cone-density maps, less cone density was observed in a ring-like region outside the fovea than in the peripheral retina. In most of the areas examined, the cone densities were lower in the OMD eyes than in the healthy control eyes.Conclusions: Cone densities in the macula of the OMD patient were greatly decreased. AO images were found to be useful to evaluate morphologic changes in cone photoreceptors in patients with OMD.Keywords: occult macular dystrophy, adaptive optics, cone photoreceptor, cone analysis, optical coherence tomography

  7. Complement factor d in age-related macular degeneration

    NARCIS (Netherlands)

    Stanton, C.M.; Yates, J.R.W.; Hollander, A.I. den; Seddon, J.M.; Swaroop, A.; Stambolian, D.; Fauser, S.; Hoyng, C.B.; Yu, Y.; Atsuhiro, K.; Branham, K.; Othman, M.; Chen, W.; Kortvely, E.; Chalmers, K.; Hayward, C.; Moore, A.T.; Dhillon, B.; Ueffing, M.; Wright, A.F.

    2011-01-01

    Purpose. To examine the role of complement factor D (CFD) in age-related macular degeneration (AMD) by analysis of genetic association, copy number variation, and plasma CFD concentrations. Methods. Single nucleotide polymorphisms (SNPs) in the CFD gene were genotyped and the results analyzed by

  8. Propionibacterium acnes and the pathogenesis of progressive macular hypomelanosis

    NARCIS (Netherlands)

    Westerhof, Wiete; Relyveld, Germaine N.; Kingswijk, Melanie M.; de Man, Peter; Menke, Henk E.

    2004-01-01

    Background: Progressive macular hypomelanosis is a common hypopigmentation mainly on the central parts of the trunk, predominantly in young adults, especially women. It is often mistaken for pityriasis versicolor and pityriasis alba. It occurs in all races and has been described in many parts of the

  9. Current surgical treatment of age-related macular degeneration

    NARCIS (Netherlands)

    Ramos de Carvalho, J. Emanuel; Willig, A. J. H. E.; Chung, R.; Peiretti, E.; Mura, M.

    2014-01-01

    Age-related macular degeneration (AMD) is the leading cause of severe, irreversible central vision loss in individuals over 65 years of age throughout much of the developed world. The advent of anti-VEGF therapy has had a great impact in the long-term natural history of this condition, more

  10. Morphometric analyses of the visual pathways in macular degeneration

    NARCIS (Netherlands)

    Hernowo, Aditya T.; Prins, Doety; Baseler, Heidi A.; Plank, Tina; Gouws, Andre D.; Hooymans, Johanna M. M.; Morland, Antony B.; Greenlee, Mark W.; Cornelissen, Frans W.

    Introduction: Macular degeneration (MD) causes central visual field loss. When field defects occur in both eyes and overlap, parts of the visual pathways are no longer stimulated. Previous reports have shown that this affects the grey matter of the primary visual cortex, but possible effects on the

  11. Age-related macular degeneration in Onitsha, Nigeria | Nwosu ...

    African Journals Online (AJOL)

    Objectives: To determine the incidence, pattern and ocular morbidity associated with age-related macular degeneration (AMD) at the Guinness Eye Center Onitsha Nigeria. Materials and Methods: The case files of all new patients aged 50 years and above seen between January 1997 and December 2004 were reviewed.

  12. Identification of Age-Related Macular Degeneration Using OCT Images

    Science.gov (United States)

    Arabi, Punal M., Dr; Krishna, Nanditha; Ashwini, V.; Prathibha, H. M.

    2018-02-01

    Age-related Macular Degeneration is the most leading retinal disease in the recent years. Macular degeneration occurs when the central portion of the retina, called macula deteriorates. As the deterioration occurs with the age, it is commonly referred as Age-related Macular Degeneration. This disease can be visualized by several imaging modalities such as Fundus imaging technique, Optical Coherence Tomography (OCT) technique and many other. Optical Coherence Tomography is the widely used technique for screening the Age-related Macular Degeneration disease, because it has an ability to detect the very minute changes in the retina. The Healthy and AMD affected OCT images are classified by extracting the Retinal Pigmented Epithelium (RPE) layer of the images using the image processing technique. The extracted layer is sampled, the no. of white pixels in each of the sample is counted and the mean value of the no. of pixels is calculated. The average mean value is calculated for both the Healthy and the AMD affected images and a threshold value is fixed and a decision rule is framed to classify the images of interest. The proposed method showed an accuracy of 75%.

  13. Metamorphopsia assessment before and after vitrectomy for macular hole

    DEFF Research Database (Denmark)

    Krøyer, Kristian; Christensen, Ulrik; la Cour, Morten

    2009-01-01

    PURPOSE: To evaluate the degree of metamorphopsia in 42 patients before and 6 months after vitrectomy for idiopathic unilateral macular hole. METHODS: Semicircular test and reference stimuli of variable diameters were applied in a binocular test that measured interocular size disparity in patient...

  14. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    Purpose: To determine the intra-session and inter-session reproducibility of corneal, macular and retinal nerve fiber layer thickness (RNFL) measurements with the iVue-100 optical coherence tomography in normal eyes. Methods: These parameters were measured in the right eyes of 50 healthy participants with normal ...

  15. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    in determining the utility of a device used for clinical and research purposes.2 The aim of this study was therefore to determine the reproducibility of corneal, macular and. RNFL thickness measurements in normal eyes using the. iVue-100 SD-OCT. Subjects and methods. The study was approved by the University of KwaZu-.

  16. Treatment of dry age-related macular degeneration with dobesilate

    OpenAIRE

    Cuevas, P; Outeiriño, L A; Angulo, J; Giménez-Gallego, G

    2012-01-01

    The authors present anatomical and functional evidences of dry age-macular degeneration improvement, after intravitreal treatment with dobesilate. Main outcomes measures were normalisation of retinal structure and function, assessed by optical coherence tomography, fundus-monitored microperimetry, electrophysiology and visual acuity. The effect might be related to the normalisation of the outer retinal architecture.

  17. Technology needs for tomorrow's treatment and diagnosis of macular diseases

    Science.gov (United States)

    Soubrane, Gisèle

    2008-02-01

    Retinal imaging is the basis of macular disease's diagnosis. Currently available technologies in clinical practice are fluorescein and indocyanin green (ICG) angiographies, in addition to optical coherence tomography (OCT), which is an in vivo "histology-like" cross-sectional images of the retina. Recent developments in the field of OCT imaging include Spectral-Domain OCT. However OCT remains a static view of the macula with no direct link with dynamic observation obtained by angiographies. Adaptative optics is an encouraging perspective for fundus analysis in the future, and could be linked to OCT or angiographies. Treatments of macular disease have exploded these past few years. Pharmacologic inhibition of angiogenesis represents a novel approach in the treatment of choroidal neovascularization in eyes with age-related macular degeneration. The major action explored is the direct inhibition of the protein VEGF with antibody-like products. New anti-VEGF drugs are in development aiming at the VEGF receptors or synthesis of VEGF. But various components of the neovascular cascade, including growth factor expression, extracellular matrix modulation, integrin inhibition represent potential targets for modulation with drugs. Intra-vitreal injections are nowadays the main route of administration for these new treatments but they are potentially responsible of side effects such as endophtalmitis. Development of other routes of treatment would require new formulation of used drugs. The improvement of retinal imaging leads to a better understanding of macular disease mechanisms and will help to develop new routes and targets of treatment.

  18. Gene-diet interactions in age-related macular degeneration

    Science.gov (United States)

    Age-related macular degeneration (AMD) is a prevalent blinding disease, accounting for roughly 50% of blindness in developed nations. Very significant advances have been made in terms of discovering genetic susceptibilities to AMD as well as dietary risk factors. To date, nutritional supplementation...

  19. Nutritional modulation of age-related macular degeneration

    Science.gov (United States)

    Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30-50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated wi...

  20. Awareness, Knowledge, and Concern about Age-Related Macular Degeneration

    Science.gov (United States)

    Cimarolli, Verena R.; Laban-Baker, Allie; Hamilton, Wanda S.; Stuen, Cynthia

    2012-01-01

    Age-related macular degeneration (AMD)--a common eye disease causing vision loss--can be detected early through regular eye-health examinations, and measures can be taken to prevent visual decline. Getting eye examinations requires certain levels of awareness, knowledge, and concern related to AMD. However, little is known about AMD-related…

  1. Therapeutic Potential of Statins in Age-related Macular Degeneration

    African Journals Online (AJOL)

    Age-related macular degeneration (ARMD) is the leading cause of irreversible vision loss, affecting one in three people aged 75 and above. Although exciting new pharmaceuticals to treat ARMD such as endothelial growth factor (VEGF) inhibitors, are now available, they are effective only in selected group of patients, and ...

  2. on visual acuity in age related macular degeneration

    African Journals Online (AJOL)

    marine origin) in the treatment of age related macular degeneration (AMD). In a randomized double blind clinical trial 280 eyes of 280 (157 F, 123 M) patients with wet and dry AMD were randomly assigned in treatment or placebo groups. Patients in ...

  3. The molecular genetic basis of age-related macular degeneration ...

    Indian Academy of Sciences (India)

    2009-12-10

    Dec 10, 2009 ... ula of the eye and involves the retinal pigment epithelium. (RPE), Bruch's membrane (BM) and choriocapillaries (Fine .... macular or melanin pigment densities between eyes with and without early AMD (Kayatz et al. 2001). Smoking ..... Involved in lipoprotein metabolism, coagulation, and the production of.

  4. Prevalence of Age-Related Macular Degeneration in Europe

    NARCIS (Netherlands)

    Colijn, Johanna M.; Buitendijk, Gabriëlle H. S.; Prokofyeva, Elena; Alves, Dalila; Cachulo, Maria L.; Khawaja, Anthony P.; Cougnard-Gregoire, Audrey; Merle, Bénédicte M. J.; Korb, Christina; Erke, Maja G.; Bron, Alain; Anastasopoulos, Eleftherios; Meester-Smoor, Magda A.; Segato, Tatiana; Piermarocchi, Stefano; de Jong, Paulus T. V. M.; Vingerling, Johannes R.; Topouzis, Fotis; Creuzot-Garcher, Catherine; Bertelsen, Geir; Pfeiffer, Norbert; Fletcher, Astrid E.; Foster, Paul J.; Silva, Rufino; Korobelnik, Jean-François; Delcourt, Cécile; Klaver, Caroline C. W.; Ajana, Soufiane; Arango-Gonzalez, Blanca; Arndt, Verena; Bhatia, Vaibhav; Bhattacharya, Shomi S.; Biarnés, Marc; Borrell, Anna; Bühren, Sebastian; Calado, Sofia M.; Cougnard-Grégoire, Audrey; Dammeier, Sascha; de Jong, Eiko K.; de la Cerda, Berta; den Hollander, Anneke I.; Diaz-Corrales, Francisco J.; Diether, Sigrid; Emri, Eszter; Endermann, Tanja; Ferraro, Lucia L.; Garcia, Míriam; Heesterbeek, Thomas J.; Honisch, Sabina; Hoyng, Carel B.; Kersten, Eveline; Kilger, Ellen; Langen, Hanno; Lengyel, Imre; Luthert, Phil; Maugeais, Cyrille; Meester-Smoor, Magda; Monés, Jordi; Nogoceke, Everson; Peto, Tunde; Pool, Frances M.; Rodríguez, Eduardo; Ueffing, Marius; Ulrich Bartz-Schmidt, Karl U.; van Leeuwen, Elisabeth M.; Verzijden, Timo; Zumbansen, Markus; Acar, Niyazi; Anastosopoulos, Eleftherios; Azuara-Blanco, Augusto; Bergen, Arthur; Binquet, Christine; Bird, Alan; Brétillon, Lionel; Buitendijk, Gabrielle; Cachulo, Maria Luz; Chakravarthy, Usha; Chan, Michelle; Chang, Petrus; Colijn, Johanna; Cumberland, Philippa; Cunha-Vaz, José; Daien, Vincent; Deak, Gabor; Delyfer, Marie-Noëlle; den Hollander, Anneke; Dietzel, Martha; Erke, Maja Gran; Fauser, Sascha; Finger, Robert; Fletcher, Astrid; Foster, Paul; Founti, Panayiota; Göbel, Arno; Gorgels, Theo; Grauslund, Jakob; Grus, Franz; Hammond, Christopher; Helmer, Catherine; Hense, Hans-Werner; Hermann, Manuel; Hoehn, René; Hogg, Ruth; Holz, Frank; Hoyng, Carel; Jansonius, Nomdo; Janssen, Sarah; Khawaja, Anthony; Klaver, Caroline; Lamparter, Julia; Le Goff, Mélanie; Leal, Sergio; Lechanteur, Yara; Lehtimäki, Terho; Lotery, Andrew; Leung, Irene; Mauschitz, Matthias; Merle, Bénédicte; Meyer Zu Westrup, Verena; Midena, Edoardo; Miotto, Stefania; Mirshahi, Alireza; Mohan-Saïd, Sadek; Mueller, Michael; Muldrew, Alyson; Nunes, Sandrina; Oexle, Konrad; Rahi, Jugnoo; Raitakari, Olli; Ribeiro, Luisa; Rougier, Marie-Bénédicte; Sahel, José; Salonikiou, Aggeliki; Sanchez, Clarisa; Schmitz-Valckenberg, Steffen; Schweitzer, Cédric; Shehata, Jasmin; Silvestri, Giuliana; Simader, Christian; Souied, Eric; Springelkamp, Henriet; Tapp, Robyn; Verhoeven, Virginie; Von Hanno, Therese; Vujosevic, Stela; Williams, Katie; Wolfram, Christian; Yip, Jennifer; Zerbib, Jennyfer; Zwiener, Isabella

    2017-01-01

    Purpose: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in

  5. Prevalence of Age-Related Macular Degeneration in Europe

    DEFF Research Database (Denmark)

    Colijn, Johanna M; Buitendijk, Gabriëlle H S; Prokofyeva, Elena

    2017-01-01

    PURPOSE: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD...

  6. Treatment of dry age-related macular degeneration with dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Angulo, J; Giménez-Gallego, G

    2012-01-01

    The authors present anatomical and functional evidences of dry age-macular degeneration improvement, after intravitreal treatment with dobesilate. Main outcomes measures were normalisation of retinal structure and function, assessed by optical coherence tomography, fundus-monitored microperimetry, electrophysiology and visual acuity. The effect might be related to the normalisation of the outer retinal architecture. PMID:22729337

  7. Non-invasive in vivo measurement of macular carotenoids

    Science.gov (United States)

    Lambert, James L. (Inventor); Borchert, Mark S. (Inventor)

    2009-01-01

    A non-invasive in vivo method for assessing macular carotenoids includes performing Optical Coherence Tomography (OCT) on a retina of a subject. A spatial representation of carotenoid levels in the macula based on data from the OCT of the retina can be generated.

  8. Resultado funcional e índice macular em portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna Functional outcome and macular index in macular hole patients who underwent surgery with internal limiting membrane removal

    Directory of Open Access Journals (Sweden)

    José Ricardo Diniz

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar o resultado funcional e o índice macular dos portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna. MÉTODOS: Quinze olhos de 15 pacientes com buraco macular estágios 2, 3 e 4 foram incluídos no estudo. Todos foram submetidos à cirurgia de buraco macular convencional com remoção da membrana limitante interna corada pelo azul de tripan. Melhor acuidade visual com correção e cortes transversais medidos por tomografia de coerência óptica (OCT foram avaliados no pré- e pós-operatório. O índice macular (razão entre a altura e base do buraco macular foi calculado e correlacionado com o diâmetro mínimo do buraco macular e o ganho de acuidade visual pós-operatória. RESULTADOS: Obteve-se fechamento do buraco macular em todos pacientes operados. Em 86,7%, houve ganho de pelo menos três linhas de visão. O índice macular demonstrou correlação negativa significante com o diâmetro mínimo (r=0,811. Não foi observada correlação significante entre o índice macular e o ganho de acuidade visual pós-operatória (r=0,351. CONCLUSÃO: Os resultados funcionais na cirurgia do buraco macular com remoção da membrana limitante interna foram bons neste grupo de pacientes. O índice macular demonstrou ser compatível com a configuração espacial do buraco macular, porém não foi preditor de resultados visuais.PURPOSE: To evaluate the functional outcome and macular index in patients with macular hole who underwent surgery with internal limiting membrane removal. METHODS: Fifteen eyes of 15 patients with idiopathic macular hole stages 2, 3 or 4 were enrolled in this study. All patients underwent conventional macular hole surgery with trypan blue staining to remove the internal limiting membrane. The best-corrected visual acuity and cross-sectional images of macular hole measured by optical coherence tomography (OCT were evaluated pre- and postoperatively. The macular hole index

  9. RETINA EXPANSION TECHNIQUE FOR MACULAR HOLE APPOSITION REPORT 2: Efficacy, Closure Rate, and Risks of a Macular Detachment Technique to Close Large Full-Thickness Macular Holes.

    Science.gov (United States)

    Wong, Roger; Howard, Catherine; Orobona, Giancarlo Dellʼaversana

    2018-04-01

    To describe the safety and efficacy of a technique to close large thickness macular holes. A consecutive retrospective interventional case series of 16 patients with macular holes greater than 650 microns in "aperture" diameter were included. The technique involves vitrectomy, followed by internal limiting membrane peeling. The macula is detached using subretinal injection of saline. Fluid-air exchange is performed to promote detachment and stretch of the retina. After this, the standard fluid-air exchange is performed and perfluoropropane gas is injected. Face-down posturing is advised. Adverse effects, preoperative, and postoperative visual acuities were recorded. Optical coherence tomography scans were also taken. The mean hole size was 739 microns (SD: 62 microns; mean base diameter: 1,311 microns). Eighty-three percent (14 of 16) of eyes had successful hole closure after the procedure. At 12-month follow-up, no worsening in visual acuity was reported, and improvement in visual acuity was noted in 14 of 16 eyes. No patients lost vision because of the procedure. It is possible to achieve anatomical closure of large macular holes using RETMA. No patients experienced visual loss. The level of visual improvement is likely limited because of the size and chronicity of these holes.

  10. Optimal management of idiopathic macular holes

    Directory of Open Access Journals (Sweden)

    Madi HA

    2016-01-01

    Full Text Available Haifa A Madi,1,* Ibrahim Masri,1,* David H Steel1,2 1Sunderland Eye Infirmary, Sunderland, 2Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle, UK *These authors contributed equally to this work Abstract: This review evaluates the current surgical options for the management of idiopathic macular holes (IMHs, including vitrectomy, ocriplasmin (OCP, and expansile gas use, and discusses key background information to inform the choice of treatment. An evidence-based approach to selecting the best treatment option for the individual patient based on IMH characteristics and patient-specific factors is suggested. For holes without vitreomacular attachment (VMA, vitrectomy is the only option with three key surgical variables: whether to peel the inner limiting membrane (ILM, the type of tamponade agent to be used, and the requirement for postoperative face-down posturing. There is a general consensus that ILM peeling improves primary anatomical hole closure rate; however, in small holes (<250 µm, it is uncertain whether peeling is always required. It has been increasingly recognized that long-acting gas and face-down positioning are not always necessary in patients with small- and medium-sized holes, but large (>400 µm and chronic holes (>1-year history are usually treated with long-acting gas and posturing. Several studies on posturing and gas choice were carried out in combination with ILM peeling, which may also influence the gas and posturing requirement. Combined phacovitrectomy appears to offer more rapid visual recovery without affecting the long-term outcomes of vitrectomy for IMH. OCP is licensed for use in patients with small- or medium-sized holes and VMA. A greater success rate in using OCP has been reported in smaller holes, but further predictive factors for its success are needed to refine its use. It is important to counsel patients realistically regarding the rates of success with

  11. Ranibizumab and diabetic macular oedema: after laser therapy.

    Science.gov (United States)

    2012-03-01

    Diabetic retinopathy is sometimes accompanied by macular oedema, leading to a marked decline in visual acuity. The standard treatment, in addition to glycaemic and blood pressure control, is laser photocoagulation, despite its modest efficacy. Ranibizumab (Lucentis, Novartis), a VEGF (vascular endothelial growth factor) inhibitor, was initially authorised for age-related macular degeneration (AMD) in the European Union. It is now also approved for the treatment of visual loss due to macular oedema in diabetic patients. In this setting, clinical evaluation of ranibizumab is mainly based on two double-blind randomised trials comparing ranibizumab + laser photocoagulation versus placebo + laser photo-coagulation in a total of about 1000 patients. Compared with placebo, addition of ranibizumab to laser therapy led to a marked improvement in visual acuity in approximately 15% of patients after 12 months of treatment. The improvement appeared to persist after 24 months of treatment. In a trial that included a group treated with ranibizumab alone, efficacy did not differ from that of the ranibizumab + laser combination. Uncertainties remain concerning the long-term efficacy of ranibizumab and its benefits in patients with poorly controlled diabetes or proliferative retinopathy. The adverse effect profile of ranibizumab in patients with diabetic macular oedema is similar to that reported in patients with AMD, and mainly includes ocular adverse effects such as pain, bleeding and increased intraocular pressure. A risk of systemic adverse effects, particularly cardiovascular disorders, should be kept in mind in case of long-term treatment. Ranibizumab can cause birth defects, even after intravitreal injection during pregnancy. Monthly treatment with ranibizumab is inconvenient, difficult and expensive. In practice, laser therapy remains the standard treatment for diabetic patients with significantly reduced visual acuity due to macular oedema. Ranibizumab, which requires

  12. Macular buckling for eyes with myopic foveoschisis secondary to posterior staphyloma.

    Science.gov (United States)

    Mateo, Carlos; Burés-Jelstrup, Anniken; Navarro, Rafael; Corcóstegui, Borja

    2012-06-01

    To determine the effectiveness of macular buckling in eyes with myopic foveoschisis and describe two methods of macular buckling: hard silicone implant and Ando plombe. Sixteen eyes of 16 consecutive patients with myopic foveoschisis who underwent surgery with the macular buckling procedure were studied. Pars plana vitrectomy combined with macular buckling with hard silicone implant was used in 6 eyes, whereas the other 10 eyes underwent pars plana vitrectomy and macular buckling with the Ando macular plombe. Macular buckling, with both hard silicone implant and macular plombe resulted in reduction of retinal thickness in all patients. Best-corrected visual acuity improved in 14 of 16 eyes (87.5%), whereas it remained stable or decreased in 2 eyes (12.5%). Mean preoperative best-corrected visual acuity was 20/125 (mean logarithm of the minimal angle of resolution 0.8), whereas mean postoperative best-corrected visual acuity improved to 20/50 (mean logarithm of the minimal angle of resolution 0.39). Both methods showed a similar rate of complications, the most frequent being the development of localized areas of retinal pigment epithelium atrophy. Combined pars plana vitrectomy and macular buckling is an effective approach to treat myopic foveoschisis with both anatomical and visual improvement. Despite a similar complication rate with both buckling techniques, macular buckling with the Ando plombe was found to be technically easier with shorter surgical times.

  13. Triamcinolona subtenoniana en el edema macular diabético Subtenon triamcinolone in the diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Eddy Mesa Hernández

    2009-12-01

    Full Text Available INTRODUCCIÓN: La prevalencia de la retinopatía diabética está determinada por el tipo de diabetes mellitus y por el tiempo de evolución de la enfermedad. El edema macular es la principal causa de la disminución de la agudeza visual en el paciente diabético. Un diagnóstico precoz y certero de esta enfermedad, unido al establecimiento de un tratamiento adecuado es crucial en el esfuerzo por reducir la incapacidad visual. El propósito de este trabajo fue determinar la efectividad de la triamcinolona subtenoniana como tratamiento del edema macular en un grupo de pacientes diabéticos. MÉTODOS: Se realizó un estudio descriptivo-prospectivo de caso control. La muestra estuvo formada por 30 pacientes diabéticos que fueron atendidos en el Hospital Clínicoquirúrgico "Dr. Miguel Enríquez, desde enero a junio de 2007, con diagnóstico de edema macular diabético que cumplieron con los criterios de inclusión. RESULTADOS: Predominó el sexo femenino, el grupo de edades más frecuentes fue de 55 a 65 años. Se relacionó el tiempo de evolución con la presencia de edema macular, se evidenció una involución de esta patología, así como una mejoría en la agudeza visual después de aplicado el tratamiento y no se presentaron complicaciones graves. CONCLUSIONES: El tratamiento con acetato de triamcinolona por vía subtenoniana posterior es una alternativa efectiva en el tratamiento de el edema macular.INTRODUCTION: Prevalence of diabetic retinopathy is determined by type of diabetes mellitus and the length of development of the disease. Macular edema is the main cause of reduction in visual acuity of the diabetic patient. An early exact diagnosis of the disease together with an adequate treatment is essential to decrease visual disability. The objective of this paper was to evaluate the effectiveness of subtenon triamcinolone as therapy for macular edema in a group of diabetics. METHODS: A prospective descriptive case-control study was

  14. MACULAR HOLE CLOSURE OVER RESIDUAL SUBRETINAL FLUID BY AN INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE IN PATIENTS WITH MACULAR HOLE RETINAL DETACHMENT IN HIGH MYOPIA.

    Science.gov (United States)

    Okuda, Tetsuhiko; Higashide, Tomomi; Kobayashi, Koh; Ikuno, Yasushi; Sugiyama, Kazuhisa

    2016-01-01

    To describe the closure of a macular hole over residual subretinal fluid in patients with macular hole retinal detachment in high myopia who had been treated using an inverted internal limiting membrane flap technique. Three patients with macular hole retinal detachment in high myopia underwent pars plana vitrectomy using the inverted internal limiting membrane flap technique. One patient received a silicone oil injection, and the other two patients received a long-acting gas injection at the end of the surgery. After surgery, spectral domain ocular coherence tomography examination was performed. In the patient with the silicone oil injection, spectral domain optical coherence tomography revealed that the macular hole was sealed with an inverted internal limiting membrane flap in the presence of subretinal fluid 1 day after surgery. The inner retinal layers gradually regained a more physiologic configuration over the residual subretinal fluid. In all patients, macular holes were completely closed over the subretinal fluid, which was gradually absorbed. Using the inverted internal limiting membrane flap technique, macular holes were closed over residual subretinal fluid in patients with macular hole retinal detachment. The results indicate that reattachment of the retina may not be necessary for closure of macular holes.

  15. Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema: An Attempt of Composite Grading of Macular Edema

    NARCIS (Netherlands)

    Vujosevic, Stela; Varano, Monica; Egan, Catherine; Sivaprasad, Sobha; Menon, Geeta; Erginay, Ali; Verbraak, Frank D.; Lund-Andersen, Henrik; Martinez, Jose P.; Jürgens, Ignasi; Smets, Erica; Coriat, Caroline; Wiedemann, Peter; Ágoas, Victor; Querques, Giuseppe; Holz, Frank G.; Nunes, Sandrina; Alves, Dalila; Neves, Catarina; Santos, Torcato; Ribeiro, Luisa; Bandello, Francesco; Tejerina, Amparo Navea; Cunha-Vaz, José

    2016-01-01

    To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were included in a 12-month

  16. The prevalence of microcystic macular changes on optical coherence tomography of the macular region in optic nerve atrophy of non-neuritis origin : a prospective study

    NARCIS (Netherlands)

    Pott, J. W. R.; de Vries-Knoppert, W. A. E. J.; Petzold, A.

    2015-01-01

    Background Microcystic macular changes, also called microcystic macular oedema, have recently been reported in patients with multiple sclerosis, particularly after optic neuritis. But it has since emerged that the finding is not specific for optic neuritis. This study was designed to prospectively

  17. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-01-01

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate. PMID:24225910

  18. Change in macular thickness in a case of refractory diabetic macular edema with dexamethasone intravitreal implant in comparison to intravitreal bevacizumab: A case report

    Directory of Open Access Journals (Sweden)

    Ashish Sharma

    2012-01-01

    Full Text Available We report on the significant improvement of central macular thickness in a case of clinically significant macular edema after dexamethasone 0.7 mg sustained-release intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA, USA. Patient presented to us with persistent clinically significant macular edema (CSME in both eyes. Right eye received dexamethasone implant and left eye received two intravitreal bevacizumab injections 1.25 mg/0.05 mL (Avastin®; Genentech Inc., South San Francisco, CA, USA with an interval of four weeks. After six weeks of follow-up, dexamethasone implant in the right eye showed normal macular thickness whereas persistent macular edema (ME was found even after second intravitreal bevacizumab injection in the left eye.

  19. Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review

    Directory of Open Access Journals (Sweden)

    Laura N. Distefano

    2017-01-01

    Full Text Available Diabetic macular edema (DME is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept, better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy. Macular laser therapy may still play an important role as an adjuvant treatment because it is able to improve macular thickness outcomes and reduce the number of injections needed. Here, we review some of the clinical trials that have assessed the efficacy of macular laser treatment, either as part of the treatment protocol or as rescue therapy.

  20. Idiopathic horseshoe-like macular tear: a case report

    Directory of Open Access Journals (Sweden)

    Kubota M

    2016-07-01

    Full Text Available Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD. Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords

  1. Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema Consistência da tomografia de coerência óptica no edema macular difuso diabético

    Directory of Open Access Journals (Sweden)

    Fábio Petersen Saraiva

    2007-01-01

    Full Text Available OBJECTIVES: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. INTRODUCTION: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. METHODS: The study recruited diabetic patients without clinically evident retinopathy (control group and with diffuse macular edema (case group. Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. RESULTS: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. DISCUSSION: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. CONCLUSIONS: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema.OBJETIVOS: Investigar a consistência das medidas de espessura foveal, volume foveal e volume macular total feitas pela tomografia de coerência óptica em pacientes com e sem edema macular difuso diabético. INTRODUÇÃO: A tomografia de coerência óptica é uma t

  2. Bilateral macular holes in X-linked retinoschisis: Now the spectrum is wider

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    Manoj Gautam

    2011-01-01

    Full Text Available Bilateral occurrence of macular hole in X-linked retinoschisis is an extremely rare event. Spectral domain optical coherence tomography (OCT findings revealed that formation of a macular hole is secondary to the retinoschisis process alone. Bilateral macular holes should be added to the spectrum of X-linked retinoschisis variations and the retinoschisis process alone should be accounted for their formation.

  3. Degeneração macular relacionada à idade: novas perspectivas Age-related macular degeneration: new perspectives

    Directory of Open Access Journals (Sweden)

    Marcio Bittar Nehemy

    2006-12-01

    Full Text Available A degeneração macular relacionada à idade (DMRI é a principal causa de cegueira legal em indivíduos acima de 50 anos de idade. Embora estudos recentes tenham mostrado que o fator genético é significativo, a patogênese da degeneração macular relacionada à idade permanece obscura, e os fatores de risco não estão ainda completamente estabelecidos. Estudos multicêntricos randomizados, publicados nos últimos anos, demonstraram que uma combinação de vitaminas e minerais é eficaz na redução do risco de desenvolvimento de neovascularização e de progressão para os estágios mais avançados da degeneração macular relacionada à idade. De maneira análoga, a terapia fotodinâmica (PDT e a terapia antiangiogênica também tiveram sua eficácia comprovada no tratamento de membrana neovascular coroideana subfoveal associada à degeneração macular relacionada à idade. Ambas reduzem o risco de perda de visão e, eventualmente, permitem melhora temporária da acuidade visual. Outras modalidades de tratamento, tais como fotocoagulação a laser, remoção cirúrgica da membrana e termoterapia transpupilar (TTT, podem beneficiar apenas um pequeno subgrupo de pacientes. Uma melhor compreensão dos mecanismos fisiopatológicos e dos eventos moleculares nas diversas fases da doença deverão propiciar, em futuro próximo, melhores estratégias para o controle e tratamento da degeneração macular relacionada à idade.Age-related macular degeneration (ARMD is a major source of legal blindness in individuals older than 50 years. Even though recent reports suggest that genetics plays an important role, its pathogenesis remains puzzling and the risk factors for its occurrence are not completely established. Vitamin and mineral supplementation reduced the risk of development of choroidal neovascularization (CNV or progression to the most advanced stages of age-related macular degeneration. Photodynamic therapy (PDT and antiangiogenic therapy

  4. Aspectos clínicos e tomográficos dos microburacos maculares Clinical and tomographic aspects of macular microholes

    Directory of Open Access Journals (Sweden)

    Fernando José de Novelli

    2009-02-01

    Full Text Available OBJETIVO: Descrever os aspectos clínicos e tomográficos do microburaco macular. MÉTODOS: Estudaram-se pacientes portadores de microburaco macular de forma retrospectiva e observacional. Apurou-se história clínica, medida de acuidade visual, biomicroscopia de polo posterior, retinografia, angiofluoresceinografia retiniana e tomografia de coerência óptica. RESULTADOS: Examinaram-se oito olhos de sete pacientes portadores de microburaco macular. A idade variou entre 26 e 63 anos (média de 48,8 anos. Seis pacientes eram do sexo feminino (85,7%. Cinco pacientes apresentaram o microburaco macular no olho direito (62,5%. Quanto à sintomatologia, cinco indivíduos referiram diminuição da acuidade visual (71,4%, um referiu escotoma central (14,3% e um não apresentou queixas visuais (14,3%. A angiofluoresceinografia retiniana não mostrou alterações maculares em cinco dos olhos (71,4%. À tomografia de coerência óptica, os oito olhos apresentaram uma lesão foveal hiporrefletiva e menor do que 100 micra, que acometia as camadas mais profundas da retina neurossensorial. CONCLUSÃO: Microburaco macular é um pequeno defeito lamelar presente na camada externa profunda da retina, que é evidente à biomicroscopia macular como uma lesão arredondada avermelhada de tamanho diminuto, levando a pouca repercussão na função visual, sem caráter progressivo. A história clínica, a acuidade visual, a biomicroscopia de fundo e a tomografia de coerência óptica são os principais elementos para a detecção e o estudo dos mecanismos fisiopatológicos responsáveis pela sua origem e evolução.PURPOSE: To describe the clinical aspects and evaluate optical coherence tomography of macular microholes. METHODS: Seven patients were assessed (8 eyes with microholes of the macula. All patients underwent complete eye examination, fundus photography, fluorescent angiography and OCT-3 imaging. RESULTS: Ages ranged from 26 to 69 years. Six patients were female

  5. [Epidemiology of the age-related macular degeneration].

    Science.gov (United States)

    Kolár, P

    2010-07-01

    The age-related macular degeneration is the most common cause of severe decrease of the visual acuity in industrial countries. The epidemiological data published in last 30 years are very alarming. They document that the age-related macular degeneration is the most common cause of blindness in industrial countries in the population of patients older than 65 years. The signs of beginning disease may be diagnosed as early as in the patients older than 45 years. The disease is strictly age-related and its prevalence and incidence is markedly increasing according to the older age. The basic risk factors of the disease are smoking, untreated hypertension, atherosclerosis, cataract surgery, and appearance of the disease in the family. Among further possible risk factors we count diabetes mellitus and the light color of the iris. Equivocal is the negative influence of ultraviolet rays.

  6. Grid pattern Argon Laser photocoagulation for diabetic diffuse macular edema

    Directory of Open Access Journals (Sweden)

    Karkhane R

    1998-05-01

    Full Text Available Purpose: to determine the effect of Grid pattern laser photocoagulation on diabetic diffuse macular edema with assessment of visual outcome. Patients & Methods: The author reviewed the medical records of 84 eyes of 62 patients with diabetic diffuse macular edema treated with Grid pattern green Argon laser photocoagulation in Farabi Eye Hospital between the years 1992-1995, the follow-up period was 16-48 months (average 24.55±6.42, median 28 mounths. Results: Visual acuity was improved in 11.9%; unchanged in 65.4% and worsened in 22.7% of eyes. Conclusion: In assessing long-term visual outcome, Grid laser photocoagulation is an effective modality in maintaining or improving visual acuity.

  7. [Cystoid macular oedema after fingolimod treatment in multiple sclerosis].

    Science.gov (United States)

    Asensio-Sánchez, V M; Trujillo-Guzmán, L; Ramoa-Osorio, R

    2014-03-01

    A woman, treated with immunomodulatory and immunosuppressive drugs for multiple sclerosis, developed macular oedema 4 months after oral fingolimod administration. The patient was previously seen by an ophthalmologist, with a normal anterior segment and funduscopic examination. Four months after the treatment she referred to decreased visual acuity in both eyes. The funduscopic and OCT examination now revealed cystoid macular oedema (CME). Attention to visual changes and periodic funduscopic examinations are an important part of monitoring while using fingolimod. In our patient early recognition and discontinuation of fingolimod did not result in resolution of the CME. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  8. Clinical and histopathological study of primary cutaneous macular amyloidosis

    Directory of Open Access Journals (Sweden)

    Fatima Razvi

    2013-02-01

    Full Text Available Primary cutaneous amyloidosis often presents with pigmentary dystonias of the skin in the form of asymptomatic reticulate hyper-pigmentation or pruritic lichenoid papular lesions. The aim of this study was to evaluate the incidence of primary cutaneous macular amyloidosis and also to find out the possible etiological agents, to correlate their clinical disease with histopathological positivity for amyloid deposition, and to find out the percentage of positive cas-es by special stains. A total of 24 patients attending dermatology out-patient clinic of Princess Esra Hospital, Hyderabad over a pe-riod of 1 year presenting with hyperpigmented skin lesions and clinically diagnosed as macular amyloidosis were taken up for this study.

  9. Age-related macular degeneration: epidemiology and optimal treatment

    DEFF Research Database (Denmark)

    la Cour, Morten; Kiilgaard, Jens Folke; Nissen, Mogens Holst

    2002-01-01

    cause of blindness among Caucasian individuals in developed countries. Blindness resulting from AMD rarely occurs before age 70, and most cases occur after age 80. The age-standardised 1-year incidence of legal blindness resulting from AMD is 212 cases per million. Two-thirds of AMD cases have CNV......Age-related macular degeneration (AMD) is a common macular disease affecting elderly people in the Western world. It is characterised by the appearance of drusen in the macula, accompanied by choroidal neovascularisation (CNV) or geographic atrophy. The disease is more common in Caucasian...... individuals than in pigmented races. In predominantly Caucasian populations, the age-standardised prevalence of AMD in at least one eye is 7760 cases per million. The age-standardised cumulated 1-year incidence of AMD in at least one eye is 1051 cases per million individuals. AMD is the most important single...

  10. Localized bi-nasal macular edema in optic chiasmal syndrome

    Directory of Open Access Journals (Sweden)

    Alejandro J Lavaque

    2013-01-01

    Full Text Available A 28-year-old healthy male complaining of vision loss in his right eye was discovered to have localized bi-nasal macular edema in the presence of a pituitary adenoma. The presence of a junctional scotoma composed by a central scotoma in the right eye associated with superior temporal quadrantanopia in the fellow eye was seen. The pattern detected in the visual field suggested the presence of an expansive mass at the level of the optic chiasm. Optical coherence tomography findings also revealed subtle macular thickness beyond normal in the superior and nasal quadrants of both maculae. This report illustrates the importance of suspecting a pituitary adenoma in the light of uncharacteristic retinal alterations.

  11. Smooth pursuit eye movements in patients with macular degeneration

    OpenAIRE

    Shanidze, Natela; Fusco, Giovanni; Potapchuk, Elena; Heinen, Stephen; Verghese, Preeti

    2016-01-01

    Currently, there are no quantitative studies of smooth pursuit, a behavior attributed to the fovea, in individuals with macular degeneration (MD). We hypothesize that pursuit in MD patients depends on the relative positions of the scotoma and target trajectory. We tested this hypothesis with a scanning laser ophthalmoscope (SLO), which allows for direct visualization of the target on the damaged retina. Monocular microperimetry and eye movements were assessed in eleven individuals with differ...

  12. Macular structural characteristics in children with Down syndrome.

    Science.gov (United States)

    O'Brien, Scott; Wang, Jingyun; Smith, Heather A; Donaldson, Dana L; Haider, Kathryn M; Roberts, Gavin J; Sprunger, Derek T; Neely, Daniel E; Plager, David A

    2015-12-01

    This prospective study aimed to investigate macular structural characteristics in children with Down syndrome compared to those in healthy children. Two groups of children (aged 6-16 years) were enrolled: children with Down syndrome (Down syndrome group, N = 17) and age-matched healthy children who were full-term at birth (control group, N = 18). Eligible patients had visual acuity of 20/100 or better and gestational age at birth of ≥ 36 weeks. Fourier domain optical coherence tomography was used for imaging of the macular retinal structure, and retinal volume scans centered on the macula were obtained. Central subfield thickness (CST) and the thickness of the inner and outer retinal layer regions were analyzed using the instrument's segmentation software. The analysis of data is provided for the right eye only, since there was no significant difference between right and left eyes for either the Down syndrome or control groups. Children in the Down syndrome group generally had identifiable retinal structure. The CST for the full retina and inner and outer retinal layers were all significantly greater in the Down syndrome group than the control group (independent t test, all p syndrome had macular thickness outside the normal range. Visual acuity in the Down syndrome group was not directly correlated with increased CST (t = 1.288, r = 0.326, p = 0.202). On average, CST in the Down syndrome group was greater than that in the control group, suggesting abnormal macular development in children with Down syndrome.

  13. Complement pathway biomarkers and age-related macular degeneration

    Science.gov (United States)

    Gemenetzi, M; Lotery, A J

    2016-01-01

    In the age-related macular degeneration (AMD) ‘inflammation model', local inflammation plus complement activation contributes to the pathogenesis and progression of the disease. Multiple genetic associations have now been established correlating the risk of development or progression of AMD. Stratifying patients by their AMD genetic profile may facilitate future AMD therapeutic trials resulting in meaningful clinical trial end points with smaller sample sizes and study duration. PMID:26493033

  14. Best Macular Dystrophy in a Nigerian: A Case Report

    Directory of Open Access Journals (Sweden)

    Tunji S. Oluleye

    2012-06-01

    Full Text Available Best macular dystrophy is reported to be rare in Africans. It is a hereditary disease that starts in childhood and progresses through some stages before visual symptoms occur. This case report presents a 43-year-old Nigerian with the disease and stresses the importance of regular eye exams of patients and relatives to detect changes such as choroidal neovascular membrane amenable to treatment.

  15. Risks of age related macular degeneration and led lighting

    Directory of Open Access Journals (Sweden)

    V.A. Kaptsov

    2017-12-01

    Full Text Available Spectral structure of environmental light can have significant influence on risks of various eye diseases which can evolve quite early. The paper dwells on how age-related macular degeneration evolves and on a part which eye age pigment plays in the process. We discuss predictive models for age pigment accumulation and methodology of their creation. We created a predictive mathematical model for accumulated A2E age pigment quantity allowing for LED lighting peculiarities and its age-related perception. The model encompasses active oxygen forms generation evolving due to decrease in antioxidant cellular protection efficiency in a lighting environment with a higher blue light dose. It is shown that superoxide dismutase, catalase and glutathione peroxidase 1 (GRX 1 efficiency within 445 (plus minus 10 nanometers range drops substantially in blue light; it increases risks of lower cellular resistance to effects exerted by non-compensated active oxygen forms. These processes which are rather long-term can lead to early age-related macular degeneration. Mathematical calculations prove that in the nearest future a share of patients aged 30–40 who suffer from age-related macular degeneration will grow drastically; it will eventually lead to an increased number of disabled people aged 50–60 whose disability is caused by eyesight disorders. It is shown that if we fail to discover any mechanisms aimed at lowering risks of early age-related macular degeneration evolvement in the nearest future, total costs required for solving eyesight disorders issue will grow substantially. Thus, in 2012 about 140 billion dollars were spent on the eyesight disorders issue all over the world; the sum is likely to reach 377 billion dollars in 2050.

  16. [Factors related to intraoperative retinal breaks in macular hole surgery].

    Science.gov (United States)

    Kumagai, K; Ogino, N; Demizu, S; Atsumi, K; Kurihara, H; Iwaki, M; Ishigooka, H; Tachi, N

    2001-02-01

    To evaluate the factors of intraoperative retinal breaks in macular hole surgery. This study included 558 eyes of 506 patients who underwent idiopathic macular hole surgery by one surgeon. Multiple regression was performed using the variables of gender, age, affected eye, lens status, stage, duration of symptoms, hole size, axial length, and lattice degeneration. The rate of retinal breaks was higher in stage 3 (16.0%) than in stage 4 (8.2%) (p = 0.014). In eyes with lattice degeneration intraoperative retinal breaks occurred in about 40% of the cases. Major factors were as follows: lattice degeneration (r = 0.24, p lattice degeneration, and gender (r = -0.18, p = 0.035) in eyes of stage 4 without lattice degeneration. The factors of intraoperative retinal breaks in macular hole surgery were lattice degeneration in all eyes and stage 3 in eyes without lattice degeneration. The high incidence of intraoperative retinal breaks in stage 3 was mainly due to the occurrence of posterior vitreous detachment. Male gender was a significant factor associated with intraoperative retinal breaks.

  17. Intraocular lens iris fixation. Clinical and macular OCT outcomes

    Science.gov (United States)

    2012-01-01

    Background To assess the efficacy, clinical outcomes, visual acuity (VA), incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany) were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%), 20/60 or better in 12 eyes (92%), and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method. PMID:23050659

  18. Intraocular lens iris fixation. Clinical and macular OCT outcomes

    Directory of Open Access Journals (Sweden)

    Garcia-Rojas Leonardo

    2012-10-01

    Full Text Available Abstract Background To assess the efficacy, clinical outcomes, visual acuity (VA, incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%, 20/60 or better in 12 eyes (92%, and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method.

  19. Changes of macular thickness in HIV positive patients using OCT

    Directory of Open Access Journals (Sweden)

    Shang Li

    2014-10-01

    Full Text Available AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome(AIDSpatients. METHODS: The study based on the data analysis of 38 human immunodeficiency virus(HIVpositive patients(64 eyes. According to CD4 count and whether cytomegalovirus retinitis(CMVRhappened, the patients were divided into 3 groups. Group A included 16 patients(32 eyes, in which CD4 count was 50cells/μL and CMVR did not happen. Group C included 12 patients(12 eyes, in which CD4 count was RESULTS: The mean foveal thicknesses in groups A, B, C and D were 254.03±15.63μm, 263.11±17.12μm, 304.50±50.62μm and 257.64±8.54μm in order. Compared with foveal thickness in each group, there were significant differences in general(F=12.933, P=0.000. The mean foveal thickness in groups CMVR increased, which was of significant difference(P=0.000, compared with other groups.CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

  20. Influence of age-related macular degeneration on macular thickness measurement made with fourier-domain optical coherence tomography.

    Science.gov (United States)

    Garas, Anita; Papp, András; Holló, Gábor

    2013-03-01

    To evaluate the influence of age-related macular degeneration (AMD) on macular thickness measurement made with Fourier-domain optical coherence tomography (RTVue-OCT) to detect glaucoma. : One nonglaucomatous eye of 79 white persons was imaged. This comprised 25 healthy eyes, 19 eyes with early/intermediate AMD (geographic atrophy excluded), 16 eyes with subfoveal choroidal neovascularization (CNV), and 19 CNV eyes after intravitreal antiangiogenic treatment [CNV-antivascular endothelial growth factor (VEGF)]. Compared with the age-matched controls, no difference in any nerve fiber layer and optic disc parameter was seen for any AMD group. No macular retinal segmentation error was detected in the control group. Localized inner retinal image segmentation errors topographically related to AMD were detected in 8 eyes with drusen (42.1%), all 16 CNV eyes (100%) and 17 eyes in the CNV-anti-VEGF group (89.5%; χ test, P0.05). In contrast, all pattern-based ganglion cell complex (GCC) parameters were significantly higher (more abnormal) in the CNV and CNV-anti-VEGF group than in the control eyes (Mann-Whitney test, Bonferroni correction, P<0.001). For GCC focal loss volume, the only pattern-based parameter classified by the software, the frequency of "borderline" and "outside normal limits" classifications was significantly greater in each AMD group than in the control group (χ test, Bonferroni correction, P ≤0.03). In nonglaucomatous eyes, AMD significantly influences the pattern-based inner macular thickness parameters of the RTVue optical coherence tomograph and the software-provided classification of GCC focal loss volume, for detection of glaucoma.

  1. Comparison and interchangeability of macular thickness measured with Cirrus OCT and Stratus OCT in myopic eyes.

    Science.gov (United States)

    Wang, Geng; Qiu, Kun-Liang; Lu, Xue-Hui; Zhang, Ming-Zhi

    2015-01-01

    To investigate the difference of macular thickness measurements between stratus optical coherence tomography (OCT) and Cirrus OCT (Carl Zeiss Meditec, Dublin, CA, USA) in the same myopic patient and to develop a conversion equation to interchange macular thickness obtained with these two OCT devices. Eighty-nine healthy Chinese adults with spherical equivalent (SE) ranging from -1.13 D to -9.63 D were recruited. The macular thickness was measured by Cirrus OCT and Stratus OCT. The correlation between macular thickness and axial length and the agreement between two OCT measurements were evaluated. A formula was generated to interchange macular thickness obtained with two OCT devices. Average macular thickness measured with Stratus OCT (r=-0.280, P=0.008) and Cirrus OCT (r=-0.224, P=0.034) were found to be negatively correlated with axial length. No statistically significant correlation was found between axial length and central subfield macular thickness (CMT) measured with Stratus OCT (r=0.191, P=0.073) and Cirrus OCT (r=0.169, P=0.113). The mean CMT measured with Cirrus OCT was 53.63±7.94 µm thicker than with Stratus OCT. The formula CMTCirrus OCT=78.328+0.874×CMTStratus OCT was generated to interchange macular thickness obtained with two OCT devices. Macular thickness measured with Cirrus OCT were thicker than with Stratus OCT in myopic eyes. A formula can be used to interchange macular thickness measured with two OCT devices in myopic eyes. Studies with different OCT devices and larger samples are warranted to enable the comparison of macular values measured with different OCT devices.

  2. Study on macular retinal thickness in young people by using 3D optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Gui-Ling Zhao

    2014-08-01

    Full Text Available AIM: To measure the macular thickness of normal young people by 3D 1000 optical coherence tomography(OCTand study the repeatability of measuring results and the relationship between the thicknesses of macular and gender. At the same time, to compare our result with the data of other types of OCT, and to understand the consistency of the measuring results of macular thickness of different types of OCT. METHODS: Totally 222 eyes in 111 young people were detected using 3D scan mode of Topcon 3D OCT 1 000(ver 2.4. Twelve cases(24 eyesunderwent repeatability check. We took transverse comparison between our measured results with other research's results. RESULTS:There were 111 cases of young people, whose age were from 18-27 years old, all uncorrected and corrected visual acuity were ≥1.0, all intraocular pressure were 3. Center thickness was 161-264μm, and the average thickness was 200.13±18.81μm. Central macular thickness were 188-273μm, and the average thickness was 229.00±18.20μm. The central macular thickness in men was significantly greater than that in women, and there was statistical difference. The results of repeated check of 12 cases(24 eyesin the macular area were no statistical difference except the outer ring of nasal quadrant, and the repeatability of average thickness in central macular thickness was better than in center thickness. CONCLUSION:The repeatability of macular examination is good. The central macular thickness can be better repeated than the center thickness. The central macular thickness is 229.00±18.20μm in young people, according to the 3D 1000 OCT measurements. There are statistical difference of central macular thickness between different genders.

  3. Prevention of visual field defects after macular hole surgery.

    LENUS (Irish Health Repository)

    Cullinane, A B

    2012-02-03

    BACKGROUND\\/AIM: The pathogenesis of visual field loss associated with macular hole surgery is uncertain but a number of explanations have been proposed, the most convincing of which is the effect of peeling of the posterior hyaloid, causing either direct damage to the nerve fibre layer or to its blood supply at the optic nerve head. The purpose of this preliminary prospective study was to determine the incidence of visual field defects following macular hole surgery in cases in which peeling of the posterior hyaloid was confined only to the area of the macula. METHODS: 102 consecutive eyes that had macular hole surgery had preoperative and postoperative visual field examination using a Humphrey\\'s perimeter. A comparison was made between two groups: I, those treated with vitrectomy with complete posterior cortical vitreous peeling; and II, those treated with a vitrectomy with peeling of the posterior hyaloid in the area of the macula but without attempting a complete posterior vitreous detachment. Specifically, no attempt was made to separate the posterior hyaloid from the optic nerve head. Eyes with stage II or III macular holes were operated. Autologous platelet concentrate and non-expansile gas tamponade was used. Patients were postured prone for 1 week. RESULTS: In group I, 22% of patients were found to have visual field defects. In group II, it was possible to separate the posterior hyaloid from the macula without stripping it from the optic nerve head and in these eyes no pattern of postoperative visual field loss emerged. There were no significant vision threatening complications in this group. The difference in the incidence of visual field loss between group I and group II was significant (p=0.02). The anatomical and visual success rates were comparable between both groups. CONCLUSION: The results from this preliminary study suggest that the complication of visual field loss after macular surgery may be reduced if peeling of the posterior hyaloid is

  4. Dexamethasone intravitreal implant in the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Dugel PU

    2015-07-01

    Full Text Available Pravin U Dugel,1,2 Francesco Bandello,3 Anat Loewenstein4 1Retinal Consultants of Arizona, Phoenix, AZ, 2Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 3Department of Ophthalmology, University Vita-Salute Scientific Institute San Raffaele, Milan, Italy; 4Department of Ophthalmology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Abstract: Diabetic macular edema (DME resembles a chronic, low-grade inflammatory reaction, and is characterized by blood–retinal barrier (BRB breakdown and retinal capillary leakage. Corticosteroids are of therapeutic benefit because of their anti-inflammatory, antiangiogenic, and BRB-stabilizing properties. Delivery modes include periocular and intravitreal (via pars plana injection. To offset the short intravitreal half-life of corticosteroid solutions (~3 hours and the need for frequent intravitreal injections, sustained-release intravitreal corticosteroid implants have been developed. Dexamethasone intravitreal implant provides retinal drug delivery for ≤6 months and recently has been approved for use in the treatment of DME. Pooled findings (n=1,048 from two large-scale, randomized Phase III trials indicated that dexamethasone intravitreal implant (0.35 mg and 0.7 mg administered at ≥6-month intervals produced sustained improvements in best-corrected visual acuity (BCVA and macular edema. Significantly more patients showed a ≥15-letter gain in BCVA at 3 years with dexamethasone intravitreal implant 0.35 mg and 0.7 mg than with sham injection (18.4% and 22.2% vs 12.0%. Anatomical assessments showed rapid and sustained reductions in macular edema and slowing of retinopathy progression. Phase II study findings suggest that dexamethasone intravitreal implant is effective in focal, cystoid, and diffuse DME, in vitrectomized eyes, and in combination with laser therapy. Ocular complications of

  5. Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema.

    Directory of Open Access Journals (Sweden)

    Yuki Mori

    Full Text Available To investigate whether baseline optical coherence tomography (OCT parameters can predict the treatment frequency of intravitreal ranibizumab (IVR injections during the first year in patients with diabetic macular edema (DME treated with pro re nata (PRN IVR injections.We retrospectively reviewed 68 eyes of 63 patients with center-involved DME who received IVR injections for 12 months or longer according to three monthly IVR injections followed by the PRN dosing. We measured the mean retinal thicknesses in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid and evaluated the qualitative and quantitative parameters on OCT sectional images. We investigated the relationship between these OCT parameters at baseline and the number of IVR injections during the 12-month follow-up.Three loading doses were administered to 10 eyes; four to seven annualized IVR injections were administered to 34 eyes. The number of eyes that received IVR injections decreased gradually until month 6 and was almost constant from months 7 to 11. No relationships were seen between the treatment frequency and baseline systemic factors and the ophthalmic examination findings. Univariate analyses showed that the number of IVR injections during the first year was associated with the mean retinal thickness in the individual subfields and the transverse length of the disrupted external limiting membrane (ELM and ellipsoid zone of the photoreceptors. Multivariate analysis showed a significant association with the thickness in the inferior subfield alone. The treatment frequency during the 12-month follow-up was not correlated with improved visual acuity but was associated with the decrease in the central subfield thickness and disrupted ELM.The retinal thickness in the inferior subfield predicts the treatment frequency during the first year in eyes with DME treated with PRN IVR injections.

  6. Macular cystic changes as predictive factor for the recurrence of macular oedema in branch retinal vein occlusion.

    Science.gov (United States)

    Tilgner, Eric; Dalcegio Favretto, Maiara; Tuisl, Maria; Wiedemann, Peter; Rehak, Matus

    2017-11-01

    To evaluate the role of small cystic macular changes as a prognostic factor for the recurrence of macular oedema (ME) in patients with branch retinal vein occlusion (BRVO) treated with anti-VEGF drugs. We performed retrospective chart analysis of 116 patients treated with intravitreal injection of ranibizumab (IVR) or bevacizumab (IVB) for ME secondary to BRVO. At the baseline and monthly follow-up visits over a period of 12 months, a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA) and volume scan of macula using Spectral domain optical coherence tomography (SD-OCT) were performed. Patients without ME (CRT <250 μm) were screened for the presence of intraretinal cysts. In these patients, the changes in BCVA and CRT were evaluated over a period of 12 months and compared with the baseline. In the IVR group (41 patients), 91 events of macular cysts, without a worsening of BCVA, were detected by OCT. In 89 of 91 events (97%), BCVA and CRT deteriorated significantly (p < 0.0001) within the next 4-11 (in mean 7.1 ± 2.0) weeks. BCVA decreased from 0.38 ± 0.25 to 0.49 ± 0.27 logMAR and CRT increased significantly from 223 ± 43 to 605 ± 244 μm. In the IVB group (19 patients), 54 events of cystic changes were detected. All of these patients showed significant worsening of BCVA from 0.40 ± 0.19 to 0.57 ± 0.22 logMAR and CRT from 251 ± 17 to 490 ± 147 μm within 4-10 (in mean 7.8 ± 2.8) weeks after the first presence of small macular cysts. In BRVO patients treated with anti-VEGF drugs, the macular cystic changes may be used as an early indicator for impending recurrence of ME, with the decrease in BCVA in the following weeks. These patients should be scheduled for a next visit within 6-8 weeks. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Macular lutein and zeaxanthin are related to brain lutein and zeaxanthin in primates

    Science.gov (United States)

    The xanthophyll pigments lutein and zeaxanthin cross the blood-retina barrier to preferentially accumulate in the macular region of the neural retina. There they form macular pigment, protecting the retina from blue light damage and oxidative stress. Lutein and zeaxanthin also accumulate in brain t...

  8. Macular pigment optical density is related to serum lutein in retinitis pigmentosa

    Science.gov (United States)

    Purpose: To determine whether macular pigment optical density (MPOD) is related to the degree of cystoid macular edema (CME) in patients with retinitis pigmentosa. Methods: We measured MPOD with heterochromatic flicker photometry and central foveal retinal thickness with optical coherence tomography...

  9. Vitamin D deficiency in neovascular versus nonneovascular age-related macular degeneration.

    Science.gov (United States)

    Itty, Sujit; Day, Shelley; Lyles, Kenneth W; Stinnett, Sandra S; Vajzovic, Lejla M; Mruthyunjaya, Prithvi

    2014-09-01

    To compare 25-hydroxyvitamin D (25OHD) levels in patients with neovascular age-related macular degeneration (NVAMD) with patients with nonneovascular age-related macular degeneration and control patients. Medical records of all patients diagnosed with age-related macular degeneration and tested for serum 25OHD level at a single medical center were reviewed. Control patients were selected from patients diagnosed with pseudophakia but without age-related macular degeneration. The lowest 25OHD level available for each patient was recorded. Two hundred sixteen patients with nonneovascular age-related macular degeneration, 146 with NVAMD, and 100 non-age-related macular degeneration control patients were included. The levels of 25OHD (mean ± SD) were significantly lower in NVAMD patients (26.1 ± 14.4 ng/mL) versus nonneovascular age-related macular degeneration (31.5 ± 18.2 ng/mL, P = 0.003) and control (29.4 ± 10.1 ng/mL, P = 0.049) patients. The prevalence of vitamin D insufficiency (age-related macular degeneration. Mean 25OHD levels were lower and vitamin D deficiency was more prevalent in NVAMD patients. These associations suggest that further research is necessary regarding vitamin D deficiency as a potentially modifiable risk factor for the development of NVAMD.

  10. 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.......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....

  11. Evaluation of an oral telomerase activator for early age-related macular degeneration - a pilot study.

    Science.gov (United States)

    Dow, Coad Thomas; Harley, Calvin B

    2016-01-01

    Telomere attrition and corresponding cellular senescence of the retinal pigment epithelium contribute to the changes of age-related macular degeneration. Activation of the enzyme telomerase can add telomeric DNA to retinal pigment epithelium chromosomal ends and has been proposed as a treatment for age-related macular degeneration. We report the use of a small molecule, oral telomerase activator (TA)-65 in early macular degeneration. This study, focusing on early macular degeneration, provides a model for the use of TAs in age-related disease. Thirty-eight (38) patients were randomly assigned to a 1-year, double-blinded, placebo-controlled interventional study with arms for oral TA-65 or placebo. Macular functions via micro-perimetry were the primary measured outcomes. The macular function in the arm receiving the TA-65 showed significant improvement relative to the placebo control. The improvement was manifest at 6 months and was maintained at 1 year: macular threshold sensitivity (measured as average dB [logarithmic decibel scale of light attenuation]) improved 0.97 dB compared to placebo (P-value 0.02) and percent reduced thresholds lessened 8.2% compared to the placebo arm (P-value 0.04). The oral TA significantly improved the macular function of treatment subjects compared to controls. Although this study was a pilot and a larger study is being planned, it is noteworthy in that it is, to our knowledge, the first randomized placebo-controlled study of a TA supplement.

  12. Subfoveal fibrosis in eyes with neovascular age-related macular degeneration treated with intravitreal ranibizumab

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi; Lund-Andersen, Henrik; Sander, Birgit

    2013-01-01

    To assess baseline and follow-up characteristics of choroidal neovascularization (CNV) lesions in age-related macular degeneration in relation to the development of subfoveal subretinal fibrosis.......To assess baseline and follow-up characteristics of choroidal neovascularization (CNV) lesions in age-related macular degeneration in relation to the development of subfoveal subretinal fibrosis....

  13. Association of familial macular degeneration with specific genetic markers: a case report.

    Science.gov (United States)

    Takayanagi, Yoshinori; Ashida, Masami; Go, Mayumi; Gunji, Mai; Sato, Izuru; Kato, Shigeaki; Miyashita, Masato

    2015-11-24

    Age-related macular degeneration is a serious visual disorder of the central retina and was recently reported to be associated with genetic background. Here we describe a genetic link to early onset age-related macular degeneration in members of an Asian family. A 73-year-old Asian woman developed age-related macular degeneration in the fifth decade of her life and her 49-year-old daughter developed age-related macular degeneration. Because of the family history and the early onset, family members were tested for two single nucleotide polymorphism variants (rs10490924 and rs11200638) at a recently identified susceptibility locus for age-related macular degeneration. Both alleles in the 73-year-old woman were of the high-risk variants (T/T for rs10490924 and A/A for rs11200638), and her two daughters and a grandson each carried the risk variants (T and A) one on each allele. In a case where multiple family members had early onset age-related macular degeneration, we found two high-risk single nucleotide polymorphism variants in the age-related macular degeneration susceptibility locus, suggesting the combination of the known single nucleotide polymorphism variants as a potent age-related macular degeneration diagnostic indicator.

  14. Macular pigment carotenoids in the retina and occipital cortex are related in humans

    Science.gov (United States)

    Objectives: Lutein and zeaxanthin are dietary carotenoids that preferentially accumulate in the macular region of the retina. Together with mesozeaxanthin, a conversion product of lutein in the macula, they form the macular pigment. Lutein is also the predominant carotenoid in human brain tissue and...

  15. One-year progression of diabetic subclinical macular edema in eyes with mild nonproliferative diabetic retinopathy

    DEFF Research Database (Denmark)

    Tejerina, Amparo Navea; Vujosevic, Stela; Varano, Monica

    2015-01-01

    PURPOSE: To characterize the 1-year progression of retinal thickness (RT) increase occurring in eyes with subclinical macular edema in type 2 diabetes. METHODS: Forty-eight type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (NPDR; levels 20 and 35 in the Early Treatment...... in these eyes was performed, followed by verification and correction by a human grader. RESULTS: The highest increase in RT over the 1-year follow-up period for the 48 eyes/patients with subclinical macular edema was found in the inner nuclear layer (INL). Progression to clinical macular edema was also...... eyes with mild NPDR and subclinical macular edema occur mainly in the INL. The development of clinical macular edema appears to be associated with increased thickening of other retinal layers and microvascular disease activity....

  16. Serum APOE, leptin, CFH and HTRA1 levels in Pakistani age related macular degeneration patients.

    Science.gov (United States)

    Qureshi, Irfan Zia; Ambreen, Fareeha

    2017-06-01

    To determine the association between serum levels of apolipoprotein E, leptin, complimentary factor H and high temperature requirement A-1 in patients with age-related macular degeneration. This case-control study was conducted at the Quaid-i-Azam University, Islamabad, Pakistan, from May to October 2013, and comprised patients with age-related macular degeneration and matching controls. The confirmation of age-related macular degeneration was carried out through slit lamp examination, fundoscopy and ocular coherence tomography. The selected subjects were not suffering with any other systemic or ophthalmic complication(s). Serum apolipoprotein E, leptin, complimentary factor H and high temperature requirement A-1 were estimated in serum samples of all subjects. SPSS 18 was used for data analysis. Of the 190 participants, 90(47.4%) were patients with age-related macular degeneration and 100(52.6%) were controls. Significantly elevated serum apolipoprotein E (page-related macular degeneration patients.

  17. Correlation between the optical coherence tomography and electroretinogram in retinal vein occlusion macular edema

    Directory of Open Access Journals (Sweden)

    Ya Xu

    2014-11-01

    Full Text Available AIM: To evaluate the correlation between retinal thickness and photopic flash electroretinogram(ERGparameters(Cone a-wave, Cone b-wave, and 30Hz flickerin patients with central retinal vein occlusion(CRVOand macular edema. METHODS: A total of 25 patients(25 CRVO eyes and 25 unaffected fellow eyeswith CRVO underwent the examination of optical coherence tomography(OCTand photopic falsh ERG. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thicknesses were measured by OCT in nine macular subfields. Then the correlations between ERG parameters and macular morphological parameters were analyzed. RESULTS: The Cone b-wave and 30Hz flicker implicit time were correlated with macular retinal thickness in seven out of nine subfields, excluding the temporal subfields. CONCLUSION: The retinal thickness of the macular edema may be associated with inner retinal function in CRVO patients.

  18. Retrospective analyses of optical coherence tomography in recurrent macular edema following intravitreal therapy in patients with retinal vein occlusion.

    Science.gov (United States)

    Holland, Stephen M; Dodwell, David G; Krimmel, Darrel A; de Fiebre, Christopher M

    2015-09-04

    Optical coherence tomography has focused mainly on central subfield thickness to quantify macular edema in central and branch retinal vein occlusion. We examined macular fields other than the central subfield to determine if they are possibly independent indicators of recurrent macular edema. Single center, retrospective, consecutive case study of patients with recurrent macular edema secondary to either central or branch retinal vein occlusion. Thickness estimates of serial domain optical coherence tomography macular fields were obtained at the time of recurrent macular edema and analyzed retrospectively. Changes were expressed as a percentage of previous baseline levels. Change in thickness at each retreatment episode as well as average changes in thickness were calculated for each macular field for each eye. Data were analyzed via analysis of variance and Fisher's post hoc analyses. The macular field which most frequently had the largest percent increase at the time of recurrence was also assessed using averages for each subject as well as for each retreatment episode. Individual episodes of recurrent macular edema were also examined to ascertain the frequency in which there was minimal foveal edema (<15 μm increase), but non-foveal edema was considered severe enough to warrant retreatment. 429 episodes of recurrent macular edema in 80 eyes were examined. In addition to the central subfield, the average mean change in thickness of the most affected quadrant (central vein occlusion) or hemisphere (branch vein occlusion) of the extrafoveal 3 mm band had the largest mean changes and also most frequently had the largest increases at the time of recurrent macular edema. In approximately 20 % of both central and branch occlusions, recurrent macular edema was detected in non-central macular fields in the absence of significant edema in the central subfield. Analyses of non-central macular fields as well as the central subfield may be useful in the early detection

  19. Comparison of Visual Function in Older Eyes in the Earliest Stages of Age-related Macular Degeneration to Those in Normal Macular Health.

    Science.gov (United States)

    Owsley, Cynthia; Huisingh, Carrie; Clark, Mark E; Jackson, Gregory R; McGwin, Gerald

    2016-01-01

    To compare the ability of several visual functional tests in terms of the strength of their associations with the earliest phases of age-related macular degeneration (AMD), which bears on their potential to serve as functional endpoints in evaluating treatments for early AMD and prevention strategies. Eyes from adults ≥60 years old were identified as being in normal macular health or in the earliest stages of AMD (steps 2, 3 or 4) through grading of color stereo-fundus photos by an experienced grader masked to all other study variables who used the 9-step Age-Related Eye Disease Study (AREDS) classification system for AMD severity. Visual function was assessed using the following tests: best-corrected visual acuity, low luminance visual acuity, spatial contrast sensitivity, macular cone-mediated light sensitivity and rod-mediated dark adaptation. A total of 1260 eyes were tested from 640 participants; 1007 eyes were in normal macular health (defined as step 1 in AREDS system) and 253 eyes had early AMD (defined as steps 2, 3 or 4). Adjusting for age and gender, early AMD eyes had two times the odds of having delayed rod-mediated dark adaptation than eyes in normal macular health (p = 0.0019). Visual acuity, low luminance acuity, spatial contrast sensitivity and macular light sensitivity did not differ between normal eyes and early AMD eyes. Eyes in the earliest phases of AMD were two times more likely to have delayed rod-mediated dark adaptation, as assessed by the rod-intercept, as compared to older eyes in normal macular health, whereas there was no difference in early AMD versus normal eyes in tests of visual acuity, low luminance acuity, macular light sensitivity and spatial contrast sensitivity.

  20. Postoperative eccentric macular holes after vitrectomy and internal limiting membrane peeling.

    Science.gov (United States)

    Brouzas, Dimitrios; Dettoraki, Maria; Lavaris, Anastasios; Kourvetaris, Dimitrios; Nomikarios, Nikolaos; Moschos, Marilita M

    2017-06-01

    The purpose of this study was to describe the incidence, clinical characteristics, and outcome of eccentric macular holes presenting after vitrectomy and internal limiting membrane (ILM) peeling for the treatment of macular pathology and discuss the pathogenesis of holes formation. A retrospective, noncomparative, interventional case-series study of five patients who developed eccentric macular holes postoperatively following vitrectomy in 198 consecutive patients who underwent ILM peeling for idiopathic macular hole and epiretinal membrane formation between 2008 and 2015. Five patients (2.5 %) developed full-thickness eccentric macular holes postoperatively. Three patients presented with a single eccentric macular hole, one patient had an eccentric hole after a failed idiopathic macular hole surgery and one patient developed four eccentric macular holes. The mean diameter of the holes was 584 μm (range 206-1317 μm) and the average time of holes formation after vitrectomy was 27.7 weeks (range 1-140 weeks). Postoperative best-corrected visual acuity ranged from "counting fingers" to 20/25. The eyes with the holes distant from the fovea had the best final visual acuity. No further intervention was attempted and no complications occurred. The mean follow-up time was 26.8 months. The postoperative macular holes after vitrectomy and ILM peeling were variable in number, size, and time of appearance but remained stable and were not associated with any complications. The pathogenesis of macular holes is most consistent with contraction of the residual ILM or secondary epimacular proliferation probably stimulated by ILM peeling.

  1. Lamellar Hole-Associated Epiretinal Proliferation in Comparison to Epiretinal Membranes of Macular Pseudoholes.

    Science.gov (United States)

    Compera, Denise; Entchev, Enrico; Haritoglou, Christos; Scheler, Renate; Mayer, Wolfgang J; Wolf, Armin; Kampik, Anselm; Schumann, Ricarda G

    2015-08-01

    To compare immunocytochemical and ultrastructural characteristics of "lamellar hole-associated epiretinal proliferation" in lamellar macular holes with "conventional epiretinal membrane" in macular pseudoholes. A consecutive observational case series, laboratory investigation. We analyzed surgically excised flat-mounted internal limiting membrane specimens and epiretinal membrane specimens removed from 25 eyes of 25 patients with lamellar macular holes (11 eyes) and macular pseudoholes (14 eyes) using interference and phase-contrast microscopy, immunocytochemistry, and transmission electron microscopy. By spectral-domain optical coherence tomography, epiretinal material of homogenous reflectivity without contractive properties was categorized as lamellar hole-associated epiretinal proliferation, whereas tractional epiretinal membranes presenting contractive properties were termed conventional epiretinal membrane. Lamellar hole-associated epiretinal proliferation was seen in 73% of eyes with lamellar macular hole. Eyes with macular pseudohole presented with conventional epiretinal membrane. In lamellar hole-associated epiretinal proliferation, positive immunoreactivity for anti-glial fibrillary acidic protein, hyalocyte markers, and anti-collagen type I and III was seen. In contrast, specimens of macular pseudoholes were positive for α-smooth muscle actin and anti-glial fibrillary acidic protein, predominantly. Cellular ultrastructure showed that lamellar hole-associated epiretinal proliferation of lamellar macular holes mainly consisted of fibroblasts and hyalocytes, whereas myofibroblasts dominated in conventional epiretinal membranes of macular pseudoholes. Cells within lamellar hole-associated epiretinal proliferation appear to originate from vitreous and possess less contractive properties than cells of conventional epiretinal membranes. Our findings point to differences in pathogenesis in a subgroup of lamellar macular holes presenting lamellar hole

  2. Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes

    Directory of Open Access Journals (Sweden)

    Alfonso L. Sabater

    2014-01-01

    Full Text Available Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT. Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA. Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole.

  3. Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes

    Science.gov (United States)

    Velázquez-Villoria, Álvaro; Zapata, Miguel A.; Figueroa, Marta S.; Suárez-Leoz, Marta; Arrevola, Luis; Teijeiro, María-Ángeles; García-Layana, Alfredo

    2014-01-01

    Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT). Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA). Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole. PMID:25110679

  4. Analysis of laser photocoagulation with cataract surgery for improvement of visual acuity and macular edema in patients with cataract and diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Chao-Yu Wang

    2016-02-01

    Full Text Available AIM:To explore laser photocoagulation with cataract surgery for improvement of visual acuity and macular edema in patients with cataract and diabetic macular edema.METHODS:A total of 60 patients(72 eyesfrom January 2014 to July 2015 in our hospital were selected, which all were diagnosed as cataract with diabetic macular edema. According to a random number table method, the patients were divided into observation group and control group, 30 cases(36 eyesin each group. The observation group was treated with combination therapy of laser photocoagulation before cataract surgeries, while the control group with the combination therapy of laser photocoagulation after cataract surgeries. At 2mo after surgeries, some routine examination, such as visual acuity, fundus examination after mydriasis, slit lamp examination, optical coherence tomography(OCTexamination, fluorescence angiography examination(FFAfor retinal blood vessels were applied in all the patients. RESULTS:The visual acuity of the observation group and the control group before treatments was not significantly different(P>0.05. At 2mo after treatments, the visual inspection showed that compared with the visual acuity before treatment, the visual acuity of the two groups were both significantly improved(PPP>0.05. At 2mo after treatments, compared with those before treatments, the macular thickness of two groups were both significantly improved(PPCONCLUSION:The laser photocoagulation before cataract surgery for patients with cataract and diabetic macular edema can significantly improve their visual acuity and macular thickness.

  5. Ranibizumab vs. aflibercept for wet age-related macular degeneration

    DEFF Research Database (Denmark)

    Szabo, Shelagh M; Hedegaard, Morten; Chan, Keith

    2015-01-01

    the efficacy and safety of reduced frequency dosing for aflibercept, relative to other approved and marketed vascular endothelial growth factor inhibitors for wet AMD, over 12 months. RESEARCH DESIGN AND METHODS: Based on a systematic literature review performed according to a pre-specified protocol......OBJECTIVE: Although a reduced aflibercept (2.0 mg) injection frequency relative to the approved dosing posology is included in national treatment guidelines for wet age-related macular degeneration (AMD), there is limited evidence of its comparative efficacy. The objective was to compare...

  6. Choroidal and macular thickness changes induced by cataract surgery

    Directory of Open Access Journals (Sweden)

    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

  7. Prognostic significance of delayed structural recovery after macular hole surgery

    DEFF Research Database (Denmark)

    Christensen, Ulrik C; Krøyer, Kristian; Sander, Birgit

    2009-01-01

    clinical trial. PARTICIPANTS: Participants were recruited from a randomized clinical trial evaluating internal limiting membrane (ILM) peeling in macular hole surgery. The study included 74 eyes in which a contiguous retinal surface or a full attachment with a flat neuroretinal rim had been reestablished...... after 12 months compared with eyes with a fully attached fovea at 3 months (70.9 letters vs. 72.0 letters; P = 0.59). Receiver operating characteristics curve analysis identified persistent photoreceptor layer discontinuity of a diameter of more than 1477 microm after 3 months to be associated...

  8. Research status of conbercept treating age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Hai-Yan He

    2015-08-01

    Full Text Available Age-related macular degeneration(AMDis one of the major reasons of blindness among the elderly in the developed countries. As AMD patients are increasing year by year, AMD has become one of the important topics of ophthalmic research to prevent blindness. Its pathogenesis is not fully understood, but many studies have shown that vascular endothelial growth factor(VEGFplays an important role in the pathogenesis. With the development and application of anti-VEGF drugs, there are a variety of drugs applied to the disease. This article introduces conbercept for the treatment of AMD.

  9. Genetics and molecular pathology of Stargardt-like macular degeneration.

    Science.gov (United States)

    Vasireddy, Vidyullatha; Wong, Paul; Ayyagari, Radha

    2010-05-01

    Stargardt-like macular degeneration (STGD3) is an early onset, autosomal dominant macular degeneration. STGD3 is characterized by a progressive pathology, the loss of central vision, atrophy of the retinal pigment epithelium, and accumulation of lipofuscin, clinical features that are also characteristic of age-related macular degeneration. The onset of clinical symptoms in STGD3, however, is typically observed within the second or third decade of life (i.e., starting in the teenage years). The clinical profile at any given age among STGD3 patients can be variable suggesting that, although STGD3 is a single gene defect, other genetic or environmental factors may play a role in moderating the final disease phenotype. Genetic studies localized the STGD3 disease locus to a small region on the short arm of human chromosome 6, and application of a positional candidate gene approach identified protein truncating mutations in the elongation of very long chain fatty acids-4 gene (ELOVL4) in patients with this disease. The ELOVL4 gene encodes a protein homologous to the ELO group of proteins that participate in fatty acid elongation in yeast. Pathogenic mutations found in the ELOVL4 gene result in altered trafficking of the protein and behave with a dominant negative effect. Mice carrying an Elovl4 mutation developed photoreceptor degeneration and depletion of very long chain fatty acids (VLCFA). ELOVL4 protein participates in the synthesis of fatty acids with chain length longer than 26 carbons. Studies on ELOVL4 indicate that VLCFA may be necessary for normal function of the retina, and the defective protein trafficking and/or altered VLCFA elongation underlies the pathology associated with STGD3. Determining the role of VLCFA in the retina and discerning the implications of abnormal trafficking of mutant ELOVL4 and depleted VLCFA content in the pathology of STGD3 will provide valuable insight in understanding the retinal structure, function, and pathology underlying STGD3

  10. [The genetic variability of complement system in pathogenesis of age-related macular degeneration].

    Science.gov (United States)

    Kubicka-Trząska, Agnieszka; Karska-Basta, Izabella; Dziedzina, Sylwia; Sanak, Marek

    2015-01-01

    Age-related macular degeneration is the leading cause of irreversible central vision impairment in people aged over 50 in developed countries. Age-related macular degeneration is a complex disease derived from environmental, immune and genetic factors. The complement pathway has been implicated in the pathogenesis of many diseases. Recently, variants in several genes, such as complement H (CFH), complement factor B (CFB), complement 2 (C2), and complement 3 (C3), encoding complement pathway proteins, have been identified as associated with age-related macular degeneration. However, the associations between these genes and age-related macular degeneration varied due to genetic variation within populations and various ethnics groups. The strongest association was found between the age-related macular degeneration and SNP Y402H rs 1061170 variant of CFH gene, which is present in 30% to 50% of age-related macular degeneration patients in Caucasian population and which is a risk factor for the development of age-related macular degeneration. Cohort studies showed that polymorphism Arg102Gly (SNP rs 2230199) of C3 protein could serve as a high-risk genetic marker for the development of age-related macular degeneration. Other rare variants of C3 (Lys155Gln, Lys65Gln, Arg735Trp, Ser1619Arg), may also be associated with a high incidence of age-related macular degeneration in some ethnic groups. A protective haplotype of variants E318D and IVS10 in the C2 gene as well as L9H and R320 in the BF were associated with age-related macular degeneration but only in Caucasians. The genetic findings in age-related macular degeneration patients stress the importance of detailed phenotyping to identify age-related macular degeneration subtypes, which may be associated with the presence of different polymorphisms and various environmental risk factors in any population. Further studies may be helpful to improve the effectiveness of prophylaxis and therapeutic options in age

  11. Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Masafumi Hamada

    2018-01-01

    Full Text Available We evaluated subthreshold photocoagulation using endpoint management (EPM for the treatment of diabetic macular edema (DME. The study enrolled 10 eyes from 10 patients (6 men and 4 women with DME. The entry criteria included central macular thickness (CMT ≥ 300 μm and decimal visual acuity (VA ≤ 0.5. The primary endpoints were VA (logMAR and CMT at 6 months follow-up. Secondary endpoints included fundus autofluorescence, macular volume (MV, and macular sensitivity (MS. We used the PASCAL Streamline Yellow® (wavelength, 577 nm system to perform grid pattern laser photocoagulation at 50% of the threshold (size, 100 μm; duration, 0.015 s; spacing, 0.5; and energy, 4.5–7.8 mJ. At 6 months posttreatment, CMT was significantly decreased, while there were no significant changes in macular sensitivity, mean BCVA (logMAR, or macular volume. Autofluorescence imaging revealed no changes after treatment in 6 of 10 eyes. No eyes exhibited subjective symptoms of scotoma after photocoagulation. Optical coherence tomography showed the complete resolution of macular edema in 4 eyes (40% after a single treatment; MS was increased in all 4 of these eyes at 6 months posttreatment. In conclusion, subthreshold photocoagulation using EPM is safe and effective for DME treatment and preserves MS. This trial is registered with UMIN000012401.

  12. [Macular thickness measured by optical coherence tomography in pseudoaphakic eyes with clear vs yellow implant].

    Science.gov (United States)

    Chamorro, E; Bonnin-Arias, C; Pérez-Carrasco, M J; Alvarez-Rementería, L; Villa-Collar, C; Armadá-Maresca, F; Sánchez-Ramos, C

    2014-04-01

    To study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. Macular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. After 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 μm (P=.02), and foveal thickness reduction was 10 ± 17 μm (P=.02). The macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  13. [Internal limiting membrane role in primary surgery of the macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2013-01-01

    To assess the anatomical result after primary macular hole surgery with or without internal limiting membrane (ILM) peeling. To assess the safety and stability results; Prospective, comparative, interventional case study of 47 eyes with stage 3 or 4 macular hole treated by pars-plana vitrectomy between 2006 and 2011. In 19 cases (40.42%) only posterior hyaloid was removed (control group) while in the other 28 cases (59.57%) additional ILM peeling was performed. All cases had gas endotamponade. Postoperatively the cases were followed-up at least 6 months clinically and by OCT. Statistical analysis was performed using ANOVA and Wilcoxon tests. The mean age of patients in the study was 54, 47 +/- 4, 83 years (ranging from 47 to 74 years). In 36 cases (76.59%) the macular hole was idiopathic. After surgery, the macular hole closed in 22 out of 28 cases with ILM peeling (78.57%) as compared to only 13 out of 19 cases from the control group (68.42%). No intraoperative complications were noted. Main postoperative complications were cataract augmentation and macular hole enlargement in 4 out of 12 failed cases (33.33%). No recurrence was noted if macular hole closed after surgery. These results confirm the stability, safety and efficacy of both techniques but with a significant higher success rate if ILM is peeled. The main postoperative complication was macular hole enlargement if surgery failed.

  14. Association of HTRA1 rs11200638 with age-related macular degeneration (AMD) in Brazilian patients.

    Science.gov (United States)

    Lana, Tamires Prates; da Silva Costa, Sueli Matilde; Ananina, Galina; Hirata, Fábio Endo; Rim, Priscila Hae Hyun; Medina, Flávio MacCord; de Vasconcellos, José Paulo Cabral; de Melo, Mônica Barbosa

    2018-01-01

    Age-related macular degeneration is a multifactorial disease that can lead to vision impairment in older individuals. Although the etiology of age-related macular degeneration remains unknown, risk factors include age, ethnicity, smoking, hypertension, obesity, and genetic factors. Two main loci have been identified through genome-wide association studies, on chromosomes 1 and 10. Among the variants located at the 10q26 region, rs11200638, located at the HTRA1 gene promoter, has been associated with age-related macular degeneration in several populations and is considered the main polymorphism. We conducted a replication case-control study to analyze the frequency and participation of rs11200638 in the etiology of age-related macular degeneration in a sample of patients and controls from the State of São Paulo, Brazil, through polymerase chain reaction and enzymatic digestion. The frequency of the A allele was 57.60% in patients with age-related macular degeneration and 36.45% in controls (p value macular degeneration group compared to the control group (p = 1.21 e-07 and 0.0357, respectively). No statistically significant results were observed after stratification in dry versus wet types or advanced versus non-advanced forms. To our knowledge, this is the first time the association between rs11200638 and overall age-related macular degeneration has been reported in South America.

  15. Intravitreal dexamethasone implant for cystoid macular edema and inflammation after scleral buckling.

    Science.gov (United States)

    Bonfiglio, Vincenza; Fallico, Matteo R; Russo, Andrea; De Grande, Vittorio; Longo, Antonio; Uva, Maurizio G; Reibaldi, Michele; Avitabile, Teresio

    2015-07-30

    Cystoid macular edema may occur following scleral buckling and therefore deteriorate the visual outcome. Inflammation may be the major causative factor in the development of postoperative cystoid macular edema. This case demonstrates the effectiveness of a dexamethasone implant as a treatment after the onset of choroidal inflammation and cystoid macular edema 6 months following scleral buckling and having visual acuity restored. A 59-year-old phakic woman treated with scleral buckling for macula-off retinal detachment presented 2 months after surgery with cystoid macular edema with choroidal inflammation. Optical coherence tomography and fluorescein angiography were performed. From the time of the diagnosis, the patient's condition had been nonresponsive to medical therapy and only partially responsive to sub-Tenon triamcinolone acetonide. An intravitreal implant with a sustained release of 0.7 mg dexamethasone was implanted. Following an intravitreal injection with a dexamethasone implant, the macular edema subsided completely and optical coherence tomography showed decreased foveal thickness from 510 μm to 220 μm. Choroidal fluorescein leakage disappeared. Best-corrected visual acuity improved from 0.70 to 0.20 logMAR, a condition maintained throughout the 6 months of follow-up. Cystoid macular edema and choroidal inflammation are difficult to treat, but the improvement observed in this case of post scleral buckling macular edema and choroidal inflammation showed how a dexamethasone implant proved to be useful during the 6-month follow-up.

  16. Intravitreal ranibizumab for diabetic macular oedema in previously vitrectomized eyes

    DEFF Research Database (Denmark)

    Laugesen, Caroline Schmidt; Ostri, Christoffer; Brynskov, Troels

    2017-01-01

    PURPOSE: There is little information about the efficacy of intravitreal vascular endothelial growth factor (VEGF) inhibition in vitrectomized eyes. This study aimed to evaluate the efficacy of anti-VEGF (ranibizumab) on diabetic macular oedema in previously vitrectomized eyes. METHODS: A nationwide...... retrospective review of medical records from 2010 to 2013. RESULTS: We identified 33 previously vitrectomized eyes in 28 patients treated with ranibizumab injections for diabetic macular oedema. Median follow-up was 323 days (interquartile range 72-1404 days). Baseline mean visual acuity was 0.57 logMAR (95% CI...... 0.13-1.01) before injections. After an average of 4.7 injections (range 1-15), mean visual acuity remained stable at 0.54 logMAR (95% CI 0.13-0.95) with a mean improvement of 0.03 (p = 0. 45, 95% CI -0.12 to 0.06). In 12 eyes (36%), visual acuity improved 0.1 logMAR or more, in 12 eyes (36%), vision...

  17. Radiation therapy for age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Chikako; Mori, Hideo; Akuta, Keizou [Otsu Red Cross Hospital, Shiga (Japan); Yoshimura, Nagahisa

    1998-04-01

    We evaluated the effect of low-dose radiation on age-related macular degeneration in 8 affected eyes. Radiation was applied using photons at 4 MV. Each eye received 10 fractions of 2 Gy per day over 2 weeks. At 6 months after treatment, funduscopic or angiographic findings had either improved or remained unchanged in all the eyes. The visual acuity improved by 2 lines or more in 2 eyes (25%), remained unchanged in 5 eyes (63%) and deteriorated in 1 eye (13%). At the last examination, fundus findings had improved in 2 eyes (25%), remained unchanged in 1 eye (13%) and deteriorated in 5 eyes (63%). The visual acuity had improved or unchanged in 2 eyes each (25%) and deteriorated in 4 eyes (50%). There has been no negative side effects of radiation. Above findings show that low-dose radiation is potentially beneficial for subfoveal or juxtafoveal choroidal neovascularizations in age-related macular degeneration on a short term basis. (author)

  18. Macular hole: 10 and 20-MHz ultrasound and spectral-domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Juliana Mantovani Bottós

    2012-12-01

    Full Text Available PURPOSE: Optical coherence tomography (OCT is valuable for macula evaluation. However, as this technique relies on light energy it cannot be performed in the presence of opaque media. In such cases, the ultrasound (US may predict some macular features. The aim of this study was to characterize images obtained by ultrasound with 10 and 20-MHz transducers comparing to OCT, as well as to analyze the relationship between the vitreous and retina in eyes with macular hole (MH. METHODS: 29 eyes of 22 patients with biomicroscopic evidence of MH at different stages were included. All patients were evaluated using ultrasonography with 10 and 20-MHz transducers and OCT. RESULTS: OCT identified signs of MH in 25 of 29 eyes. The remaining 4 cases not identified by US were pseudoholes caused by epiretinal membranes. In MH stages I (2 eyes and II (1 eye, both transducers were not useful to analyze the macular thickening, but suggestive findings as macular irregularity, operculum or partial posterior vitreous detachment (PVD were highlighted. In stages III (14 eyes and IV (5 eyes, both transducers identified the double hump irregularity and thickening. US could measure the macular thickness and other suggestive findings for MH: operculum, vitreomacular traction and partial or complete PVD. In cases of pseudoholes, US identified irregularities macular contour and a discrete depression. CONCLUSION: 10-MHz US was useful for an overall assessment of the vitreous body as well as its relationship to the retina. The 20-MHz transducer allowed valuable information on the vitreomacular interface and macular contour. OCT provides superior quality for fine morphological study of macular area, except in cases of opaque media. In these cases, and even if OCT is not available, the combined US study is able to provide a valid evaluation of the macular area improving therapeutic approach.

  19. Positioning In Macular hole Surgery (PIMS): statistical analysis plan for a randomised controlled trial.

    Science.gov (United States)

    Bell, Lauren; Hooper, Richard; Bunce, Catey; Pasu, Saruban; Bainbridge, James

    2017-06-13

    The treatment of idiopathic full-thickness macular holes involves surgery to close the hole. Some surgeons advise patients to adopt a face-down position to increase the likelihood of successful macular hole closure. However, patients often find the face-down positioning arduous. There is a lack of conclusive evidence that face-down positioning improves the outcome. The 'Positioning In Macular hole Surgery' (PIMS) trial will assess whether advice to position face-down after surgery improves the surgical success rate for the closure of large (≥400 μm) macular holes. The PIMS trial is a multicentre, parallel-group, superiority clinical trial with 1:1 randomisation. Patients (n = 192) with macular holes (≥400 μm) will be randomised after surgery to either face-down positioning or face-forward positioning for at least 8 h (which can be either consecutive or nonconsecutive) a day, for 5 days following surgery. Inclusion criteria are: presence of an idiopathic full-thickness macular hole ≥400 μm in diameter, as measured by optical coherence tomography (OCT) scans, on either or both eyes; patients electing to have surgery for a macular hole, with or without simultaneous phacoemulsification and intraocular lens implant; ability and willingness to position face-down or in an inactive face-forward position; a history of visual loss suggesting a macular hole of 12 months' or less duration. The primary outcome is successful macular hole closure at 3 months post surgery. The treatment effect will be reported as an odds ratio with 95% confidence interval, adjusted for size of macular hole and phakic lens status at baseline. Secondary outcome measures at 3 months are: further surgery for macular holes performed or planned (of those with unsuccessful closure); patient-reported experience of positioning; whether patients report they would still have elected to have the operation given what they know at follow-up; best-corrected visual acuity (BCVA) measured

  20. MR imaging in the evaluation of macular degeneration and intraocular tumorlike conditions

    International Nuclear Information System (INIS)

    Mafee, M.F.; Peyman, G.A.; Cohen, S.B.; Capek, V.

    1987-01-01

    The MR characteristics of malignant uveal melanoma and choroidal hematoma have been described. This paper reports on MR imaging and CT examinations of patients who had macular degeneration, retinal and subretinal masses (hematoma, dense scar), choroidal metastases, choroidal nevus, and choroidal leiomyoma. Several diagnostically helpful MR findings were noted. Posterior hyaloid detachment with associated retinal detachment and subretinal hematoma in patients with macular degeneration demonstrated by MR imaging. Associated liquefaction of the vitreous in our patients with macular degeneration was seen as hyperintensity of the involved vitreous. Hematomas, metastases, and nevi may be confused with uveal melanoma. Choroidal leiomyoma had characteristic high signal intensity in both T1- and T2-weighted images

  1. Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage

    Science.gov (United States)

    Kumar, Pradeep; Kumar, Vinod; Ravani, Raghav; Agarwal, Sahil

    2018-01-01

    A young male presented with diminution of vision left eye, attributable to full-thickness macular hole, and submacular hemorrhage, following closed globe injury 2 weeks ago. The patient was managed successfully with 25-gauge vitrectomy, subretinal injection of tissue plasminogen activator and aspiration of liquefied blood through the macular hole, internal limiting membrane peeling, short-acting gas tamponade, and prone positioning. This resulted in good visual improvement, type 1 macular hole closure, and restoration of foveal architecture. The outcome and rationale of treatment in this unique scenario is discussed. PMID:29480275

  2. A Layered Approach to Raising Public Awareness of Macular Degeneration in Australia

    Science.gov (United States)

    Heraghty, Julie; Cummins, Robert

    2012-01-01

    Between 2007 and 2011, the Australian Macular Degeneration Foundation conducted a multifaceted campaign to increase public awareness of macular degeneration. Regular national polls conducted by an independent social research company have shown that awareness of macular degeneration increased from 47% to 80% in Australians aged 16 years or older and from 58% to 92% in those aged 50 years or older. The percentage of people aged 50 years or older who reported having had their macula checked in the 2 years prior to the survey increased from 33% to 70% from 2007 to 2011. Other measures, including analysis of Medicare data, have confirmed the success of the campaign. PMID:22813341

  3. Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal

    Directory of Open Access Journals (Sweden)

    Hammouda Hamdy Ghoraba

    2014-01-01

    Full Text Available Purpose. To evaluate the efficacy of silicone oil (S.O reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD after silicone oil removal was 11.3% (6 out of 53 eyes. One case refused any other interference. In the remaining 5 eyes, 4 eyes (80% could be reattached by S.O re-injection and one eye (20% developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months. Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases.

  4. External radiotherapy in macular degeneration: technique and preliminary subjective response

    International Nuclear Information System (INIS)

    Freire, Jorge; Longton, Wallace A.; Miyamoto, Curtis T.; Brady, Luther W.; Augsburger, James; Brown, Gary; Micaily, Bizhan; Unda, Ricardo

    1996-01-01

    Purpose: This study attempted to assess the toxicity and possible preliminary benefits from the administration of low-dose external beam irradiation for age-related macular degeneration (ARMD). The premise of the treatment is that radiation induces regression and/or promotes inactivation of the subretinal neovasculature which would result in reabsorption of fluid and blood. This would reduce the risk for further leakage or bleeding, as well as subretinal fibrosis. Consequently, the beneficial effect could be translated into stabilization of visual acuity and prevention of progression of the wet ARMD with the possibility for slight improvement. Methods and Materials: Allegheny University Department of Radiation Oncology treated 41 patients prospectively from January through October 1995 with low-dose irradiation for wet-type macular degeneration. A total of 39 patients were treated with a total dose of 14.4 Gy in eight fractions of 1.8 Gy/fraction over 10-13 elapsed days. The first two patients were treated with a total dose of 10 Gy in fivefractions of 2 Gy. Patients were evaluated at 2-3 weeks and 2-3 months. Some of the patients (36.7%) had laser treatments in the study eye: 21.9% (9) once, 5% (2) twice, 9.7% (4) thrice or more. Subjective visual acuity and toxicity data were collected on all patients. Results: At 2-3 weeks after treatment 29 patients (70%) retained their visual acuity without change, 10 (24.5%) stated they had improved vision, and 2 (4.8%) stated their vision continued to decrease. At 2-3 months after treatment, 27 patients (65.8%) had no change in their vision, 11 (27%) had an improvement in their vision, and 3 (7.2%) had a decrease in visual acuity. Six patients of 41 in the treated group had acute transient side effects. Conclusion: Our observations in this group of 41 patients support the conclusion that many patients will have improved or stable vision after treatment with low-dose irradiation for age-related wet-type macular degeneration

  5. Ernest Borgnine Lays it on the Line Hollywood Hero Focuses on Macular Degeneration

    Science.gov (United States)

    ... Vision Ernest Borgnine Lays it on the Line Hollywood Hero Focuses on Macular Degeneration Past Issues / Summer ... on getting your eyes examined regularly. At 91, Hollywood legend Ernest Borgnine is still going strong, making ...

  6. Efficacy of first Ranibizumab intravitreal injection on macular edema caused by retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Hong Cao

    2015-09-01

    Full Text Available AIM: To observe the efficacy of first Ranibizumab intravitreal injection on macular edema caused by retinal vein occlusion(RVO. METHODS: Thirty-nine eyes of 39 patients with macular edema due to RVO were treated in our hospital during June 2014 to December 2014. Patients received intravitreal injection of 0.05mL ranibizumab. Best corrected visual acuity(BCVA, central macular thickness(CMTand cube average thickness(CATwere analyzed at 2d, 2, and 4wk after injection, respectively. RESULTS: The baseline BCVA(LogMAR, CMT and CAT were 0.82±0. 45, 541±136μm and 382±107μm before treatment. After first ranibizumab intravitreal injection, mean BVCA significantly improved at 2d(0. 56±0.35,PPPPPPPPPCONCLUSION: First intravitreal injection of ranibizumab can improve macular edema caused by RVO in short-term, but long-term effects is needed further observed.

  7. Cystoid macular edema diagnosed with optical coherent tomography in patients operated on from cataract

    International Nuclear Information System (INIS)

    Diaz Arencibia, Omar; Rodriguez Rodriguez, Beatriz; Eguias Martinez, Frank; Alemany Rubio, Ernesto; Guerra, Roberto Alejandro

    2009-01-01

    Refers frequency of cystoid macular edema diagnosed with optical coherence tomography in patients operated on from senile cataract at 'Ramon Pando Ferrer' Cuban Institute of Ophthalmology in the period from December 2006 to February 2007

  8. Comparative study between the features of FFA and OCT in diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Qin-Hui Wang

    2014-12-01

    Full Text Available AIM: To assess the correlation between the features of optical coherencetomography(OCTand fundus fluorescein angiography(FFAin diabetic macular edema(DEM. METHODS: Totally 70 patients(135 eyeswith diabetic retinopathy(DRwere evaluated by central vision, best corrected visual acuity(BCVA, intraocular pressure, indirect ophthalmoscopy, slit lamp microscope combined +90D front mirror mydriatic fundus examination, mydriatic fundus color photography, OCT, FFA, the correlation between FFA and OCT were analyzed. RESULTS: In mild macular oedema cases, abnormalities in FFA was 56 eyes, abnormalities in OCT was 68 eyes(P=0.0009; FFA showed 12 normal eyes, 10 eyes in OCT were characterized by diffused macular oedema; FFA was performed with cystoid macular oedema, OCT was 46.7% with cystoid type. CONCLUSION: DME is diagnosed by Combination FFA with OCT, OCT is an indispensable tool when following up DME, and it has advantage in early application.

  9. Resolution of advanced cystoid macular edema following photodynamic therapy for choroidal hemangioma.

    Science.gov (United States)

    Shields, Carol L; Materin, Miguel A; Marr, Brian P F; Mashayekhi, Arman; Shields, Jerry A

    2005-01-01

    A 45-year-old man was referred for 2 months of decreasing vision in his left eye. His visual acuity was 20/200 secondary to a subtle juxtapapillary choroidal hemangioma producing profound cystoid macular edema, with the affected retina measuring 330 microns thick by optical coherence tomography. Due to the severe cystoid macular edema, visual prognosis was judged to be poor. One month following photodynamic therapy to the tumor using verteporfin, the cystoid macular edema completely resolved, foveal anatomy returned to normal, optical coherence tomography thickness was 179 microns, and visual acuity recovered to 20/25. Photodynamic therapy of choroidal hemangioma may be effective in resolving associated cystoid macular edema and improving visual acuity.

  10. [Treatment of macular choroidal neovascular membrane with krypton red laser photocoagulation].

    Science.gov (United States)

    Sun, X Q

    1989-03-01

    Ten (10) cases of macular choroidal neovascular membrane were treated successfully with krypton red laser (KRL) photocoagulation. The patients were followed up 3-15 months with no recurrence. Choroidal neovascular membranes outside the foveal region carried good visual prognosis, while poor visual outcome accompanied foveal involvement. The authors were encouraged by the efficacy of KRL photocoagulation in the treatment of macular choroidal neovascular membranes. Complications were few; however, the laser parameters, especially the output power, were key points to success.

  11. Macular pigment response to a supplement containing meso-zeaxanthin, lutein and zeaxanthin

    Directory of Open Access Journals (Sweden)

    Howard Alan N

    2007-05-01

    Full Text Available Abstract Background Age-related macular degeneration (AMD is a disease with multiple risk factors, many of which appear to involve oxidative stress. Macular pigment, with its antioxidant and light-screening properties, is thought to be protective against AMD. A result has been the appearance of dietary supplements containing the macular carotenoids, lutein and zeaxanthin. More recently, a supplement has been marketed containing, in addition, the third major carotenoid of the macular pigment, meso-zeaxanthin. The purpose of the study was to determine the effectiveness of such a supplement in raising macular pigment density in human subjects. Methods A 120 day supplementation study was conducted in which 10 subjects were given gel-caps that provided 20 mg/day of predominantly meso-zeaxanthin, with smaller amounts of lutein and zeaxanthin. A second group of 9 subjects were given gel caps containing a placebo for the same 120 day period. Prior to and during the supplementation period, blood serum samples were analyzed by high performance liquid chromatography for carotenoid content. Similarly, macular pigment optical density was measured by heterochromatic flicker photometry. Differences in response between the supplementation and placebo groups were tested for significance using a student's t-test. Results During supplementation with the carotenoids, blood samples revealed the presence of all three carotenoids. Macular pigment optical density, measured at 460 nm, rose at an average rate of 0.59 ± 0.79 milli-absorbance unit/day in the 10 supplemented subjects. This was significantly different from the placebo group (9 subjects for whom the average rate was -0.17 ± 0.42 milli-absorbance units/day. Conclusion We have shown for the first time that meso-zeaxanthin is absorbed into the serum following ingestion. The data indicate that a supplement containing predominantly meso-zeaxanthin is generally effective at raising macular pigment density, and

  12. Central macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy.

    Science.gov (United States)

    Demir, Mehmet; Oba, Ersin; Dirim, Burcu; Ozdal, Erhan; Can, Efe

    2013-04-09

    An increase in macular thickness due to fluid accumulation in the macula in patients with diabetes mellitus. Optical coherence tomography (OCT) has been shown to be highly reproducible in measuring macular thickness in normal individuals and diabetic patients. OCT can detect subtle changes of macular thickness. The aim of this study is to compare central macular thickness (CMT) of diabetic patients with type 2 diabetes without clinical retinopathy and normal controls, in order to assess possible increased macular thickness associated with diabetes mellitus. Optical coherence tomography (OCT) measurements were performed in 124 eyes of 62 subjects with diabetes mellitus without clinically retinopathy (study group: 39 female, 23 male, mean age: 55.06 ± 9.77 years) and in 120 eyes of 60 healthy subjects (control group: 35 female, 25 male, mean age: 55.78 ± 10.34 years). Blood biochemistry parameters were analyzed in all cases. The data for central macular thickness (at 1 mm) and the levels of the fasting plasma glucose and glycosylated hemoglobin (HbA1c) were compared in both groups. The mean central macular thickness was 232.12 ±24.41 μm in the study group and 227.19 ± 29.94 μm in the control group.The mean HbA1c level was 8.92 ± 2.58% in the study group and 5.07 ± 0.70% in the control group (p=0.001). No statistically significant relationship was found between CMT, HbA1c, and fasting plasma glucose level in either group (p=0.05). Central macular thickness was not significantly thicker in patients with type 2 diabetes without clinical retinopathy than in healthy subjects.

  13. The Association between Plasma 25-Hydroxyvitamin D and Subgroups in Age-Related Macular Degeneration

    DEFF Research Database (Denmark)

    Singh, Amardeep; Falk, Mads Krüger; Subhi, Yousif

    2013-01-01

    To evaluate potential differences in plasma 25-hydroxyvitamin in subtypes of age-related macular degeneration (AMD), and in patients in Clinical Age-Related Maculopathy Staging (CARMS) group 5 with or without subretinal fibrosis.......To evaluate potential differences in plasma 25-hydroxyvitamin in subtypes of age-related macular degeneration (AMD), and in patients in Clinical Age-Related Maculopathy Staging (CARMS) group 5 with or without subretinal fibrosis....

  14. Self-reported optometric practise patterns in age-related macular degeneration.

    Science.gov (United States)

    Ly, Angelica; Nivison-Smith, Lisa; Zangerl, Barbara; Assaad, Nagi; Kalloniatis, Michael

    2017-11-01

    The use of advanced imaging in clinical practice is emerging and the use of this technology by optometrists in assessing patients with age-related macular degeneration is of interest. Therefore, this study explored contemporary, self-reported patterns of practice regarding age-related macular degeneration diagnosis and management using a cross-sectional survey of optometrists in Australia and New Zealand. Practising optometrists were surveyed on four key areas, namely, demographics, clinical skills and experience, assessment and management of age-related macular degeneration. Questions pertaining to self-rated competency, knowledge and attitudes used a five-point Likert scale. Completed responses were received from 127 and 87 practising optometrists in Australia and New Zealand, respectively. Advanced imaging showed greater variation in service delivery than traditional techniques (such as slitlamp funduscopy) and trended toward optical coherence tomography, which was routinely performed in age-related macular degeneration by 49 per cent of respondents. Optical coherence tomography was also associated with higher self-rated competency, knowledge and perceived relevance to practice than other modalities. Most respondents (93 per cent) indicated that they regularly applied patient symptoms, case history, visual function results and signs from traditional testing, when queried about their management of patients with age-related macular degeneration. Over half (63 per cent) also considered advanced imaging, while 31 per cent additionally considered all of these as well as the disease stage and clinical guidelines. Contrary to the evidence base, 68 and 34 per cent rated nutritional supplements as highly relevant or relevant in early age-related macular degeneration and normal aging changes, respectively. These results highlight the emergence of multimodal and advanced imaging (especially optical coherence tomography) in the assessment of age-related macular degeneration

  15. Incidence of legal blindness from age-related macular degeneration in denmark: year 2000 to 2010

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi; Larsen, Michael; Munch, Inger Christine

    2012-01-01

    To report incidence rates of legal blindness from age-related macular degeneration (AMD) and other causes in Denmark from years 2000 to 2010 in the age group at risk of AMD aged 50 years and older.......To report incidence rates of legal blindness from age-related macular degeneration (AMD) and other causes in Denmark from years 2000 to 2010 in the age group at risk of AMD aged 50 years and older....

  16. Diabetic macular edema: it is more than just VEGF [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Michael A. Singer

    2016-05-01

    Full Text Available Diabetic macular edema is a serious visual complication of diabetic retinopathy. This article reviews the history of previous and current therapies, including laser therapy, anti-vascular endothelial growth factor agents, and corticosteroids, that have been used to treat this condition. In addition, it proposes new ways to use them in combination in order to decrease treatment burden and potentially address other causes besides vascular endothelial growth factor for diabetic macular edema.

  17. Cystoid macular edema in a patient with Danon disease

    Directory of Open Access Journals (Sweden)

    Heather G Mack

    2014-01-01

    Full Text Available To report a patient with Danon retinopathy with cystoid macular edema treated with topical dorzolamide 2% eye drops and oral acetazolamide. A 37-year-old Caucasian man with Danon disease treated with topical and oral carbonic anhydrase inhibitors participated in the study. Examinations performed before and during treatment included visual acuity (VA, spectral-domain optical coherence tomography, and electroretinography. Following total 48 weeks of treatment, VA decreased from 20/30 OD, 20/200 OS, to 20/40 OD, CF OS. The mean central retinal thickness was unchanged from baseline 263 μm OD , 226 μm OS, after treatment 283 μm OD and 202 μm OS. In our case, carbonic anydrase inhibitors were not effective. However, a general recommendation cannot be given based on a single case.

  18. Imaging geographic atrophy in age-related macular degeneration.

    Science.gov (United States)

    Göbel, Arno P; Fleckenstein, Monika; Schmitz-Valckenberg, Steffen; Brinkmann, Christian K; Holz, Frank G

    2011-01-01

    Advances in retinal imaging technology have largely contributed to the understanding of the natural history, prognostic markers and disease mechanisms of geographic atrophy (GA) due to age-related macular degeneration. There is still no therapy available to halt or slow the disease process. In order to evaluate potential therapeutic effects in interventional trials, there is a need for precise quantification of the GA progression rate. Fundus autofluorescence imaging allows for accurate identification and segmentation of atrophic areas and currently represents the gold standard for evaluating progressive GA enlargement. By means of high-resolution spectral-domain optical coherence tomography, distinct microstructural alterations related to GA can be visualized. Copyright © 2011 S. Karger AG, Basel.

  19. Dome-shaped macula associated with Best vitelliform macular dystrophy.

    Science.gov (United States)

    Battaglia Parodi, Maurizio; Zucchiatti, Ilaria; Fasce, Francesco; Cascavilla, Maria Lucia; Cicinelli, Maria Vittoria; Bandello, Francesco

    2015-01-01

    Dome-shaped macula (DSM) has been described recently as an inward convexity of the macula typical of myopic eyes detectable on spectral-domain optical coherence tomography (SD-OCT). The authors describe a case of monolateral DSM associated with Best vitelliform macular dystrophy (VMD). Case report. A 60-year-old man already diagnosed with VMD in vitelliruptive stage underwent SD-OCT that revealed the typical vitelliform material accumulation associated in the left eye with a convex elevation of the macula. No change was registered over a 1-year follow-up. This is the first report describing a monolateral DSM associated with VMD. Dome-shaped macula could be considered as a nonspecific scleral alteration, probably due to increased scleral thickness, which can accompany many retinal disorders.

  20. Radiation Therapy for Neovascular Age-related Macular Degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Kishan, Amar U. [Harvard Medical School, Boston, Massachusetts (United States); Modjtahedi, Bobeck S.; Morse, Lawrence S. [Department of Ophthalmology and Vision Sciences, University of California, Davis, Sacramento, California (United States); Lee, Percy, E-mail: percylee@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

    2013-03-01

    In the enormity of the public health burden imposed by age-related macular degeneration (ARMD), much effort has been directed toward identifying effective and efficient treatments. Currently, anti-vascular endothelial growth factor (VEGF) injections have demonstrated considerably efficacy in treating neovascular ARMD, but patients require frequent treatment to fully benefit. Here, we review the rationale and evidence for radiation therapy of ARMD. The results of early photon external beam radiation therapy are included to provide a framework for the sequential discussion of evidence for the usage of stereotactic radiation therapy, proton therapy, and brachytherapy. The evidence suggests that these 3 modern modalities can provide a dose-dependent benefit in the treatment of ARMD. Most importantly, preliminary data suggest that all 3 can be used in conjunction with anti-VEGF therapeutics, thereby reducing the frequency of anti-VEGF injections required to maintain visual acuity.

  1. Bilateral macular hole secondary to remote lightning strike

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    Rao Krishna

    2009-01-01

    Full Text Available We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

  2. [Future methods of treatment in age related macular degeneration].

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    Turlea, C

    2012-01-01

    In the present time the treatment of Age Related Macular Degeneration (ARMD) begins to develop. Many medical therapies are presently tested in the two types of ARMD, geographic atrophy and exudative ARMD. In atrophic ARMD, new drugs are aimed to spare photoreceptors and the retinal pigment epithelium, to prevent oxidative damage on the retina and to suppress the inflammation process. In exudative ARMD, new therapies are already in use and in progress, especially the anti-VEGF factors, and others try to improve visual prognosis in targeting other mechanism or cells involved in the angiogenesis process. This article reviews and summarizes the available data, presented in several scientific meetings, congresses or given directly by the companies involved.

  3. Cognitive dysfunction and age-related macular degeneration.

    Science.gov (United States)

    Rozzini, Luca; Riva, Maddalena; Ghilardi, Nausica; Facchinetti, Paola; Forbice, Eliana; Semeraro, Francesco; Padovani, Alessandro

    2014-05-01

    Several previous studies showed that age-related macular degeneration (AMD) and Alzheimer's disease (AD) share common risk factors and histopathology changes, and there is epidemiological evidence linking AMD to cognitive impairment. We tested this theory in 51 patients with late-stage AMD and 24 controls by analyzing their neuropsychological profiles. In this study, data showed that patients affected by late-stage AMD have a worse global cognitive function than those of the controls and, in particular, show worse performances in memory tasks. Moreover, patients affected by the dry form of AMD are significantly impaired in executive functions in addition to memory. Data support the hypothesis of a possible association between AMD and cognitive impairment. In particular, patients affected by the dry form of AMD may be at greater risk of developing subsequent dementia.

  4. Risk Factors and Biomarkers of Age-Related Macular Degeneration

    Science.gov (United States)

    Lambert, Nathan G.; Singh, Malkit K.; ElShelmani, Hanan; Mansergh, Fiona C.; Wride, Michael A.; Padilla, Maximilian; Keegan, David; Hogg, Ruth E.; Ambati, Balamurali K.

    2016-01-01

    A biomarker can be a substance or structure measured in body parts, fluids or products that can affect or predict disease incidence. As age-related macular degeneration (AMD) is the leading cause of blindness in the developed world, much research and effort has been invested in the identification of different biomarkers to predict disease incidence, identify at risk individuals, elucidate causative pathophysiological etiologies, guide screening, monitoring and treatment parameters, and predict disease outcomes. To date, a host of genetic, environmental, proteomic, and cellular targets have been identified as both risk factors and potential biomarkers for AMD. Despite this, their use has been confined to research settings and has not yet crossed into the clinical arena. A greater understanding of these factors and their use as potential biomarkers for AMD can guide future research and clinical practice. This article will discuss known risk factors and novel, potential biomarkers of AMD in addition to their application in both academic and clinical settings. PMID:27156982

  5. Mediated-reality magnification for macular degeneration rehabilitation

    Science.gov (United States)

    Martin-Gonzalez, Anabel; Kotliar, Konstantin; Rios-Martinez, Jorge; Lanzl, Ines; Navab, Nassir

    2014-10-01

    Age-related macular degeneration (AMD) is a gradually progressive eye condition, which is one of the leading causes of blindness and low vision in the Western world. Prevailing optical visual aids compensate part of the lost visual function, but omitting helpful complementary information. This paper proposes an efficient magnification technique, which can be implemented on a head-mounted display, for improving vision of patients with AMD, by preserving global information of the scene. Performance of the magnification approach is evaluated by simulating central vision loss in normally sighted subjects. Visual perception was measured as a function of text reading speed and map route following speed. Statistical analysis of experimental results suggests that our magnification method improves reading speed 1.2 times and spatial orientation to find routes on a map 1.5 times compared to a conventional magnification approach, being capable to enhance peripheral vision of AMD subjects along with their life quality.

  6. Vitamin D and Age-Related Macular Degeneration

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    Alfredo Garcia Layana

    2017-10-01

    Full Text Available In recent years, the relationship between vitamin D and health has received growing attention from the scientific and medical communities. Vitamin D deficiencies have been repeatedly associated with various acute and chronic diseases, including age-related macular degeneration (AMD. Its active metabolite, 1α,25-dihydoxy vitamin D, acts as a modulator of cell proliferation, differentiation and apoptosis, and cumulative data from experimental and observational studies suggest that relatively a lower vitamin D status could be a potential risk factor for the development of early and/or late AMD. Herein, we made a narrative review of the mechanisms linking a potential role of vitamin D with the current concepts of AMD pathophysiology.

  7. Lipids, Lipoproteins, and Age-Related Macular Degeneration

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    Katayoon B. Ebrahimi

    2011-01-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of blindness among the elderly. While excellent treatment has emerged for neovascular disease, treatment for early AMD is lacking due to an incomplete understanding of the early molecular events. A prominent age-related change is the accumulation of neutral lipid in normal Bruch's membrane (BrM throughout adulthood and also disease-related BrM accumulations called basal deposits and drusen. AMD lesion formation has thus been conceptualized as sharing mechanisms with atherosclerotic plaque formation, where low-density lipoprotein (LDL retention within the arterial wall initiates a cascade of pathologic events. However, we do not yet understand how lipoproteins contribute to AMD. This paper explores how systemic and local production of lipoproteins might contribute to the pathogenesis of AMD.

  8. Partial-thickness macular hole in vitreomacular traction syndrome: a case report and review of the literature

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    Al Sabti Khalid

    2010-01-01

    Full Text Available Abstract Introduction Vitreomacular traction syndrome has recently been recognized as a distinct clinical condition. It may lead to many complications, such as cystoid macular edema, macular pucker formation, tractional macular detachment, and full-thickness macular hole formation. Case presentation We report a case of vitreomacular traction syndrome with eccentric traction at the macula and a partial-thickness macular hole in a 63-year-old Pakistani Punjabi man. The patient was evaluated using optical coherence tomography, and he underwent a successful pars plana vitrectomy. After the operation, his foveal contour regained normal configuration, and his visual acuity improved from 20/60 to 20/30. Conclusions Pars plana vitrectomy prevents the progression of a partial thickness macular hole in vitreomacular traction syndrome. The relief of traction by vitrectomy restores foveal anatomy and visual acuity in this condition.

  9. Age-related macular degeneration: prevention and treatment. A review

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    K. A. Mirzabekova

    2014-07-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  10. Age-related macular degeneration: prevention and treatment. A review

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-01-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  11. Static and flicker perimetry in age-related macular degeneration.

    Science.gov (United States)

    Luu, Chi D; Dimitrov, Peter N; Wu, Zhichao; Ayton, Lauren N; Makeyeva, Galina; Aung, Khin-Zaw; Varsamidis, Mary; Robman, Luba; Vingrys, Algis J; Guymer, Robyn H

    2013-05-01

    The relationship between clinical severity of age-related macular degeneration (AMD) and macular function has not been well established. In this study, we investigated the correlation between clinical severity and functional deficits as detected by static and flicker perimetry. This cross-sectional study consisted of 279 AMD subjects and 24 control participants. AMD subjects were allocated into 1 of 10 AMD severity groups depending on the status of the designated study eye and the fellow eye, as assessed by color fundus photographs. Visual acuity, and static and flicker perimetry were tested on one eye during the same session. The geometric means, SDs, and percentage of abnormal eyes of static and flicker sensitivity of each AMD severity group were determined and compared. The pattern of change in sensitivity and percentage of abnormal eyes for static perimetry across all AMD severity groups were similar to flicker perimetry. Eyes with drusen > 125 μm (P[static] = 0.018, P[flicker] = 0.024), drusenoid epithelial detachment (P[static and flicker] flicker] flicker sensitivities compared to normal eyes. Static (β-coefficient -1.59, 95% confidence interval [CI] -4.78-1.60) and flicker (β-coefficient -1.29, 95% CI -4.66-2.08) sensitivities declined at a similar rate in eyes that showed clinical signs of progression. Static and flicker perimetry were affected similarly across the spectrum of AMD severity, and methods appeared to be valid techniques for assessing retinal sensitivity in AMD once drusen > 125 μm are present, but before the development of late AMD.

  12. Asymmetric Macular Structural Damage Is Associated With Relative Afferent Pupillary Defects in Patients With Glaucoma

    Science.gov (United States)

    Gracitelli, Carolina P. B.; Tatham, Andrew J.; Zangwill, Linda M.; Weinreb, Robert N.; Abe, Ricardo Y.; Diniz-Filho, Alberto; Paranhos, Augusto; Baig, Saif; Medeiros, Felipe A.

    2016-01-01

    Purpose We examined the relationship between relative afferent pupillary defects (RAPDs) and macular structural damage measured by macular thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in patients with glaucoma. Methods A cross-sectional study was done of 106 glaucoma patients and 85 healthy individuals from the Diagnostic Innovations in Glaucoma Study. All subjects underwent standard automated perimetry (SAP) and optic nerve and macular imaging using Cirrus Spectral Domain Optical Coherence Tomography (SDOCT). Glaucoma was defined as repeatable abnormal SAP or progressive glaucomatous changes on stereo photographs. Pupil responses were assessed using an automated pupillometer, which records the magnitude of RAPD (RAPD score), with additional RAPD scores recorded for each of a series of colored stimuli (blue, red, green, and yellow). The relationship between RAPD score and intereye differences (right minus left eye) in circumpapillary retinal nerve fiber layer (cpRNFL) thickness, mGCIPL, macular thickness, and SAP mean deviation (MD), was examined using linear regression. Results There was fair correlation between RAPD score and asymmetric macular structural damage measured by intereye difference in mGCIPL thickness (R2 = 0.285, P glaucoma. PMID:27064394

  13. Effect of Amblyopia Treatment on Macular Thickness in Eyes With Myopic Anisometropic Amblyopia.

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    Pang, Yi; Frantz, Kelly A; Block, Sandra; Goodfellow, Geoffrey W; Allison, Christine

    2015-04-01

    To determine whether abnormal macular thickness in myopic anisometropic amblyopia differed after amblyopia treatment. Furthermore, to investigate whether effect of treatment on macular thickness was associated with subject age or improvement in stereoacuity. Seventeen children (mean age: 9.0 [±3.0] years, ranging from 5.7-13.9 years) with myopic anisometropic amblyopia (visual acuity [VA] in amblyopic eyes: 20/80-20/400) were recruited and treated with 16-week refractive correction, followed by an additional 16-week refractive correction and patching. Macular thickness, best-corrected VA, and stereoacuity were measured both before and after amblyopia treatment. Factorial repeated-measures analysis of variance was performed to determine whether macular thickness in amblyopic eyes changed after amblyopia treatment. Mean baseline VA in the amblyopic eye was 1.0 ± 0.3 logMAR and improved to 0.7 ± 0.3 after amblyopia treatment (P amblyopia treatment was statistically significant for average foveal thickness (P = 0.040). There was no treatment effect on fellow eyes (P = 0.245); however, the average foveal thickness in the amblyopic eye was significantly reduced after amblyopia treatment (P = 0.049). No statistically significant interactions were found for the other macular thickness parameters (P > 0.05). Abnormal central macula associated with myopic anisometropic amblyopia tended to be thinner following amblyopia treatment with no significant changes in peripheral macular thickness.

  14. Clinical effect of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

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    Wei Cao

    2014-06-01

    Full Text Available AIM: To observe the clinical effects of 23-gauge(23Gtransconjunctival sutureless vitrectomy for idiopathic macular hole.METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ2=8.65, P=0.003; χ2=10.33, P=0.001. The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%. There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up. CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

  15. Does unintentional macular translocation after retinal detachment repair influence visual outcome?

    Science.gov (United States)

    Pandya, Vivek B; Ho, I-Van; Hunyor, Alex P

    2012-01-01

    To document the occurrence of postoperative macular translocation after retinal detachment repair and discuss its influence on visual outcome. Retrospective case series in a tertiary care setting. Five eyes of five patients presenting to our clinic with macula-off rhegmatogenous retinal detachment. All patients underwent surgical repair of the retinal detachment, with regular postoperative follow-up, including macular optical coherence tomography and fundus autofluorescence. Visual acuity and subjective visual symptoms in patients with anatomically successful retinal detachment repair, in whom inadvertent macular translocation was noted. Our series demonstrates the presence of unintentional macular translocation after retinal detachment repair, detected by fundus autofluorescence imaging. In contrast to previous reports, we document inadvertent macular translocation in one patient after scleral buckling surgery. In each case, the retina was fully reattached postoperatively and no other complications were identified. There was variability in the symptoms and objective visual outcomes after surgery. Inadvertent macular translocation can occur following repair of macula-off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  16. Correlation of Macular Focal Electroretinogram with Ellipsoid Zone Extension in Stargardt Disease

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    Edoardo Abed

    2017-01-01

    Full Text Available Stargardt disease (STGD1 is the most common cause of inherited juvenile macular degeneration. This disease is characterized by a progressive accumulation of lipofuscin in the outer retina and subsequent loss of photoreceptors and retinal pigment epithelium. The aim of this study was to evaluate the relationship between cone photoreceptor function and structure in STGD1. Macular function was assessed by visual acuity measurement and focal electroretinogram (FERG recording while spectral domain optical coherence tomography (SD-OCT imaging was performed to evaluate the integrity of photoreceptors. FERG amplitude was significantly reduced in patients with Stargardt disease (p<0.0001. The amplitude of FERG showed a negative relationship with interruption of ellipsoid zone (EZ (R2=0.54, p<0.0001 and a positive correlation with average macular thickness (AMT. Conversely, visual acuity was only weakly correlated with central macular thickness (CMT (R2=0.12, p=0.04. In conclusion, this study demonstrates that FERG amplitude is a reliable indicator of macular cone function while visual acuity reflects the activity of the foveal region. A precise assessment of macular cone function by FERG recording may be useful to monitor the progression of STGD1 and to select the optimal candidates to include in future clinical trials to treat this disease.

  17. GORE-TEX VASCULAR GRAFT FOR MACULAR BUCKLING IN HIGH MYOPIA EYES.

    Science.gov (United States)

    Wu, Pei-Chang; Sheu, Jiunn-Jye; Chen, Yi-Hao; Chen, Yung-Jen; Chen, Chih-Hsin; Lee, Jong-Jer; Huang, Chih-Ling; Chen, Chueh-Tan; Kuo, Hsi-Kung

    2017-07-01

    To evaluate a new application of an expanded polytetrafluoroethylene (Gore-Tex) vascular graft for use in macular buckling surgery for treatment of highly myopic eyes. The Gore-Tex vascular graft was used as a macular buckling material in eight consecutive cases of myopic macular diseases which included fovea detachment, foveoschisis, or macular hole retinal detachment. Retinal reattachment was achieved in all cases except one which had partial resolution (88%). The postoperative best-corrected visual acuity ranged from 20/2000 to 20/100 depending on the degree preexisting macular degeneration, and significant better than the preoperative best-corrected visual acuity (P = 0.048, paired t-test). During the follow-up period, which ranged from 8 months to 3 years, no eye developed buckle-related complications such as infection or dislocation. The initial pilot results from this series using a Gore-Tex graft for macular buckling is promising. Throughout the follow-up period, the Gore-Tex was well tolerated in the highly myopic eyes. Large scale and long-term follow-up is warranted.

  18. Aspectos atuais no diagnóstico do edema macular diabético Recent aspects on diagnosis of diabetic macular edema

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    Mário Martins dos Santos Motta

    2009-02-01

    Full Text Available O diagnóstico do edema macular diabético deve ser feito precocemente, a fim de evitar perda visual significativa. Para tal, contamos com exames complementares cada vez mais desenvolvidos e específicos. Os autores fazem uma revisão dos principais métodos existentes para diagnosticar a retinopatia diabética.Diabetic macular edema must be assessed as early as possible, to avoid significant vision loss. To achieve this goal, there are many specific diagnostic tests that can be performed. The authors review the most common methods in diagnosing diabetic retinopathy.

  19. Fatores modificáveis da degeneração macular relacionada à idade Modifiable risk factors for age-related macular degeneration

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    Rogil José de Almeida Torres

    2009-06-01

    Full Text Available Os autores apresentam os principais fatores modificáveis considerados de risco para o desencadeamento e/ou agravamento da degeneração macular relacionada com a idade. São abordados os mecanismos de ação destes fatores, assim como medidas preventivas e eficácia de eventuais intervenções.The authors present the main modifiable risk factors that may trigger and/or worsen age-related macular degeneration. Mechanisms of action related to these factors as well as preventive measures and intervention effectiveness are discussed.

  20. Subfoveal choroidal thickness predicts macular atrophy in age-related macular degeneration: results from the TREX-AMD trial.

    Science.gov (United States)

    Fan, Wenying; Abdelfattah, Nizar Saleh; Uji, Akihito; Lei, Jianqin; Ip, Michael; Sadda, SriniVas R; Wykoff, Charles C

    2018-03-01

    Our purpose was to evaluate the relationship between subfoveal choroidal thickness (SCT) and development of macular atrophy (MA) in eyes with age-related macular degeneration (AMD). This was a prospective, multicenter study. Sixty participants (120 eyes) in the TREX-AMD trial (NCT01648292) with treatment-naïve neovascular AMD (NVAMD) in at least one eye were included. SCT was measured by certified reading center graders at baseline using spectral domain optical coherence tomography (SDOCT). The baseline SCT was correlated with the presence of MA at baseline and development of incident MA by month 18. Generalized estimating equations were used to account for information from both eyes. Baseline SCT in eyes with MA was statistically significantly less than in those without MA in both the dry AMD (DAMD) (P = 0.04) and NVAMD (P = 0.01) groups. Comparison of baseline SCT between MA developers and non-MA developers revealed a statistically significant difference (P = 0.03). Receiver operating characteristic curve (ROC) analysis showed the cut-off threshold of SCT for predicting the development of MA in cases without MA at baseline was 124 μm (AUC = 0.772; Sensitivity = 0.923; Specificity = 0.5). Among eyes without MA at baseline, those with baseline SCT ≤124 μm were 4.3 times more likely to develop MA (Odds ratio: 4.3, 95% confidence interval: 1.6-12, P = 0.005) than those with baseline SCT >124 μm. Eyes with AMD and MA had less SCT than those without MA. Eyes with less baseline SCT also appear to be at higher risk to develop MA within 18 months.

  1. Differentiation of Diabetic Macular Edema From Pseudophakic Cystoid Macular Edema by Spectral-Domain Optical Coherence Tomography.

    Science.gov (United States)

    Munk, Marion R; Jampol, Lee M; Simader, Christian; Huf, Wolfgang; Mittermüller, Tamara J; Jaffe, Glenn J; Schmidt-Erfurth, Ursula

    2015-10-01

    To differentiate diabetic macular edema (DME) from pseudophakic cystoid macular edema (PCME) based solely on spectral-domain optical coherence tomography (SD-OCT). This cross-sectional study included 134 participants: 49 with PCME, 60 with DME, and 25 with diabetic retinopathy (DR) and ME after cataract surgery. First, two unmasked experts classified the 25 DR patients after cataract surgery as either DME, PCME, or mixed-pattern based on SD-OCT and color-fundus photography. Then all 134 patients were divided into two datasets and graded by two masked readers according to a standardized reading-protocol. Accuracy of the masked readers to differentiate the diseases based on SD-OCT parameters was tested. Parallel to the masked readers, a computer-based algorithm was established using support vector machine (SVM) classifiers to automatically differentiate disease entities. The masked readers assigned 92.5% SD-OCT images to the correct clinical diagnose. The classifier-accuracy trained and tested on dataset 1 was 95.8%. The classifier-accuracy trained on dataset 1 and tested on dataset 2 to differentiate PCME from DME was 90.2%. The classifier-accuracy trained and tested on dataset 2 to differentiate all three diseases was 85.5%. In particular, higher central-retinal thickness/retinal-volume ratio, absence of an epiretinal-membrane, and solely inner nuclear layer (INL)-cysts indicated PCME, whereas higher outer nuclear layer (ONL)/INL ratio, the absence of subretinal fluid, presence of hard exudates, microaneurysms, and ganglion cell layer and/or retinal nerve fiber layer cysts strongly favored DME in this model. Based on the evaluation of SD-OCT, PCME can be differentiated from DME by masked reader evaluation, and by automated analysis, even in DR patients with ME after cataract surgery. The automated classifier may help to independently differentiate these two disease entities and is made publicly available.

  2. [Pharmacological therapy of age-related macular degeneration based on etiopathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-11-15

    It is of great therapeutic significance that disordered function of the vascular endothelium which supply the affected ocular structures plays a major role in the pathogenesis and development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfunction, and age-related macular degeneration is accompanied by a general inflammatory response. According to current concept, age-related macular degeneration is a local manifestation of systemic vascular disease. This recognition could have therapeutic implications because restoration of endothelial dysfunction can restabilize the condition of chronic vascular disease including age-related macular degeneration as well. Restoration of endothelial dysfunction by pharmaacological or non pharmacological interventions may prevent the development or improve endothelial dysfunction, which result in prevention or improvement of age related macular degeneration as well. Medicines including inhibitors of the renin-angiotensin system (converting enzyme inhibitors, angiotensin-receptor blockers and renin inhibitors), statins, acetylsalicylic acid, trimetazidin, third generation beta-blockers, peroxisome proliferator-activated receptor gamma agonists, folate, vitamin D, melatonin, advanced glycation end-product crosslink breaker alagebrium, endothelin-receptor antagonist bosentan, coenzyme Q10; "causal" antioxidant vitamins, N-acetyl-cysteine, resveratrol, L-arginine, serotonin receptor agonists, tumor necrosis factor-alpha blockers, specific inhibitor of the complement alternative pathway, curcumin and doxycyclin all have beneficial effects on endothelial dysfunction. Restoration of endothelial dysfunction can restabilize chronic vascular disease including age-related macular degeneration as well. Considering that the human vascular system is consubstantial, medicines listed above should be given to patients (1) who have no macular degeneration but have risk factors

  3. Correlation of visual recovery with macular height in macula-off retinal detachments.

    Science.gov (United States)

    Mowatt, L; Tarin, S; Nair, R G; Menon, J; Price, N J

    2010-02-01

    To determine the relationship between the preoperative macular height of a macular detachment and visual outcome of the post retinal reattachment. Prospective case series of 26 patients who presented to the Wolverhampton Eye Infirmary with a primary rhegmatogenous macula-off retinal detachment. Macular detachment height was assessed by B-scan ultrasound (10 Mhz) in the seated and supine postures before surgery. Age, gender, duration of the detachment, type of surgery, preoperative (pre-op) and postoperative (post-op) visual acuities at 3 and 6 months and status of the fellow eye were noted. A total of 26 eyes of 26 patients (mean age: 61.4 years+/-15.56 SD) were recruited. The mean logMAR pre- and post-op visual acuities at 3 and 6 months were 1.5+/-1.1 SD (range: 0.2-3), 0.38+/-0.23 SD (range: 0-0.84), and at 6 months 0.29+/-0.22 SD (range: 0-1.0). The median period of the macular detachment was 4.5 days (95% CI: 2-8 days). There was no significant difference between the mean macular heights while seated 2.42 mm+/-1.2 or supine 2.39 mm+/-1.0 (t-test, P=0.9). Correlation showed that the pre-op macular height is a statistical predictor of post-op visual acuity in our group of patients with macula-off retinal detachments. The shallower the macular detachment the greater the likelihood of a good visual outcome.

  4. Efficacy of 20G or 25G three-channel vitrectomy for idiopathic macular epiretinal membrane

    Directory of Open Access Journals (Sweden)

    Hua Zhang

    2017-11-01

    Full Text Available AIM: To explore the curative effect of 20G and 25G three-channel pars plana vitrectomy in the treatment of idiopathic macular epiretinal membrane, and to provide a theoretical basis for the minimally invasive treatment of idiopathic macular epiretinal membrane.METHODS: Medical records were retrospectively analyzed to explore curative effect. From January 2014 to December 2016, 60 patients(60 eyeswith idiopathic macular pucker in our hospital for eye treatment were selected. They were grouped according to different operation way, in 28 patients(28 eyesusing three-channel 20G pars plana vitrectomy as the control group, 32 patients(32 eyeswith 25G no-suture conjunctival vitrectomy as observation group. Two groups of patients were evaluated at 3mo after treatment for visual acuity, OCT examination, comfort, and we recorded the operation time, complications and recurrence. RESULTS: The operating time of observation group was 18-25min, average 20±2.15min, the control group was 22-35min, 28±2.07min on average,the difference was statistically significant(Pχ2=7.287, PFtime=31.34, PFgroup=17.43, PP>0.05. Preoperative OCT on macular thickness of the two groups had no statistically significant difference. At 7d, 1 and 3mo after treatment, epiretinal membranes disappeared in all patients, and the macular thickness reduced, the macular edema relieved(PCONCLUSION: The 20G of three-channel pars plana vitrectomy and 25G the no-suture conjunctival vitrectomy are equal for idiopathic macular epiretinal membrane, 25G vitrectomy operation time is short with better patient comfort.

  5. Intravitreal bevacizumab (Avastin treatment of diffuse diabetic macular edema in an Indian population

    Directory of Open Access Journals (Sweden)

    Kumar Atul

    2007-01-01

    Full Text Available Background: To report the anatomic and visual acuity response after intravitreal bevacizumab (Avastin in patients with diffuse diabetic macular edema. Design: Prospective, interventional case series study. Materials and Methods: This study included 20 eyes of metabolically stable diabetes mellitus with diffuse diabetic macular edema with a mean age of 59 years who were treated with two intravitreal injections of bevacizumab 1.25 mg in 0.05 ml six weeks apart. Main outcome measures were 1 early treatment diabetic retinopathy study visual acuity, 2 central macular thickness by optical coherence tomography imaging. Each was evaluated at baseline and follow-up visits. Results: All the eyes had received some form of laser photocoagulation before (not less than six months ago, but all of these patients had persistent diffuse macular edema with no improvement in visual acuity. All the patients received two injections of bevacizumab at an interval of six weeks per eye. No adverse events were observed, including endophthalmitis, inflammation and increased intraocular pressure or thromboembolic events in any patient. The mean baseline acuity was 20/494 (log Mar=1.338±0.455 and the mean acuity at three months following the second intravitreal injection was 20/295 (log Mar=1.094±0.254, a difference that was highly significant ( P =0.008. The mean central macular thickness at baseline was 492 µm which decreased to 369 µm ( P =0.001 at the end of six months. Conclusions: Initial treatment results of patients with diffuse diabetic macular edema not responding to previous photocoagulation did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in a significant decrease in macular thickness and improvement in visual acuity at three months but the effect was somewhat blunted, though still statistically significant at the end of six months.

  6. Long-term follow-up of oral administration of flavonoids, Centella asiatica and Melilotus, for diabetic cystoid macular edema without macular thickening.

    Science.gov (United States)

    Forte, Raimondo; Cennamo, Gilda; Bonavolontà, Paola; Pascotto, Arduino; de Crecchio, Giuseppe; Cennamo, Giovanni

    2013-10-01

    To evaluate long-term follow-up of the orally administered combination of flavonoids with Centella asiatica and Melilotus for treatment of diabetic cystoid macular edema (CME) without macular thickening. Seventy consecutive patients with type 2 diabetes and CME without macular thickening at optical coherence tomography (OCT) were prospectively and randomly enrolled in two groups of 35 subjects each (treatment and control groups). Patients in the treatment group were treated with an oral combination of diosmin (300 mg/day), with C. asiatica (15 mg/day) and Melilotus (160 mg/day). All patients underwent a complete ophthalmologic examination, OCT (Spectralis HRA-OCT), and central microperimetry (SD-SLO/OCT) at baseline, month 3, month 6, month 12, month 24, and month 36. No differences in HbAc1 percentage, blood pressure, microalbuminuria, visual acuity, mean central retinal thickness, and stability of fixation were present between the two groups during follow up (p>0.05). Retinal sensitivity reduced in the control group only from month 6 until month 36 (pasiatica and Melilotus, in patients with CME without macular thickening provided preservation of retinal sensitivity during 36 months of follow up when compared with untreated patients.

  7. EN FACE VERSUS 12-LINE RADIAL OPTICAL COHERENCE TOMOGRAPHY SCAN PATTERNS FOR DETECTION OF MACULAR FLUID IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Adam, Murtaza K; Shahlaee, Abtin; Samara, Wasim A; Maguire, Joseph I; Ho, Allen C; Hsu, Jason

    2017-08-14

    To compare fluid detection of autosegmented en face to 12-line radial spectral domain optical coherence tomography scan patterns in neovascular age-related macular degeneration. Retrospective observational case series. Sixty-seven patients (94 eyes) with neovascular age-related macular degeneration underwent autosegmented en face optical coherence tomography (with associated 304-line raster scan) and 12-line radial scan patterns. Sensitivity and specificity of fluid detection for en face scan and 12-line radial scans were determined by combining radial and 304-line raster scans as a gold standard. Two hundred and fifty-eight en face and 12-line radial spectral domain optical coherence tomography scans were interpreted. Seventy-five scans (58.1%) had fluid, whereas 54 scans (41.9%) did not. En face scan pattern fluid detection sensitivity and specificity was 89.3% and 61.1%, respectively. Twelve-line radial scan pattern fluid detection sensitivity and specificity was 97.3% and 100%, respectively. The difference in fluid detection between scan patterns was statistically significant (P = 0.01). Decreased central macular thickness was associated with false-positive (P = 0.035) and false-negative (P = 0.01) fluid detection on en face scans. En face optical coherence tomography alone is not as sensitive or specific as the 12-line radial scan pattern in detecting fluid in neovascular age-related macular degeneration. En face scans should be corroborated with other optical coherence tomography protocols to guide clinical decision making.

  8. Suitability and repeatability of a photostress recovery test device, the macular test device, macular degeneration TEST DEVICE, detector (MDD-2), for diabetes and diabetic retinopathy assessment

    LENUS (Irish Health Repository)

    Loughman, James

    2013-10-16

    Diabetic retinopathy can result in impaired photostress recovery time despite normal visual acuity and fundoscopic appearance. The Macular Degeneration Detector (MDD-2) is a novel flash photostress recovery time device. In this study, we examine the repeatability of the MDD-2 in normal and diabetic subjects.

  9. ADJUSTABLE MACULAR BUCKLING FOR FULL-THICKNESS MACULAR HOLE WITH FOVEOSCHISIS IN HIGHLY MYOPIC EYES: Long-Term Anatomical and Functional Results.

    Science.gov (United States)

    Cacciamani, Andrea; Lazzeri, Stefano; Rossi, Tommaso; Scarinci, Fabio; Parravano, Mariacristina; Ripandelli, Guido; Pileri, Marco A G; Nardi, Marco; Stirpe, Mario

    2016-04-01

    To assess functional and structural outcome after adjustable macular buckling for the treatment of foveoschisis (FS), associated with full-thickness macular hole (FTMH) in highly myopic eyes. Eighteen consecutive patients who underwent adjustable macular buckling for FS associated with FTMH were included in this prospective study. Three cases were not included in the analysis due to short follow-up period (less than 3 months). Outcome measures included anatomical success rate with FS resolution and FTMH closure, best-corrected visual acuity, mean retinal sensitivity, central retinal thickness, and fixation site and stability. Foveoschisis resolution and FTMH closure were observed in all cases between 1 month to 3 months after surgery. At 24 months of follow-up visit visual acuity improved in 13/15 eyes (86.7%) and remained stable in 2 (13.3%). Mean retinal sensitivity showed significant improvement from baseline 5.69 ± 3.52 dB to final 8.35 ± 3.86 dB; P buckling exoplant may represent an effective surgical option for the treatment of FS associated with FTMH in highly myopic eyes. Adjustable macular buckling showed high closure rate and virtually no tendency to recur. Functional results and safety are also interesting because vision improved and retinal thickness did not reduce significantly at 24 months of follow-up.

  10. Consumption of 2 and 4 egg yolks/d for 5 wk increases macular pigment concentrations in older adults with low macular pigment taking cholesterol-lowering statins.

    Science.gov (United States)

    Vishwanathan, Rohini; Goodrow-Kotyla, Elizabeth F; Wooten, Billy R; Wilson, Thomas A; Nicolosi, Robert J

    2009-11-01

    Lutein and zeaxanthin may reduce the risk of dry, age-related macular degeneration because of their photo-oxidative role as macular pigment. The present study evaluated serum lutein, zeaxanthin, and macular pigment optical density (MPOD) responses at 0.25 degrees , 0.5 degrees , and 1 degree retinal eccentricities to the consumption of 2 and 4 egg yolks/d by older adults taking cholesterol-lowering medications. Subjects consumed foods containing 2 followed by 4 egg yolks/d for 5 wk each with a 4-wk egg-free period at baseline and between the 2 interventions. Changes in MPOD (n = 37) with egg yolk consumption were inversely associated (P egg yolks at the 3 retinal eccentricities. MPOD increased by 31% (P = 0.059) at 0.5 degrees with 2 egg yolks. Serum lutein increased by only 16% and 24% (P egg yolks, respectively. Serum HDL cholesterol increased by 5% (P egg yolks. Serum LDL cholesterol did not change with either egg yolk treatment. Consumption of 4 egg yolks/d, and possibly of 2 egg yolks/d, for 5 wk benefited macular health in older adults with low MPOD. Serum HDL cholesterol increased without an increase in LDL cholesterol in this study population, most of whom were taking cholesterol-lowering statins.

  11. Association of statin use and hypertriglyceridemia with diabetic macular edema in patients with type 2 diabetes and diabetic retinopathy.

    Science.gov (United States)

    Chung, Yoo-Ri; Park, Sung Wook; Choi, Shin-Young; Kim, Seung Woo; Moon, Ka Young; Kim, Jeong Hun; Lee, Kihwang

    2017-01-07

    To investigate the effects of dyslipidemia and statin therapy on progression of diabetic retinopathy and diabetic macular edema in patients with type 2 diabetes. The medical records of 110 patients with type 2 diabetes (70 statin users and 40 non-users) were retrospectively reviewed. The two outcome measures were progression of diabetic retinopathy by two or more steps on the early treatment diabetic retinopathy study scale and diabetic macular edema based on optical coherence tomography. Serum lipid profiles were analyzed from 6 months prior to diagnosis of diabetic macular edema. Diabetic retinopathy progressed in 23% of statin users and 18% of non-users (p = 0.506), but diabetic macular edema was present in 23% of statin users and 48% of non-users (p = 0.008). Statins reduced low-density lipoprotein cholesterol levels in patients with and without diabetic macular edema (p = 0.043 and p = 0.031, respectively). Among statin users, patients with diabetic macular edema had higher levels of triglycerides (p = 0.004) and lower levels of high-density lipoprotein cholesterol (p = 0.033) than those without diabetic macular edema. Logistic regression analysis showed that statin use significantly lowered the risk of diabetic macular edema [odds ratio (OR): 0.33, 95% confidence interval (CI) 0.12-0.91, p = 0.032]. Hypertriglyceridemia at 6 months prior to development of macular edema was significantly associated with central retinal thickness (OR: 1.52; 95% CI 1.14-2.02, p = 0.005). Lipid lowering therapy with statins protected against the development of diabetic macular edema and progression of diabetic retinopathy in patients with type 2 diabetes. Hypertriglyceridemia could be used as a surrogate marker for diabetic macular edema.

  12. Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Karim R

    2013-06-01

    Full Text Available Rushmia Karim,1 Evripidis Sykakis,2 Susan Lightman,3 Samantha Fraser-Bell4 1Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia; 2Department of Ophthalmology, Whipps Cross University Hospital, 3UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, UK; 4University of Sydney, Clinical Ophthalmology and Eye Health, Sydney Adventist Hospital Clinical School, Sydney, NSW, Australia Background: Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives: To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy: Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria: Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis: Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion: More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic

  13. Clinical application of OCTA in observation of macular blood flow density in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Xiang Xiang

    2017-07-01

    Full Text Available AIM: Using optical coherence tomography angiography(OCTAto observe the changes and clinical significance of macular blood flow density in patients with diabetic retinopathy(DR.METHODS: Totally 47 eyes(28 patientswith diabetic retinopathy(DRwere enrolled in the DR group. According to the international clinical grading criteria of diabetic retinopathy, 30 eyes(19 patientswith non-proliferative diabetic retinopathy were classified as the NPDR group, and 17 eyes(11 patientswith proliferative diabetic retinopathy were classified as PDR group. A total of 46(27 subjectshealthy eyes with matched age were enrolled in the control group. All the subjects underwent the 3mm×3mm scanning of macular retina by optical coherence tomography angiography(OCTA, obtaining 4 levels of macular blood flow density map. The macular blood flow density at 3 levels, including superficial retinal layer, deep retinal layer and choroidal capillaries layer, were measured. RESULTS: The macular blood flow density of superfical retinal layer, deep retinal layer and choroidal capillaries layer in DR group were 0.4963±0.0840, 0.4798±0.0801 and 0.5290±0.0528, respectively. Among them, the blood flow density of each layer were 0.5064±0.0843,0.4983±0.0766,0.5345±0.0529, respectively, for the NPDR group, and were 0.4786±0.0830, 0.4473±0.0778,0.5192±0.0526, respectively, for the PDR group. For the control group, the density of each layers were 0.5919±0.0704, 0.6301±0.0527, 0.5691±0.0169, respectively. The macular blood flow density was significantly different in the superficial retinal layer, deep retinal layer and choroidal capillary layer between the control group and the NPDR group, as well as the PDR group and the DR group(total PP=0.029, but not in the superficial retina layer and choroid capillary layer(P=0.236, 0.268. CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary

  14. Quantitive study for retinal function before and after photocoagulation in patients with diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Rui-Xue Sun

    2017-03-01

    Full Text Available AIM: To study the retinal function in patients with diabetic macular edema after photocoagulation. METHODS: A total of 30 eyes in 19 patients with diabetic macular edema(DME, who were diagnosed through fundus fluorescein angiography, consecutively recruited from March 2010 to March 2014 and were treated with macular grid pattern photocoagulation. Multifocal electroretinogram(mfERGsystem(version 3.15was performed before and after photocoagulation therapy for 3mo. All data were statistically analyzed. RESULTS: The amplitude densities of a-ware and b-ware for the fovea increased after macular grid pattern photocoagulation therapy, and there were significantly changes relative to its preoperation(t=-3.7683, Pt=-3.6570, Pt=1.7103, P>0.05; t=1.5623, P>0.05 . Compared with pretreatment, the amplitude densities of a-ware and b-ware at macular were statistically larger(t=4.8337, Pt=-2.0376, Pt=-2.1892, Pt=-3.5024, Pt=-1.4387, P>0.05; t=-0.1766, P>0.05. It was significant longer in the latency of a-wave and b-wave at paramacular after photocoagulation(t=-2.0905, Pt=-2.5646, PCONCLUSION: The laser photocoagulation treatment for DME can improve the retinal function at fovea, which benefits the vision acuity. Unfortunately,it induces extensively damaging effects on the macula and paramacular.

  15. Macular and peripapillary retinal nerve fiber layer thickness in children with hyperopic anisometropic amblyopia

    Directory of Open Access Journals (Sweden)

    Shuang-Qing Wu

    2013-02-01

    Full Text Available AIM:To compare the retinal nerve fiber layer (RNFL thickness and macular thickness in the amblyopic eye with that in the sound eye of children with hyperopic anisometropic amblyopia using optical coherence tomography (OCT.METHODS: A prospective, nonrandom, intraindividual comparative cohort study includes 72 children with hyperopic anisometropic amblyopia in a single center. Macular thickness, macular foveola thickness, and peripapillary RNFL thickness were compared between the amblyopia eyes and the contralateral sound eyes.RESULTS:There were 38 male and 34 female patients, with a mean age as 9.7±1.9 years (range, 5–16 years. Hyperopic was +3.62±1.16D (range +2.00D to +6.50D in the amblyopic eyes, which was significantly higher in the control eyes with +0.76±0.90D (range 0D to +2.00D (P P = 0.02. The mean macular foveola thickness was significantly thicker in the amblyopic eyes than the contralateral sound eyes (181.4±14.2µm vs 175.2±13.3µm, P CONCLUSION:Eyes with hyperopic anisometropic amblyopia are found thicker macular foveola and peripapillary RNFL than the contralateral eyes in children.

  16. Evaluation of circulating miRNAs in wet age-related macular degeneration.

    Science.gov (United States)

    Ertekin, Sevda; Yıldırım, Ozlem; Dinç, Erdem; Ayaz, Lokman; Fidancı, Senay Balcı; Tamer, Lülüfer

    2014-01-01

    In the present study, we aimed to investigate the changes in plasma miRNA in patients with wet age-related macular degeneration. The expression profiles of 384 miRNAs in plasma from 33 patients (22 male, 11 female) who were diagnosed with wet age-related macular degeneration with fundus examination, fundus fluorescein angiography, and optical coherence tomography and 31 controls (17 male, 14 female) were evaluated using high-throughput quantitative real-time PCR. Our results demonstrated that the expression level of five miRNAs (miR-17-5p, miR-20a-5p, miR-24-3p, miR-106a-5p, and miR-223-3p) was significantly upregulated in patients with age-related macular degeneration when compared to the control group (page-related macular degeneration. These molecules may have an important therapeutic target in patients who are unresponsive to antivascular endothelial growth factor therapy. However, further studies must be conducted for possible effects of miRNAs in vascular disorders of eye such as age-related macular degeneration.

  17. Critical appraisal of ranibizumab in the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Stewart MW

    2013-06-01

    Full Text Available Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME. The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea.Keywords: aflibercept, bevacizumab, diabetic macular edema, diabetic retinopathy, ranibizumab, vascular endothelial growth factor

  18. CLINICAL AND ELECTROPHYSIOLOGICAL EVALUATION AFTER INTRAVITREAL ZIV-AFLIBERCEPT FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    de Oliveira Dias, João Rafael; de Andrade, Gabriel Costa; Kniggendorf, Vinicius Ferreira; Novais, Eduardo Amorim; Maia, André; Meyer, Carsten; Watanabe, Sung Eun Song; Farah, Michel Eid; Rodrigues, Eduardo Büchele

    2017-08-01

    To evaluate the 6-month safety and efficacy of ziv-aflibercept intravitreal injections for treating exudative age-related macular degeneration. Fifteen patients with unilateral exudative age-related macular degeneration were enrolled. The best-corrected visual acuity was measured and spectral domain optical coherence tomography was performed at baseline and monthly. Full-field electroretinography and multifocal electroretinography were obtained at baseline and 4, 13, and 26 weeks after the first injection. All patients received three monthly intravitreal injections of ziv-aflibercept (1.25 mg) followed by as-needed treatment. Between baseline and 26 weeks, the mean logMAR best-corrected visual acuity improved (P = 0.00408) from 0.93 ± 0.4 (20/200) to 0.82 ± 0.5 (20/160) logarithm of the minimum angle of resolution, respectively; the central retinal thickness decreased significantly (P = 0.0007) from 490.3 ± 155.1 microns to 327.9 ± 101.5 microns; the mean total macular volume decreased significantly (P macular responses within the first central 15° showed significantly (P macular volume from baseline to 26 weeks. No retinal toxicity on full-field electroretinography or adverse events occurred during the follow-up period.

  19. OUTER RETINAL TUBULATION: Characteristics in Patients With Neovascular Age-Related Macular Degeneration.

    Science.gov (United States)

    Iaculli, Cristiana; Barone, Antonio; Scudieri, Marilisa; Giovanna Palumbo, Maria; Delle Noci, Nicola

    2015-10-01

    To assess the incidence, characteristics, best-corrected visual acuity (BCVA), central macular thickness (CMT), and retinal sensitivity correlations in patients with and without outer retinal tubulation (ORT) affected by subfoveal choroidal neovascularization due to neovascular age-related macular degeneration. Prospective case series including 78 eyes of 78 consecutive patients with subfoveal choroidal neovascularization due to neovascular age-related macular degeneration. Baseline and follow-up visits included BCVA, intraocular pressure, ophthalmoscopic examination, CMT as measured by spectral domain optical coherence tomography, and retinal sensitivity tested with fundus-related perimetry (MP-1). Fluorescent angiography was performed at baseline. At the end of the follow-up period, the mean BCVA and CMT of patients with ORT were statistically different from those without ORT (BCVA: 0.61 ± 0.13 vs. 0.37 ± 1.59, P macular degeneration suggest that these parameters are statistically different in patients with ORT; this may be due to the pathogenesis of ORT formation, secondary to retinal pigment epithelial tears or photoreceptor damage. MP-1 microperimeter is a noninvasive instrument that provides useful information to better characterize the functional aspect of ORT in patients with age-related macular degeneration.

  20. Spontaneous Closure of a Fully Developed Macular Hole in a Severely Myopic Eye

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    C. Bruè

    2014-01-01

    Full Text Available Purpose. Myopic macular holes can be difficult to close with surgery and are frequently associated with retinal detachment. We report on a case of a macular hole in a severely myopic eye that underwent spontaneous closure. Methods. An observational case study. Results. A 55-year-old female was referred to Ophthalmology for a central scotoma and metamorphopsia in the right eye. Visual acuity was 1/20 in both eyes. Fundus examination showed loss of the foveal depression, with a small yellow ring in the center of the fovea in the right eye, and a tilted optic disc and peripapillary staphyloma bilaterally. Spectral domain optical coherence tomography (SD-OCT revealed a fully developed macular hole with a rim of thickened and slightly elevated retina in the right eye. The patient refused surgery. After 4 years of follow-up, her visual acuity improved to 20/40 in the right eye, and SD-OCT revealed spontaneous sealing of the macular hole without bare retinal pigment epithelium. Conclusions. Myopic macular holes represent a challenge regarding their management, and the prognosis is often poor.

  1. Macular pigment density in relation to serum and adipose tissue concentrations of lutein and serum concentrations of zeaxanthin

    NARCIS (Netherlands)

    Broekmans, W.M.R.; Berendschot, T.T.J.R.; Klöpping-Ketelaars, I.A.A.; Vries, A.J. de; Goldbohm, R.A.; Tijburg, L.B.M.; Kardinaal, A.F.M.; Poppel, G. van

    2002-01-01

    Background: Macular pigment (MP), concentrated in the central area of the retina, contains the carotenoids lutein and zeaxanthin. A low MP density could be a risk factor for age-related macular degeneration. Little information is available regarding MP density in relation to serum lutein and

  2. Macular hole formation, progression, and surgical repair: case series of serial optical coherence tomography and time lapse morphing video study

    Science.gov (United States)

    2010-01-01

    Background To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure. Case Presentations Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the fovea and at the same orientation were digitally exported and morphed into an Audiovisual Interleaving (avi) movie format. Morphing videos from serial OCTs allowed the OCTs to be viewed dynamically. The videos supported anterior-posterior vitreofoveal traction as the initial event in macular hole formation. Progression of the macular hole occurred with increased cystic thickening of the fovea without evidence of further vitreofoveal traction. During cyst formation, the macular hole enlarged as the edges of the hole became elevated from the retinal pigment epithelium (RPE) with an increase in subretinal fluid. Surgical repair of a macular hole revealed initial closure of the macular hole with subsequent reabsorption of the sub-retinal fluid and restoration of the foveal contour. Conclusions Morphing videos from serial OCTs are a useful tool and helped illustrate and support anterior-posterior vitreofoveal traction with subsequent retinal hydration as the pathogenesis of idiopathic macular holes. PMID:20849638

  3. Localized changes in Retinal Vessel Caliber after focal/grid laser treatment in Patients with Diabetic Macular Edema

    DEFF Research Database (Denmark)

    Lundberg, Lars Kristian; Kawasaki, Ryo; Sjølie, Anne K

    2013-01-01

    PURPOSE:: To compare retinal vessel caliber changes at the macula region and surrounding the optic disk after focal/grid laser treatment for diabetic macular edema. METHODS:: The study included 69 eyes from 46 patients treated with focal/grid laser for diabetic macular edema. Retinal photographs...

  4. [Risk factors for age-related macular degeneration].

    Science.gov (United States)

    Starzycka, M; Słomska, J; Górniak-Bednarz, A; Ortyl, E

    1997-01-01

    To present the results of examinations of the risk factors for age-related macular degeneration (AMD) carried out in the last 3 years. Our clinical material comprised 119 patients, 69 women and 50 men, aged 43-85, mean age 70 years. Using classification according to the worse eye, there were 20 patients with drusen, 27 with atrophic changes and 72 with exudative form and AMD. The following risk factors were evaluated: age, sex, body mass index, history of general medical conditions, cigarette smoking, sun exposure, family history of AMD and ocular conditions such as iris color, lens opacities, hyperopia, gerontoxon and changes in retinal vessels. The significant relationships were found between the development of AMD and the age of patients, as well as between the advanced forms of AMD and the history of cardiovascular diseases and sclerotic changes in retinal vessels, 87% of examined patients have light iris and 52% body mass index above 26. The studies confirmed the role of age in the development of AMD and indicated cardiovascular disturbances, increased body mass index and light iris as the possible risk factors for AMD that are most worth further studying. The special attention should be also paid to drusen as the risk factor of AMD.

  5. Ocular Surface Temperature in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Andrea Sodi

    2014-01-01

    Full Text Available Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320. The ocular surface temperature (OST of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value >0.272. OST in AMD patients was significantly lower than in controls (P>0.05. Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

  6. Smooth pursuit eye movements in patients with macular degeneration.

    Science.gov (United States)

    Shanidze, Natela; Fusco, Giovanni; Potapchuk, Elena; Heinen, Stephen; Verghese, Preeti

    2016-01-01

    Currently, there are no quantitative studies of smooth pursuit, a behavior attributed to the fovea, in individuals with macular degeneration (MD). We hypothesize that pursuit in MD patients depends on the relative positions of the scotoma and target trajectory. We tested this hypothesis with a scanning laser ophthalmoscope (SLO), which allows for direct visualization of the target on the damaged retina. Monocular microperimetry and eye movements were assessed in eleven individuals with differing degrees of MD. Observers were asked to visually track a 1.7° target that moved in one of eight radial directions at 5°/s-6°/s. Consistent with our hypothesis, pursuit metrics depended on whether the target moved into or out of scotoma. Pursuit gains decreased with increasing scotoma extent in the target's heading direction (p = 0.017). Latencies were higher when the scotoma was present along the target trajectory (in either starting or heading directions, p < 0.001). Furthermore, an analysis of retinal position shows that targets fell on the fixational locus nearly 50% of the time. The results suggest that MD patients are capable of smooth pursuit eye movements, but are limited by target trajectory and scotoma characteristics.

  7. Mechanism of Inflammation in Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Francesco Parmeggiani

    2012-01-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease that represents the most common cause of irreversible visual impairment among people over the age of 50 in Europe, the United States, and Australia, accounting for up to 50% of all cases of central blindness. Risk factors of AMD are heterogeneous, mainly including increasing age and different genetic predispositions, together with several environmental/epigenetic factors, that is, cigarette smoking, dietary habits, and phototoxic exposure. In the aging retina, free radicals and oxidized lipoproteins are considered to be major causes of tissue stress resulting in local triggers for parainflammation, a chronic status which contributes to initiation and/or progression of many human neurodegenerative diseases such as AMD. Experimental and clinical evidences strongly indicate the pathogenetic role of immunologic processes in AMD occurrence, consisting of production of inflammatory related molecules, recruitment of macrophages, complement activation, microglial activation and accumulation within those structures that compose an essential area of the retina known as macula lutea. This paper reviews some attractive aspects of the literature about the mechanisms of inflammation in AMD, especially focusing on those findings or arguments more directly translatable to improve the clinical management of patients with AMD and to prevent the severe vision loss caused by this disease.

  8. Evidence of macular pigment in the central macula in albinism.

    Science.gov (United States)

    Wolfson, Yulia; Fletcher, Emily; Strauss, Rupert W; Scholl, Hendrik P N

    2016-04-01

    Albinism represents a spectrum of disorders with diminished to absent amounts of melanin pigmentation including the posterior segment of the eye. Macular pigment (MP) consists of two main carotenoids, lutein and zeaxanthin, concentrated in the macula. MP serves as blue light absorbent, antioxidant, and may reduce chromatic aberration and glare. It remains unclear if albinos have detectable MP. The purpose was to investigate the distribution of MP in albino patients with psychophysical and imaging techniques. MP was measured at the eccentricity of 0.5° by heterochromatic flicker perimetry (QuantifEye(®); Tinsley Precision Instruments Ltd.) or by scanning laser ophthalmoscopy (MPOD module, MultiColor Spectralis(®), Heidelberg Engineering, Heidelberg, Germany) in four albino patients, who were also investigated with multimodal ophthalmic imaging. Visual acuity ranged from 20/32 to 20/125, nystagmus was present in three patients, and all patients showed typical foveal hypoplasia on fundus exam and optical coherence tomography. Fundus autofluorescence (FAF) demonstrated various degrees of central FAF signal attenuation. Genetic testing was available in three patients and confirmed the diagnosis. Measurable amounts of MP were detected in all four patients and ranged from 0.05 to 0.24, which is below the normal range. We conclude that MP can be demonstrated and measured in albinos. Further studies are needed to investigate MP accumulation following carotenoid supplementation and its impact on visual performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Radiation therapy for age-related macular degeneration

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    Yoshida, Ayako; Honda, Kaoru; Ishibashi, Tatsuro; Shioyama, Yoshiyuki [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1998-11-01

    We evaluated the effects of low-dose radiation on choroidal neovascular membrane (CNV) in age-related macular degeneration (AMD). Since Chakravarthy reported the benefits from administration of low-dose external-beam irradiation for CNV, many studies have demonstrated that irradiation could have a beneficial treatment effect, whereas several reports have not. In our hospital, 12 eyes with AMD received 10 Gy of 4 MV photons and the other 9 eyes received 20 Gy. Another 4 eyes were untreated as control. After 6 months of treatment, visual acuity was maintained in 11 eyes, improved in 5 eyes, and deteriorated in 5 eyes of treated patients. In control group, visual acuity was maintained in 1 eye and deteriorated in 3 eyes. The size of CNV regressed in 10 eyes, remained stationary in 2 eyes and progressed in 2 eyes of treated patients, while in control group CNV regressed in 2 eyes and remained stationary in 1 eye. After 12 months some CNV progressed. Although the present result seems to be better than those in previous reports, whether or not the treatment is beneficial has to be awaited. (author)

  10. Cellular models and therapies for age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    David L. Forest

    2015-05-01

    Full Text Available Age-related macular degeneration (AMD is a complex neurodegenerative visual disorder that causes profound physical and psychosocial effects. Visual impairment in AMD is caused by the loss of retinal pigmented epithelium (RPE cells and the light-sensitive photoreceptor cells that they support. There is currently no effective treatment for the most common form of this disease (dry AMD. A new approach to treating AMD involves the transplantation of RPE cells derived from either human embryonic or induced pluripotent stem cells. Multiple clinical trials are being initiated using a variety of cell therapies. Although many animal models are available for AMD research, most do not recapitulate all aspects of the disease, hampering progress. However, the use of cultured RPE cells in AMD research is well established and, indeed, some of the more recently described RPE-based models show promise for investigating the molecular mechanisms of AMD and for screening drug candidates. Here, we discuss innovative cell-culture models of AMD and emerging stem-cell-based therapies for the treatment of this vision-robbing disease.

  11. Bilateral Macular Roth Spots as a Manifestation of Subacute Endocarditis

    Directory of Open Access Journals (Sweden)

    Karolina Ceglowska

    2015-01-01

    Full Text Available A 42-year-old man presented with a 2-day history of impaired vision in the right eye (OD. The best corrected visual acuity (BCVA (LogMAR was 1.1 for the right eye and 0.0 for the left eye (OS. Fundus examination revealed white-centered hemorrhages resembling Roth spots in both macular regions. The spectral-domain optical coherence tomography (SD-OCT showed intraretinal pseudocysts and hyperreflective deposits in the areas corresponding to the Roth spots. Conducted blood tests revealed elevated D-dimer concentration, increased total number of neutrophils, high C-reactive protein concentration, and elevated erythrocyte sedimentation rate. Procalcitonin concentration, platelet count, and body temperature were within normal ranges. A blood culture was ordered and yielded Streptococcus mitis and intravenous antibiotics were started immediately. The patient started complaining of chest and left calf pain. The systemic examination revealed infective endocarditis accompanied by bicuspid aortic valve and paravalvular abscess formation. The patient underwent cardiac surgery with mechanical aortic valve implantation. After recovery, the patient’s visual acuities improved fully. Control ophthalmic examination, including SD-OCT, showed no abnormalities.

  12. Mechanism of Inflammation in Age-Related Macular Degeneration

    Science.gov (United States)

    Parmeggiani, Francesco; Romano, Mario R.; Costagliola, Ciro; Semeraro, Francesco; Incorvaia, Carlo; D'Angelo, Sergio; Perri, Paolo; De Palma, Paolo; De Nadai, Katia; Sebastiani, Adolfo

    2012-01-01

    Age-related macular degeneration (AMD) is a multifactorial disease that represents the most common cause of irreversible visual impairment among people over the age of 50 in Europe, the United States, and Australia, accounting for up to 50% of all cases of central blindness. Risk factors of AMD are heterogeneous, mainly including increasing age and different genetic predispositions, together with several environmental/epigenetic factors, that is, cigarette smoking, dietary habits, and phototoxic exposure. In the aging retina, free radicals and oxidized lipoproteins are considered to be major causes of tissue stress resulting in local triggers for parainflammation, a chronic status which contributes to initiation and/or progression of many human neurodegenerative diseases such as AMD. Experimental and clinical evidences strongly indicate the pathogenetic role of immunologic processes in AMD occurrence, consisting of production of inflammatory related molecules, recruitment of macrophages, complement activation, microglial activation and accumulation within those structures that compose an essential area of the retina known as macula lutea. This paper reviews some attractive aspects of the literature about the mechanisms of inflammation in AMD, especially focusing on those findings or arguments more directly translatable to improve the clinical management of patients with AMD and to prevent the severe vision loss caused by this disease. PMID:23209345

  13. Automatic age-related macular degeneration detection and staging

    Science.gov (United States)

    van Grinsven, Mark J. J. P.; Lechanteur, Yara T. E.; van de Ven, Johannes P. H.; van Ginneken, Bram; Theelen, Thomas; Sánchez, Clara I.

    2013-03-01

    Age-related macular degeneration (AMD) is a degenerative disorder of the central part of the retina, which mainly affects older people and leads to permanent loss of vision in advanced stages of the disease. AMD grading of non-advanced AMD patients allows risk assessment for the development of advanced AMD and enables timely treatment of patients, to prevent vision loss. AMD grading is currently performed manually on color fundus images, which is time consuming and expensive. In this paper, we propose a supervised classification method to distinguish patients at high risk to develop advanced AMD from low risk patients and provide an exact AMD stage determination. The method is based on the analysis of the number and size of drusen on color fundus images, as drusen are the early characteristics of AMD. An automatic drusen detection algorithm is used to detect all drusen. A weighted histogram of the detected drusen is constructed to summarize the drusen extension and size and fed into a random forest classifier in order to separate low risk from high risk patients and to allow exact AMD stage determination. Experiments showed that the proposed method achieved similar performance as human observers in distinguishing low risk from high risk AMD patients, obtaining areas under the Receiver Operating Characteristic curve of 0.929 and 0.934. A weighted kappa agreement of 0.641 and 0.622 versus two observers were obtained for AMD stage evaluation. Our method allows for quick and reliable AMD staging at low costs.

  14. Updates in the Management of Diabetic Macular Edema

    Directory of Open Access Journals (Sweden)

    Christopher Mathew

    2015-01-01

    Full Text Available Diabetes mellitus is a chronic disease which has multiple effects on different end-organs, including the retina. In this paper, we discuss updates on diabetic macular edema (DME and the management options. The underlying pathology of DME is the leakage of exudates from retinal microaneurysms, which trigger subsequent inflammatory reactions. Both clinical and imaging techniques are useful in diagnosing, classifying, and gauging the severity of DME. We performed a comprehensive literature search using the keywords “diabetes,” “macula edema,” “epidemiology,” “pathogenesis,” “optical coherence tomography,” “intravitreal injections,” “systemic treatment,” “hypertension,” “hyperlipidemia,” “anemia,” and “renal disease” and collated a total of 47 relevant articles published in English language. The main modalities of treatment currently in use comprise laser photocoagulation, intravitreal pharmacological and selected systemic pharmacological options. In addition, we mention some novel therapies that show promise in treating DME. We also review systemic factors associated with exacerbation or improvement in DME.

  15. Imaging Polarimetry in Age-Related Macular Degeneration

    Science.gov (United States)

    Miura, Masahiro; Yamanari, Masahiro; Iwasaki, Takuya; Elsner, Ann E.; Makita, Shuichi; Yatagai, Toyohiko; Yasuno, Yoshiaki

    2010-01-01

    PURPOSE To evaluate the birefringence properties of eyes with age-related macular degeneration (AMD). To compare the information from two techniques—scanning laser polarimetry (GDx) and polarization-sensitive spectral-domain optical coherence tomography (OCT)—and investigate how they complement each other. METHODS The authors prospectively examined the eyes of two healthy subjects and 13 patients with exudative AMD. Using scanning laser polarimetry, they computed phase-retardation maps, average reflectance images, and depolarized light images. To obtain polarimetry information with improved axial resolution, they developed a fiber-based, polarization-sensitive, spectral-domain OCT system and measured the phase retardation associated with birefringence in the same eyes. RESULTS Both GDx and polarization-sensitive spectral-domain optical coherence tomography detected abnormal birefringence at the locus of exudative lesions. Polarization-sensitive, spectral-domain OCT showed that in the old lesions with fibrosis, phase-retardation values were significantly larger than in the new lesions (P = 0.020). Increased scattered light and altered polarization scramble were associated with portions of the lesions. CONCLUSIONS GDx and polarization-sensitive spectral-domain OCT are complementary in probing birefringence properties in exudative AMD. Polarimetry findings in exudative AMD emphasized different features and were related to the progression of the disease, potentially providing a noninvasive tool for microstructure in exudative AMD. PMID:18515594

  16. Small, hard macular drusen and peripheral drusen: associations with AMD genotypes in the Inter99 Eye Study

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Ek, Jakob; Kessel, Line

    2010-01-01

    PURPOSE: To study associations of small, hard macular drusen and peripheral drusen with genotypes associated with age-related macular degeneration (AMD). METHODS: Digital grayscale fundus photographs recorded in red-free illumination were graded for the presence of drusen in 1107 subjects aged 30...... to 66 years. Participants were genotyped for AMD-related polymorphisms in complement factor H (CFH), in LOC387715, and in complement factor B (CFB). RESULTS: The prevalence of 20 or more small, hard macular drusen per eye was 14%, with no association to the investigated polymorphisms. Peripheral drusen...... were associated with CFHY402H (odds ratio [OR], 4.3; 95% confidence interval [95% CI], 1.4-13, for CC versus TT genotypes) as was macular drusen >63 microm (OR, 1.9; 95% CI, 1.1-3.1, for CC versus TT genotypes). Macular drusen >63 microm were associated with the presence of 20 or more small, hard...

  17. Retinal oxygen saturation in relation to retinal thickness in diabetic macular edema

    DEFF Research Database (Denmark)

    Blindbæk, Søren Leer; Peto, Tunde; Grauslund, Jakob

    .4 and 3.8 years. Median HbA1c was 61.5 mmol/mol and 22.2% were women. Mean oxygen saturation was higher in retinal macular venules as compared to global venous oxygen saturation (76.7% vs. 66.3%, p=0.0001), whereas there was no difference between macular and global arteriolar oxygen saturations (94.8% vs......Purpose: Retinal oximetry is a non-invasive measure of retinal metabolism. Diabetic retinopathy is associated with increased oxygen saturation in retinal venules. Hence, we examined if there are regional differences in retinal oxygen saturation, and if retinal oxygen saturation is correlated...... with DME had higher retinal oxygen saturation in macular venules as compared to the global retinal venous oxygen saturation. No correlation was demonstrated between retinal thickness and retinal oxygen saturation. Retinal oximetry may become an important clinical tool to monitor disease activity...

  18. [Congenital retinal macrovessel: an atypical presentation with low vision and macular thickening].

    Science.gov (United States)

    Blanco Domínguez, I; Vidal Fernández, P; Rojas Lozano, P; Oteiza Álvarez, A; Suárez Leoz, M

    2015-01-01

    We report a case of a 35 year old male patient with no medical history, who experienced decreased vision in his left eye that he noticed by chance. After a complete ophthalmic examination, he was diagnosed with congenital retinal macrovessel with macular thickening. Congenital retinal macrovessels are rare vascular anomalies, in which the diagnosis is usually incidental as their visual impact is minimal. In the rare cases where there is a significant visual impairment, this is due to macular hemorrhages, foveal cysts, serous macular detachment, or the course of the vessel itself through the foveal avascular zone. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  19. [Traumatic macular hole with central retinal detachment and choroidal rupture with ora serrata dialysis].

    Science.gov (United States)

    Fiorentzis, M; Seitz, B; Viestenz, A

    2015-08-01

    Closed ocular trauma is associated with various retinal complications, such as Berlin's edema, peripheral retinal tears, retinal hemorrhage, choroidal rupture, subretinal bleeding and macular holes. Traumatic macular holes (TMH) are rare and surgical intervention is controversial due to possible spontaneous closure. The positive development in the patient described here indicates that a pars plana vitrectomy with drainage of subretinal hemorrage combined with peeling of the internal limiting membrane (ILM) for a penetrating traumatic macular hole with choroidal rupture can lead to the restoration of visual acuity. The anti-vascular endothelial growth factor (VEGF) therapy (under silicone oil with avastin 0.02 ml) can successfully lead to limitation of posttraumatic choroidal neovascularization (CNV). Patients with ocular contusion require extensive long-term ophthalmological follow-up. Furthermore, prevention, education and information is essential to prevent serious injuries.

  20. Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY

    Directory of Open Access Journals (Sweden)

    John R. Gonder

    2014-01-01

    Full Text Available Purpose. To characterize the economic and quality of life burden of diabetic macular edema (DME in Canadian patients. Patients and Methods. 145 patients with DME were followed for 6 months with monthly telephone interviews and medical chart reviews at months 0, 3, and 6. Visual acuity in the worst-seeing eye was assessed at months 0 and 6. DME-related healthcare costs were determined over 6 months, and vision-related (National Eye Institute Visual Functioning Questionnaire and generic (EQ-5D quality of life was assessed at months 0, 3, and 6. Results. Mean age of patients was 63.7 years: 52% were male and 72% had bilateral DME. At baseline, visual acuity was categorized as normal/mild loss for 63.4% of patients, moderate loss for 10.4%, and severe loss/nearly blind for 26.2%. Mean 6-month DME-related costs/patient were as follows: all patients (n=135, $2,092; normal/mild loss (n=88, $1,776; moderate loss (n=13, $1,845; and severe loss/nearly blind (n=34, $3,007. Composite scores for vision-related quality of life declined with increasing visual acuity loss; generic quality of life scores were highest for moderate loss and lowest for severe loss/nearly blind. Conclusions. DME-related costs in the Canadian healthcare system are substantial. Costs increased and vision-related quality of life declined with increasing visual acuity severity.

  1. Phacoemulsification with intravitreal bevacizumab injection in diabetic patients with macular edema and cataract.

    Science.gov (United States)

    Akinci, Arsen; Batman, Cosar; Ozkilic, Ersel; Altinsoy, Ali

    2009-01-01

    The purpose of this study was to evaluate the results of phacoemulsification with intravitreal bevacizumab injection in patients with diabetic clinically significant macular edema and cataract. The records of 31 patients with diabetic clinically significant macular edema and cataract, which would interfere with macular laser photocoagulation, who have undergone phacoemulsification with intravitreal injection of 1.25 mg bevacizumab were retrospectively evaluated. All patients had undergone focal or modified grid laser photocoagulation 1 month after the surgery. All patients were evaluated by spectral optical coherence tomography/optical coherence tomography SLO before and 1 and 3 months after the surgery beyond complete ophthalmologic examination. The best-corrected visual acuity (BCVA) levels and central macular thickness (CMT) recorded at the first and third months after the surgery were compared with the initial values. Paired samples t test was used for statistical analysis. The mean initial BCVA was 0.10 +/- 0.04 (range, 0.05-0.2). The mean BCVA at the first and third months after the surgery were 0.47 +/- 0.16 (standard deviation) (range, 0.2-0.5) and 0.51 +/- 0.12 (standard deviation) (range, 0.3-0.6), respectively. The BCVA level recorded at the first and third months after the surgery were significantly higher than the initial BCVA (P = 0.004). The mean initial CMT was 387.5 +/- 109.5 microm. The mean CMT at the first and third months after the surgery were 292.7 +/- 57.2 and 275.5 +/- 40.3. The CMT recorded at the first and third months after the surgery were significantly lower than the initial CMT (P < 0.001, P < 0.001). Phacoemulsification with intravitreal injection of bevacizumab provides improvement in clinically significant macular edema with a gain in BCVA in patients with diabetes with clinically significant macular edema and cataract.

  2. Comparative efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Regnier, Stephane A; Larsen, Michael; Bezlyak, Vladimir

    2015-01-01

    OBJECTIVE: To compare the efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion (BRVO). DESIGN: Randomised controlled trials (RCTs) evaluating the efficacy and safety of approved treatments for macular oedema secondary to BRVO were identified from....... Bevacizumab and triamcinolone were excluded. OUTCOME MEASURES: Efficacy outcomes were mean change in best corrected visual acuity (Early Treatment Diabetic Retinopathy Study scale) and the percentage of patients gaining ≥ 15 letters. Safety outcome was the percentage of patients with increased intraocular...

  3. Retinal pigment epithelial atrophy following indocyanine green dye-assisted surgery for serous macular detachment

    Directory of Open Access Journals (Sweden)

    Hussain Nazimul

    2008-01-01

    Full Text Available To report subretinal migration of indocyanine green dye (ICG and subsequent retinal pigment epithelial (RPE atrophy during macular surgery for serous macular detachment. A 65-year-old woman presented with residual epiretinal membrane and serous detachment of the macula following vitreoretinal surgery for epiretinal membrane. She underwent resurgery with ICG-assisted internal limiting membrane peeling and intraocular tamponade. Intraoperatively a large area of subretinal ICG was seen with subsequent RPE mottling and atrophy of the macula in the area involved during follow-up. This case demonstrates that subretinal migration of ICG is possible and can be toxic to RPE.

  4. Refractive changes after vitrectomy and phacovitrectomy for macular hole and epiretinal membrane

    DEFF Research Database (Denmark)

    Hamoudi, Hassan; La Cour, Morten

    2013-01-01

    Several studies have described changes in refraction toward myopia in eyes having vitrectomy and phacovitrectomy. This article reviews studies of the refractive outcome in phakic and pseudophakic eyes after vitrectomy and phacovitrectomy for macular hole or epiretinal membrane. Several factors play...... a role in refraction, including measurement of the axial length, changes in the effective lens position and the anterior chamber depth, the use of intraocular gas tamponade, the formula for intraocular lens (IOL) power calculation, and the IOL type. Most phakic eyes with macular hole or epiretinal...

  5. Vitrectomy with Internal Limiting Membrane Peeling versus No Peeling for Idiopathic Full-Thickness Macular Hole

    DEFF Research Database (Denmark)

    Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil W

    2014-01-01

    under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included. PARTICIPANTS AND CONTROLS: Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling. INTERVENTION: Macular hole surgery, including vitrectomy and gas......) and final (after >1 surgery) macular hole closure; need for additional surgical interventions; intraoperative and postoperative complications; patient-reported outcomes (PROs) (EuroQol-5D and Vision Function Questionnaire-25 scores at 6 months); and cost-effectiveness. RESULTS: Four RCTs were identified...

  6. Diabetic macular oedema and visual loss: relationship to location, severity and duration

    DEFF Research Database (Denmark)

    Gardner, Thomas W; Larsen, Michael; Girach, Aniz

    2009-01-01

    Abstract. Purpose: To assess the relationship between visual acuity (VA) and diabetic macular oedema (DMO) in relation to the location of retinal thickening and the severity and duration of central macular thickening. Methods: Data from 584 eyes in 340 placebo-treated patients in the 3-years...... (Snellen equivalent = 20/125). Diabetic retinopathy and DMO status were assessed using stereo photographs. Results: Nearly one third of study eyes had foveal centre-involving DMO at the start of the trial. Sustained moderate visual loss was found in 36 eyes, most commonly associated with DMO at the centre...

  7. Intravitreal bevacizumab therapy for idiophatic juxtafoveolar retinal telangiectasis associated with serous macular detachment

    Directory of Open Access Journals (Sweden)

    Paulo Escarião

    2014-01-01

    Full Text Available The authors describe a 50-year-old woman with group 2 juxtafoveolar retinal telangiectasis and macular detachment treated with a single-dose of intravitreous bevacizumab injection. There was an improvement in her visual acuity, with a decrease in retinal thickness showed by the optical coherence tomography and fluorescein leakage in the angiography on follow-up visits. No adverse events were observed as a result of the treatment used. After one year of follow-up, the vision remained stable and macular detachment did not recur.

  8. Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

    Directory of Open Access Journals (Sweden)

    Cassandra C. Lautredou

    2018-01-01

    Full Text Available Purpose. To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis. Methods/Patients. An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants. Results. Treatment led to the resolution of CME and improvement in visual acuity. Conclusions. Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.

  9. Systemic and Ocular Long Pentraxin 3 in Patients with Age-Related Macular Degeneration

    DEFF Research Database (Denmark)

    Juel, Helene Bæk; Faber, Carsten; Fog, Lea Munthe

    2015-01-01

    Age-related macular degeneration (AMD) has been associated with both systemic and ocular alterations of the immune system. In particular dysfunction of complement factor H (CFH), a soluble regulator of the alternative pathway of the complement system, has been implicated in AMD pathogenesis. One......CRP or CFH genotype. The gene expression of PTX3 increased in RPE/choroid with age (P=0.0098 macular; P=0.003 extramacular), but did not differ between aged controls and AMD patients. In vitro, ARPE-19 cells increased expression of the PTX3 gene as well PTX3 apical secretions after stimulation with TNF...

  10. Aflibercept in exudative age related macular degeneration refractory to ranibizumab.

    Science.gov (United States)

    Ruiz Ramos, J; Pascual-Camps, I; Cuéllar-Monreal, M J; Dolz-Marco, R; Fenoll, M A; Font-Noguera, I; Poveda-Andrés, J L; Gallego-Pinazo, R

    2015-12-01

    The aim of this study is to determine the effectiveness, safety and cost of aflibercept in the treatment of wet age-related macular degeneration (ARMD) refractory to ranibizumab. Retrospective observational study was conducted on patients diagnosed with wet ARMD, and previously treated with ranibizumab. Efficacy variables assessed were changes in visual acuity (BCVA) and anatomical improvements in the most affected eye. Factors associated with improvement of BCVA with aflibercept were also studied. Adverse events related to the aflibercept administration were recorded. Cost analysis data were collected from the hospital perspective, and only taking the direct medical costs into account. Cost-effectiveness analysis was calculated using the aflibercept treatment cost, and effectiveness calculated as BCVA gained. A total of 50 eyes corresponding to 46 patients were included. The median follow-up period was 4.6 months (range: 1.0-6.0). Improvement in visual acuity after the first 2 doses and at the end of the follow-up period was observed in 32.0 and 28.0% of treated eyes, respectively. None of the variables studied was associated with an improvement in the BCVA after treatment. No significant differences were found in the average monthly cost between treatments. Aflibercept is shown to be an effective treatment in a significant number of patients resistant to treatment with ranibizumab, presenting a cost similar to that generated during the final stages of treatment with ranibizumab. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  11. DNA damage and repair in age-related macular degeneration

    International Nuclear Information System (INIS)

    Szaflik, Jacek P.; Janik-Papis, Katarzyna; Synowiec, Ewelina; Ksiazek, Dominika; Zaras, Magdalena; Wozniak, Katarzyna; Szaflik, Jerzy; Blasiak, Janusz

    2009-01-01

    Age-related macular degeneration (AMD) is a retinal degenerative disease that is the main cause of vision loss in individuals over the age of 55 in the Western world. Clinically relevant AMD results from damage to the retinal pigment epithelial (RPE) cells thought to be mainly caused by oxidative stress. The stress also affects the DNA of RPE cells, which promotes genome instability in these cells. These effects may coincide with the decrease in the efficacy of DNA repair with age. Therefore individuals with DNA repair impaired more than average for a given age may be more susceptible to AMD if oxidative stress affects their RPE cells. This may be helpful in AMD risk assessment. In the present work we determined the level of basal (measured in the alkaline comet assay) endogenous and endogenous oxidative DNA damage, the susceptibility to exogenous mutagens and the efficacy of DNA repair in lymphocytes of 100 AMD patients and 110 age-matched individuals without visual disturbances. The cells taken from AMD patients displayed a higher extent of basal endogenous DNA damage without differences between patients of dry and wet forms of the disease. DNA double-strand breaks did not contribute to the observed DNA damage as checked by the neutral comet assay and pulsed field gel electrophoresis. The extent of oxidative modification to DNA bases was grater in AMD patients than in the controls, as probed by DNA repair enzymes NTH1 and Fpg. Lymphocytes from AMD patients displayed a higher sensitivity to hydrogen peroxide and UV radiation and repaired lesions induced by these factors less effectively than the cells from the control individuals. We postulate that the impaired efficacy of DNA repair may combine with enhanced sensitivity of RPE cells to blue and UV lights, contributing to the pathogenesis of AMD.

  12. Macular pigment spatial distribution effects on glare disability.

    Science.gov (United States)

    Putnam, Christopher M; Bassi, Carl J

    2015-01-01

    This project explored the relationship of the macular pigment optical density (MPOD) spatial profile with measures of glare disability (GD) across the macula. A novel device was used to measure MPOD across the central 16° of retina along four radii using customized heterochromatic flicker photometry (cHFP)at eccentricities of 0°, 2°, 4°, 6° and 8°. MPOD was measured as discrete and integrated values at all measured retinal loci. GD was calculated as a difference in contrast sensitivity (CS) between no glare and glare conditions using identical stimuli presented at the same eccentricities. GD was defined as [(CSNo Glare-CSGlare)/CSNo Glare] in order to isolate the glare attenuation effects of MPOD by controlling for CS variability among the subject sample. Correlations of the discrete and integrated MPOD with GD were compared. The cHFP identified reliable MPOD spatial distribution maps demonstrating a 1st-order exponential decay as a function of increasing eccentricity. There was a significant negative correlation between both measures of foveal MPOD and GD using 6 cycles per degree (cpd) and 9 cpd stimuli. Significant correlations were found between corresponding parafoveal MPOD measures and GD at 2 and 4° of eccentricity using 9 cpd stimuli with greater MPOD associated with less glare disability. These results are consistent with the glare attenuation effects of MP at higher spatial frequencies and support the hypothesis that discrete and integrated measures of MPOD have similar correlations with glare attenuation effects across the macula. Additionally, peak foveal MPOD appears to influence GD across the macula. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  13. DNA damage and repair in age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Szaflik, Jacek P. [Department of Ophthalmology, Medical University of Warsaw and Samodzielny Publiczny Szpital Okulistyczny, Sierakowskiego 13, 03-710 Warsaw (Poland); Janik-Papis, Katarzyna; Synowiec, Ewelina; Ksiazek, Dominika [Department of Molecular Genetics, University of Lodz, Banacha 12/16, 90-237 Lodz (Poland); Zaras, Magdalena [Department of Ophthalmology, Medical University of Warsaw and Samodzielny Publiczny Szpital Okulistyczny, Sierakowskiego 13, 03-710 Warsaw (Poland); Wozniak, Katarzyna [Department of Molecular Genetics, University of Lodz, Banacha 12/16, 90-237 Lodz (Poland); Szaflik, Jerzy [Department of Ophthalmology, Medical University of Warsaw and Samodzielny Publiczny Szpital Okulistyczny, Sierakowskiego 13, 03-710 Warsaw (Poland); Blasiak, Janusz, E-mail: januszb@biol.uni.lodz.pl [Department of Molecular Genetics, University of Lodz, Banacha 12/16, 90-237 Lodz (Poland)

    2009-10-02

    Age-related macular degeneration (AMD) is a retinal degenerative disease that is the main cause of vision loss in individuals over the age of 55 in the Western world. Clinically relevant AMD results from damage to the retinal pigment epithelial (RPE) cells thought to be mainly caused by oxidative stress. The stress also affects the DNA of RPE cells, which promotes genome instability in these cells. These effects may coincide with the decrease in the efficacy of DNA repair with age. Therefore individuals with DNA repair impaired more than average for a given age may be more susceptible to AMD if oxidative stress affects their RPE cells. This may be helpful in AMD risk assessment. In the present work we determined the level of basal (measured in the alkaline comet assay) endogenous and endogenous oxidative DNA damage, the susceptibility to exogenous mutagens and the efficacy of DNA repair in lymphocytes of 100 AMD patients and 110 age-matched individuals without visual disturbances. The cells taken from AMD patients displayed a higher extent of basal endogenous DNA damage without differences between patients of dry and wet forms of the disease. DNA double-strand breaks did not contribute to the observed DNA damage as checked by the neutral comet assay and pulsed field gel electrophoresis. The extent of oxidative modification to DNA bases was grater in AMD patients than in the controls, as probed by DNA repair enzymes NTH1 and Fpg. Lymphocytes from AMD patients displayed a higher sensitivity to hydrogen peroxide and UV radiation and repaired lesions induced by these factors less effectively than the cells from the control individuals. We postulate that the impaired efficacy of DNA repair may combine with enhanced sensitivity of RPE cells to blue and UV lights, contributing to the pathogenesis of AMD.

  14. Modelling the genetic risk in age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Felix Grassmann

    Full Text Available Late-stage age-related macular degeneration (AMD is a common sight-threatening disease of the central retina affecting approximately 1 in 30 Caucasians. Besides age and smoking, genetic variants from several gene loci have reproducibly been associated with this condition and likely explain a large proportion of disease. Here, we developed a genetic risk score (GRS for AMD based on 13 risk variants from eight gene loci. The model exhibited good discriminative accuracy, area-under-curve (AUC of the receiver-operating characteristic of 0.820, which was confirmed in a cross-validation approach. Noteworthy, younger AMD patients aged below 75 had a significantly higher mean GRS (1.87, 95% CI: 1.69-2.05 than patients aged 75 and above (1.45, 95% CI: 1.36-1.54. Based on five equally sized GRS intervals, we present a risk classification with a relative AMD risk of 64.0 (95% CI: 14.11-1131.96 for individuals in the highest category (GRS 3.44-5.18, 0.5% of the general population compared to subjects with the most common genetic background (GRS -0.05-1.70, 40.2% of general population. The highest GRS category identifies AMD patients with a sensitivity of 7.9% and a specificity of 99.9% when compared to the four lower categories. Modeling a general population around 85 years of age, 87.4% of individuals in the highest GRS category would be expected to develop AMD by that age. In contrast, only 2.2% of individuals in the two lowest GRS categories which represent almost 50% of the general population are expected to manifest AMD. Our findings underscore the large proportion of AMD cases explained by genetics particularly for younger AMD patients. The five-category risk classification could be useful for therapeutic stratification or for diagnostic testing purposes once preventive treatment is available.

  15. The effect of macular pigment on heterochromatic luminance contrast.

    Science.gov (United States)

    Renzi, Lisa M; Hammond, Billy R

    2010-12-01

    Macular pigment (MP) selectively filters short-wave light and may improve visual performance via this mechanism. This study was designed to test the hypothesis that MP alters contrast between an object and its background, and thus alters the object's detectability. In order to test this hypothesis, participants of a variety of ages were recruited into two groups. Group 1 consisted of 50 healthy elderly subjects (M = 72.7, SD = 7.3 years). Group 2 consisted of 28 healthy younger subjects (M = 22.7, SD = 3.6 years). For all subjects, contrast thresholds were assessed in Maxwellian-view. For subjects in Group 1, a circular grating target (600 nm, 1°; not absorbed by MP) was surrounded by a 10°, 460 nm field (strongly absorbed by MP). Subjects in Group 2 were measured using identical conditions with the exception that the surround was changed to 425 nm in one condition and to a broad-band (xenon) white in another. All subjects adjusted the intensity of the surround until the target was no longer visible. Finally, for a sub-sample of subjects in Group 2, a 1° bipartite field was used and wavelength was varied on one side to minimize the appearance of the border with the 460 nm reference side, foveally and parafoveally between 420-540 nm, with 20 nm steps, using the minimally distinct border (MDB) technique. MP density was assessed psychophysically. MP density was related to the amount of energy in the surround (at 425 and 460 nm, and for broad-band white) needed to lose sight of the central target. When the MDB technique was used to measure spectral sensitivity, the differences in the two curves yielded a spectrum that closely matched MP's ex vivo spectrum. Our data suggest that MP modifies an object's contrast against a short-wave background via simple filtration. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Vitaminas e antioxidantes na degeneração macular relacionada à idade Vitamins and antioxidants in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Pedro Durães Serracarbassa

    2006-06-01

    Full Text Available O autor descreve os efeitos bioquímicos e estruturais das vitaminas e antioxidantes na retina. Apresenta as principais substâncias presentes na dieta alimentar e na suplementação vitamínica envolvidas na gênese da degeneração macular relacionada à idade. Relata ainda os resultados de estudos prospectivos multicêntricos relacionados ao assunto, por meio de revisão bibliográfica.The author describes biochemical and structural effects of vitamins and antioxidants on the retina. The main substances present in diet food and vitamin supplies involved in the genesis of age-related macular degeneration are shown. Also reports on the outcomes of prospective studies related to the subject, by literature review are presented.

  17. Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    Takafumi Hirashima

    2014-01-01

    Full Text Available Background. To evaluate the efficacy of intravitreal bevacizumab (IVB injection with or without macular laser photocoagulation (MLP for recurrent or persistent macular edema (ME secondary to branch retinal vein occlusion (BRVO. Methods. Thirty-four eyes underwent IVB injection for ME secondary to BRVO as a primary treatment. Twenty of the 34 eyes experienced recurrent or persistent ME after the first IVB. Nine of the 20 eyes (Group 1 were retreated with IVB combined with MLP. The remaining 11 eyes (Group 2 were retreated with IVB alone. Results. In Group 1, the postoperative best corrected visual acuity (BCVA improved compared with the preoperative value at all follow-up visits, although no statistically significant improvement was observed at 6 months. In contrast, BCVA significantly improved from 0.53 to 0.40 at 6 months (P<0.05 in Group 2. Conclusion. Combined therapy tended to have a smaller effect on visual acuity compared with IVB monotherapy.

  18. Blood-retinal barrier glycerol permeability in diabetic macular edema and healthy eyes: estimations from macular volume changes after peroral glycerol

    DEFF Research Database (Denmark)

    Thornit, Dorte Nellemann; Vinten, Carl Martin; Sander, Birgit

    2010-01-01

    PURPOSE: To compare the changes in macular volume (MV) between healthy subjects and patients with diabetic macular edema (DME) after an osmotic load and to determine the glycerol permeability (P(gly)) of the blood-retinal barrier (BRB). METHODS: In this unmasked study, 13 patients with DME and 5...... model of glycerol and osmotic water movements across the BRB was constructed to estimate P(gly). RESULTS: Median MV decreased from 7.30 mm(3) (range, 6.68-7.35) to the maximum median DeltaMV of -0.30 mm(3) (25%-75% quartile: -0.34 to -0.25) in the healthy volunteers and from 7.97 mm(3) (range, 6...

  19. Uso intravítreo de la triamcinolona en el edema macular diabético Use of intravitreous Triamcinolone in cases of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Juana Elvira Maciques Rodríguez

    2009-04-01

    Full Text Available ANTECEDENTES: el edema macular diabético constituye la causa más frecuente de baja visión en personas con retinopatía diabética. En los diabéticos con edema macular diabético severo o difuso, la fotocoagulación con láser no ha brindado los resultados deseados. OBJETIVOS: revisar el estado actual del uso del acetato de triamcinolona por vía intravítrea en los pacientes con esa enfermedad. DESARROLLO: el acetato de triamcinolona es un corticoide con una potente acción antiinflamatoria y antiangiogénica, que consigue estabilizar la barrera hematorretiniana e inhibir la angiogénesis, de ahí que se ha empleado en el tratamiento del edema macular diabético, donde el daño de la barrera hematorretiniana y la liberación de factores angiogénicos en respuesta a la hipoxia están implicados fuertemente en la patogénesis de este tipo de edema. La administración intravítrea en diversas dosificaciones, y no en pocas ocasiones en forma repetida, han mostrado resultados un tanto controversiales al comparar el efecto beneficioso que produce el acetato de triamcinolona, con la corta duración de su efecto y las preocupaciones relacionadas con las complicaciones (hipertensión ocular, endoftalmitis, hemorragia vítrea, etc. relacionadas con las reinyecciones. Actualmente se ensayan dispositivos que liberan el acetato de triamcinolona de forma lenta y prolongan su efecto, para encontrar una estrategia de tratamiento más razonable y que sus efectos terapéuticos sean siempre superiores a los efectos indeseados. CONCLUSIONES: el tratamiento con acetato de triamcinolona constituye una alternativa en la mejoría del edema macular diabético, aunque estudios prospectivos y con período de seguimiento largo son necesarios para llegar a resultados más consistentes.BACKGROUNDS: diabetic macular edema is the more frequent cause of low grade vision in persons presenting with diabetic retinopathy. In diabetic patients with severe or diffuse diabetic

  20. Comparison of ketorolac 0.45% versus diclofenac 0.1% for macular thickness and volume after uncomplicated cataract surgery.

    Science.gov (United States)

    Lee, Tae Hee; Choi, Won; Ji, Yong Sok; Yoon, Kyung Chul

    2016-05-01

    To compare the effects of ketorolac 0.45% and diclofenac 0.1% on macular thickness and volume after uncomplicated cataract surgery. A total of 76 eyes of 76 patients who underwent uncomplicated cataract surgery were included. Patients were treated with either diclofenac 0.1% (38 eyes) or ketorolac 0.45% (38 eyes) after surgery. The macular thickness and volume were obtained with optical coherence tomography (OCT). Central subfield thickness (CST, OCT 1 mm zone), total foveal thickness (TFT, OCT 3 mm zone), total macular thickness (TMT, OCT 6 mm zone), average macular thickness (AMT) and total macular volume (TMV) were compared between the two study groups. No significant differences between groups were found in macular thickness or volume 1 month after cataract surgery. Two months after surgery, the ketorolac group had significantly lower CST, TFT, TMT and AMT than the diclofenac group (p diclofenac group. Following uncomplicated cataract surgery, topical ketorolac 0.45% was more effective than diclofenac 0.1% in preventing increases in macular thickness and volume. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Effects of Vitrectomy on Recurrent Macular Edema due to Branch Retinal Vein Occlusion after Intravitreal Injection of Bevacizumab

    Directory of Open Access Journals (Sweden)

    Tatsuya Yunoki

    2013-01-01

    Full Text Available Purpose. To evaluate the effects of pars plana vitrectomy (PPV on recurrent macular edema due to branch retinal vein occlusion (BRVO after intravitreal injections of bevacizumab (IVB. Methods. This retrospective study included 22 eyes of 22 patients who underwent single or multiple IVB injections for macular edema due to BRVO and showed a recurrence of macular edema. All patients then underwent PPV and were followed up for more than 6 months after the surgery with examinations of best corrected visual acuity (BCVA and optical coherence tomography (OCT. OCT parameters were central macular thickness (CMT and average retinal thickness in a 1-mm-diameter circular region at the fovea (MRT. Results. Mean BCVA, CRT, and MRT were significantly improved from the baseline after PPV. Greater improvement of BCVA, CRT, and MRT was obtained after 1 month of IVB than after 6 months of PPV. No eyes showed worsening of macular edema after the surgery. Conclusion. PPV improved BCVA and recurrent macular edema due to BRVO, but PPV that was less effective than IVB had been in the same patients. PPV may be one of the treatment options for recurrent macular edema due to BRVO after IVB.

  2. Macular ganglion cell complex and retinal nerve fiber layer comparison in different stages of age-related macular degeneration.

    Science.gov (United States)

    Zucchiatti, Ilaria; Parodi, Maurizio Battaglia; Pierro, Luisa; Cicinelli, Maria Vittoria; Gagliardi, Marco; Castellino, Niccolò; Bandello, Francesco

    2015-09-01

    To employ optical coherence tomography (OCT) to analyze the morphologic changes in the inner retina in different categories of age-related macular degeneration (AMD). Observational cross-sectional study. Single-center study. Inclusion criteria were age over 50, diagnosis of Age-Related Eye Disease Study (AREDS) category 2 and 3, naïve neovascular AMD, and atrophic AMD. Healthy patients of similar age acted as a control group. Primary outcome measures were the changes in ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). Secondary outcomes included modifications of rim area and cup-to-disc ratio. One hundred and thirty eyes of 130 patients were recruited: 26 eyes for AREDS category 2, 26 for AREDS category 3, 26 for neovascular AMD, 26 with atrophic AMD, and 26 controls. Mean peripapillary RNFL thickness was significantly lower in neovascular AMD, compared to controls (P = .004); peripapillary RNFL did not significantly vary among AREDS category 2 and 3 and atrophic AMD groups, compared to controls. Mean GCC thickness was higher in the control group, becoming progressively thinner up to neovascular and atrophic AMD groups (P < .0001). Rim area was significantly thinner in the neovascular AMD group compared with controls (P = .047); cup-to-disc ratio was higher in the neovascular AMD group compared with the control group (P = .047). This study demonstrates that eyes with neovascular AMD display reduced RNFL and GCC thickness. RNFL is partially spared in atrophic advanced AMD. The identification of alteration in RNFL and GCC thickness may reveal useful for future therapeutic implications. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Effect of Supplemental Lutein and Zeaxanthin on Serum, Macular Pigmentation, and Visual Performance in Patients with Early Age-Related Macular Degeneration

    Science.gov (United States)

    Huang, Yang-Mu; Dou, Hong-Liang; Huang, Fei-Fei; Xu, Xian-Rong; Zou, Zhi-Yong

    2015-01-01

    Purpose. To compare the 2-year effect of multiple doses of lutein/zeaxanthin on serum, macular pigmentation, and visual performance on patients with early age-related macular degeneration (AMD). Methods. In this randomized, double-blinded, and placebo-controlled trial, 112 early AMD patients randomly received either 10 mg lutein, 20 mg lutein, a combination of lutein (10 mg) and zeaxanthin (10 mg), or placebo daily for 2 years. Serum concentration of lutein/zeaxanthin, macular pigment optical density (MPOD), visual functions including best-spectacle corrected visual acuity (BCVA), contrast sensitivity (CS), flash recovery time (FRT), and vision-related quality of life (VFQ25) was quantified. Results. Serum lutein concentration and MPOD significantly increased in all the active treatment groups. Supplementation with 20 mg lutein was the most effective in increasing MPOD and CS at 3 cycles/degree for the first 48 weeks. However, they both significantly increased to the same peak value following supplementation with either 10 mg or 20 mg lutein during the intervention. No statistical changes of BCVA or FRT were observed during the trial. Conclusions. Long-term lutein supplementation could increase serum lutein concentration, MPOD, and visual sensitivities of early AMD patients. 10 mg lutein daily might be an advisable long-term dosage for early AMD treatment. PMID:25815324

  4. The effect of intravitreal administration of bevacizumab on macular edema and visual acuity in age-related macular degeneration with subfoveolar choroidal neovascularisation

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    Ristić Dragana

    2013-01-01

    Full Text Available Background/Aim. Age-related macular degeneration (AMD is a leading cause of the loss of central visual acuity in population older than 70 years. We can distinguish wet and dry form of AMD. The aim of the study was to present our early results in treatment of the wet (neovascular form of AMD with intravitreal administration of bevacizumab. Methods. The study included 39 patients. Each patient underwent a complete ophthalmological examination, fluorescein angiography (FA and optical coherence tomography (OCT. All the patients received 1.25 mg of intravitreal bevacizumab (0.05 mL of commercial phial of Avastin®. The total of three doses was given with a one-month interval between doses. Results. Among 39 patients, 24 were women and 15 men. The average best corrected visual acuity (BCVA was improved from 0.09 before the therapy to 0.24 after the administration of all the three doses of bevacizumab (p < 0.001. The average central macular thickness (CMT measured by OCT was improved from 474 μm in the beginning to 341 μm after the administration of all the three doses of the drug (p < 0.001. There were no side effects. Conclusions. Our short-term experience indicates that intravitreal administration of three doses of bevacizumab in one-month intervals between the doses leads to a significant reduction of macular edema and improvement of BCVA in patients with neovascular AMD.

  5. Macular pigment density variation after supplementation of lutein and zeaxanthin using the Visucam®200 pigment module: Impact of age-related macular degeneration and lens status.

    Science.gov (United States)

    Azar, G; Quaranta-El Maftouhi, M; Masella, J-J; Mauget-Faÿsse, M

    2017-04-01

    To assess the evolution of macular pigment optical density (MPOD) following supplementation with various macular formulations obtained with the Visucam ® 200, and to study the factors affecting MPOD measurements. In this prospective, randomized, double-masked multicenter study, patients were divided into 2 groups: group A (patients without retinal pathology who underwent cataract surgery 1 month previously) and group B (patients with neovascular age-related macular degeneration [AMD] in one eye). In each group, half of the patients were randomly assigned to receive a food supplementation either with or without carotenoids (5mg of Lutein and 1mg of Zeaxanthin). Outcome measures included MPOD responses obtained with the Visucam ® 200 for one year. In total, 126 subjects (52 men, 74 women) with a mean age of 75.3±7.61 years were enrolled. Mean MPOD values at the time of inclusion were statistically lower in group A (0.088 density unit [DU]) compared to group B (0.163 DU, P<0.05). No statistically significant increase in MPOD was noted in either group, even after discontinuation of the supplementation. By multiple regression analysis, age, female gender, lens status and the presence of AMD seemed to significantly affect MPOD measurements. No significant improvement in MPOD seems to be detected with the Visucam ® 200 after carotenoid supplementation. The MPOD measurement seems to be highly affected by cataract extraction and the presence of AMD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. The macular degeneration and aging study: Design and research protocol of a randomized trial for a psychosocial intervention with macular degeneration patients.

    Science.gov (United States)

    Sörensen, Silvia; White, Katherine; Mak, Wingyun; Zanibbi, Katherine; Tang, Wan; O'Hearn, Amanda; Hegel, Mark T

    2015-05-01

    Age-related Macular Degeneration (AMD) is the leading cause of irreversible and predictable blindness among older adults with serious physical and mental health consequences. Visual impairment is associated with negative future outlook and depression and has serious consequences for older adults' quality of life and, by way of depression, on long-term survival. Psychosocial interventions have the potential to alleviate and prevent depression symptoms among older AMD patients. We describe the protocol of the Macular Degeneration and Aging Study, a randomized clinical trial of a psychosocial Preventive Problem-Solving Intervention. The intervention is aimed at enhancing well-being and future planning among older adults with macular degeneration by increasing preparation for future care. Adequate randomization and therapeutic fidelity were achieved. Current retention rates were acceptable, given the vulnerability of the population. Acceptability (adherence and satisfaction) was high. Given the high public health significance and impact on quality of life among older adults with vision loss, this protocol contributes a valid test of a promising intervention for maintaining mental and physical health in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. The relationship of major American dietary patterns to age-related macular degeneration

    Science.gov (United States)

    We hypothesized that major American dietary patterns are associated with age-related macular degeneration (AMD) risk. This was a cross-sectional study with 8,103 eyes from 4,088 eligible participants in the baseline Age-Related Eye Disease Study (AREDS) were classified into control (n=2,739), early ...

  8. Automated Segmentability Index for Layer Segmentation of Macular SD-OCT Images

    NARCIS (Netherlands)

    Lee, K.; Buitendijk, G.H.; Bogunovic, H.; Springelkamp, H.; Hofman, A.; Wahle, A.; Sonka, M.; Vingerling, J.R.; Klaver, C.C.W.; Abramoff, M.D.

    2016-01-01

    PURPOSE: To automatically identify which spectral-domain optical coherence tomography (SD-OCT) scans will provide reliable automated layer segmentations for more accurate layer thickness analyses in population studies. METHODS: Six hundred ninety macular SD-OCT image volumes (6.0 x 6.0 x 2.3 mm3)

  9. Harmonizing the classification of age-related macular degeneration in the three-continent AMD consortium

    NARCIS (Netherlands)

    Klein, Ronald; Meuer, Stacy M; Myers, Chelsea E; Buitendijk, Gabriëlle H S; Rochtchina, Elena; Choudhury, Farzana; de Jong, Paulus T V M; McKean-Cowdin, Roberta; Iyengar, Sudha K; Gao, Xiaoyi; Lee, Kristine E; Vingerling, Johannes R; Mitchell, Paul; Klaver, Caroline C W; Wang, Jie Jin; Klein, Barbara E K

    PURPOSE: To describe methods to harmonize the classification of age-related macular degeneration (AMD) phenotypes across four population-based cohort studies: the Beaver Dam Eye Study (BDES), the Blue Mountains Eye Study (BMES), the Los Angeles Latino Eye Study (LALES), and the Rotterdam Study (RS).

  10. Near-infrared reflectance imaging of neovascular age-related macular degeneration.

    NARCIS (Netherlands)

    Theelen, T.; Berendschot, T.T.; Hoyng, C.B.; Boon, C.J.F.; Klevering, B.J.

    2009-01-01

    PURPOSE: To evaluate various types of neovascular age-related macular degeneration (AMD) by near-infrared fundus reflectance (NIR) as compared to fundus fluorescein angiography (FFA) and to test NIR for assessment of leakage due to choroidal neovascularization (CNV). PATIENTS AND METHODS:

  11. Early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema

    International Nuclear Information System (INIS)

    Wahab, S.; Rab, K. F. U.; Hargun, L. D.

    2013-01-01

    Objective: To get optimal visualization of fundus by early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema. Study Design: Interventional study. Place and Duration of Study: Ophthalmology Unit III, Sindh Government Lyari General Hospital and Dow University of Health Sciences and Al-Noor Eye Hospital, Karachi, from July 2008 to June 2009. Methodology: Patients with uncontrolled type-II diabetes mellitus of more than 10 years of duration were selected. Patients with clinical significant macular oedema (CSME), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were excluded. Follow-up was done on day 1, 1 week, 1 month, 3 months and 6 months. Results: The male to female ratio was 1:1.44. Out of 218 patients; 129 (59.2%) were males and 89 (40.8%) were females. CSME was found in 82 patients (37.6%) at first postoperative week which declined to 29 cases (13.3%) at first month follow-up. Three subjects developed mild to moderate NPDR. In majority of the subjects, best corrected visual acuity (BCVA) gradually improved in each subsequent follow-up visit. Conclusion: Early phacoemulsification in diabetic cataract offers optimal posterior pole visualization and clears the ambiguity of decreased vision either caused by cataract or macular oedema. Uncomplicated phacoemulsification does not accelerate diabetic macular oedema or retinopathy provided glycemic control and co-morbids are well addressed. (author)

  12. Bilateral detachment of the macular neuroepithelium in a patient with Klinefelter syndrome.

    NARCIS (Netherlands)

    Haarlem, J. van; Cruysberg, J.R.M.; Deutman, A.F.

    2003-01-01

    PURPOSE: To describe the occurrence of atypical, bilateral detachment of the macular neuroepithelium and Klinefelter syndrome in a young patient. METHODS: Case report. RESULTS: A 20-year-old male of Chinese origin with karyotype 47,XXY presented with bilateral central neurosensory retinal

  13. Psychosocial Intervention for Age-Related Macular Degeneration: A Pilot Project

    Science.gov (United States)

    Wahl, Hans-Werner; Kammerer, Annette; Holz, Frank; Miller, Daniel; Becker, Stefanie; Kaspar, Roman; Himmelsbach, Ines

    2006-01-01

    This study evaluated an emotion-focused and a problem-focused intervention designed for patients with age-related macular degeneration. It found a limited decrease in depression in the emotion-focused group and an increase in active problem orientation and in adaptation to vision loss in the problem-focused group.

  14. Genetics of Unilateral and Bilateral Age-Related Macular Degeneration Severity Stages

    NARCIS (Netherlands)

    Schick, T.; Altay, L.; Viehweger, E.; Hoyng, C.B.; Hollander, A.I. den; Felsch, M.; Fauser, S.

    2016-01-01

    BACKGROUND: Age-related macular degeneration (AMD) is a common disease causing visual impairment and blindness. Various gene variants are strongly associated with late stage AMD, but little is known about the genetics of early forms of the disease. This study evaluated associations of genetic

  15. HISTORY OF SUNLIGHT EXPOSURE IS A RISK FACTOR FOR AGE-RELATED MACULAR DEGENERATION

    NARCIS (Netherlands)

    Schick, T.; Ersoy, L.; Lechanteur, Y.T.; Saksens, N.T.; Hoyng, C.B.; Hollander, A.I. den; Kirchhof, B.; Fauser, S.

    2016-01-01

    PURPOSE: To evaluate effects of current and past sunlight exposure and iris color on early and late age-related macular degeneration (AMD). METHODS: Of 3,701 individuals from the EUGENDA database, 752 (20.3%) showed early AMD, 1,179 (31.9%) late AMD, and 1,770 (47.8%) were controls. Information

  16. INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP.

    Science.gov (United States)

    Casini, Giamberto; Mura, Marco; Figus, Michele; Loiudice, Pasquale; Peiretti, Enrico; De Cillà, Stefano; Fuentes, Taiusha; Nasini, Francesco

    2017-11-01

    To determine whether surgical manipulation steps of the internal limiting membrane (ILM) flap, such as ILM trimmed, ILM tuck inside the hole, ILM massage, are mandatory to obtain satisfactory outcomes for the repair of large stage IV idiopathic macular hole using the inverted ILM flap technique. In this interventional comparative prospective single-masked study, 81 eyes were randomized into 2 treatments groups. In Group 1 (41 eyes), the classic inverted ILM flap technique was performed. In Group 2 (40 eyes), a modified procedure was used: after ILM peeling, no extra flap manipulation was performed. The macular hole was covered by the inverted ILM flap because of the air pressure at the time of the fluid-air exchange. At 12 months, macular hole closure was observed in 40 eyes (97.6%) in Group 1 and in 39 eyes in Group 2 (97.5%). U-shape closure rate, ellipsoid zone defects, and external limiting membrane defects were similar in both groups. The results indicate no statistical difference in anatomical and functional success between both groups. The macular hole closure rate, improved visual acuity, and no extra complications indicate noninferiority of the modified inverted ILM technique. Internal limiting membrane finishing, tucking, and massage may not be required to obtain surgical success.

  17. Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema

    Directory of Open Access Journals (Sweden)

    Rocío Herrero-Vanrell, Jose Augusto Cardillo

    2011-02-01

    Full Text Available Rocío Herrero-Vanrell1, Jose Augusto Cardillo2, Baruch D Kuppermann31Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Complutense University, Madrid, Spain; 2Hospital de Olhos de Araraquara, Araraquara, São Paulo, Brazil; 3Gavin Herbert Eye Institute, University of California, Irvine, CA, USAAbstract: Macular edema is one of the leading causes of vision loss among patients with retinal vein occlusion, diabetic retinopathy, and posterior chamber inflammatory disease. However, the treatment of macular edema is considerably limited by the difficulty in delivering effective doses of therapeutic agents into the vitreous cavity. In recent years, the development of a sustained-release dexamethasone intravitreal implant (Ozurdex® has enabled more controlled drug release at a stable rate over a long period of time, with a potentially lower rate of adverse events. Clinical studies indicate that this dexamethasone implant is a promising new treatment option for patients with persistent macular edema resulting from retinal vein occlusion, diabetic retinopathy, and uveitis or Irvine-Gass syndrome.Keywords: diabetic retinopathy, macular edema, Ozurdex®, posterior-segment inflammatory disease, retinal vein occlusion, sustained-release dexamethasone implant

  18. Letter to the editor: dexamethasone intravitreal implant in the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Hall J

    2015-11-01

    Full Text Available John Hall Alimera Sciences Ltd., Aldershot, Hampshire, UK I read “Dexamethasone intravitreal implant in the treatment of diabetic macular edema” published July 2015 by Dugel et al.1This article is very interesting in terms of providing an outline of the role of inflammation in the pathogenesis of diabetic macular edema and explaining the value of corticosteroids in the treatment of diabetic macular edema. However, I would like to draw your attention to the data presented for ILUVIEN® (fluocinolone acetonide; FAc in Table 2, which has been presented incorrectly and does not reflect the approved product and dose in Europe. ILUVIEN is indicated in Europe for the treatment of vision impairment associated with chronic diabetic macular edema, considered insufficiently responsive to available therapies2 and is approved in Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Ireland, Italy, Luxembourg, the Netherlands, Norway, Poland, Portugal, Spain, Sweden, and the United Kingdom. ILUVIEN was launched in the United Kingdom in April 2013, Germany in May 2013, and Portugal in January 2015.3View original paper by Dugel et al.

  19. Macular pigment optical density spatial distribution measured in a subject with oculocutaneous albinism

    Directory of Open Access Journals (Sweden)

    Christopher M. Putnam

    2014-10-01

    Conclusions: Consistent with previous macular pigment (MP studies of OCA, overall MPOD is reduced in our subject. Mild phenotypic expression of OCA with high functional visual acuity may represent a Henle fiber layer amenable to additional MP deposition. Further study of MP supplementation in OCA patients is warranted.

  20. Retinal Vascular Caliber Changes After Topical Nepafenac Treatment for Diabetic Macular Edema.

    Science.gov (United States)

    Evliyaoğlu, Ferhat; Akpolat, Çetin; Kurt, Muhammed Mustafa; Çekiç, Osman; Nuri Elçioğlu, Mustafa

    2018-03-01

    To assess changes in retinal vascular caliber in response to short-term use of nepafenac eye drops in patients with mild diabetic macular edema. Thirty-four patients with previously untreated bilateral mild diabetic macular edema were included in this prospective study. For each participant, one eye was randomly assigned to nepafenac treatment (0.1%, three times/day) and the other eye was left untreated throughout the study. Using digital fundus photographs, retinal vascular calibers were calculated and compared in treated and untreated eyes at the baseline, week 1, and week 6. Baseline vessel diameters did not differ in treated and fellow eyes (p > 0.05). Over the 6 weeks of the study, significant vasoconstriction of the retinal arteriolar caliber was observed at weeks 1 (p  0.44). Significant macular thickness difference was only observed at week 6 (p = 0.002). Topical nepafenac has a significant narrowing effect on the retinal arteriolar diameter and a significant reductive effect on central macular thickness in eyes with mild diabetic retinopathy.

  1. Mediterranean Diet Score and Its Association with Age-Related Macular Degeneration : The European Eye Study

    NARCIS (Netherlands)

    Hogg, Ruth E; Woodside, Jayne V; McGrath, Alanna; Young, Ian S; Vioque, Jesus L; Chakravarthy, Usha; de Jong, Paulus T; Rahu, Mati; Seland, Johan; Soubrane, Gisele; Tomazzoli, Laura; Topouzis, Fotis; Fletcher, Astrid E

    2017-01-01

    PURPOSE: To examine associations between adherence to a Mediterranean diet and prevalence of age-related macular degeneration (AMD) in countries ranging from Southern to Northern Europe. DESIGN: Cross-sectional, population-based epidemiologic study. PARTICIPANTS: Of 5060 randomly sampled people aged

  2. GLIAL CELLS AND COLLAGENS IN EPIRETINAL MEMBRANES ASSOCIATED WITH IDIOPATHIC MACULAR HOLES

    NARCIS (Netherlands)

    Bu, Shao-Chong; Kuijer, Roelof; van der Worp, Roelofje J.; Huiskamp, Eveline A.; De Lavalette, Victor W. Renardel; Li, Xiao-Rong; Hooymans, Johanna M. M.; Los, Leonoor I.

    Purpose: To investigate the identity of collagens and cellular components in the epiretinal membrane (ERM) associated with full-thickness idiopathic macular hole and their clinical relevance. Methods: Pars plana vitrectomy with the peeling of internal limiting membrane and ERM was performed by 2

  3. Macular pigment carotenoids in the retina and occipital cortex are related in humans.

    Science.gov (United States)

    Vishwanathan, Rohini; Schalch, Wolfgang; Johnson, Elizabeth J

    2016-01-01

    Lutein and zeaxanthin are dietary carotenoids that preferentially accumulate in the macular region of the retina. Together with meso-zeaxanthin, a conversion product of lutein in the macula, they form the macular pigment. Lutein is also the predominant carotenoid in human brain tissue and lutein status is associated with cognitive function in adults. The study objective was to evaluate the relationship between retinal and brain lutein and zeaxanthin in humans. Donated brain tissue (occipital cortex and hippocampus) and matched retina were obtained from the National Disease Research Interchange, a national human tissue resource center which adheres to strict consent and confidentiality procedures. Decedents were men and women aged >50 years who either had normal cognitive function or Alzheimer's disease. Tissues were analyzed using standard lipid extractions followed by analysis on reverse-phase high performance liquid chromatography (HPLC) and normal-phase HPLC (for meso-zeaxanthin). Macular pigment carotenoids (lutein, meso-zeaxanthin, and zeaxanthin combined) in the retina were significantly related to the combined concentrations of lutein and zeaxanthin in the occipital cortex. When analyzed separately, only retinal lutein (plus meso-zeaxanthin), not zeaxanthin, was significantly related to lutein in the occipital cortex. No correlations were observed with lutein and zeaxanthin in the hippocampus. Total macular pigment density measured via non-invasive, psychophysical techniques can be used as a biomarker to ascertain brain lutein and zeaxanthin status in clinical studies.

  4. TOPOGRAPHIC CHANGES OF THE MACULA AFTER CLOSURE OF IDIOPATHIC MACULAR HOLE.

    Science.gov (United States)

    Pak, Kang Yeun; Park, Keun Heung; Kim, Kyong Ho; Park, Sung Who; Byon, Ik Soo; Kim, Hyun Woong; Chung, In Young; Lee, Joo Eun; Lee, Sang Joon; Lee, Ji Eun

    2017-04-01

    To investigate retinal displacement in the macula after surgical closure of idiopathic macular hole and to identify factors correlated with displacement. This retrospective multicenter study included 73 eyes of 73 patients having idiopathic macular hole. A custom program was developed to compare the position of the retinal vessels in the macula between preoperative and postoperative photographs. En face images of a 6 mm × 6 mm optical coherence tomography volume scans were registered to calculate the scale. A grid comprising 16 sectors in 2 rings (inner; 2-4 mm and outer; 4-6 mm) was superimposed. The displacement of the retinal vessels was measured as a vector value by comparing the location of the retinal vessels in each sector. The correlation between displacement and various clinical parameters was analyzed. The average displacement was 57.2 μm at an angle of -3.3° (nasal and slightly inferior). Displacement was larger in the inner ring (79.2 μm) than in the outer ring (35.3 μm, P macula was displaced centripetally, nasally, and slightly inferiorly after surgical closure of idiopathic macular hole. Hole closure, contraction of the nerve fiber layer, and gravity are the suggested mechanisms of macular displacement caused by internal limiting membrane peeling.

  5. Bilateral Dome-Shaped Macula with Serous Macular Detachment in a Child

    OpenAIRE

    Cebeci, Zafer; Kir, Nur

    2015-01-01

    Dome-shaped macula is a structural disorder and optical coherence tomography (OCT) helps us to confirm macular convexity. We describe the first case of bilateral dome-shaped macula in an 8-year-old boy with subretinal fluid. The patient was diagnosed using spectral-domain OCT and received indocyanine green angiography-guided half-fluence photodynamic therapy as treatment.

  6. Strong topical steroid, NSAID, and carbonic anhydrase inhibitor cocktail for treatment of cystoid macular edema

    Directory of Open Access Journals (Sweden)

    Asahi MG

    2015-12-01

    Full Text Available Masumi G Asahi, Gabriela L Bobarnac Dogaru, Spencer M Onishi, Ron P GallemoreRetina Macula Institute, Torrance, CA, USA Purpose: To report the combination cocktail of strong steroid, non-steroidal anti-inflammatory drug (NSAID, and carbonic anhydrase inhibitor drops for treatment of cystoid macular edema. Methods: This is a retrospective case series of patients with cystoid macular edema managed with a topical combination of strong steroid (difluprednate, NSAID, and carbonic anhydrase inhibitor drops. The patients were followed with optical coherence tomography and fluorescein angiography. Results: In our six cases, resolution of the cystic edema with improvement in visual acuity was achieved with the use of a combination cocktail of drops. Leakage on fluorescein angiography and cystic edema on optical coherence tomography both responded to treatment with the topical cocktail of drops. Conclusion: A topical cocktail of strong steroid, NSAID, and carbonic anhydrase inhibitor drops are effective for managing cystoid macular edema. Further studies comparing this combination with more invasive treatments should be undertaken to determine the efficacy of this cocktail over other treatment options. Keywords: birdshot chorioretinopathy, diabetic macular edema, retinal vein occlusion

  7. Visual acuity and microperimetric mapping of lesion area in eyes with inflammatory cystoid macular oedema

    DEFF Research Database (Denmark)

    Munk, Marion R; Kiss, Christopher G; Huf, Wolfgang

    2014-01-01

    PURPOSE:   To evaluate the effect of fluid accumulation on local visual function in inflammatory cystoid-macular-edema (ICME). METHODS:   This cross-sectional study applied optical-coherence-tomography over a 12×12 fovea-centered field in 50 patients with ICME and mapped the extent of fluid-fille...

  8. TYPE 2 (SUBRETINAL) NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH PURE RETICULAR PSEUDODRUSEN PHENOTYPE.

    Science.gov (United States)

    Naysan, Jonathan; Jung, Jesse J; Dansingani, Kunal K; Balaratnasingam, Chandrakumar; Freund, K Bailey

    2016-03-01

    To report the association of pure type 2 neovascularization (NV) in age-related macular degeneration occurring almost exclusively in patients with reticular pseudodrusen. An observational retrospective cohort study of all eyes receiving antivascular endothelial growth factor therapy for newly diagnosed neovascular age-related macular degeneration by a single practitioner over a 6-year period. Only patients with treatment-naive, pure type 2 NV who also had either pre-neovascular imaging of the study eye or imaging of a nonneovascular fellow eye available to determine baseline characteristics including drusen type and choroidal thickness were incuded. Of 694 patients treated for neovascular age-related macular degeneration, only 8 met the inclusion criteria with pure type 2 NV. Of these, 7 (88%) had exclusively reticular pseudodrusen (5 in the nonneovascular fellow eye, 2 in the study eye before developing NV). Six (75%) patients in the affected neovascular eye and 6 (75%) in the fellow nonneovascular eye had choroidal thickness age-related macular degeneration, occurring almost exclusively in patients with reticular pseudodrusen and thin choroids.

  9. Role of growth factors and the wound healing response in age-related macular degeneration

    NARCIS (Netherlands)

    Schlingemann, Reinier O.

    2004-01-01

    Growth factors (GF) are important in several stages of the pathogenesis of age-related macular disease (AMD). In choroidal neovascularization (CNV) in exudative AMD, the GF involved are similar to those involved in wound healing of the skin. Like granulation tissue of skin, CNV is characterized by

  10. A novel mutation in the ELOVL4 gene causes autosomal dominant Stargardt-like macular dystrophy.

    NARCIS (Netherlands)

    Maugeri, A.; Meire, F.; Hoyng, C.B.; Vink, C.W.; Regemorter, N. van; Karan, G.; Yang, Z.; Cremers, F.P.M.; Zhang, K.

    2004-01-01

    PURPOSE: To conduct clinical and genetic studies in a European family with autosomal dominant Stargardt-like macular dystrophy (adSTGD-like MD) and to investigate the functional consequences of a novel ELOVL4 mutation. METHODS: Ophthalmic examination and mutation screening by direct sequencing of

  11. Spectral and directional reflectance of the fovea in diabetes mellitus: Photoreceptor integrity, macular pigment and lens

    NARCIS (Netherlands)

    Zagers, N.P.A.; Pot, M.C.A.; Norren, D. van

    2005-01-01

    Our aim was to assess the integrity of the photoreceptors in the fovea, and to measure the optical density of the macular pigment and the eye lens in patients with diabetes mellitus, and to compare the results with those of a group of healthy subjects. The directional and spectral properties of the

  12. Macular pigment and melanin in age-related maculopathy in a general population

    NARCIS (Netherlands)

    Berendschot, Tos T. J. M.; Willemse-Assink, Jacqueline J. M.; Bastiaanse, Mieke; de Jong, Paulus T. V. M.; van Norren, Dirk

    2002-01-01

    It has been suggested that macular pigment (MP) and melanin may protect against age-related maculopathy (ARM). To check this, MP and melanin optical density were measured in a random population-based sample of subjects 55 years of age or older. Spectral fundus reflectance of the fovea was measured

  13. The RESTORE Study Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

    NARCIS (Netherlands)

    Mitchell, Paul; Bandello, Francesco; Schmidt-Erfurth, Ursula; Lang, Gabriele E.; Massin, Pascale; Schlingemann, Reinier O.; Sutter, Florian; Simader, Christian; Burian, Gabriela; Gerstner, Ortrud; Weichselberger, Andreas

    2011-01-01

    Objective: To demonstrate superiority of ranibizumab 0.5 mg monotherapy or combined with laser over laser alone based on mean average change in best-corrected visual acuity (BCVA) over 12 months in diabetic macular edema (DME). Design: A 12-month, randomized, double-masked, multicenter,

  14. Macular pigment optical density measurements: evaluation of a device using heterochromatic flicker photometry

    NARCIS (Netherlands)

    de Kinkelder, R.; van der Veen, R. L. P.; Verbaak, F. D.; Faber, D. J.; van Leeuwen, T. G.; Berendschot, T. T. J. M.

    2011-01-01

    Purpose Accurate assessment of the amount of macular pigment (MPOD) is necessary to investigate the role of carotenoids and their assumed protective functions. High repeatability and reliability are important to monitor patients in studies investigating the influence of diet and supplements on MPOD.

  15. Multimodality imaging in macular telangiectasia 2: A clue to its pathogenesis

    Directory of Open Access Journals (Sweden)

    Lihteh Wu

    2015-01-01

    Full Text Available Macular telangiectasia type 2 also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A is an acquired bilateral neurodegenerative macular disease that manifests itself during the fifth or sixth decades of life. It is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV. Our understanding of the disease has paralleled advances in multimodality imaging of the fundus. Optical coherence tomography (OCT images typically demonstrate the presence of intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic (FA finding is a deep intraretinal hyperfluorescent staining in the temporal parafoveal area. With time, the staining may involve the whole parafoveal area but does not extend to the center of the fovea. Long-term prognosis for central vision is poor, because of the development of SRNV or macular atrophy. Its pathogenesis remains unclear but multimodality imaging with FA, spectral domain OCT, adaptive optics, confocal blue reflectance and short wave fundus autofluorescence implicate Müller cells and macular pigment. Currently, there is no known treatment for this condition.

  16. SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Tran, Irwin; Turpcu, Adam; Colman, Shoshana

    2016-02-01

    The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration. Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration. The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

  17. Clinical study of Conbercept intravitreal injection for the treatment of wet age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Xu-Ting He

    2015-09-01

    Full Text Available AIM: To observe the clinical curative effect of conbercept intravitreal injection for the treatment of wet age-related macular degeneration.METHODS: Sixty patients with wet age related macular degeneration were randomly divided into treatment group 30 cases and control group 30 cases according to the random number table. The treatment group was injected with Conbercept 0.05mL, the control group was injected with triamcinolone acetonide 0.1mL. The best corrected visual acuity(BCVAwas performed before and after 1d, 1 and 3mo after treatment, and the thickness of macular was detected by optical coherence tomography(OCT. The complications of patients were observed after 1d, 1 and 3mo,including inflammatory reaction, corneal edema, anterior chamber, high intraocular pressure, etc.RESULTS:In treatment group 1d, 1 and 3mo after treatment, eyesight was improved significantly better than the control group(PPCONCLUSION: Intravitreal injection of Conbercept in the treatment of wet age-related macular degeneration can improve the curative effect.

  18. Side effects after radiotherapy of age-related macular degeneration with the Nijmegen technique.

    NARCIS (Netherlands)

    Hoyng, C.B.; Tromp, A.I.; Meulendijks, C.F.M.; Leys, A.; Maazen, R.W.M. van der; Deutman, A.F.; Vingerling, J.R.

    2002-01-01

    BACKGROUND: In a randomized trial concerning radiotherapy for age-related macular degeneration, fluorescein angiograms were taken of controls and patients. In this study the frequency of side effects in eyes receiving radiotherapy with the Nijmegen technique is compared with the findings in the eyes

  19. Immunological Factors in the Pathogenesis and Treatment of Age-Related Macular Degeneration

    NARCIS (Netherlands)

    Kijlstra, A.; Heij, La E.C.; Hendrikse, F.

    2005-01-01

    Recent findings indicate that immunological factors are involved not only in the pathogenesis of age-related macular degeneration (AMD), but also in its treatment. Earlier data showing the presence of inflammatory cells in affected areas of AMD retinas support this statement. Although a possible

  20. Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy

    DEFF Research Database (Denmark)

    Rönnbäck, Cecilia; Larsen, Michael

    2014-01-01

    with exon 28 (2826 delT) mutation in OPA1 (age 11.7-71.5 years, best-corrected visual acuity (BCVA) 20/24-20/13). The patients and 49 mutation-free first-degree relatives (BCVA 20/25-20/10) underwent ophthalmic examination including macular microperimetry out to 12° eccentricity with registration...

  1. 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, randomized...

  2. Introduction to the issue regarding research regarding age related macular degeneration

    Science.gov (United States)

    Blindness is the second greatest fear among the elderly. Age-related macular degeneration (AMD) is the leading cause of vision loss among the elderly in most industrialized nations. AMD first compromises central high acuity vision. Subsequently, all vision may be lost. AMD is a progressive retinal d...

  3. RISK FACTORS AND CLINICAL SIGNIFICANCE OF PRECHOROIDAL CLEFT IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Kim, Jong Min; Kang, Se Woong; Son, Dae Yong; Bae, Kunho

    2017-11-01

    To investigate the risk factors associated with prechoroidal cleft occurrence after treatment for neovascular age-related macular degeneration (nAMD) and to elucidate its clinical significance. Two hundred thirty-four subjects who were treated for neovascular age-related macular degeneration were assessed to identify prechoroidal cleft on optical coherence tomography. Clinical variables were compared between patients manifesting a cleft (cleft group) and patients who did not (control group). Prechoroidal cleft was detected in 29 of 234 patients (8.1%). Although the baseline visual acuity was not different between the 2 groups, logMAR visual acuity at final visit was 0.89 ± 0.74 (with approximate Snellen equivalent of 20/160) in the cleft group and 0.65 ± 0.69 (with approximate Snellen equivalent of 20/100) in controls (P macular degeneration (P macular degeneration, and a submacular hemorrhage treated by pneumatic displacement were the independent risk factors for development of prechoroidal cleft. Eyes with a cleft, especially clefts that develop early, generally had worse prognoses than eyes without clefts.

  4. 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...

  5. The Effect of an Educational Program for Persons with Macular Degeneration: A Pilot Study

    Science.gov (United States)

    Smith, Theresa Marie; Thomas, Kimberly; Dow, Katherine

    2009-01-01

    Macular degeneration is the leading cause of vision loss in the United States for persons aged 60 and older. Compared to individuals without disabilities, individuals with low vision demonstrate a 15% to 30% higher dependence on others to perform activities of daily living. In addition, low vision can adversely affect a person's quality of life.…

  6. Cardiovascular risk factors associated with age-related macular degeneration: the Tromso Study

    DEFF Research Database (Denmark)

    Erke, M. G.; Bertelsen, G.; Peto, T.

    2014-01-01

    PurposeTo examine associations between cardiovascular risk factors and age-related macular degeneration (AMD). MethodsA population-based, cross-sectional study of Caucasians aged 65-87years was conducted in Norway in 2007/2008. Retinal photographs were graded for AMD. Multivariable logistic...

  7. A systematic review on zinc for the prevention and treatment of age-related macular degeneration

    Science.gov (United States)

    Zinc is a potential candidate for the prevention and treatment of age-related macular degeneration (AMD) due to its high concentration in the retina and role as a cofactor for antioxidant enzymes. The objective of this work was to conduct a systematic review of studies that investigated dietary inta...

  8. Age-related Macular Degeneration-an Emerging And Re-emerging ...

    African Journals Online (AJOL)

    Age-related macular degeneration (ARMD) is an ocular condition that affects older adults (50 years and above age group), resulting in loss of central vision. It is emerging as the leading cause of legal blindness in the world, over taking glaucoma and diabetic retinopathy combined. Arecent study carried out in an Eye Clinic ...

  9. Cataract surgery and age-related macular degeneration. An evidence-based update

    DEFF Research Database (Denmark)

    Kessel, Line; Erngaard, Ditte; Flesner, Per

    2015-01-01

    PURPOSE: Age-related macular degeneration (AMD) and cataract often coexist in patients and concerns that cataract surgery is associated with an increased risk of incidence or progression of existing AMD has been raised. This systematic review and meta-analysis is focused on presenting the evidence...

  10. Systemic and ocular fluid compounds as potential biomarkers in age-related macular degeneration

    NARCIS (Netherlands)

    Kersten, E. (Eveline); C.C. Paun (Codrut); Schellevis, R.L. (Rosa L.); C. Hoyng (Carel); C. Delcourt (Cécile); Lengyel, I. (Imre); T. Peto (Tünde); Ueffing, M. (Marius); C.C.W. Klaver (Caroline); Dammeier, S. (Sascha); A.I. Hollander (Anneke); E.K. de Jong (Eiko)

    2017-01-01

    textabstractBiomarkers can help unravel mechanisms of disease and identify new targets for therapy. They can also be useful in clinical practice for monitoring disease progression, evaluation of treatment efficacy, and risk assessment in multifactorial diseases, such as age-related macular

  11. Clinical characteristics of familial and sporadic age-related macular degeneration: differences and similarities

    NARCIS (Netherlands)

    Saksens, N.T.M.; Kersten, E.; Groenewoud, J.M.M.; Grinsven, M.J.J.P. van; Ven, J.P.H. van de; Sanchez, C.I.; Schick, T.; Fauser, S.; Hollander, A.I. den; Hoyng, C.B.; Boon, C.J.F.

    2014-01-01

    PURPOSE: We describe the differences and similarities in clinical characteristics and phenotype of familial and sporadic patients with age-related macular degeneration (AMD). METHODS: We evaluated data of 1828 AMD patients and 1715 controls enrolled in the European Genetic Database. All subjects

  12. North Carolina Macular Dystrophy Is Caused by Dysregulation of the Retinal Transcription Factor PRDM13

    DEFF Research Database (Denmark)

    Small, Kent W; DeLuca, Adam P; Whitmore, S Scott

    2016-01-01

    PURPOSE: To identify specific mutations causing North Carolina macular dystrophy (NCMD). DESIGN: Whole-genome sequencing coupled with reverse transcription polymerase chain reaction (RT-PCR) analysis of gene expression in human retinal cells. PARTICIPANTS: A total of 141 members of 12 families...

  13. Prevalence of age-related macular degeneration in the United States

    NARCIS (Netherlands)

    Friedman, David S.; O'Colmain, Benita J.; Muñoz, Beatriz; Tomany, Sandra C.; McCarty, Cathy; de Jong, Paulus T. V. M.; Nemesure, Barbara; Mitchell, Paul; Kempen, John

    2004-01-01

    To estimate the prevalence and distribution of age-related macular degeneration (AMD) in the United States by age, race/ethnicity, and gender. Summary prevalence estimates of drusen 125 microm or larger, neovascular AMD, and geographic atrophy were prepared separately for black and white persons in

  14. MACULAR BUCKLING USING A THREE-ARMED SILICONE CAPSULE FOR FOVEOSCHISIS ASSOCIATED WITH HIGH MYOPIA.

    Science.gov (United States)

    Liu, Bingqian; Ma, Wei; Li, Yonghao; Luo, Yan; Jin, Chenjin; Liang, Xiaoling; Sadda, Srinivas R; Gao, Qianying; Lu, Lin

    2016-10-01

    To investigate the safety and efficacy of a novel macular buckling technique on foveoschisis in highly myopic eyes. Highly myopic eyes with foveoschisis, posterior staphyloma, and axial length greater than 26.5 mm, but without a full-thickness macular hole, were included. Macular buckling was performed in the included eyes using a three-armed adjustable silicon capsule. Eight eyes from eight patients (five women) were enrolled in this study. The mean follow-up period was 11.6 (range 9-14) months. After surgery, the best-corrected visual acuity was improved in 7/8 (87.5%) eyes, optical coherence tomography imaging showed gradual anatomic improvement of macula over time. The final best-corrected visual acuity gained 21.5 early treatment diabetes retinopathy study letters from baseline on average (P = 0.014). Postoperatively, the most common complications were transiently elevated intraocular pressure (62.5%) and asymptomatic abduction limitation (100%), and the most serious complication was hemorrhagic choroidal detachment (25%). Macular buckling with a three-armed adjustable silicone capsule resulted in anatomic and visual improvement in eyes with myopic foveoschisis.

  15. Therapeutic interventions for macular diseases show characteristic effects on near and distance visual function.

    Science.gov (United States)

    Munk, Marion; Kiss, Christopher; Huf, Wolfgang; Sulzbacher, Florian; Bolz, Matthias; Sayegh, Ramzi; Eisenkölbl, Stefan; Simader, Christian; Schmidt-Erfurth, Ursula

    2013-10-01

    To compare therapy-induced reading and distance visual acuity (dVA) increases in neovascular age-related macular degeneration (nAMD) and uveitis-associated cystoid macular edema. This longitudinal study included 68 treatment-naive eyes: 39 subfoveal nAMD eyes with disrupted photoreceptor layers treated with monthly ranibizumab and 29 uveitis-associated cystoid macular edema eyes with intact photoreceptor layer treated with 1 triamcinolone injection. Patients were examined with high-definition optical coherence tomography, Early Treatment Diabetic Retinopathy Study dVA (logarithm of the minimum angle of resolution), reading acuity (logRADscore), and maximum reading speed (words per minute) over 3 months of therapy. In uveitis-associated cystoid macular edema, logarithm of the minimum angle of resolution and logRADscore improved 1 day post treatment, from 0.49 ± 0.28 to 0.39 ± 0.3 (P = 0.018) and 0.71 ± 0.53 to 0.56 ± 0.49 (P = 0.012), respectively. In nAMD, logarithm of the minimum angle of resolution improved 1 week after anti-vascular endothelial growth factor therapy from 0.59 ± 0.29 to 0.49 ± 0.24 (P = 0.002), with no change in logRADscore. One month after treatment, logRADscore improved from 1.09 ± 0.65 to 0.90 ± 0.60 (P = 0.002). In uveitis-associated cystoid macular edema, the recovery course of reading and dVA was comparable, and in nAMD, reading acuity recovery was delayed. Irrespective of disease, a small reduction in dVA resulted in a larger reading acuity decrease. Cystoid macular edema resolution was associated with rapid synchronous reading and dVA improvement, whereas nAMD was followed by faster recovery of distance than reading acuity. In both conditions, reading acuity expressed by critical angular resolution was more suppressed by active disease and recovered relatively more than distance acuity. These discrepancies indicate that reading acuity might be a more sensitive measure for vision decrease in macular diseases than dVA. Reading

  16. Oxidative stress, innate immunity, and age-related macular degeneration

    Science.gov (United States)

    Shaw, Peter X.; Stiles, Travis; Douglas, Christopher; Ho, Daisy; Fan, Wei; Du, Hongjun; Xiao, Xu

    2016-01-01

    Age-related macular degeneration (AMD) is a leading cause of vision loss affecting tens of millions of elderly worldwide. Early AMD is characterized by the appearance of soft drusen, as well as pigmentary changes in the retinal pigment epithelium (RPE). These soft, confluent drusen can progress into two forms of advanced AMD: geographic atrophy (GA, or dry AMD) or choroidal neovascularization (CNV, or wet AMD). Both forms of AMD result in a similar clinical progression in terms of loss of central vision. The exact mechanism for developing early AMD, as well as triggers responsible for progressing to advanced stage of disease, is still largely unknown. However, significant evidence exists demonstrating a complex interplay of genetic and environmental factors as causes of AMD progression. Multiple genes and/or single nucleotide polymorphisms (SNPs) have been found associated with AMD, including various genes involved in the complement pathway, lipid metabolism and extracellular matrix (ECM) remodeling. Of the known genetic contributors to disease risk, the CFH Y402H and HTRA1/ARMS polymorphisms contribute to more than 50% of the genetic risk for AMD. Environmentally, oxidative stress plays a critical role in many aging diseases including cardiovascular disease, cancer, Alzheimer’s disease and AMD. Due to the exposure to sunlight and high oxygen concentration, the oxidative stress burden is higher in the eye than other tissues, which can be further complicated by additional oxidative stressors such as smoking. Increasingly, evidence is accumulating suggesting that functional abnormalities of the innate immune system incurred via high risk genotypes may be contributing to the pathogenesis of AMD by altering the inflammatory homeostasis in the eye, specifically in the handling of oxidation products. As the eye in non-pathological instances maintains a low level of inflammation despite the presence of a relative abundance of potentially inflammatory molecules, we have

  17. Interleukin-13 and age-related macular degeneration

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    Bo Fu

    2017-04-01

    Full Text Available AIM: To identify the effects of interleukin (IL-13 on retinal pigment epithelial (RPE cells and the IL-13 level in aqueous humor of age-related macular degeneration (AMD patients. METHODS: IL-13 levels in aqueous humor specimens from AMD patients were detected with enzyme-linked immunosorbent assay (ELISA. ARPE-19 cells were treated with 10 ng/mL IL-13 for 12, 24, and 48h. The cell proliferaton was evaluated by the MTS method. The mRNA and protein levels of α-SMA and ZO-1 were evaluated with quantitative real-time polymerase chain reaction (qRT-PCR and Western blot respectively. The expression of tumor necrosis factor-α (TNF-α, transforming growth factor-β (TGF-β and vascular endothelial growth factor (VEGF were assessed by ELISA. RESULTS: IL-13 levels in the aqueous humor of patients with AMD were significantly higher than those in the control (167.33±17.64 vs 27.12±5.65 pg/mL; P<0.01. In vitro, IL-13 of high concentrations (10, 15, and 20 ng/mL inhibited ARPE-19 cell proliferation. α-SMA mRNA in ARPE-19 cell were increased (1.017±0.112 vs 1.476±0.168; P<0.001 and ZO-1 decreased (1.051±0.136 vs 0.702±0.069; P<0.001 after treated with 10 ng/mL IL-13 for 48h. The protein expression of α-SMA and ZO-1 also showed the same tendency (α-SMA: P=0.038; ZO-1: P=0.008. IL-13 significantly reduced the level of TNF-α (44.70±1.67 vs 31.79±3.53 pg/mL; P=0.005 at 48h, but the level of TGF-β2 was significantly increased from 34.44±2.92 to 57.61±6.31 pg/mL at 24h (P=0.004 and from 61.26±1.11 to 86.91±3.59 pg/mL at 48h (P<0.001. While expressions of VEGF didn’t change after IL-13 treatment. CONCLUSION: IL-13 in vitro inhibit ARPE-19 cell proliferation and expression in the aqueous may be associated with AMD.

  18. Progress on retinal image analysis for age related macular degeneration.

    Science.gov (United States)

    Kanagasingam, Yogesan; Bhuiyan, Alauddin; Abràmoff, Michael D; Smith, R Theodore; Goldschmidt, Leonard; Wong, Tien Y

    2014-01-01

    Age-related macular degeneration (AMD) is the leading cause of vision loss in those over the age of 50 years in the developed countries. The number is expected to increase by ∼1.5 fold over the next ten years due to an increase in aging population. One of the main measures of AMD severity is the analysis of drusen, pigmentary abnormalities, geographic atrophy (GA) and choroidal neovascularization (CNV) from imaging based on color fundus photograph, optical coherence tomography (OCT) and other imaging modalities. Each of these imaging modalities has strengths and weaknesses for extracting individual AMD pathology and different imaging techniques are used in combination for capturing and/or quantification of different pathologies. Current dry AMD treatments cannot cure or reverse vision loss. However, the Age-Related Eye Disease Study (AREDS) showed that specific anti-oxidant vitamin supplementation reduces the risk of progression from intermediate stages (defined as the presence of either many medium-sized drusen or one or more large drusen) to late AMD which allows for preventative strategies in properly identified patients. Thus identification of people with early stage AMD is important to design and implement preventative strategies for late AMD, and determine their cost-effectiveness. A mass screening facility with teleophthalmology or telemedicine in combination with computer-aided analysis for large rural-based communities may identify more individuals suitable for early stage AMD prevention. In this review, we discuss different imaging modalities that are currently being considered or used for screening AMD. In addition, we look into various automated and semi-automated computer-aided grading systems and related retinal image analysis techniques for drusen, geographic atrophy and choroidal neovascularization detection and/or quantification for measurement of AMD severity using these imaging modalities. We also review the existing telemedicine studies which

  19. Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma

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    Abe K

    2014-05-01

    Full Text Available Kosuke Abe,1,2 Jumi Shirane,2 Masuo Sakamoto,1 Fumi Tanabe,1 Kazuki Kuniyoshi,1 Chota Matsumoto,1 Yoshikazu Shimomura11Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; 2Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Nara, JapanBackground: Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT at the fixation point in a case of bilateral macular coloboma.Case report: The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS junction line.Conclusion: The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved.Keywords: pediatric macular disease, macular structure, strabismus

  20. Increased apoptosis and hypomyelination in cerebral white matter of macular mutant mouse brain

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    Shoichi Takikita

    2015-09-01

    Full Text Available Hypomyelination in developing brain is often accompanied by congenital metabolic disorders. Menkes kinky hair disease is an X-linked neurodegenerative disease of impaired copper transport, resulting from a mutation of the Menkes disease gene, a transmembrane copper-transporting p-type ATPase gene (ATP7A. In a macular mutant mouse model, the murine ortholog of Menkes gene (mottled gene is mutated, and widespread neurodegeneration and subsequent death are observed. Although some biochemical analysis of myelin protein in macular mouse has been reported, detailed histological study of myelination in this mouse model is currently lacking. Since myelin abnormality is one of the neuropathologic findings of human Menkes disease, in this study early myelination in macular mouse brain was evaluated by immunohistochemistry. Two-week-old macular mice and normal littermates were perfused with 4% paraformaldehyde. Immunohistochemical staining of paraffin embedded and vibratome sections was performed using antibodies against either CNPase, cleaved caspase-3 or O4 (marker of immature oligodendrocytes. This staining showed that cerebral myelination in macular mouse was generally hypoplastic and that hypomyelination was remarkable in internal capsule, corpus callosum, and cingulate cortex. In addition, an increased number of cleaved caspase-3 positive cells were observed in corpus callosum and internal capsule. Copper deficiency induced by low copper diet has been reported to induce oligodendrocyte dysfunction and leads to hypomyelination in this mouse model. Taken together, hypomyelination observed in this study in a mouse model of Menkes disease is assumed to be induced by increased apoptosis of immature oligodendrocytes in developing cerebrum, through deficient intracellular copper metabolism.

  1. Superior cervical gangliectomy induces non-exudative age-related macular degeneration in mice

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    Hernán H. Dieguez

    2018-02-01

    Full Text Available Non-exudative age-related macular degeneration, a prevalent cause of blindness, is a progressive and degenerative disease characterized by alterations in Bruch's membrane, retinal pigment epithelium, and photoreceptors exclusively localized in the macula. Although experimental murine models exist, the vast majority take a long time to develop retinal alterations and, in general, these alterations are ubiquitous, with many resulting from non-eye-specific genetic manipulations; additionally, most do not always reproduce the hallmarks of human age-related macular degeneration. Choroid vessels receive sympathetic innervation from the superior cervical ganglion, which, together with the parasympathetic system, regulates blood flow into the choroid. Choroid blood flow changes have been involved in age-related macular degeneration development and progression. At present, no experimental models take this factor into account. The aim of this work was to analyze the effect of superior cervical gangliectomy (also known as ganglionectomy on the choroid, Bruch's membrane, retinal pigment epithelium and retina. Adult male C57BL/6J mice underwent unilateral superior cervical gangliectomy and a contralateral sham procedure. Although superior cervical gangliectomy induced ubiquitous choroid and choriocapillaris changes, it induced Bruch's membrane thickening, loss of retinal pigment epithelium melanin content and retinoid isomerohydrolase, the appearance of drusen-like deposits, and retinal pigment epithelium and photoreceptor atrophy, exclusively localized in the temporal side. Moreover, superior cervical gangliectomy provoked a localized increase in retinal pigment epithelium and photoreceptor apoptosis, and a decline in photoreceptor electroretinographic function. Therefore, superior cervical gangliectomy recapitulated the main features of human non-exudative age-related macular degeneration, and could become a new experimental model of dry age

  2. The effects of intravitreal bevacizumab in infectious and noninfectious uveitic macular edema.

    Science.gov (United States)

    Al-Dhibi, Hassan; Hamade, Issam H; Al-Halafi, Ali; Barry, Maan; Chacra, Charbel Bou; Gupta, Vishali; Tabbara, Khalid F

    2014-01-01

    Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41 ± 16 years with a mean followup of 4 ± 1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet's disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8 ± 0.8 at baseline to 0.4 ± 0.5 at 1 month and 0.3 ± 0.5 at 3 months (P < 0.002, at 3 months). The mean macular thickness was 430 ± 132 μm at baseline. Following IVBI macular thickness improved to 286 ± 93 μm at 1 month and to 265 ± 88 μm at 3 months of followup (P < 0.001, at 3 months). Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

  3. The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema

    Directory of Open Access Journals (Sweden)

    Hassan Al-Dhibi

    2014-01-01

    Full Text Available Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41±16 years with a mean followup of 4±1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8±0.8 at baseline to 0.4±0.5 at 1 month and 0.3±0.5 at 3 months (P<0.002, at 3 months. The mean macular thickness was 430±132 μm at baseline. Following IVBI macular thickness improved to 286±93 μm at 1 month and to 265±88 μm at 3 months of followup (P<0.001, at 3 months. Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

  4. Microcurrent stimulation in the treatment of dry and wet macular degeneration.

    Science.gov (United States)

    Chaikin, Laurie; Kashiwa, Kellen; Bennet, Michael; Papastergiou, George; Gregory, Walter

    2015-01-01

    To determine the safety and efficacy of the application of transcutaneous (transpalpebral) microcurrent stimulation to slow progression of dry and wet macular degeneration or improve vision in dry and wet macular degeneration. Seventeen patients aged between 67 and 95 years with an average age of 83 years were selected to participate in the study over a period of 3 months in two eye care centers. There were 25 eyes with dry age-related macular degeneration (DAMD) and six eyes with wet age-related macular degeneration (WAMD). Frequency-specific microcurrent stimulation was applied in a transpalpebral manner, using two programmable dual channel microcurrent units delivering pulsed microcurrent at 150 µA for 35 minutes once a week. The frequency pairs selected were based on targeting tissues, which are typically affected by the disease combined with frequencies that target disease processes. Early Treatment Diabetic Retinopathy Study or Snellen visual acuity (VA) was measured before and after each treatment session. All treatment was administered in a clinical setting. Significant increases were seen in VA in DAMD (P=0.012, Wilcoxon one-sample test), but in WAMD, improvements did not reach statistical significance (P=0.059). In DAMD eyes, twice as many patients showed increase in VA (52%) compared to those showing deterioration (26%), with improvements being often sizeable, whereas deteriorations were usually very slight. In WAMD eyes, five of six (83%) patients showed an increase and none showed deterioration. The substantial changes observed over this period, combined with continued improvement for patients who continued treatment once a month, are encouraging for future studies. The changes observed indicate the potential efficacy of microcurrent to delay degeneration and possibly improve age-related macular degeneration, both wet and dry. However, this study has no control arm, so results should be treated with caution. Randomized double-blind controlled studies

  5. Superior cervical gangliectomy induces non-exudative age-related macular degeneration in mice.

    Science.gov (United States)

    Dieguez, Hernán H; Romeo, Horacio E; González Fleitas, María F; Aranda, Marcos L; Milne, Georgia A; Rosenstein, Ruth E; Dorfman, Damián

    2018-02-07

    Non-exudative age-related macular degeneration, a prevalent cause of blindness, is a progressive and degenerative disease characterized by alterations in Bruch's membrane, retinal pigment epithelium, and photoreceptors exclusively localized in the macula. Although experimental murine models exist, the vast majority take a long time to develop retinal alterations and, in general, these alterations are ubiquitous, with many resulting from non-eye-specific genetic manipulations; additionally, most do not always reproduce the hallmarks of human age-related macular degeneration. Choroid vessels receive sympathetic innervation from the superior cervical ganglion, which, together with the parasympathetic system, regulates blood flow into the choroid. Choroid blood flow changes have been involved in age-related macular degeneration development and progression. At present, no experimental models take this factor into account. The aim of this work was to analyze the effect of superior cervical gangliectomy (also known as ganglionectomy) on the choroid, Bruch's membrane, retinal pigment epithelium and retina. Adult male C57BL/6J mice underwent unilateral superior cervical gangliectomy and a contralateral sham procedure. Although superior cervical gangliectomy induced ubiquitous choroid and choriocapillaris changes, it induced Bruch's membrane thickening, loss of retinal pigment epithelium melanin content and retinoid isomerohydrolase, the appearance of drusen-like deposits, and retinal pigment epithelium and photoreceptor atrophy, exclusively localized in the temporal side. Moreover, superior cervical gangliectomy provoked a localized increase in retinal pigment epithelium and photoreceptor apoptosis, and a decline in photoreceptor electroretinographic function. Therefore, superior cervical gangliectomy recapitulated the main features of human non-exudative age-related macular degeneration, and could become a new experimental model of dry age-related macular degeneration, and

  6. Optical Coherence Tomography and the Development of Antiangiogenic Therapies in Neovascular Age-Related Macular Degeneration

    Science.gov (United States)

    Rosenfeld, Philip J.

    2016-01-01

    Purpose To explain the pivotal role optical coherence tomography (OCT) imaging had in the development of antiangiogenic therapies for the treatment of neovascular age-related macular degeneration (nvAMD). Methods A historical literature review was combined with personal perspectives from the introduction of OCT imaging and the early clinical use of vascular endothelial growth factor (VEGF) inhibitors. Results At the time that OCT emerged, the gold standard for imaging of nvAMD was fluorescein angiography (FA), a time-consuming, dye-based, invasive technique that provided en face images of the retina and was used to characterize leakage, perfusion status, and the types of macular neovascularization (MNV). In comparison, OCT imaging was a fast, safe, noninvasive technique that complemented FA imaging by providing cross-sectional images of the macula. OCT was able to visualize and quantify the macular fluid that was associated with the presence of excess VEGF, which was identified by intraretinal fluid, subretinal fluid, and fluid under the retinal pigment epithelium (RPE). Clinicians quickly appreciated the benefits of OCT imaging for following macular fluid after anti-VEGF therapy. By observing the qualitative and quantitative changes in macular fluid depicted by OCT imaging, clinicians were empowered to compare anti-VEGF drugs and move from fixed-dosing regimens to patient-specific dosing strategies requiring fewer injections. Conclusions Optical coherence tomography imaging was adopted as a VEGF-meter, a method to detect excess VEGF, and evolved to become the gold standard imaging strategy for diagnosing nvAMD, assessing treatment responses to anti-VEGF drugs, deciding when to re-treat, and evaluating disease progression. PMID:27409464

  7. Prophylactic nepafenac and ketorolac versus placebo in preventing postoperative macular edema after uneventful phacoemulsification.

    Science.gov (United States)

    Almeida, David R P; Khan, Zainab; Xing, Lin; Bakar, Shahrukh N; Rahim, Karim; Urton, Todd; El-Defrawy, Sherif R

    2012-09-01

    To evaluate the efficacy of prophylactic ketorolac 0.5% versus nepafenac 0.1% versus placebo on macular volume 1 month after uneventful phacoemulsification and evaluate the health-related quality-of-life (HRQOL) of topical nonsteroidal antiinflammatory drugs (NSAIDs) in the context of cataract surgery. Hotel Dieu Hospital, Kingston, Ontario, Canada. Prospective placebo-controlled parallel-assignment double-masked randomized clinical trial. In this study, patients 18 years or older scheduled for routine phacoemulsification were randomized to a placebo, ketorolac 0.5%, or nepafenac 0.1% and dosed 4 times a day starting 1 day before surgery and continuing for 4 weeks. Spectral-domain macular cube ocular coherence tomography scans measuring central subfield thickness, macular cube volume, and average macular cube thickness were performed at baseline and 1 month postoperatively. The HRQOL metrics were determined with the Comparison of Ophthalmic Medications for Tolerability (COMTOL) questionnaire. Each study group comprised 54 patients. One month postoperatively, although a trend toward significance occurred for nepafenac and ketorolac, analysis of the means of differences showed no statistically significant differences between the 3 study groups (P=.2901). The COMTOL analysis found no difference in tolerability, compliance, side-effect frequency and bother, and effects on HRQOL between ketorolac and nepafenac compared with the placebo. One month after uneventful phacoemulsification, there was no difference in macular volume between the placebo, ketorolac, and nepafenac. Ketorolac and nepafenac were well tolerated with minimal side-effect profiles. Thus, for patients without risk factors having routine surgery, prophylactic topical NSAIDs are not recommended. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Congenital high myopia and central macular atrophy: a report of 3 families.

    Science.gov (United States)

    Hull, S; Kalhoro, A; Marr, J; Thompson, D A; Holder, G E; Robson, A G; Moore, A T

    2015-07-01

    To report the clinical phenotype in a series of four children from three families with the rare association of high myopia, central macular atrophy, and normal full-field electroretinography (ERG). Four male patients were ascertained with reduced vision, nystagmus, and atrophy of the macula from early childhood. Patients underwent full ophthalmic examination, electrophysiological testing, and retinal imaging. Minimum duration of follow-up was 8 years. At last review, visual acuity ranged from 0.22 to 1.20 logMAR (6/9.5-6/95 Snellen) at a mean age of 10.5 years (median 9.5 years, range 9-14 years). Refractive error ranged from a spherical equivalent of -7.40 D to -24.00 D. Three had convergent squint. Fundus examination and imaging demonstrated bilateral macular atrophy in all patients that varied from mild atrophy of the retinal pigment epithelium (RPE) to well-demarcated, punched-out atrophic lesions of retina, RPE, and choroid. Flash ERG was normal under photopic and scotopic conditions in all patients. Pattern ERG, performed in three patients, was consistent with mild to severe macular dysfunction. Progression of the area of atrophy was evident in one patient and of the myopia in two patients but all patients had stable visual acuity. Patients with congenital high myopia and macular atrophy present in infancy with reduced visual acuity and nystagmus. The macular atrophic lesions vary in size and severity but electrophysiological testing is consistent with dysfunction confined to the macula. There was no deterioration in visual acuity over 8-10 years of monitoring.

  9. Influences of OCT image on the prognosis of visual outcomes among patients with idiopathic macular holes

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    Jian-Ping Gao

    2013-11-01

    Full Text Available AIM:To observe the optical coherence tomography(OCTimages of idiopathic macular hole(IMHon patients before and after vitrectomy and internal limiting membrane peeling(ILMPsurgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes. METHODS: A total of 32 consecutive patients of IMH(7 males, 25 femalesreceiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVAin the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHIand BCVA post operation was analyzed using SPSS 13.0.RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(r=-0.524, -0.610, Pr=-0.064, 0.003, P>0.05. The positive correlation was observed between the postoperative BCVA and the MHI before operation(r=0.457, PU=30.0, W=135, PCONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.

  10. Estudo do tratamento do edema macular difuso do diabético com triancinolona intravítrea e fotocoagulação Use of intravitreal triamcinolone and laser photocoagulation for the treatment of diffuse diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Fábio Petersen Saraiva

    2008-08-01

    Full Text Available OBJETIVO: Avaliar a eficácia do uso intravítreo da triancinolona acetonida associada a fotocoagulação com laser no tratamento do edema macular difuso diabético. Comparar esta associação terapêutica com o uso isolado de cada tratamento. MÉTODOS: Após controle clínico sistêmico, trinta pacientes portadores de edema macular difuso diabético foram divididos em 3 grupos de tratamento: (1 fotocoagulação macular em grade com laser de argônio; (2 aplicação intravítrea de 4 mg de triancinolona acetonida; (3 associação dos itens anteriores. O seguimento foi realizado em intervalos predeterminados de um dia, uma semana e mensalmente, até completar 6 meses. Foram analisados os parâmetros: acuidade visual corrigida LogMAR, espessura macular central, volume macular total e pressão intra-ocular. RESULTADOS: A fotocoagulação com laser não reduziu de forma estatisticamente significativa a espessura macular central e o volume macular total. Esta redução foi significativa e estatisticamente semelhante nos outros dois grupos. Todos os grupos apresentaram melhora da acuidade visual, entretanto, o grupo que recebeu a associação do laser com a triancinolona intravítrea obteve maior porcentagem de pacientes com ganho de 10 ou mais letras de visão. CONCLUSÃO: O uso simultâneo da fotocoagulação com a triancinolona intravítrea pode ser considerado uma opção terapêutica para o edema macular difuso diabético.PURPOSE: To assess the efficacy of intravitreal use of triamcinolone acetonide combined with laser photocoagulation for the treatment of diffuse diabetic macular edema and to compare it with the separate use of each treatment. METHODS: After systemic clinical control, thirty patients with diffuse diabetic macular edema were divided into 3 treatment groups: (1 macular grid photocoagulation; (2 intravitreal injection of 4 mg of triamcinolone acetonide; (3 combination of the two previous therapies. Follow-up was scheduled at

  11. Edema quístico macular diagnosticado por tomografía de coherencia óptica en pacientes operados de catarata Cystoid macular edema diagnosed with optical coherente tomography in patients operated on from cataract

    Directory of Open Access Journals (Sweden)

    Omar Díaz Arencibia

    2009-12-01

    Full Text Available OBJETIVOS: Describir la frecuencia de edema quístico macular diagnosticado por tomografía de coherencia óptica en pacientes operados de catarata senil en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", de diciembre 2006 a febrero 2007. MÉTODOS: Se realizó un estudio descriptivo, prospectivo en 108 ojos de 94 pacientes operados, a los que se les realizó un examen con el Stratus OCT 3000 de Zeiss Meditec AG. RESULTADOS: El 20,3 % de los pacientes presentó edema quístico macular. El 59,1 % de pacientes con edema quístico macular no manifestaron sintomatología alguna. Existió mayor probabilidad de desarrollar edema quístico macular cuando ocurrieron complicaciones durante la cirugía. Se observó por biomicroscopia del polo posterior, quistes intrarretiniales perifoveolares en el 81,8 % de los operados, y una relación inversamente proporcional entre el grosor macular y la agudeza visual alcanzada. CONCLUSIONES: Un número apreciable de pacientes con edema quístico macular fueron diagnosticados por tomografía de coherencia óptica. Se presentó de manera asintomática en la mayoría de los pacientes. Existe mayor probabilidad de desarrollar edema quístico macular cuando ocurren complicaciones durante la cirugía, en especial la ruptura de la cápsula posterior con vitreorragia. Los cambios morfológicos que se presentan en estos pacientes determinan que exista una relación inversamente proporcional entre el grosor macular y la agudeza visual alcanzada.OBJECTIVES: To describe the frequency of cystoid macular edema diagnosed with optical coherence tomography in patients operated on from senile cataract at "Ramón Pando Ferrer" Cuban Institute of Ophthalmology in the period from December 2006 to February 2007. METHODS: A prospective and descriptive study of 106 eyes from 94 surgical patients was conducted; they were examined with Zeiss Meditec AG Stratus OCT 3000. RESULTS: Of the total number of patients, 20,3 % presented

  12. Retinal layer location of increased retinal thickness in eyes with subclinical and clinical macular edema in diabetes type 2

    DEFF Research Database (Denmark)

    Bandello, Francesco; Tejerina, Amparo Navea; Vujosevic, Stela

    2015-01-01

    PURPOSE: To identify the retinal layer predominantly affected in eyes with subclinical and clinical macular edema in diabetes type 2. METHODS: A cohort of 194 type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20/35) were examined with Cirrus spectral......-domain optical coherence tomography (OCT) at the baseline visit (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers of the eyes with subclinical and clinical macular edema was compared with a sample of 31 eyes from diabetic patients with normal OCT and an age......). Increases were also found in the neighboring layers. Thinning of the retina was registered in the retinal nerve fiber, ganglion cells and inner plexiform layers in the diabetic eyes without macular edema. CONCLUSIONS: The increase in RT occurring in diabetic eyes with macular edema is predominantly located...

  13. Evaluation of the macular architecture of patients operated on from macula-off rhegmatogenous retinal detachment using optical coherence tomography

    International Nuclear Information System (INIS)

    Ramos Lopez, Meisy; Obret Mendive, Isabel; Hernandez Silva, Juan Raul

    2010-01-01

    With the support of optical coherence tomography, to evaluate the macular condition of the patients operated on from rhegmatogenous retinal detachment, with detached macula, who underwent buckling surgery and pars plana vitrectomy

  14. Efficacy and Safety of Monthly versus Quarterly Ranibizumab Treatment in Neovascular Age-related Macular Degeneration: The EXCITE Study

    NARCIS (Netherlands)

    Schmidt-Erfurth, Ursula; Eldem, Bora; Guymer, Robyn; Korobelnik, Jean-Franc̦ois; Schlingemann, Reinier O.; Axer-Siegel, Ruth; Wiedemann, Peter; Simader, Christian; Gekkieva, Margarita; Weichselberger, Andreas

    2011-01-01

    Objective: To demonstrate noninferiority of a quarterly treatment regimen to a monthly regimen of ranibizumab in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Design: A 12-month, multicenter, randomized, double-masked,

  15. 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...... was 34.7 μm (95% CI 33.7-35.7 μm). CONCLUSIONS: This study suggests that a change of greater than 31 μm in Spectralis SDOCT-derived retinal thickness measurement of the central macular subfield and 35 μm in subfoveal choroidal thickness is necessary to detect true clinical change associated with disease...

  16. Diagnostic Accuracy of Spectralis SD OCT Automated Macular Layers Segmentation to Discriminate Normal from Early Glaucomatous Eyes.

    Science.gov (United States)

    Pazos, Marta; Dyrda, Agnieszka Anna; Biarnés, Marc; Gómez, Alicia; Martín, Carlos; Mora, Clara; Fatti, Gianluca; Antón, Alfonso

    2017-08-01

    To evaluate the accuracy of the macular retinal layer segmentation software of the Spectralis spectral-domain (SD) optical coherence tomography (OCT) device (Heidelberg Engineering, Inc., Heidelberg, Germany) to discriminate between healthy and early glaucoma (EG) eyes. Prospective, cross-sectional study. Forty EG eyes and 40 healthy controls were included. All participants were examined using the standard posterior pole and the peripapillary retinal nerve fiber layer (pRNFL) protocols of the Spectralis OCT device. Using an Early Treatment Diagnostic Retinopathy Study circle at the macular level, the automated retinal segmentation software was applied to determine thicknesses of the following parameters: total retinal thickness, inner retinal layer (IRL), macular retinal nerve fiber layer (mRNFL), macular ganglion cell layer (mGCL), macular inner plexiform layer (mIPL), macular inner nuclear layer (mINL), macular outer plexiform layer (mOPL), macular outer nuclear layer (mONL), photoreceptors (PR), and retinal pigmentary epithelium (RPE). The ganglion cell complex (GCC) was determined by adding the mRNFL, mGCL, and mIPL parameters and the ganglion cell layer-inner plexiform layer (mGCL-IPL) was determined by combining the mGCL and mIPL parameters. Thickness of each layer was compared between the groups, and the layer and sector with the best area under the receiver operating characteristic curve (AUC) were identified. Comparison of pRNFL, IRL, mRNFL, mGCL, mIPL, mGCC, mGCL-IPL, mINL, mOPL, mONL, PR, and RPE parameters and total retinal thicknesses between groups for the different areas and their corresponding AUCs. Peripapillary RNFL was significantly thinner in the EG group globally and in all 6 sectors assessed (P < 0.0005). For the macular variables, retinal thickness was significantly reduced in the EG group for total retinal thickness, mIRL, mRNFL, mGCL, and mIPL. The 2 best isolated parameters to discriminate between the 2 groups were pRNFL (AUC, 0.956) and

  17. Uso de triamcinolona intravítrea en edema macular del diabético Intravitreal triamcinolone to treat diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Meysi Ramos López

    2007-12-01

    Full Text Available Se estima que en el mundo hay 120 millones de diabéticos y que cada 15 años el número de estos se duplica. Algunos datos son descriptivos y reflejan la situación actual: en los países avanzados solo 30 % de los diabéticos tipo I están adecuadamente controlados y 7 % de los tipo 2 con características de alto riesgo no han sido revisados nunca por ningún oftalmólogo. La prevalencia de la retinopatía diabética está determinada por el tipo de diabetes mellitus y por la edad del paciente, disminuye según aumenta la edad. La retinopatía diabética más frecuente es la no proliferativa en un 80 %, contra un 20 %, la proliferativa. La diabetes mellitus en Cuba tiene una prevalencia aproximadamente de 1/10 000. Estudios recientes revelan una prevalencia de la retinopatía diabética de alrededor de 20-25 % entre los pacientes diabéticos. La detección temprana de la retinopatía, el edema macular, y el tratamiento precoz son cruciales en el esfuerzo por reducir la incapacidad visual presentada en los pacientes con diabetes. En este trabajo se evalúa la efectividad de la triamcinolona intravítrea como tratamiento general antiangiogénico y antiinflamatorio del edema macular en un grupo de pacientes diabéticos que fueron atendidos en el Instituto Cubano Oftalmológico "Ramón Pando Ferrer, desde enero hasta julio de 2006. Se realizó un estudio descriptivo-prospectivo de caso control, en el cual, el paciente constituyó su propio control. La muestra estuvo formada por 30 pacientes diabéticos, con diagnóstico de edema macular diabético que fueron candidatos a la aplicación del medicamento. Predominó el sexo femenino con más de 6 años de edad, a pesar que se mejora la agudeza visual, esta no se correspondía con la disminución evidente del edema macular. Los pacientes que no tuvieron tratamiento láser previo, respondieron mejor al medicamento aplicado, como complicaciones postratamiento se presentó hipertensión ocular, involuci

  18. Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Singh R

    2012-08-01

    Full Text Available Rishi Singh,1 Louis Alpern,2 Glenn J Jaffe,3 Robert P Lehmann,4 John Lim,5 Harvey J Reiser,6 Kenneth Sall,7 Thomas Walters,8 Dana Sager91Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2The Cataract, Glaucoma, and Refractive Surgery Center, El Paso, TX, 3Duke Eye Center, Duke Reading Center, Duke University, Durham, NC, 4Lehmann Eye Center, Nacogdoches, TX, 5Houston Eye Associates, Houston, TX, 6Eye Care Specialists, Kingston, PA, 7Sall Research Medical Center, Artesia, CA, 8Texan Eye, Austin, TX, 9Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to evaluate nepafenac ophthalmic suspension 0.1% (Nevanac®; Alcon Research Ltd in the prevention of macular edema following cataract surgery in diabetic retinopathy patients.Methods: This was a multicenter, randomized, double-masked, vehicle-controlled study of 263 adult diabetic patients with nonproliferative diabetic retinopathy requiring cataract surgery. Patients were randomized (1:1 to instill nepafenac or vehicle three times daily beginning 1 day prior to surgery through day 90. Efficacy included the percentage of patients who developed macular edema (≥30% increase in central subfield macular thickness from baseline and the percentage of patients with decreases of more than five letters in best-corrected visual acuity from day 7 to 90.Results: A significantly lower percentage of patients in the nepafenac group developed macular edema relative to patients in the vehicle group (3.2% versus 16.7%; P < 0.001. A significantly lower percentage of patients in the nepafenac group had best-corrected visual acuity decreases of more than five letters relative to patients in the vehicle group on day 30 (P < 0.001, day 60 (P = 0.002, and day 90 (P = 0.006. The mean central subfield macular thickness and mean percent change from baseline in macular volume were also significantly lower in the nepafenac group versus the vehicle group at days 14 through 90 (P

  19. Scleral infolding combined with vitrectomy and gas tamponade for retinal detachment with macular holes in highly myopic eyes.

    Science.gov (United States)

    Matsuo, T; Shiraga, F; Takasu, I; Okanouchi, T

    2001-01-01

    To describe the effectiveness of a surgical procedure, scleral infolding combined with vitrectomy and gas tamponade, for retinal detachment caused by macular holes in highly myopic eyes. In a pilot study, scleral infolding was performed in 5 patients with macular holes, who were selected from 10 consecutive highly myopic patients with retinal detachment caused by macular holes (8 patients) or extramacular posterior-pole holes (2 patients), treated during 1 year at Okayama University Hospital. The patients were all women, 48-77 years of age (mean = 63.4 years), who had been followed-up for 1-2 years. Selection criteria for scleral infolding were either second surgeries for reopening of macular holes (2 patients) or residual retinal detachment around macular holes after complete fluid-air exchange with drainage of subretinal fluid at the initial surgery (3 patients). Following vitrectomy and complete epiretinal membrane removal in the posterior pole, the sclera was shortened by infolding on the temporal side. Three mattress sutures with 5-0 Dacron in each quadrant, 6 sutures in total, were placed at a 7-mm anteroposterior interval with posterior sutures located as deep as possible, near vortex veins. Fluid-gas exchange was then done, with or without endophotocoagulation applied around macular holes. After scleral infolding, macular holes were closed, and the retina was totally attached in all 5 patients. The final visual acuity ranged from 20/2000 to 20/70. Scleral infolding is a simple and effective procedure for treating retinal detachment with macular holes in highly myopic eyes and could be used as an optional procedure of reoperation for a failed initial vitrectomy.

  20. 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.......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....

  1. Macular edema in underserved diabetic patients: Improving detection by enhancing the optical signature and data analysis techniques

    Science.gov (United States)

    Alhamami, Mastour Abdullah

    Diabetic retinopathy and diabetic macular edema are chief causes of vision loss in working adults. Thus, retinal screening of patients with diabetes has become standard practice in some countries to prevent visual impairment and blindness from diabetic retinopathy. One goal is to improve techniques currently used to diagnose diabetic retinopathy. Another goal is to probe pathophysiological changes seen with imaging methods. Analysis was performed on a novel dataset from more than 2000 underserved adult diabetic patients, who were recruited for a screening study for diabetic eye disease. Data were collected from four county clinics at Alameda Health, Alameda County, CA. Over 90% of patients self-identified as a racial/ethnic identity other than non-Hispanic white. We investigated the prevalence and optical properties of macular edema. In the first study, a retrospective cohort study was performed to compare macular thickness in diabetic patients with and without macular edema to determine the presence of damage to the external limiting membrane or and the relation of damage to the ELM to damage to photoreceptors. In the second study, we investigated whether the information in red light better visualizes cysts in diabetic macular edema, as compared to green light. In the third study, we investigated whether the demographic and blood glucose information predict diabetic macular edema. Three logistic regression analyses were compared. In the fourth study, we examined how different outcome measures of retinal thickness vary with demographic and blood glucose measures, using a trichotomous variable for retinal thickness. The findings point strongly to large individual differences in the development of macular edema, which is difficult to diagnose with the most common methods in dark eyes. Further, while blood glucose was found to be important, there are additional differences in the potential for macular edema that are associated with ethnic group and gender.

  2. Ginkgo biloba extract for age-related macular degeneration.

    Science.gov (United States)

    Evans, Jennifer R

    2013-01-31

    Ginkgo is used in the treatment of peripheral vascular disease and 'cerebral insufficiency'. It is thought to have several potential mechanisms of action including increased blood flow, platelet activating factor antagonism, and prevention of membrane damage caused by free radicals. Vascular factors and oxidative damage are thought to be two potential mechanisms in the pathology of age-related macular degeneration (AMD). The objective of this review was to determine the effect of Ginkgo biloba extract on the progression of AMD. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2012), EMBASE (January 1980 to October 2012), Allied and Complementary Medicine Database (AMED) (January 1985 to October 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 5 October 2012. We searched the reference lists of identified reports and the Science Citation Index. We also contacted investigators of included studies for additional information. All randomised trials in people with AMD where Ginkgo biloba extract had been compared to control were included. The review author extracted data using a standardised form. The data were verified with the trial investigators. Trial quality was assessed. Two published trials were identified that randomised a total of 119 people. In one study conducted in France, 20 people were randomly allocated to Gingko biloba extract EGb 761 80 mg twice daily or placebo. In

  3. Microcurrent stimulation in the treatment of dry and wet macular degeneration

    Directory of Open Access Journals (Sweden)

    Chaikin L

    2015-12-01

    Full Text Available Laurie Chaikin,1 Kellen Kashiwa,2 Michael Bennet,2 George Papastergiou,3 Walter Gregory4 1Private practice, Alameda, CA, USA; 2Retina Institute of Hawaii, Honolulu, HI, USA; 3California Retinal Associates, San Diego, CA, USA; 4Clinical Trials Research Unit, Faculty of Medicine and Health, University of Leeds, Leeds, UK Purpose: To determine the safety and efficacy of the application of transcutaneous (transpalpebral microcurrent stimulation to slow progression of dry and wet macular degeneration or improve vision in dry and wet macular degeneration. Methods: Seventeen patients aged between 67 and 95 years with an average age of 83 years were selected to participate in the study over a period of 3 months in two eye care centers. There were 25 eyes with dry age-related macular degeneration (DAMD and six eyes with wet age-related macular degeneration (WAMD. Frequency-specific microcurrent stimulation was applied in a transpalpebral manner, using two programmable dual channel microcurrent units delivering pulsed microcurrent at 150 µA for 35 minutes once a week. The frequency pairs selected were based on targeting tissues, which are typically affected by the disease combined with frequencies that target disease processes. Early Treatment Diabetic Retinopathy Study or Snellen visual acuity (VA was measured before and after each treatment session. All treatment was administered in a clinical setting. Results: Significant increases were seen in VA in DAMD (P=0.012, Wilcoxon one-sample test, but in WAMD, improvements did not reach statistical significance (P=0.059. In DAMD eyes, twice as many patients showed increase in VA (52% compared to those showing deterioration (26%, with improvements being often sizeable, whereas deteriorations were usually very slight. In WAMD eyes, five of six (83% patients showed an increase and none showed deterioration. Conclusion: The substantial changes observed over this period, combined with continued improvement for

  4. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Directory of Open Access Journals (Sweden)

    Campos Polo R

    2018-01-01

    Full Text Available Rafael Campos Polo, Consuelo Rubio Sánchez, Diego Manuel García Guisado, María José Díaz Luque Unit of Retina, Department of Ophthalmology, Hospital Virgen del Puerto, Plasencia, Cáceres, Spain Purpose: To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME in daily clinical practice. Methods: Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA (Early Treatment Diabetic Retinopathy Study [ETDRS] letters was the primary outcome. Results: The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001. Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%, with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2. A significant reduction in central macular thickness from a mean of 460.5 (11.8 µm at baseline to 229.0 (43.8 µm at 12 months (P<0.001 was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion: Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. Keywords: aflibercept, central macular thickness, diabetic macular

  5. Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit

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    Nadal J

    2015-10-01

    Full Text Available Jeroni Nadal,1,2 Marta S Figueroa,3 Elisa Carreras,2,4 Patricia Pujol,2,4 Maria Isabel Canut,2,4,5 Rafael Ignacio Barraquer2,6 1Vitreoretinal Surgery Department at Centro de Oftalmología Barraquer, 2Universitat autónoma de Barcelona, Barcelona, 3Vissum Madrid, Madrid, 4Instituto Barraquer, 5Glaucoma Department at Centro de Oftalmología Barraquer, 6Cornea and Cataract Surgery Department at Centro de Oftalmología Barraquer, Barcelona, Spain Purpose: To evaluate the anatomical and functional results obtained with pars plana vitrectomy (PPV plus autologous platelet concentrate (APC as a treatment for macular detachment associated with optic disc pit (ODP.Methods: We performed a prospective interventional study of 19 eyes of 19 consecutive patients with posterior macular detachment due to ODP. All patients underwent PPV, posterior hyaloid peeling, fluid–air exchange, injection of 0.05 mL of APC over the ODP and 15% perfluoropropane (C3F8 endotamponade. Postoperative measures included face-up positioning for 2 hours and then avoidance of the face-up position during the ensuing 10 days. All patients underwent complete ophthalmologic examination and optical coherence tomography preoperatively at 1 month, 3 months, 6 months, 9 months, and 12 months postoperatively and then annually. Outcome measures were best corrected visual acuity (BCVA by logMAR, improvement of quality of vision, macular attachment, and resolution of intraretinal schisis-like separation.Results: Preoperatively, the median BCVA was 0.70 (range: 0.30–1.70 and all patients showed improved visual acuity after surgery; BCVA was 0.22 (range: 0.07–0.52 at 12 months follow-up. All patients showed complete reabsorption of intraretinal fluid (median time: 3.5 months [range: 2–8 months] and macular attachment at the end of follow-up (median: 60 months [range: 12–144 months], with stable or improved visual acuity. No reoperations were needed and no major adverse events were

  6. Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

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    Hyun Ju Kim

    2018-02-01

    Full Text Available AIM: To examine the thickness of the ganglion cell-inner plexiform layer (GCIPL in eyes with resolved macular edema (ME in non-ischemic central retinal vein occlusion (CRVO, applying spectral-domain optical coherence tomography (SD-OCT, and its relationship with visual acuity. METHODS: The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes. The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL thickness and central macular thickness (CMT were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA. RESULTS: No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT were observed between ME group and non-ME group (P=0.296, 0.183, 0.846. But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022. Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007, whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. CONCLUSION: Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.

  7. Predictors of drusen reduction after subthreshold infrared (810 nm) diode laser macular grid photocoagulation for nonexudative age-related macular degeneration.

    Science.gov (United States)

    Rodanant, Nuttawut; Friberg, Thomas R; Cheng, Lingyun; Aurora, Ajay; Bartsch, Dirk; Toyoguchi, Mitsuko; Corbin, Patricia S; El-Bradey, Mohamed H; Freeman, William R

    2002-10-01

    To determine the predictors of drusen reduction in eyes with nonexudative age-related macular degeneration (ARMD) treated with subthreshold infrared (810 nm) diode laser macular grid photocoagulation. Additionally, to determine the relationship of laser-induced drusen reduction and best-corrected visual acuity (BCVA) 18 months after laser treatment. Randomized controlled clinical trial. Fifty patients (100 eyes) with bilateral nonexudative ARMD were enrolled at two centers. One eye of each patient was randomized to the observation; the other eye was treated with 48 subthreshold (invisible end point) applications of infrared (810 nm) diode laser in a macular grid pattern. The eyes that received subthreshold laser treatment were compared with the eyes that received no treatment. The baseline fundus characteristics (number, size, and distribution of drusen, as well as focal hyperpigmentation) from two macula areas (central 1500 micro diameter, pericentral 1500 micro ring area) on stereo color photographs, the number of laser-induced lesions, and the area of laser induced retinal pigment epithelial (RPE) lesions on fluorescein angiography 3 months after treatment were studied as predictors of major drusen reduction (> or = 50% drusen reduction from baseline) 18 months after laser treatment. BCVA at baseline and 18 months later was compared in observation eyes and in laser-treated eyes. Eighteen months after randomization, 24 (48%) of 50 eyes treated with subthreshold laser had major drusen reduction compared with three (6%) of 50 observation eyes (P =.00001). At 3 months post-treatment in laser-treated eyes with major drusen reduction, the mean number of laser-induced lesions on fluorescein angiography was 30.7 and the mean area of RPE change was 0.81 mm(2) compared with 14.8 laser-induced lesions and 0.35 mm(2) area of RPE change in eyes without major drusen reduction (P =.0001 and P =.0003, respectively). At baseline, fundus characteristics were not significantly

  8. Nanotechnology-based drug delivery treatments and specific targeting therapy for age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Tai-Chi Lin

    2015-11-01

    Full Text Available Nanoparticles combined with cells, drugs, and specially designed genes provide improved therapeutic efficacy in studies and clinical setting, demonstrating a new era of treatment strategy, especially in retinal diseases. Nanotechnology-based drugs can provide an essential platform for sustaining, releasing and a specific targeting design to treat retinal diseases. Poly-lactic-co-glycolic acid is the most widely used biocompatible and biodegradable polymer approved by the Food and Drug Administration. Many studies have attempted to develop special devices for delivering small-molecule drugs, proteins, and other macromolecules consistently and slowly. In this article, we first review current progress in the treatment of age-related macular degeneration. Then, we discuss the function of vascular endothelial growth factor (VEGF and the pharmacological effects of anti-VEGF-A antibodies and soluble or modified VEGF receptors. Lastly, we summarize the combination of antiangiogenic therapy and nanomedicines, and review current potential targeting therapy in age-related macular degeneration.

  9. Classification of wet aged related macular degeneration using optical coherence tomographic images

    Science.gov (United States)

    Haq, Anam; Mir, Fouwad Jamil; Yasin, Ubaid Ullah; Khan, Shoab A.

    2013-12-01

    Wet Age related macular degeneration (AMD) is a type of age related macular degeneration. In order to detect Wet AMD we look for Pigment Epithelium detachment (PED) and fluid filled region caused by choroidal neovascularization (CNV). This form of AMD can cause vision loss if not treated in time. In this article we have proposed an automated system for detection of Wet AMD in Optical coherence tomographic (OCT) images. The proposed system extracts PED and CNV from OCT images using segmentation and morphological operations and then detailed feature set are extracted. These features are then passed on to the classifier for classification. Finally performance measures like accuracy, sensitivity and specificity are calculated and the classifier delivering the maximum performance is selected as a comparison measure. Our system gives higher performance using SVM as compared to other methods.

  10. Bilateral macular hemorrhage as a complication of drug-induced anemia: a case report

    Directory of Open Access Journals (Sweden)

    Belfort Rubens N

    2009-01-01

    Full Text Available Abstract Introduction Bilateral macular hemorrhage is a rare ocular finding and to the best of our knowledge, this is the first report of such hemorrhages as a presentation of drug-induced anemia. Case presentation We describe the case of a 14-year-old Caucasian boy who presented with a toxoplasmic retinochoroiditis and was treated with sulfadiazine and pyrimethamine. Three months later, he presented with a bilateral macular hemorrhage as a complication of a toxic induced anemia. Conclusion Our patient presented with toxic anemia secondary to the treatment of a very common disease, ocular toxoplasmosis. Prophylactic use of folinic acid could prevent such complications but in many cases, it is not prescribed owing to its cost or is mistakenly substituted with folic acid, which does not present as a valid substitute.

  11. Laser-Based Strategies to Treat Diabetic Macular Edema: History and New Promising Therapies

    Directory of Open Access Journals (Sweden)

    Young Gun Park

    2014-01-01

    Full Text Available Diabetic macular edema (DME is the main cause of visual impairment in diabetic patients. The management of DME is complex and often various treatment approaches are needed. At the present time, despite the enthusiasm for evaluating several new treatments for DME, including the intravitreal pharmacologic therapies (e.g., corticosteroids and anti-VEGF drugs, laser photocoagulation still remains the current standard in DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME and describe the developments in laser systems. And we will also discuss the new laser techniques and review the latest results including benefits of combined therapy. In this paper, we briefly summarize the major laser therapeutics for the treatment of diabetic macular edema and allude to some future promising laser therapies.

  12. Optical coherence tomography and vessel diameter changes after intravitreal bevacizumab in diabetic macular oedema

    DEFF Research Database (Denmark)

    Soliman, W.; Vinten, M.; Sander, B.

    2008-01-01

    Purpose: To assess the effect of intravitreal bevacizumab on diabetic macular oedema (DMO) and retinal vessel calibres. Methods: We performed a consecutive case series study in which 10 consecutive eyes with diffuse DMO, two of which had not previously been treated, received an intravitreal...... injection of bevacizumab 1 mg, which was followed by two more injections at 6-week intervals. Fundus photography and optical coherence tomography (OCT) were carried out at baseline immediately before injection and at 1, 2.5 and 4 months after the first injection. Outcome measures were best corrected visual...... acuity (BCVA) in Early Treatment Diabetic Retinopathy Study letters, macular volume, foveal subfield thickness and vessel diameter measurement. Results: Intravitreal administration of bevacizumab was followed by a mean increase in BCVA of 7.3 +/- 17 (mean +/- standard deviation) letters between baseline...

  13. [Summarize drug dosage forms in treatment of age-related macular degeneration disease].

    Science.gov (United States)

    Du, Mao-Bo; Liu, Shu-Zhi; Xu, Kai; Liang, Li-Na; He, Ai-Ping; Yao, Yao; Liu, Ya-Mei

    2017-02-01

    In this review, the authors summarized the drugs in treatment of the age-related macular degeneration (AMD or ARMD), including the pathogenesis of the age-related macular degeneration at home and abroad, dosage forms used in the treatment, and the drugs research and development directions in the future. AMD disease is the third largest blinding diseases all over the world, with an incidence of 6.62%. The dosage form of the traditional medicine is mostly oral formulations, playing a role in body, while the newly dosage form is topical drug delivery formulation. Traditional Chinese medicine (TCM) has certain advantages in the treatment of AMD disease and the development of topical drug delivery preparations with newly preparation technologies would have a very bright prospect in the future. Copyright© by the Chinese Pharmaceutical Association.

  14. Factors related to the effect of radiation treatment for age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Mandai, Michiko; Takahashi, Masayo; Matsumura, Miyo; Sasai, Keisuke; Honda, Yoshihito [Kyoto Univ. (Japan). Graduate School of Medicine; Ogura, Yuichiro

    2000-04-01

    We treated 31 eyes of 30 patients with age-related macular degeneration by 10 sessions of radiation totalling 20 Gy. One year after treatment, 21 eyes (68%) showed improvement in the score of fundus lesions based on funduscopic and fluorescein angiographic findings. The visual acuity, expressed as LogMAR, improved in 20% and remained stationary in 50% of eyes. Improvement in visual acuity was significantly better in eyes with greater amount of exudate before treatment (p<0.01). Posttreatment visual acuity was correlated neither with the amount of subretinal fluid, presence of retinal hemorrhage, the size of subfoveal vascular membrane, nor its type as classified into classic, mainly occult or occult type. Above findings show that radiation is more effective in eyes of age-related macular degeneration with massive exudate. (author)

  15. Factors related to the effect of radiation treatment for age-related macular degeneration

    International Nuclear Information System (INIS)

    Mandai, Michiko; Takahashi, Masayo; Matsumura, Miyo; Sasai, Keisuke; Honda, Yoshihito; Ogura, Yuichiro

    2000-01-01

    We treated 31 eyes of 30 patients with age-related macular degeneration by 10 sessions of radiation totalling 20 Gy. One year after treatment, 21 eyes (68%) showed improvement in the score of fundus lesions based on funduscopic and fluorescein angiographic findings. The visual acuity, expressed as LogMAR, improved in 20% and remained stationary in 50% of eyes. Improvement in visual acuity was significantly better in eyes with greater amount of exudate before treatment (p<0.01). Posttreatment visual acuity was correlated neither with the amount of subretinal fluid, presence of retinal hemorrhage, the size of subfoveal vascular membrane, nor its type as classified into classic, mainly occult or occult type. Above findings show that radiation is more effective in eyes of age-related macular degeneration with massive exudate. (author)

  16. Automated detection of age-related macular degeneration in OCT images using multiple instance learning

    Science.gov (United States)

    Sun, Weiwei; Liu, Xiaoming; Yang, Zhou

    2017-07-01

    Age-related Macular Degeneration (AMD) is a kind of macular disease which mostly occurs in old people,and it may cause decreased vision or even lead to permanent blindness. Drusen is an important clinical indicator for AMD which can help doctor diagnose disease and decide the strategy of treatment. Optical Coherence Tomography (OCT) is widely used in the diagnosis of ophthalmic diseases, include AMD. In this paper, we propose a classification method based on Multiple Instance Learning (MIL) to detect AMD. Drusen can exist in a few slices of OCT images, and MIL is utilized in our method. We divided the method into two phases: training phase and testing phase. We train the initial features and clustered to create a codebook, and employ the trained classifier in the test set. Experiment results show that our method achieved high accuracy and effectiveness.

  17. Optical coherence tomography of macular atrophy associated with microcephaly and presumed intrauterine Zika virus infection

    Directory of Open Access Journals (Sweden)

    Adriana Gondim de Moura Campos

    Full Text Available ABSTRACT This case report describes the retinal optical coherence tomography (OCT findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.

  18. Usefulness of axonal tract-dependent OCT macular sectors for evaluating structural change in normal-tension glaucoma.

    Science.gov (United States)

    Omodaka, Kazuko; Kikawa, Tsutomu; Shiga, Yukihiro; Tsuda, Satoru; Yokoyama, Yu; Sato, Haruka; Ohuchi, Junko; Matsumoto, Akiko; Takahashi, Hidetoshi; Akiba, Masahiro; Nakazawa, Toru

    2017-01-01

    To identify sectors of the optical coherence tomography (OCT) macular map that could be used to effectively assess structural progression in patients with normal-tension glaucoma (NTG). This study examined 117 eyes of 117 NTG patients to establish axonal tract-dependent macular sectors, and also examined a separate group of 122 eyes of 81 NTG patients to evaluate the ability of these sectors to reveal glaucoma progression. Longitudinal data, including macular maps from at least 5 OCT examinations performed over at least 2 years, was available for all patients in this group. Circumpapillary retinal nerve fiber layer thickness (cpRNFLT), temporal clockwise sector scans (from 7 to 11 o'clock), macular retinal nerve fiber layer thickness (mRNFLT), and macular ganglion cell layer plus inner plexiform layer thickness (mGCIPLT) were measured with spectral-domain OCT (3D OCT-2000, TOPCON). The axonal tract-dependent macular sectors were identified by calculating Spearman's rank correlation coefficient for each point on a grid overlaid on the macular map and cpRNFLT in each clockwise scan sector. Trend and event analyses for the slope of progression in each sector and macular map were performed. Visual field progression in the macula was defined by the presence of more than 2 progressive test points in the 16 central test points of the Humphrey field analyzer SITA standard 24-2 program, evaluated with Progressor software. The slope of progression in the entire macular area was -0.22 ± 0.58 μm/year for mRNFLT and -0.35 ± 0.52 μm/year for mGCIPLT. The fastest-progressing mRNFLT sector (-1.00 ± 0.84 μm/year, p OCT macular sectors could effectively reveal structural change in patients with NTG. Furthermore, mRNFLT slope was consistent with visual field progression. This method promises to open new avenues for the OCT-based evaluation of glaucoma progression.

  19. Patients' experiences of nursing actions during intravitreal treatment for wet age-related macular degeneration

    OpenAIRE

    Rönn Emsfors, Åsa; Elgán, Carina

    2015-01-01

    Purpose: The aim was to identify and describe nursing actions performed by nursing staff in which patients with wet age-related macular degeneration (AMD) experience good nursing care. Method: An explorative and descriptive qualitative design based on the Critical incident technique (CIT) was used. A strategic sample of 16 patients, aged 61-87 years (eleven women and five men) with wet AMD who received intravitreal treatment were interviewed. Results: Two main areas of good nursing care was i...

  20. Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

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    Elizabeth Pearce

    Full Text Available PURPOSE: To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. METHODS: Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40 measured with Early Treatment Diabetic Retinopathy Study (ETDRS charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA, contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. RESULTS: The slow reading group had poorer contrast sensitivity (p = 0.001, reduced retinal sensitivity (p = 0.027 and less stable fixation (p = 0.013. Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033, (nasal to the fovea in the right eye and temporal to the fovea in the left eye. Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001. CONCLUSION: Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

  1. Effect of intravitreal bevacizumab on diabetic macular edema with hard exudates

    Science.gov (United States)

    Jeon, Sohee; Lee, Won Ki

    2014-01-01

    Background We evaluated the efficacy of intravitreal bevacizumab on diabetic macular edema with subfoveal and perifoveal hard exudates. Materials and methods Eleven eyes (11 patients) exhibiting diabetic macular edema with subfoveal and perifoveal hard exudates were included in this prospective, nonrandomized interventional pilot study. All patients were treated with monthly scheduled intravitreal bevacizumab injections for 6 months. Changes in the Early Treatment Diabetic Retinopathy Study best corrected visual acuity, amount of hard exudates on fundus photography, and macular edema detected by central subfield thickness on spectral domain optical coherence tomography after six serial injections, were assessed. The amount of hard exudates at each visit was evaluated as pixels in fundus photography, using an Adobe Photoshop program. Results Ten of 11 patients completed follow-up. The mean Early Treatment Diabetic Retinopathy Study best corrected visual acuity was 59.9±5.7 letters (Snellen equivalent, 20/63) at baseline evaluation. The best corrected visual acuity exhibited no significant difference at month 6 compared with at baseline (57.9±6.0 letters or 20/70 at month 6; P=0.085). At month 6, mean central subfield thickness decreased from 370.4±56.5 to 334.6±65.0 μm (P=0.009). The mean amount of hard exudates increased from 4467.1±2736.1 to 6592.4±2498.3 pixels at month 6 (P=0.022). No serious adverse events occurred. Conclusion Continuous intravitreal bevacizumab was found to have no benefit in visual acuity and amount of hard exudates, despite the improvement of macular edema at 6 months. PMID:25143708

  2. Factors affecting reading speed in patients with diabetic macular edema treated with laser photocoagulation.

    Science.gov (United States)

    Pearce, Elizabeth; Sivaprasad, Sobha; Chong, Ngaihang V

    2014-01-01

    To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. The slow reading group had poorer contrast sensitivity (p = 0.001), reduced retinal sensitivity (p = 0.027) and less stable fixation (p = 0.013). Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033), (nasal to the fovea in the right eye and temporal to the fovea in the left eye). Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001). Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

  3. Influence of macular choroidal thickness on visual function in highly myopic eyes.

    Science.gov (United States)

    Parravano, Mariacristina; Oddone, Francesco; Giorno, Paola; Cacciamani, Andrea; Abbate, Rosa; Caminiti, Giulia; Peiretti, Enrico; Varano, Monica

    2014-01-01

    To explore the retinal and choroidal thicknesses (RT, CT), as measured using enhanced depth imaging (EDI) optical coherence tomography (OCT, Spectralis) in highly myopic eyes and its relationship with visual function. Prospective, case-control, noninterventional clinical study. CT was measured by EDI-OCT in highly myopic eyes (≥6 dpt) without any macular diseases and age-matched control eyes. A complete ophthalmological examination, visual acuity assessment and MP1 microperimetry were obtained. 38 myopic (15 M/23 F, mean age 51 ± 8.9 years) and 21 control eyes (5 M/16 F, mean age 50 ± 5.4 years) were included. The myopic mean refractive error was -13.3 ± 4.9 dpt and axial length 29.2 ± 2.2 mm. The mean best-corrected visual acuity (BCVA) was lower in highly myopic than in control eyes (77.3 ± 9.25 vs. 84.8 ± 0.6 letters, p = 0.0001, respectively) as was the mean retinal sensitivity (MRS; 16.32 ± 2.6 vs. 19.9 ± 0.2 dB, p < 0.0001). While RT was similar between groups (291.5 ± 24.2 vs. 283.6 ± 13.9 µm, p = 0.06, respectively), subfoveal CT was thinner in highly myopic compared to control eyes (114.3 ± 78.5 vs. 272.6 ± 110.2 µm, p < 0.0001). A significant relationship was found between subfoveal CT and MRS (R(2) = 0.22; p = 0.003) and BCVA (R(2) = 0.13; p = 0.027). Macular function is reduced in highly myopic eyes without any visible macular diseases compared to controls, and a significant proportion of the macular function variability seems to be related to a reduced CT. © 2014 S. Karger AG, Basel.

  4. Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results

    OpenAIRE

    Demir M; Oba E; Gulkilik G; Odabasi M; Ozdal E

    2011-01-01

    Mehmet Demir, Ersin Oba, Gökhan Gulkilik, Mahmut Odabasi, Erhan OzdalSisli Etfal Training and Research Hospital, Eye Clinic, Sisli, Istanbul, TurkeyPurpose: To present the functional and anatomic changes after intravitreal bevacizumab in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO).Design: The study was a retrospective study.Materials and methods: The study included 31 patients with ME due to BRVO. We compared the examination findings of patients with ME b...

  5. CDH3 gene related hypotrichosis and juvenile macular dystrophy – A case with a novel mutation

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    Omer Karti

    2017-09-01

    Conclusions and importance: This case of HJMD was related to a novel homozygous mutation, termed c.447_467del (p.149_156del. These findings have significance for the future mutational analysis and genetic counseling of families with HJMD, particularly in our region. The presence of sparse hair in childhood, with or without limb anomalies, should alert clinicians to request an eye consultation. Pediatricians, dermatologists, and ophthalmologists should be aware of the rarely seen entity of juvenile macular dystrophy with hypotrichosis.

  6. Decreased fixation stability of the preferred retinal location in juvenile macular degeneration.

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    Richard A I Bethlehem

    Full Text Available Macular degeneration is the main cause for diminished visual acuity in the elderly. The juvenile form of macular degeneration has equally detrimental consequences on foveal vision. To compensate for loss of foveal vision most patients with macular degeneration adopt an eccentric preferred retinal location that takes over tasks normally performed by the healthy fovea. It is unclear however, whether the preferred retinal locus also develops properties typical for foveal vision. Here, we investigated whether the fixation characteristics of the preferred retinal locus resemble those of the healthy fovea. For this purpose, we used the fixation-offset paradigm and tracked eye-position using a high spatial and temporal resolution infrared eye-tracker. The fixation-offset paradigm measures release from fixation under different fixation conditions and has been shown useful to distinguish between foveal and non-foveal fixation. We measured eye-movements in nine healthy age-matched controls and five patients with juvenile macular degeneration. In addition, we performed a simulation with the same task in a group of five healthy controls. Our results show that the preferred retinal locus does not adopt a foveal type of fixation but instead drifts further away from its original fixation and has overall increased fixation instability. Furthermore, the fixation instability is most pronounced in low frequency eye-movements representing a slow drift from fixation. We argue that the increased fixation instability cannot be attributed to fixation under an unnatural angle. Instead, diminished visual acuity in the periphery causes reduced oculomotor control and results in increased fixation instability.

  7. Displacement of fovea toward optic disk after macular hole surgery with internal limiting membrane peeling

    OpenAIRE

    Ohta, Kouichi; Sato, Atsuko; Senda, Nami; Fukui, Emi

    2017-01-01

    Kouichi Ohta, Atsuko Sato, Nami Senda, Emi Fukui Department of Ophthalmology, Matsumoto Dental University, Shiojiri, Nagano, Japan Purpose: The purpose of this study was to demonstrate a displacement of the foveal depression toward the optic disk after idiopathic macular hole (MH) surgery with internal limiting membrane (ILM) peeling.Methods: Two patients with a unilateral MH developed an MH in the fellow eyes. Vitrectomy with ILM peeling was performed on the fellow...

  8. BRIDGE ARCH-SHAPED SEROUS RETINAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Fajnkuchen, Franck; Cohen, Salomon Y; Thay, Nathalie; Ayrault, Sandrine; Delahaye-Mazza, Corinne; Grenet, Typhaine; Nghiem-Buffet, Sylvia; Quentel, Gabriel; Giocanti-Auregan, Audrey

    2016-03-01

    To describe bridge arch-shaped serous retinal detachment (SRD) in exudative age-related macular degeneration and evaluate its functional outcomes. In this monocentric, retrospective, noncomparative case series, patients were included. Patients with exudative age-related macular degeneration and bridge arch-shaped SRD treated with ranibizumab were included. Anatomical patterns of SRD and functional outcomes were assessed. Twenty-two eyes with bridge arch-shaped SRD of 22 patients with age-related macular degeneration were included. Serous retinal detachments were characterized by a steep angle at the junction between the retinal pigment epithelium and the sensory retina (mean, 53.45 ± 12.5°), and characterized by the presence of adhesion areas between the sensory retina and a fibrous complex developed from the choroidal neovascularization. In 15 eyes, the choroidal neovascularization was classic choroidal neovascularization and a fibrotic evolution was observed. Serous retinal detachments were compartmentalized in 14 eyes, leading to a multipocket structure. Visual acuity decreased from 49.9 ± 19.2 letters (20/100) to 40.3 ± 18.6 letters (20/160), corresponding to a mean change of -9.6 ± 19.4 letters. This was the first study to describe the specific morphologic features of bridge arch-shaped SRD, a previously undescribed type of SRD complicating exudative age-related macular degeneration. Patients with bridge arch-shaped SRD responded to intravitreal injections of ranibizumab, but their visual prognosis was unfavorable, compared with the literature. The presence of bridge arch-shaped SRD seemed to be a marker for the fibrotic evolution of the choroidal neovascularization.

  9. Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice

    Science.gov (United States)

    Campos Polo, Rafael; Rubio Sánchez, Consuelo; García Guisado, Diego Manuel; Díaz Luque, María José

    2018-01-01

    Purpose To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME) in daily clinical practice. Methods Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. The mean change in best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] letters) was the primary outcome. Results The mean BCVA improved significantly as compared with baseline at 12 months of treatment (47.3 [14.2] vs 62.2 [13.9] ETDRS letters, P<0.001). Significant improvement in BCVA was already observed at visit 2 after the loading doses of aflibercept. At 12 months, gains in ETDRS letters were documented in all eyes (100%), with gains ≥10 letters in 89.6%, ≥15 letters in 65.5%, and ≥20 letters in 6.9% (n=2). A significant reduction in central macular thickness from a mean of 460.5 (11.8) μm at baseline to 229.0 (43.8) μm at 12 months (P<0.001) was observed. Significant reductions of central macular thickness were already observed after the loading doses and continued lowering throughout the study period. No adverse events occurred. Conclusion Aflibercept as a first-line therapy was effective and well tolerated for treating clinically significant DME in naïve patients in daily practice. Successful results in terms of improvement of visual and reduction in central macular thickness contribute to provide evidence for the positioning of aflibercept as a first-line indication of newly diagnosed clinically significant DME. PMID:29386883

  10. VITRECTOMY FOR INTERMEDIATE AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH TANGENTIAL VITREOMACULAR TRACTION: A CLINICOPATHOLOGIC CORRELATION.

    Science.gov (United States)

    Ziada, Jean; Hagenau, Felix; Compera, Denise; Wolf, Armin; Scheler, Renate; Schaumberger, Markus M; Priglinger, Siegfried G; Schumann, Ricarda G

    2018-03-01

    To describe the morphologic characteristics of the vitreomacular interface in intermediate age-related macular degeneration associated with tangential traction due to premacular membrane formation and to correlate with optical coherence tomography (OCT) findings and clinical data. Premacular membrane specimens were removed sequentially with the internal limiting membrane from 27 eyes of 26 patients with intermediate age-related macular degeneration during standard vitrectomy. Specimens were processed for immunocytochemical staining of epiretinal cells and extracellular matrix components. Ultrastructural analysis was performed using transmission electron microscopy. Spectral domain optical coherence tomography images and patient charts were evaluated in retrospect. Immunocytochemistry revealed hyalocytes and myofibroblasts as predominant cell types. Ultrastructural analysis demonstrated evidence of vitreoschisis in all eyes. Myofibroblasts with contractile properties were observed to span between folds of the internal limiting membrane and vitreous cortex collagen. Retinal pigment epithelial cells or inflammatory cells were not detected. Mean visual acuity (Snellen) showed significant improvement from 20/72 ± 20/36 to 20/41 ± 20/32 (P < 0.001) after a mean follow-up period of 19 months (median, 17 months). During this period, none of the eyes required anti-vascular endothelial growth factor therapy. Fibrocellular premacular proliferation in intermediate age-related macular degeneration predominantly consists of vitreous collagen, hyalocytes, and myofibroblasts with contractile properties. Vitreoschisis and vitreous-derived cells appear to play an important role in traction formation of this subgroup of eyes. In patients with intermediate age-related macular degeneration and contractile premacular membrane, release of traction by vitrectomy with internal limiting membrane peeling results in significantly functional and anatomical improvement.

  11. Functional Magnetic Resonance Imaging in Patients with the Wet Form of Age-Related Macular Degeneration

    Science.gov (United States)

    Lešták, Jan; Tintěra, Jaroslav; Karel, Ivan; Svatá, Zuzana; Rozsíval, Pavel

    2013-01-01

    Abstract The study is designed to determine the relationship between the progress of the wet form of age-related macular degeneration and the activity of the visual cortex examined using functional magnetic resonance imaging. Ten patients with the wet form of age-related macular degeneration (9 female and 1 male) with a mean age of 74.7 years (58–85 years) at various stages of bilateral involvement of the disease were included. Patients did not suffer from any other ocular nor neurological disease. All the patients underwent functional magnetic resonance imaging examinations with stimulation of both eyes using a black-and-white checkerboard of size 25.8 × 16.2 degrees. The group was compared with a group of healthy subjects with an average age of 54.1 years (45–65 years). For statistical evaluation, the Mann-Whitney U test was used. Comparing the extent of visual cortex activations we found a statistically significant difference between both the groups (p = 0.0247). However, the dependence of functional magnetic resonance imaging activity on visual acuity was not statistically significant (p = 0.223). We conclude that in patients with the wet form of age-related macular degeneration, lower functional magnetic resonance imaging activity of the visual cortex was found compared with the control group of healthy subjects. Dependence of functional magnetic resonance imaging activity on visual acuity was not statistically significant. PMID:28167987

  12. Use of Mechanical Turk as a MapReduce Framework for Macular OCT Segmentation

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    Aaron Y. Lee

    2016-01-01

    Full Text Available Purpose. To evaluate the feasibility of using Mechanical Turk as a massively parallel platform to perform manual segmentations of macular spectral domain optical coherence tomography (SD-OCT images using a MapReduce framework. Methods. A macular SD-OCT volume of 61 slice images was map-distributed to Amazon Mechanical Turk. Each Human Intelligence Task was set to $0.01 and required the user to draw five lines to outline the sublayers of the retinal OCT image after being shown example images. Each image was submitted twice for segmentation, and interrater reliability was calculated. The interface was created using custom HTML5 and JavaScript code, and data analysis was performed using R. An automated pipeline was developed to handle the map and reduce steps of the framework. Results. More than 93,500 data points were collected using this framework for the 61 images submitted. Pearson’s correlation of interrater reliability was 0.995 (p<0.0001 and coefficient of determination was 0.991. The cost of segmenting the macular volume was $1.21. A total of 22 individual Mechanical Turk users provided segmentations, each completing an average of 5.5 HITs. Each HIT was completed in an average of 4.43 minutes. Conclusions. Amazon Mechanical Turk provides a cost-effective, scalable, high-availability infrastructure for manual segmentation of OCT images.

  13. Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma.

    Science.gov (United States)

    Abe, Kosuke; Shirane, Jumi; Sakamoto, Masuo; Tanabe, Fumi; Kuniyoshi, Kazuki; Matsumoto, Chota; Shimomura, Yoshikazu

    2014-01-01

    Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT) at the fixation point in a case of bilateral macular coloboma. The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS) junction line. The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved.

  14. Correlation between macular changes and the peripapillary nerve fiber layer in primary open angle glaucoma.

    Science.gov (United States)

    Manasia, D; Voinea, L; Vasinca, I D; Alexandrescu, C

    2014-03-15

    Glaucoma is a leading cause of blindness and the early diagnosis is crucial for treatment and follow-up in the progression of the disease. To evaluate the changes in mean macular thickness and volume and compare them with the mean thickness of the peripapillary nerve fiber layer in primary open angle glaucoma, using Time Domain (TD) optical coherence tomography ( OCT). The examinations were conducted on 275 eyes of 138 patients, as it follows: 203 eyes of 102 patients diagnosed with primary open angle glaucoma in various stages of evolution, representing the study group, and 72 normal eyes from 36 patients, representing the control group. The study was conducted from March 2010 to December 2012. All the patients gave their consent, in accordance with the Helsinki Declaration. The study group showed a decrease in mean macular thickness and volume, as well as mean thickness of the peripapillary nerve fiber layer (RNFL) compared to the control group. According to the OCT measurements, the results of the study have shown that the decrease of the mean thickness of the RNFL is a better differentiator between glaucomatous and normal eyes compared to the decrease of the mean macular thickness and volume.

  15. Ciliary neurotrophic factor for macular telangiectasia type 2: results from a phase 1 safety trial.

    Science.gov (United States)

    Chew, Emily Y; Clemons, Traci E; Peto, Tunde; Sallo, Ferenc B; Ingerman, Avner; Tao, Weng; Singerman, Lawrence; Schwartz, Steven D; Peachey, Neal S; Bird, Alan C

    2015-04-01

    To evaluate the safety and tolerability of intraocular delivery of ciliary neurotrophic factor (CNTF) using an encapsulated cell implant for the treatment of macular telangiectasia type 2. An open-label safety trial conducted in 2 centers enrolling 7 participants with macular telangiectasia type 2. The participant's more severely affected eye (worse baseline visual acuity) received the high-dose implant of CNTF. Patients were followed for a period of 36 months. The primary safety outcome was a change in the parameters of the electroretinogram (ERG). Secondary efficacy outcomes were changes in visual acuity, en face measurements of the optical coherence tomography of the disruption in the ellipsoid zone, and microperimetry when compared with baseline. The ERG findings demonstrated a reduction in the amplitude of the scotopic b-wave in 4 participants 3 months after implantation (month 3). All parameters returned to baseline values by month 12 and remained so at month 36 with no clinical impact on dark adaptation. There was no change in visual acuity compared with baseline. The area of the defect as measured functionally by microperimetry and structurally by the en face OCT imaging of the ellipsoid zone loss appeared unchanged from baseline. The intraocular delivery of CNTF in the encapsulated cell implant appeared to be safe and well tolerated in eyes with macular telangiectasia type 2. Further evaluation in a randomized controlled clinical trial is warranted to test for efficacy. Published by Elsevier Inc.

  16. Macular and Multifocal PERG and FD-OCT in Preperimetric and Hemifield Loss Glaucoma.

    Science.gov (United States)

    Kreuz, André C; de Moraes, Carlos G; Hatanaka, Marcelo; Oyamada, Maria K; Monteiro, Mario L R

    2018-02-01

    To evaluate the ability of macular and multifocal (mf) pattern electroretinogram (PERG) to differentiate preperimetric glaucoma (PG) and glaucoma with hemifield loss (GHL) from controls, to compare the discrimination ability of PERG and fourier-domain optical coherence tomography (FD-OCT), and to assess the relationship between measurements. Standard automated perimetry, steady-state and transient PERG and mfPERG measurements were obtained from PG (n=14, 24 eyes), GHL (n=5, 7 eyes), and controls (n=19, 22 eyes). Circumpapillary retinal nerve fiber layer (cpRNFL), full-thickness macula, and segmented macular layer thicknesses on FD-OCT were investigated. Measurements were compared using mixed effects linear models. The relationships between measurements and the diagnostic performance of each technology were assessed. Compared with controls, average P50 peak time transient PERG responses were reduced in PG and GHL, whereas average latency and amplitude steady-state and mfPERG responses were abnormal only in GHL. cpRNFL and macular thickness measurements in PG and GHL differed significantly from controls. A significant relationship was found between PERG and most FD-OCT or SAP parameters. Partial least squares discriminant analysis revealed that OCT parameters, along with mfPERG and transient PERG parameters had similar ability to discriminate PG and GHL from healthy controls. PERG and OCT parameters may be abnormal, with significant correlations between measurements, in PG eyes. Both technologies may be useful for detection of early glaucoma.

  17. Stereotactic radiotherapy for wet age-related macular degeneration: current perspectives

    Directory of Open Access Journals (Sweden)

    Neffendorf JE

    2015-09-01

    Full Text Available James E Neffendorf, Timothy L Jackson Department of Ophthalmology, School of Medicine, King’s College London, London, United Kingdom Abstract: Neovascular age-related macular degeneration is a leading cause of blindness in the developed world. Currently, the treatment of choice is intravitreal injections of anti-VEGF medications. These require frequent dosing, up to monthly, and impose a substantial burden on patients and the health economy. Ionizing radiation was proposed as a possible treatment for age-related macular degeneration due to its anti-inflammatory and anti-fibrotic properties. Stereotactic radiotherapy is an outpatient-based radiotherapy platform that provides stereotactic application of low energy X-ray to the retina in three highly collimated beams that cross the inferior sclera to overlap at the macula. A randomized, double-masked, sham-controlled trial of 230 patients (INTREPID showed that a single dose of stereotactic radiotherapy significantly reduces the number of intravitreal anti-VEGF injections needed over 2 years. A larger randomized controlled trial (STAR is underway. Keywords: wet age-related macular degeneration, radiation therapy, stereotactic radiotherapy, vascular endothelial growth factor

  18. Optical Coherence Tomography of Bilateral Nanophthalmos with Macular Folds and High Hyperopia

    Directory of Open Access Journals (Sweden)

    Firat Helvacioglu

    2014-01-01

    Full Text Available Importance. There is a conflict about the content of the macular folds in nanophthalmic eyes in the literature. Our study clearly demonstrated that papillomacular folds seen in nanophthalmos or posterior microphthalmos were only composed of neurosensory retina without involvement of retinal pigment epithelium and choroid. Observations. This is a report of two consecutive nanophthalmic patients with macular folds at Maltepe University School of Medicine, Department of Ophthalmology, from January to June 2012. Anterior segment dimensions were near normal. The axial lengths of the eyes were short with markedly shortened posterior segment. A macular fold extending from the center of the fovea towards the optic nerve head was present in all eyes. Optic coherence tomography clearly demonstrated that folds were only composed of neurosensory retina. Binocular visual acuities and refractive errors of the cases were 0.3, 0.2 and +16.00, +15.75 diopters, respectively. Conclusions and Relevance. Our study proposes a surgical option to treat these folds like serous retinal detachments by showing the true content of the folds, although there is not any surgical operation accepted for this condition yet. Further studies dealing with the surgical interventions of these folds should be performed to support this option.

  19. ¿Neumodesplazamiento vigente? Uso en hemorragia subretiniana y agujero macular traumático

    Directory of Open Access Journals (Sweden)

    Gabriela Papa-Oliva

    2015-07-01

    Conclusiones: El trauma ocular representa todo un desafío para el oftalmólogo, en este caso producto de un trauma ocular contuso. Para la resolución de la hemorragia subretiniana producto de una rotura coroidea yuxtapapilar y del agujero macular traumático, tenemos varias opciones quirúrgicas que dependerán de la decisión del especialista en cuanto conocimiento, experiencia y experticia del mismo. El neumodesplazamiento sin vitrectomía vía pars plana ha sido utilizado para desplazar sangre subretiniana secundaria a degeneración macular relacionada con la edad. Usando el mismo principio pero aplicado a diferente patología, se decidió realizar desplazamiento neumático, obteniendo como resultado drenaje a cavidad vítrea de la hemorragia subretiniana y cierre del agujero macular. El neumodesplazamiento puede ser considerado una opción terapéutica eficaz versus la vitrectomía vía pars plana en el manejo de esta dolencia.

  20. Automated detection of exudates and macula for grading of diabetic macular edema.

    Science.gov (United States)

    Akram, M Usman; Tariq, Anam; Khan, Shoab A; Javed, M Younus

    2014-04-01

    Medical systems based on state of the art image processing and pattern recognition techniques are very common now a day. These systems are of prime interest to provide basic health care facilities to patients and support to doctors. Diabetic macular edema is one of the retinal abnormalities in which diabetic patient suffers from severe vision loss due to affected macula. It affects the central vision of the person and causes total blindness in severe cases. In this article, we propose an intelligent system for detection and grading of macular edema to assist the ophthalmologists in early and automated detection of the disease. The proposed system consists of a novel method for accurate detection of macula using a detailed feature set and Gaussian mixtures model based classifier. We also present a new hybrid classifier as an ensemble of Gaussian mixture model and support vector machine for improved exudate detection even in the presence of other bright lesions which eventually leads to reliable classification of input retinal image in different stages of macular edema. The statistical analysis and comparative evaluation of proposed system with existing methods are performed on publicly available standard retinal image databases. The proposed system has achieved average value of 97.3%, 95.9% and 96.8% for sensitivity, specificity and accuracy respectively on both databases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. 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. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  2. Macular and retinal nerve fiber thickness in recovered and persistent amblyopia.

    Science.gov (United States)

    Yassin, Sanaa A; Al-Tamimi, Elham R; Al-Hassan, Sultan

    2015-12-01

    The aim of this study was to investigate the presence of increased macular or retinal nerve fiber layer thickness (RNFLT) in amblyopic eyes, find if the increased macular or RNFLT is related to the lack of response in amblyopic eyes, and to explore whether the increased central macular thickness (CMT) in amblyopic eyes is purely related to the hyperopia. This is a prospective descriptive study. CMT and peripapillary RNFLT were measured by spectral-domain optical coherence tomography to evaluate 60 patients with unilateral-treated amblyopia (median age 11.00 year). Patients were divided into two groups: 33 patients in recovered amblyopia group and 27 patients in persistent amblyopia group. The mean CMT in the recovered group was 247.31 (±23.4) versus 246.8 (±32.7) µm (p = 0.95) for the persistent group. The mean peripapillary RNFLT was 99.13 (±12.1) versus 99.9 (±14.9) µm (p = 0.85) for the persistent group. In anisometropic amblyopia, there was no significant difference in CMT and RNFLT in either group. Also there was no relation between the type of refractive error and CMT or RNFLT. There was no significant difference in CMT and RNFLT in amblyopic eyes for both the recovered amblyopia group and the persistent amblyopia group to explain the lack of response in persistent amblyopic eyes. Additionally there was no relation between the type of refractive error and CMT or peripapillary RNFLT.

  3. Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2014-01-01

    Full Text Available A 65-year-old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full-thickness macular hole in left eye; confirmed by optical coherence tomography (OCT. Patient underwent phacoemulsification with intraocular lens (IOL implantation, vitrectomy, internal limiting membrane (ILM peeling and 14% C 3 F 8 gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid-gas exchange with 14% C 3 F 8 gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re-surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re-surgery than those without. However, larger studies with longer follow-up are required to validate this finding.

  4. Consecutive Macular Edema and Visual Outcome in Branch Retinal Vein Occlusion

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    Sung Uk Baek

    2014-01-01

    Full Text Available Purposes. The study introduced the concept of “consecutive macular edema” and evaluated the validity of visual outcome in macular edema (ME secondary to branch retinal vein occlusion (BRVO. Methods. Patients were categorized into the gainer group and the nongainer group according to the final visual acuity. We analyzed clinical characteristics involving total and consecutive duration of ME between the two groups. Results. Among the total 71 eyes of 71 patients, intravitreal bevacizumab injection (26 patients, triamcinolone (21, and natural course (33 were enrolled. The consecutive duration of ME was shorter in the gainer group than in the nongainer group (3.33 ± 1.50 and 5.24 ± 2.39 months; P=0.000. After exclusion of macular ischemia, consecutive duration of ME in gainer group was also significantly shorter than in nongainer group (3.62 ± 1.60 and 6.11 ± 4.20 months; P=0.010. Conclusions. The duration of ME in the nongainer group was longer than in the gainer group. In particular, the consecutive duration was an important factor in determining the final visual outcome. Clinical Trial Registration. Approval by Hallym University Sacred Heart Hospital Institutional Review Board/Ethics Committee was obtained for this retrospective study.

  5. Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage.

    LENUS (Irish Health Repository)

    Kirwan, R P

    2012-02-01

    AIM: To report a case of successful drainage of a large pre-macular haemorrhage using laser photo-disruption of the posterior hyaloid membrane. MATERIALS AND METHODS: A case report. RESULTS: A 47-year-old man presented acutely to our emergency department complaining of a 24-h history of sudden onset, painless and persistent loss of vision in his left eye. Immediately before noticing this loss of vision, he had been vomiting violently from excessive alcohol intake. The left visual acuity was counting fingers. Dilated fundoscopy of the left eye revealed a large pre-macular haemorrhage which was 14 disc diametres in size. Clotting investigations were normal. A diagnosis of valsalva retinopathy was made and the patient elected to receive a prompt neodymium-doped yttrium aluminium garnet (Nd:YAG) laser posterior hyaloidotomy as an outpatient. At 1 week follow-up, the haemorrhage had drained completely into the vitreous space revealing a healthy macula and the visual acuity had improved to 6\\/12 unaided. At 6-month follow-up the left visual acuity stabilised at 6\\/9 unaided. CONCLUSION: Nd:YAG laser posterior hyaloidotomy is a useful outpatient procedure for successful clearance of large pre-macular haemorrhages that offers patients rapid recovery of visual acuity and the avoidance of more invasive intraocular surgery.

  6. Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

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    M.M. Moschos

    2010-12-01

    Full Text Available We report a case of a human leukocyte antigen B27 (HLA-B27-negative patient with cystoid macular edema (CME and ankylosing spondylitis (AS after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA and ocular coherent tomography (OCT showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.

  7. Image-guided macular laser therapy: design considerations and progress toward implementation

    Science.gov (United States)

    Berger, Jeffrey W.; Shin, David S.

    1999-06-01

    Laser therapy is currently the only treatment of proven benefit for exudative age related macular degeneration and diabetic retinopathy. To guide treatment for macular diseases, investigations were initiated to permit overlay of previously-stored angiographic images and image sequences superimposed onto the real-time biomicroscopic fundus image. Prior to treatment, a set of partially overlapping fundus images is acquired and montaged in order to provide a map for subsequent tracking operations. A binocular slit-lamp biomicroscope interfaced to a CCD camera, framegrabber board, and PC permits acquisition and rendering of retinal images. Computer-vision algorithms facilitate robust tracking, registration, and near-video-rate image overlay of previously-stored retinal photographic and angiographic images onto the real-time fundus image. Laser treatment is guided in this augmented reality environment where the borders of the treatment target--for example, the boundaries of a choroidal neovascularization complex--are easily identified through overlay of angiographic information superimposed on, and registered with, the real-time fundus image. During periods of misregistration as judged by the amplitude of the tracking similarity metric, laser function is disabled, affording additional safety. Image-guided macular laser therapy should facilitate accurate targeting of treatable lesions and less unintentional retinal injury when compared with standard techniques.

  8. Clinical efficacy of Ranibizumab in the treatment of wet age-related macular degeneration

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    Ling-Jun Wei

    2017-12-01

    Full Text Available AIM:To analyze the clinical efficacy of Ranibizumab in the treatment of wet age-related macular degeneration(ARMD.METHODS: Clinical data of patients with wet age-related macular degeneration received treatment of ranibizumab at our hospital from 2015 to 2017 were analyzed. At 1mo after treatment, the clinical efficacy, ocular hemodynamics and ocular inflammation were evaluated. RESULTS: A total of 41 patients were analyzed. After treatment, patients got significantly increased in LogMAR(0.651±0.067 vs 0.321±0.049; t=25.460, Pvs 452.9±69.8μm; t=15.740, Pvs 16.1±3.5ng/L; t=3.563, Pvs 13.8±2.5ng/L; t=3.467, PP>0.05. CONCLUSION: In the treatment of wet age-related macular degeneration, the ranibizumab shows a good therapeutic effect without serious adverse drug reactions.

  9. Drugs in Phase II clinical trials for the treatment of age-related macular degeneration.

    Science.gov (United States)

    Tolentino, Michael John; Dennrick, Abrahan; John, Elizabeth; Tolentino, Michael Steven

    2015-02-01

    The clinical development of anti-VEGF therapies for the treatment of exudative age-related macular degeneration (wet AMD) has revolutionized ophthalmology. Indeed, it has provided clinicians and patients with treatments that lessen visual loss from in a disease that once was uniformly blinding. Although blindness is yet to be eradicated from AMD, repeated intraocular anti-VEGF injections are required to preserve a patient's vision. Therefore, further advances in this field are necessary. This review provides an overview of the agents that are in mid-stage phase trials for both exudative (wet AMD) and nonexudative macular degeneration (dry AMD). For wet AMD, new agents intend to enhance efficacy, develop alternative delivery such as eye drops, investigate alternate targets and construct sustained release strategies. For advanced dry AMD, the goal is to develop a strategy to slow or stop progressive loss of retinal tissue seen in geographic atrophy, the hallmark of advanced dry AMD. It is important to develop better more sensitive biomarkers, validating different approvable clinical trial endpoints and stratifying patients on their genetic polymorphisms. These developments should help to progress the already rapidly developing field of macular degeneration therapy.

  10. [Clinical observation on treating diabetic macular edema with intravitreal triamcinolone acetonide and laser].

    Science.gov (United States)

    Wang, Yongbo; Shi, Anna; Shi, Xun; Liu, Weifeng

    2010-08-01

    To evaluate the effect of intravitreal injection of triamcinolone acetonide(IVTA) combining with retinal laser treating for diabetic macular edema(DME). Twenty five patients(32 eyes) with DME who has microangioma in macula lutea were randomly divided into group A, B,C and D(8 eyes each group). Eyes in group A were treated with laser photocoagulation. Eyes in group B were treated with multiplier-532 laser photocoagulation and transpupillary thermotherapy. Eyes in group C were treated with multiplier-532 laser photocoagulation and intravitreal triamcinolone acetonide. Eyes in group D were treated with multiplier-532 laser, transpupillary thermotherapy plus triamcinolone acetonide injection. Intravitreal injection of 4 mg triamcinolone acetonide was done 1 week after laser photocoagulation in group C and D. The visual acuity, intraocular pressure, macular thickness (foveal thickness) of the eyes in 4 groups were observed before and 1, 3 and 6 months after treatment. The visual acuity, intraocular pressure and foveal thickness of the 4 groups before treatment showed no significant difference(p> ). The visual acuity, intraocular pressure, macular thickness of eyes in group A, B were better than those of group C, D at 1, 3 and 6 months after treatment, and they had significant difference(p0.05). The effect of laser photocoagulation and intravitreal triamcinolone acetonide, laser photocoagulation combining with transpupillary thermotherapy plus triamcinolone acetonide injectionvisual treating for DME was better than laser photocoagulation alone, laser photocoagulation combining with transpupillary thermotherapy.

  11. Monoscopic versus stereoscopic photography in screening for clinically significant macular edema.

    Science.gov (United States)

    Welty, Christopher J; Agarwal, Anita; Merin, Lawrence M; Chomsky, Amy

    2006-01-01

    The purpose of the study was to determine whether monoscopic photography could serve as an accurate tool when used to screen for clinically significant macular edema. In a masked randomized fashion, two readers evaluated monoscopic and stereoscopic retinal photographs of 100 eyes. The photographs were evaluated first individually for probable clinically significant macular edema based on the Early Treatment Diabetic Retinopathy Study criteria and then as stereoscopic pairs. Graders were evaluated for sensitivity and specificity individually and in combination. Individually, reader one had a sensitivity of 0.93 and a specificity of 0.77, and reader two had a sensitivity of 0.88 and a specificity of 0.94. In combination, the readers had a sensitivity of 0.91 and a specificity of 0.86. They correlated on 0.76 of the stereoscopic readings and 0.92 of the monoscopic readings. These results indicate that the use of monoscopic retinal photography may be an accurate screening tool for clinically significant macular edema.

  12. Correlation of neutrophil/lymphocyte and platelet/lymphocyte ratio with visual acuity and macular thickness in age-related macular degeneration

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    Elvan Alper Sengul

    2017-05-01

    Full Text Available AIM: To investigate the place of neutrophil-to-lymphocyte ratio (NLR and platelet-to-lymphocyte ratio (PLR in the diagnosis of and prognosis for neovascular age-related macular degeneration (AMD. METHODS: One hundred AMD patients and 100 healthy controls were included in the study. Blood samples were obtained from the venous blood, which is used for routine analysis, and these samples were subjected to complete blood count. NLR was defined as the neutrophil count divided by the number of lymphocytes, and PLR was defined as the platelet count divided by the number of lymphocytes. RESULTS: No statistically significant difference was observed between the two groups under consideration in terms of demographic features (P>0.05. The average NLR in the patient group was found to be significantly higher than that in the healthy control group (P<0.05. The average PLR was significantly higher in the patient group as compared to the control group (P<0.05. As best corrected visual acuity (BCVA increased, both NLR and PLR decreased (significant negative correlations at 49.8% and 63.0%, respectively, whereas as central macular thickness (CMT increased, both NLR and PLR increased (significant positive correlations at 59.3% and 70.0%, respectively. CONCLUSION: NLR and PLR levels are higher among neovascular AMD patients as compared to healthy control group. NLR and PLR levels were found to be inversely proportional to BCVA and directly proportional to CMT.

  13. Pilot evaluation of short-term changes in macular pigment and retinal sensitivity in different phenotypes of early age-related macular degeneration after carotenoid supplementation.

    Science.gov (United States)

    Corvi, Federico; Souied, Eric H; Falfoul, Yousra; Georges, Anouk; Jung, Camille; Querques, Lea; Querques, Giuseppe

    2017-06-01

    To investigate the response of carotenoid supplementation in different phenotypes of early age-related macular degeneration (AMD) by measuring macular pigment optical density (MPOD) and retinal sensitivity. Consecutive patients with only medium/large drusen and only reticular pseudodrusen (RPD) and age-matched and sex-matched controls were enrolled. At baseline, participants underwent a complete ophthalmological examination including measurement of best-corrected visual acuity (BCVA), MPOD and retinal sensitivity. Patients were put on vitamin supplementation (lutein 10 mg/day, zeaxanthin 2 mg/day) and 3 months later underwent a repeated ophthalmological examination. Twenty patients with medium/large drusen, 19 with RPD and 15 control subjects were included. At baseline, in controls, mean MPOD and BCVA were significantly higher compared with RPD (p=0.001 and p=0.01) but similar to medium/large drusen (p=0.9 and p=0.4). Mean retinal sensitivity was significantly higher in controls compared with RPD and medium/large drusen (for all pmacular sensitivity and MPOD than controls. After supplementation, MPOD significantly increased in RPD. These results suggest different pathophysiology for RPD as compared with medium/large drusen and may open new ways to identifying further therapeutic targets in this phenotype of early AMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. ASSOCIATION OF DRUSEN VOLUME WITH CHOROIDAL PARAMETERS IN NONNEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Balasubramanian, Siva; Lei, Jianqin; Nittala, Muneeswar G; Velaga, Swetha B; Haines, Jonathan; Pericak-Vance, Margaret A; Stambolian, Dwight; Sadda, SriniVas R

    2017-10-01

    The choroid is thought to be relevant to the pathogenesis of nonneovascular age-related macular degeneration, but its role has not yet been fully defined. In this study, we evaluate the relationship between the extent of macular drusen and specific choroidal parameters, including thickness and intensity. Spectral domain optical coherence tomography images were collected from two distinct, independent cohorts with nonneovascular age-related macular degeneration: Amish (53 eyes of 34 subjects) and non-Amish (40 eyes from 26 subjects). All spectral domain optical coherence tomography scans were obtained using the Cirrus HD-OCT with a 512 × 128 macular cube (6 × 6 mm) protocol. The Cirrus advanced retinal pigment epithelium analysis tool was used to automatically compute drusen volume within 3 mm (DV3) and 5 mm (DV5) circles centered on the fovea. The inner and outer borders of the choroid were manually segmented, and the mean choroidal thickness and choroidal intensity (i.e., brightness) were calculated. The choroidal intensity was normalized against the vitreous and nerve fiber layer reflectivity. The correlation between DV and these choroidal parameters was assessed using Pearson and linear regression analysis. A significant positive correlation was observed between normalized choroidal intensity and DV5 in the Amish (r = 0.42, P = 0.002) and non-Amish (r = 0.33, P = 0.03) cohorts. Also, DV3 showed a significant positive correlation with normalized choroidal intensity in both the groups (Amish: r = 0.30, P = 0.02; non-Amish: r = 0.32, P = 0.04). Choroidal thickness was negatively correlated with normalized choroidal intensity in both Amish (r = -0.71, P = 0.001) and non-Amish (r = -0.43, P = 0.01) groups. Normalized choroidal intensity was the most significant constant predictor of DV in both the Amish and non-Amish groups. Choroidal intensity, but not choroidal thickness, seems to be associated with drusen volume in Amish and non-Amish populations. These

  15. Quantifying metamorphopsia with M-CHARTS in patients with idiopathic macular hole

    Directory of Open Access Journals (Sweden)

    Wada I

    2017-09-01

    Full Text Available Iori Wada, Shigeo Yoshida, Yoshiyuki Kobayashi, Yedi Zhou, Keijiro Ishikawa, Shintaro Nakao, Toshio Hisatomi, Yasuhiro Ikeda, Tatsuro Ishibashi, Koh-hei Sonoda Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan Purpose: The purpose of this study was to determine the degree of metamorphopsia using M-CHARTS™ in patients with idiopathic macular hole before and after pars plana vitrectomy and internal limiting membrane (ILM peeling. Patients and methods: The records of 22 eyes of 22 patients with a full-thickness macular hole who underwent pars plana vitrectomy and ILM peeling were reviewed. All patients underwent a complete ophthalmic examination including spectral-domain optical coherence tomography (OCT. Horizontal metamorphopsia (MH and vertical metamorphopsia (MV scores were determined using M-CHARTS at the same time. The time course of changes in metamorphopsia and the relationship between best-corrected visual acuity (BCVA and OCT parameters were assessed. Results: Sealing of the macular hole was noted in all eyes after surgery. BCVA improved significantly from 1 month after surgery (P<0.001. The MV score was significantly higher than the MH score before surgery (P<0.05 and improved significantly from 1 month after surgery (P<0.03. The MH score improved significantly at 6 months after surgery (P<0.001. The postoperative MV and MH scores became closer to one another from 1 month after surgery. Moreover, the MV score was higher than the MH score at all postoperative assessments. There was a significant correlation between the MV and MH scores at all follow-up assessments. There was no significant correlation between BCVA and the MV or MH score at any follow-up assessment. Conclusion: The satisfaction of the patients with macular hole after surgery cannot be necessarily measured by BCVA alone, because M-scores were not correlated to BCVA in postoperative evaluation. Therefore, evaluation of

  16. Fully Automated Detection and Quantification of Macular Fluid in OCT Using Deep Learning.

    Science.gov (United States)

    Schlegl, Thomas; Waldstein, Sebastian M; Bogunovic, Hrvoje; Endstraßer, Franz; Sadeghipour, Amir; Philip, Ana-Maria; Podkowinski, Dominika; Gerendas, Bianca S; Langs, Georg; Schmidt-Erfurth, Ursula

    2018-04-01

    Development and validation of a fully automated method to detect and quantify macular fluid in conventional OCT images. Development of a diagnostic modality. The clinical dataset for fluid detection consisted of 1200 OCT volumes of patients with neovascular age-related macular degeneration (AMD, n = 400), diabetic macular edema (DME, n = 400), or retinal vein occlusion (RVO, n = 400) acquired with Zeiss Cirrus (Carl Zeiss Meditec, Dublin, CA) (n = 600) or Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) (n = 600) OCT devices. A method based on deep learning to automatically detect and quantify intraretinal cystoid fluid (IRC) and subretinal fluid (SRF) was developed. The performance of the algorithm in accurately identifying fluid localization and extent was evaluated against a manual consensus reading of 2 masked reading center graders. Performance of a fully automated method to accurately detect, differentiate, and quantify intraretinal and SRF using area under the receiver operating characteristics curves, precision, and recall. The newly designed, fully automated diagnostic method based on deep learning achieved optimal accuracy for the detection and quantification of IRC for all 3 macular pathologies with a mean accuracy (AUC) of 0.94 (range, 0.91-0.97), a mean precision of 0.91, and a mean recall of 0.84. The detection and measurement of SRF were also highly accurate with an AUC of 0.92 (range, 0.86-0.98), a mean precision of 0.61, and a mean recall of 0.81, with superior performance in neovascular AMD and RVO compared with DME, which was represented rarely in the population studied. High linear correlation was confirmed between automated and manual fluid localization and quantification, yielding an average Pearson's correlation coefficient of 0.90 for IRC and of 0.96 for SRF. Deep learning in retinal image analysis achieves excellent accuracy for the differential detection of retinal fluid types across the most prevalent exudative

  17. Estudo macular na doença de Stargardt Macula study in Stargardt's disease

    Directory of Open Access Journals (Sweden)

    Otacílio de Oliveira Maia Júnior

    2008-02-01

    Full Text Available OBJETIVO: Avaliar dano estrutural macular na doença de Stargardt por meio da tomografia de coerência óptica, correlacionando-o com acuidade visual e duração da doença. MÉTODOS: Foram incluídos portadores da doença de Stargardt, submetidos à medida da acuidade visual (logMAR e exames complementares (retinografia, angiofluoresceinografia e tomografia de coerência óptica. Todos os casos foram reexaminados para confirmação diagnóstica, sendo determinada duração da doença. O grupo controle foi composto pelo mesmo número de casos, pareados por sexo, idade e sem qualquer alteração oftalmológica. RESULTADOS: A amostra foi composta por 22 pacientes (44 olhos, sendo 11 (50% do sexo masculino e 11 (50%, do feminino. A duração da doença variou de 3 a 21 anos (média de 11,4 ± 5,3 anos. Os grupos não apresentaram diferença significante na idade (p=0,98 e no sexo. O grupo caso apresentou valores de espessura macular na tomografia de coerência óptica significativamente menores em relação ao grupo controle (pPURPOSE: To evaluate de macular structural damage in Stargardt's disease by optical coherence tomography, correlating with visual acuity and disease duration. METHODS: Patients with Stargardt's disease were included and submitted to visual acuity (logMAR measurement and complementary examinations performed were color fundus photographs, fluorescein angiography and optical coherence tomography. All cases were reexamined for diagnostic confirmation and the duration of symptoms was determined. The control group was composed of the same number of subjects, matched by sex and age, without any ophthalmologic alteration. RESULTS: The sample was composed of 22 patients (44 eyes with Stargardt's disease, 11 (50% males and 11 (50% females. The duration of the disease varied from 3 to 21 years (mean of 11.4 ± 5.3 years. The groups did not show significant differences in age (p= 0.98 and sex. Concerning the macular thickness in optical

  18. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

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    Elaine W Chong

    Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

  19. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Science.gov (United States)

    Chong, Elaine W; Wang, Yuanyuan; Robman, Liubov D; Aung, Khin Zaw; Makeyeva, Galina A; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M; Guymer, Robyn H

    2015-01-01

    Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be

  20. Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment.

    Science.gov (United States)

    Kumar, Atul; Kakkar, Prateek; Ravani, Raghav Dinesh; Markan, Ashish

    2017-07-14

    Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM). 1â€"3 Shimada et al 4 described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction. 5 6 Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography (MIOCT) in assisting complete removal of PVC and internal limiting membrane (ILM) peeling with multilayered inverted ILM flap in the treatment of myopic macular hole retinal detachment. MIOCT helped identify vitreoschisis and confirm the position of ILM flaps over the macular hole intraoperatively. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Outcomes of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration.

    Science.gov (United States)

    Hwang, John; Escariao, Paulo; Iranmanesh, Reza; Tosi, Gian Marco; Chang, Stanley

    2007-01-01

    To assess the outcome of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration. Retrospective review of patients who underwent macular hole surgery from September 1998 to August 2005. Outcomes in eyes that received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration were compared to outcomes in a case-matched control group without retinal breaks or lattice degeneration. A total of 235 consecutive macular hole surgery cases were reviewed. Twenty-four eyes from 24 patients received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration. Macular hole closure occurred in all case and control eyes without any incidence of postoperative retinal detachment. Best-corrected visual acuity improvement of at least three Snellen lines occurred in 100% of case eyes and 92% of control eyes. Outcomes of macular hole surgery in patients with retinal breaks and/or lattice degeneration are similar to outcomes in the overall population when these conditions are treated with intraoperative endolaser photocoagulation. Postoperative retinal detachment does not appear to be correlated with treated retinal tears and greater attention should focus on detecting and managing intraoperative breaks. In our hands, routine use panoramic viewing has replaced indirect ophthalmoscopy, by saving time, and reducing the risk of contamination.

  2. Quantification of Macular Vascular Density Using Optical Coherence Tomography Angiography and Its Relationship with Retinal Thickness in Myopic Eyes of Young Adults

    Directory of Open Access Journals (Sweden)

    Shiqi Yang

    2017-01-01

    Full Text Available Purpose. To quantify macular vascular density using optical coherence tomography angiography (OCTA and to investigate its relationship with retinal thickness in myopic eyes of young adults. Methods. In this cross-sectional study, 268 myopic eyes without pathological changes were recruited and divided into three groups: mild myopia (n=81, moderate myopia (n=117, and high myopia (n=70. Macular vascular density was quantified by OCTA and compared among three groups. Average retinal thickness, central subfield thickness, and macular ganglion cell complex (mGCC thickness were also evaluated and compared. Correlations among these variables were analyzed. Results. There was no statistical difference in superficial (62.3 ± 5.7% versus 62.7 ± 5.9% versus 63.8 ± 5.5% and deep macular vascular densities (58.3 ± 9.6% versus 59.2 ± 9.3% versus 60.9 ± 7.9% among mild-myopia, moderate-myopia, and high-myopia groups (both P>0.05. Superficial and deep macular vascular densities both had correlations with mean arterial pressure. Furthermore, superficial macular vascular density was significantly correlated with mGCC thickness. Conclusions. Varying degrees of myopia did not affect macular vascular density in young healthy adults. In addition, superficial macular vascular density, as an independent factor, was positively correlated with mGCC thickness.

  3. 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)....

  4. Absolute and estimated values of macular pigment optical density in young and aged Asian participants with or without age-related macular degeneration.

    Science.gov (United States)

    Ozawa, Yoko; Shigeno, Yuta; Nagai, Norihiro; Suzuki, Misa; Kurihara, Toshihide; Minami, Sakiko; Hirano, Eri; Shinoda, Hajime; Kobayashi, Saori; Tsubota, Kazuo

    2017-08-29

    Lutein and zeaxanthin are suggested micronutrient supplements to prevent the progression of age-related macular degeneration (AMD), a leading cause of blindness worldwide. To monitor the levels of lutein/zeaxanthin in the macula, macular pigment optical density (MPOD) is measured. A commercially available device (MPSII®, Elektron Technology, Switzerland), using technology based on heterochromatic flicker photometry, can measure both absolute and estimated values of MPOD. However, whether the estimated value is applicable to Asian individuals and/or AMD patients remains to be determined. The absolute and estimated values of MPOD were measured using the MPSII® device in 77 participants with a best-corrected visual acuity (BCVA) > 0.099 (logMAR score). The studied eyes included 17 young (20-29 years) healthy, 26 aged (>50 years) healthy, 18 aged and AMD-fellow, and 16 aged AMD eyes. The mean BCVA among the groups were not significantly different. Both absolute and estimated values were measurable in all eyes of young healthy group. However, absolute values were measurable in only 57.7%, 66.7%, and 43.8%, of the aged healthy, AMD-fellow, and AMD groups, respectively, and 56.7% of the eyes included in the 3 aged groups. In contrast, the estimated value was measurable in 84.6%, 88.9% and 93.8% of the groups, respectively, and 88.3% of eyes in the pooled aged group. The estimated value was correlated with absolute value in individuals from all groups by Spearman's correlation coefficient analyses (young healthy: R 2  = 0.885, P = 0.0001; aged healthy: R 2  = 0.765, P = 0.001; AMD-fellow: R 2  = 0.851, P = 0.0001; and AMD: R 2  = 0.860, P = 0.013). Using the estimated value, significantly lower MPOD values were found in aged AMD-related eyes, which included both AMD-fellow and AMD eyes, compared with aged healthy eyes by Student's t-test (P = 0.02). Absolute, in contrast to estimated, value was measurable in a limited number of aged participants

  5. Distrofia macular cristalina em paciente com síndrome de Sjögren-Larsson: relato de caso Macular crystalline dystrophy in Sjögren-Larsson syndrome: case report

    Directory of Open Access Journals (Sweden)

    David Leonardo Cruvinel Isaac

    2009-04-01

    Full Text Available Apresentação de um caso de distrofia macular cristalina em paciente do sexo feminino com síndrome de Sjögren-Larsson. A doença caracteriza-se pela tríade: ictiose congênita, diplegia ou tetraplegia espástica e retardo mental. Os olhos são acometidos em até 100% dos casos sendo característica a presença de maculopatia cristalina como observado na paciente relatada. À fundoscopia observou-se a presença de depósitos esbranquiçados perifoveais. A tomografia de coerência óptica evidenciou pontos hiper-reflexivos correspondentes aos depósitos intrarretinianos, atrofia macular com redução na espessura macular em ambos os olhos. Os achados relacionados à síndrome, à tomografia de coerência óptica foram apresentados de maneira inédita em nosso meio.Presentation of a case of crystalline macular distrophy diagnosed in a female patient with Sjögren-Larsson syndrome. The disease consists of clinical findings of spastic diplegia or tetraplegia, mental retardation, and congential ichthyosis. The eyes are affected in up to 100% of cases, and crystalline maculopathy is the main finding as described in this case report. On fundus examination multiple white dots were observed at ophthalmoscopy. The optical coherence tomography has shown not only the hipereflexive intraretinal spots but also macular atrophy with macular thickness reduction. The tomographic findings were first described in our country.

  6. The north Jutland county diabetic retinopathy study (NCDRS) 2. Non-ophthalmic parameters and clinically significant macular oedema

    DEFF Research Database (Denmark)

    Knudsen, Lars Loumann; Lervang, Hans-Henrik; Lundbye-Christensen, Søren

    2007-01-01

    subjects undergoing retinopathy screening in the county of North Jutland. The association between the presence of clinically significant macular oedema and blood-pressure, HbA1c, BMI, age, onset of diabetes, duration of diabetes, blood pressure reducing medication, lipid lowering medication, neuropathy......Background: The influence of non-ophthalmic parameters on the prevalence of clinically significant macular oedema has not been unambiguously established. The present study was initiated with the aim of clarification. Methods: This cross-sectional study comprised 656 type 1 and 328 type 2 diabetic......, and urinary albumin excretion was explored using multiple logistic regression analysis. Findings: We found no significant association between the presence of clinically significant macular oedema and any of the examined parameters in type 1 diabetic subjects. In type 2 diabetic subjects the duration...

  7. Early changes in macular optical coherence tomography parameters after Ranibizumab intravitreal injection in patients with exsudative age-related macular degeneration.

    Science.gov (United States)

    de Almeida, Nicole Antunes; de Souza, Osias Francisco

    2018-01-01

    Evaluation of the impact of different macular optical coherence parameters on visual acuity as early as 1 day after injection of ranibizumab in patients with subfoveal exsudative age-related macular degeneration. This was an interventional, non randomized, open label prospective study, where we evaluated 20 eyes of 20 patients affected by exudative age-related macular degeneration. These patients were treated with injections of ranibizumab between February 2013 and January 2015. The primary endpoint of this study was to evaluate the early changes in optical coherence tomography parameters (retinal thickness, central and total retinal volume) and impact on best-corrected visual acuity (BCVA) obtained by logarithm of minimum resolution using ETDRS protocol in patients treated with a single dose intravitreal injection of ranibizumab (0.5 mg/0.05 mL) during the first month of follow. The patients were evaluated on the first day, them at 7 and 30 days after the treatment. The National Eye Institute Visual Functioning Questionnaire was applied during the study period to assess early perception of ranibizumab injection effectiveness. The adverse events were monitored throughout the study. Central retinal thickness values at 1 (464.0 ± 97.8 µm), 7 (379.9 ± 107.8 µm) and 30 days (365.5 ± 95.1 µm) after ranibizumab injection showed a statically significant reduction when compared with baseline results ( P  = 0.01, P  = 0.001, P  = 0.001, respectively). Similar alterations were observed in central and total retinal volume, which were detected early on the first day of evaluation, after the measurement at baseline (central: 0.36 ± 0.07 vs. 0.40 ± 0.10 mm 3 , P  = 0.01; total: 9.62 ± 1.10 vs. 9.99 ± 2.56 mm 3 , P  = 0.002) and remained steady at 7 ( P  = 0.001, P  = 0.002, respectively) and 30 days ( P  = 0.001, P  = 0.004, respectively) with slight variations without losing their gains in these parameters. The best

  8. [Non-pharmacologic therapy of age-related macular degeneration, based on the etiopathogenesis of the disease].

    Science.gov (United States)

    Fischer, Tamás

    2015-07-12

    It has a great therapeutic significance that the disorder of the vascular endothelium, which supplies the affected ocular structures, plays a major role in the development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfuncition and age-related macular degeneration is accompanied by a general inflammatory response. The vascular wall including those in chorioids may be activated by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic and genetic factors causing a protracted host defence response with a consequent vascular damage, which leads to age-related macular degeneration. Based on this concept, age-related macular degeneration is a local manifestation of the systemic vascular disease. This recognition should have therapeutic implications because restoration of endothelial dysfunction can stabilize the condition of chronic vascular disease including age-related macular degeneration, as well. Restoration of endothelial dysfunction by non-pharmacological or pharmacological interventions may prevent the development or improve endothelial dysfunction resulting in prevention or improvement of age-related macular degeneration. Non-pharmacological interventions which may have beneficial effect in endothelial dysfunction include (1) smoking cessation; (2) reduction of increased body weight; (3) adequate physical activity; (4) appropriate diet (a) proper dose of flavonoids, polyphenols and kurcumin; (b) omega-3 long-chain polyunsaturated fatty acids: docosahexaenoic acid and eicosapentaenoic acid; (c) carotenoids, lutein and zeaxanthins), (d) management of dietary glycemic index, (e) caloric restriction, and (5) elimination of stressful lifestyle. Non-pharmacological interventions should be preferable even if medicaments are also used for the treatment of endothelial dysfunction.

  9. [Observation of single-layered inverted internal limiting membrane flap technique for macular hole with retinal detachment in high myopia].

    Science.gov (United States)

    Xu, C Z; Wu, J H; He, J W; Feng, C

    2017-05-11

    Objective: To compare the outcome of pars plana vitrectomy (PPV) with a single-layered inverted internal limiting membrane (ILM) flap versus PPV with ILM peeling for the treatment of macular hole associated retinal detachment (MHRD) in high myopia. Methods: In a retrospective cohort study, PPV with 2 kinds of adjuvant surgical procedures were used in 35 moderately high myopia eyes with MHRD. These eyes were divided into 2 groups: group 1 (17 eyes) receiving PPV and ILM peeling and group 2 (18 eyes) receiving PPV with a single-layered inverted ILM flap. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity (BCVA) were measured at 6 months after surgery. Results: The retina was successfully reattached in all cases. The difference of the retinal reattachment rate between the two groups was not statistically significant (Fisher's exact test, P= 1.000). The rate of macular hole closure was 47.1% in group 1 (8 eyes) and 88.9% in group 2 (16 eyes). The difference of the macular hole closure rate between the two groups was statistically significant (Fisher's exact test, P= 0.012). Significant improvement in logarithm of minimal angle of resolution (logMAR) BCVA was achieved in both groups. There was no difference in the initial, final, or improved logMAR BCVA in the 2 groups. Conclusion: Single-layered inverted ILM flap technique effectively helps close the macular hole in moderately high myopia with MHRD. This may prevent the possible redetachment from the macular hole. (Chin J Ophthalmol, 2017, 53: 338 - 343) .

  10. SAFETY AND EFFICACY OF INTRAVITREAL DEXAMETHASONE IMPLANTS IN THE MANAGEMENT OF MACULAR EDEMA SECONDARY TO INFECTIOUS UVEITIS.

    Science.gov (United States)

    Fonollosa, Alex; Llorenç, Victor; Artaraz, Joseba; Jimenez, Beatriz; Ruiz-Arruza, Ioana; Agirrebengoa, Koldo; Cordero-Coma, Miguel; Costales-Mier, Felipe; Adan, Alfredo

    2016-09-01

    To assess the safety and efficacy of intravitreal dexamethasone implants in the treatment of macular edema secondary to infectious uveitis. We retrospectively reviewed clinical records from three uveitis referral units in Spain. The main outcome measures were rate of reactivation of infection, improvements in visual acuity and resolution of macular edema, as measured by optical coherence tomography. We included eight eyes from seven patients with a median age of 64 years (30-75). Etiologies of the infections were Herpes simplex virus-type 1, Varicela-Zoster virus, Treponema pallidum, Brucella mellitensis, Borrelia burgdorferi, Toxoplasma gondii, and cytomegalovirus. Median visual acuity was 20/160 (20/30-20/400) at baseline and 20/70 (20/25-20/200) at the last follow-up visit. Mean macular thickness was 516 μm (115) at baseline and 266.3 μm (40) at the last follow-up visit. Visual acuity improved in 100% of the eyes and none of the eyes showed macular edema at the last follow-up visit. Five patients required reinjections of the implant. Only one patient required antiglaucoma drops for a temporary increase in ocular pressure. There were no cases of reactivation of the infectious ocular disease. Median follow-up time was 18 months. In this small case series of eyes with macular edema secondary to infectious uveitis, treatment with dexamethasone intravitreal implants was not associated with reactivation of the infectious ocular disease. Furthermore, significant improvements in visual acuity and macular thickness were observed in our patients.

  11. Inertial sensor based gait analysis discriminates subjects with and without visual impairment caused by simulated macular degeneration.

    Science.gov (United States)

    Kanzler, Christoph M; Barth, Jens; Klucken, Jochen; Eskofier, Bjoern M

    2016-08-01

    Macular degeneration is the third leading cause of blindness worldwide and the leading cause of blindness in the developing world. The analysis of gait parameters can be used to assess the influence of macular degeneration on gait. This study examines the effect of macular degeneration on gait using inertial sensor based 3D spatio-temporal gait parameters. We acquired gait data from 21 young and healthy subjects during a 40 m obstacle walk. All subjects had to perform the gait trial with and without macular degeneration simulation glasses. The order of starting with or without glasses alternated between each subject in order to test for training effects. Multiple 3D spatio-temporal gait parameters were calculated for the normal vision as well as the impaired vision groups. The parameters trial time, stride time, stride time coefficient of variation (CV), stance time, stance time CV, stride length, cadence, gait velocity and angle at toe off showed statistically significant differences between the two groups. Training effects were visible for the trials which started without vision impairment. Inter-group differences in the gait pattern occurred due to an increased sense of insecurity related with the loss of visual acuity from the simulation glasses. In summary, we showed that 3D spatio-temporal gait parameters derived from inertial sensor data are viable to detect differences in the gait pattern of subjects with and without a macular degeneration simulation. We believe that this study provides the basis for an in-depth analysis regarding the impact of macular degeneration on gait.

  12. Plasma long-chain omega-3 polyunsaturated fatty acids and macular pigment in subjects with family history of age-related macular degeneration: the Limpia Study.

    Science.gov (United States)

    Merle, Bénédicte M J; Buaud, Benjamin; Korobelnik, Jean-François; Bron, Alain; Delyfer, Marie-Noëlle; Rougier, Marie-Bénédicte; Savel, Hélène; Vaysse, Carole; Creuzot-Garcher, Catherine; Delcourt, Cécile

    2017-12-01

    In numerous epidemiological studies, omega-3 polyunsaturated fatty acids (PUFAs) have been associated with a decreased risk of age-related macular degeneration (AMD). Beyond their structural, functional and neuroprotective roles, omega-3 PUFAs may favour the retinal accumulation of lutein and zeaxanthin and thus increase macular pigment optical density (MPOD). We examined the associations of MPOD with plasma omega-3 PUFAs in subjects with family history of AMD. The Limpia study is a double-blind, placebo-controlled, prospective randomized clinical trial performed in 120 subjects. Subjects with at least one parent treated for neovascular AMD, aged 40-70, with a best corrected visual acuity (BCVA) >20/25, free of late AMD and other major eye conditions and with no use of supplement containing lutein or zeaxanthin the preceding year were recruited in Bordeaux and Dijon, France. At baseline, MPOD within 1° of eccentricity was measured by modified Heidelberg retinal analyser (Heidelberg, Germany) and plasma omega-3 PUFAs by gas chromatography. Medical history and lifestyle data were collected from a standardized questionnaire. Associations of MPOD with plasma omega-3 PUFAs were assessed at the baseline examination, using mixed linear models adjusted for age, gender, centre, body mass index, smoking, plasma high-density lipoprotein (HDL) cholesterol and lutein+zeaxanthin. After multivariate adjustment, high MPOD was significantly associated with higher level of plasma docosapentaenoic acid (DPA) (β = 0.029, 95% CI: 0.003, 0.055; p = 0.03). Plasma alpha linolenic, eicosapentaenoic and docosahexaenoic acids were not significantly associated with MPOD. In the Limpia study, high MPOD within 1° was significantly associated with higher plasma levels of omega-3 DPA. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. Analysis of costs associated with the management and morbidity of diabetic macular oedema and macular oedema secondary to retinal vein occlusion.

    Science.gov (United States)

    Abraldes, M J; Pareja, A; Roura, M

    2016-06-01

    To analyse the disease burden in patients with diabetic macular oedema (DMO) or with retinal vein occlusion macular oedema (RVOMO) from a societal perspective. Observational, cross-sectional, multicentre study conducted on patients >18 years old diagnosed with uni- or bilateral DMO or unilateral RVOMO. Data on the use of health resources from diagnosis was collected, and the impact of disease on work life was assessed. Costs were annualised (euros, January 2014). Differences were contrasted using Chi-squared test (or Fisher Exact test), Mann Whitney-U test or Kruskal-Wallis test (Dunn contrast). A total of 448 patients were included (DMO 255; RVOMO 193). There were significant differences in costs of diagnosis: RVOMO €1856, bilateral DMO €1661, and unilateral DMO €1401 (P<.001) and the aggregate medical costs: RVOMO €4639, bilateral DMO 6275€ and unilateral DMO 6269€ (P<.001). Cost by permanent time off work was higher in bilateral DMO €11712, than in unilateral DMO €4284€, and than in RVOMO €1052 (P<.05). Linear regression analysis showed that variables associated with direct health costs were: Diagnosis (bilateral DMO was associated with higher cost), as well as number of days in hospital, number of visits, time of observation, and number of days of time off work. Patients with bilateral DMO are associated with a higher direct health cost, as well as a higher indirect cost by impact of the disease on work life. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  14. [Progression of nerve fiber layer defects in retrobulbar optic neuritis by the macular ganglion cell complex].

    Science.gov (United States)

    Hong, D; Bosc, C; Chiambaretta, F

    2017-11-01

    Recent studies with SD OCT had shown early axonal damage to the macular ganglion cell complex (which consists of the three innermost layers of the retina: Inner Plexiform Layer [IPL], Ganglion Cell Layer [GCL], Retinal Nerve Fibre layer [RNFL]) in optic nerve pathology. Retrobulbar optic neuritis (RBON), occurring frequently in demyelinating diseases, leads to atrophy of the optic nerve fibers at the level of the ganglion cell axons, previously described in the literature. The goal of this study is to evaluate the progression of optic nerve fiber defects and macular ganglion cell complex defects with the SPECTRALIS OCT via a reproducible method by calculating a mean thickness in each quadrant after an episode of retrobulbar optic neuritis. This is a prospective monocentric observational study including 8 patients at the Clermont-Ferrand university medical center. All patients underwent ocular examination with macular and disc OCT analysis and a Goldmann visual field at the time of inclusion (onset or recurrence of RBON), at 3 months and at 6 months. Patients were 40-years-old on average at the time of inclusion. After 6 months of follow-up, there was progression of the atrophy of the macular ganglion cell complex in the affected eye on (11.5% or 11μm) predominantly inferonasally (13.9% or 16μm) and superonasally (12.9% or 14μm) while the other eye remained stable. The decrease in thickness occurred mainly in the most internal 3 layers of the retina. On average, the loss in thickness of the peripapillary RNFL was predominantly inferotemporal (24.9% or 39μm) and superotemporal (21.8% or 28μm). In 3 months of progression, the loss of optic nerve fibers is already seen on macular and disc OCT after an episode of RBON, especially in inferior quadrants in spite of the improvement in the Goldmann visual field and visual acuity. Segmentation by quadrant was used here to compare the progression of the defect by region compared to the fovea in a global and reproducible

  15. Prevention and treatment of age-related macular degeneration: an update for pharmacists.

    Science.gov (United States)

    Marshall, Leisa L; Roach, J Michael

    2013-11-01

    Review the current recommendations for the prevention and treatment of age-related macular degeneration (AMD). Articles indexed in PubMed (National Library of Medicine), the Cochrane Reviews and Trials, Dynamed, and Iowa Drug Information Service (IDIS) in the last 10 years using the key words macular degeneration, agerelated macular degeneration (AMD), AMD and treatment, AMD and prevention. Sixty-nine published papers were reviewed, and criteria supporting the primary objective were used to identify useful resources. The literature included practice guidelines, original research articles, review articles, product prescribing information, and supplement product information for the prevention and treatment of AMD. AMD is a leading cause of visual impairment in older adults. At present there is no cure for advanced AMD, but intravitreal vascular endothelial growth factor inhibitors minimize and even reverse vision loss in patients with AMD of the neovascular type. In the Age-Related Eye Disease Study (AREDS), participants with intermediate AMD who received a supplement combination of vitamins C and E, beta-carotene, and zinc had a greater delay in progression to advanced AMD than those participants who received a portion of these supplements. In the second AREDS, AREDS2, the addition of lutein + zeaxanthin, docosahexaenoic acid (DHA) + eicosapentaenoic acid (EPA), or lutein + zeaxanthin and DHA + EPA to the complete AREDS formulation did not further reduce the risk of progression to advanced AMD. Subgroup analyses indicated that additional research with lutein + zeaxanthin supplementation is warranted as it was beneficial in participants with low dietary intake of lutein + zeaxanthin. A formulation without beta-carotene may be best for most patients, especially smokers or former smokers. Health care professionals will want to consider patient-specific information before recommending ocular health supplements.

  16. Results of Intravitreal Ranibizumab Treatment for Exudative Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Umut Karaca

    2012-01-01

    Full Text Available Pur po se: To evaluate the efficacy and safety of intravitreal ranibizumab injection for exudative age-related macular degeneration. Ma te ri al and Met hod: In this study, we included forty-eight eyes of 43 age-related macular degeneration patients followed for at least twelve months. Mean age was 73.65±8.93 years and mean follow-up time was 14.2 months. All patients received three consecutive monthly intravitreal ranibizumab injections and then were followed up with clinical examination and optic coherence tomography monthly. Re-injection was executed as needed. Re sults: Twenty patients were male (46.5% and twenty-three patients were female (53.5%. The average number of ranibizumab injection was 3.7 (3-7 per eye. Twenty-six lesions (54.2% were classic (predominantly and minimally and twenty-two (45.8% were occult. Mean best-corrected visual acuity was 46.8 letters with ETDRS chart at the initial examination and 55.5 letters at twelfth month. Mean central foveal thickness decreased from 320 microns to 269 microns. There was a statistically significant improvement in visual acuity and central foveal thickness. On the other hand, this improvement was not significant between lesion types. During follow-up, there were no systemic or serious ocular complications determined. Dis cus si on: Intravitreal ranibizumab injection is safe and effective, both anatomically and functionally, for age-related macular degeneration. (Turk J Ophthalmol 2012; 42: 25-9

  17. A patient with acute macular neuroretinopathy and central retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Hirooka K

    2013-07-01

    Full Text Available Kiriko Hirooka,1 Wataru Saito,1,2 Kousuke Noda,1,2 Susumu Ishida1,21Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Sapporo, JapanPurpose: The precise mechanism causing acute macular neuroretinopathy (AMN is still unknown. A recent report suggested that choroidal circulation impairment correlates with its pathogenesis. We report a rare case with simultaneous onset of AMN and central retinal vein occlusion (CRVO, which is a retinal circulation disorder.Methods: Case report.Results: A 44-year-old woman complained of central visual loss of the left eye for the previous 2 weeks. The patient’s visual acuity was 0.5 in the left eye (OS. Fundoscopic examination revealed a wedge-shaped, dark reddish-brown lesion at the macula, and CRVO-like retinal hemorrhages OS. Fluorescein angiography revealed retinal vasculitis and hypofluorescence corresponding to the macular lesion. The patient’s scanning laser ophthalmoscopy infrared imaging result led to a diagnosis of AMN. Two weeks after corticosteroid pulse therapy, her visual acuity improved to 1.2 OS, with improvement of macular findings and Humphrey perimetry. When the dose of oral corticosteroid was decreased, the AMN lesion worsened, with recurrence of retinal hemorrhages. Visual functions improved again after an increased dose of corticosteroid.Conclusion: These results suggest that circulatory disorders almost simultaneously occurred in choroidal and retinal vessels, resulting in the onset of both AMN and CRVO.Keywords: choroidal circulation, optical coherence tomography, retinal circulation, systemic corticosteroid therapy

  18. An exploratory study evaluating the effects of macular carotenoid supplementation in various retinal diseases

    Directory of Open Access Journals (Sweden)

    Crosby-Nwaobi R

    2016-05-01

    Full Text Available Roxanne Crosby-Nwaobi, Philip Hykin, Tunde Peto, Sobha Sivaprasad NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK Purpose: The aim of this study was to assess the impact of daily oral supplementation with Macushield (10 mg/d meso-zeaxanthin, 10 mg/d lutein, and 2 mg/d zeaxanthin on eye health in patients with retinal diseases by assessing the macular pigment (MP profile, the visual function, and the quality of life. Methods: Fifty-one patients with various retinal diseases were supplemented daily and followed up for 6 months. The MP optical density was measured using the customized heterochromatic flicker photometry and dual-wavelength autofluorescence. Visual function was evaluated by assessing the change in best corrected visual acuity, contrast sensitivity, and glare sensitivity in mesopic and photopic conditions. Vision-related and general quality of life changes were determined using the National Eye Insititute- Visual Function Questionnaire-25 (NEI-VFQ-25 and EuroQoL-5 dimension questionnaires. Results: A statistically significant increase in the MP optical density was observed using the dual-wavelength autofluorescence (P=0.04 but not with the customized heterochromatic flicker photometry. Statistically significant (P<0.05 improvements in glare sensitivity in low and medium spatial frequencies were observed at 3 months and 6 months. Ceiling effects confounded other visual function tests and quality of life changes. Conclusion: Supplementation with the three carotenoids enhances certain aspects of visual performance in retinal diseases. Keywords: macular pigment optical density, diabetes, central serous retinopathy, age-related macular degeneration

  19. Interaction of complement factor h and fibulin3 in age-related macular degeneration.

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    M Keith Wyatt

    Full Text Available Age-related macular degeneration (AMD is a major cause of vision loss. It is associated with development of characteristic plaque-like deposits (soft drusen in Bruch's membrane basal to the retinal pigment epithelium (RPE. A sequence variant (Y402H in short consensus repeat domain 7 (SCR7 of complement factor H (CFH is associated with risk for "dry" AMD. We asked whether the eye-targeting of this disease might be related to specific interactions of CFH SCR7 with proteins expressed in the aging human RPE/choroid that could contribute to protein deposition in drusen. Yeast 2-hybrid (Y2H screens of a retinal pigment epithelium/choroid library derived from aged donors using CFH SCR7 baits detected an interaction with EFEMP1/Fibulin 3 (Fib3, which is the locus for an inherited macular degeneration and also accumulates basal to macular RPE in AMD. The CFH/Fib3 interaction was validated by co-immunoprecipitation of native proteins. Quantitative Y2H and ELISA assays with different recombinant protein constructs both demonstrated higher affinity for Fib3 for the disease-related CFH 402H variant. Immuno-labeling revealed colocalization of CFH and Fib3 in globular deposits within cholesterol-rich domains in soft drusen in two AMD donors homozygous for CFH 402H (H/H. This pattern of labeling was quite distinct from those seen in examples of eyes with Y/Y and H/Y genotypes. The CFH 402H/Fib3 interaction could contribute to the development of pathological aggregates in soft drusen in some patients and as such might provide a target for therapeutic intervention in some forms of AMD.

  20. Effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography

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    Mohana Kuppuswamy Parthasarathy

    2015-01-01

    Full Text Available Aim: The aim of the present study was to study the effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography (OCT. Materials and Methods: One hundred and fifty-one subjects were included from the normative study of foveal morphology carried out at our hospital. Subjects underwent comprehensive eye examination and macular scanning using Cirrus high-definition OCT and axial length (AXL measurement. Macular cube 512 × 128 scan protocol was used for scanning the macula. Automated measurements of the fovea namely foveal diameter, foveal slope (lateral measurements and foveal depth (axial measurement were taken. A correction factor for ocular magnification was done using the formula t = p × q × s, where "t0" is the corrected measurement, "p" is the magnification of OCT, "q0" is the ocular magnification, and "s" is the measurement on OCT without correction. The difference between corrected and uncorrected measurements was evaluated for statistical significance. Results: Mean AXL was 22.95 ± 0.78 mm. Refractive error ranged from −3D to +4D. Mean difference between measured and corrected foveal diameter, slope and depth was 166.05 ± 95.37 ΅m (P < 0.001, 0.81° ± 0.53° (P < 0.001 and 0.05 ± 0.49 ΅m (P = 0.178 respectively. AXL lesser than the OCT calibrated value of 24.46 mm showed an increased foveal diameter (r = 0.961, P < 0.001 and a reduced foveal slope (r = −0.863, P < 0.001 than the corrected value. Conclusion: Lateral measurements made on OCT varied with AXL s other than the OCT calibrated value of 24.46 mm. Therefore, to estimate the actual dimensions of a retinal lesion using OCT, especially lateral dimensions, we recommend correction for the ocular magnification factor.