WorldWideScience

Sample records for subfoveal choroidal neovascular

  1. Visual function after strontium-90 plaque irradiation in patients with age-related subfoveal choroidal neovascularization

    Energy Technology Data Exchange (ETDEWEB)

    Jaakkola, A.; Tarkkanen, A.; Immonen, I. [Helsinki Univ. Central Hospital, Dept. of Ophthalmology (Finland); Heikkonen, J. [Helsinki Univ. Central Hospital, Dept. of Oncology (Finland)

    1999-05-01

    Purpose: To report 2-year visual and angiographic results in eyes treated with strontium plaque irradiation for subfoveal choroidal neovascular membranes (CNVM) in age-related macular degeneration. Methods: Twenty eyes with recent subfoveal CNVM were treated with local irradiation. The impact of the treatment on visual function was evaluated by visual acuity, contrast sensitivity and reading speed testing. Results: At 12 months visual acuity had improved or remained the same in 9/20 eyes (45%). At 24 months visual acuity was stable in 5/18 eyes (28%). Eyes with signs of CNVM regression (13/18,72%) lost a mean of 3.3 lines, but eyes with recurrent CNVM lost a mean of 5.1 lines of vision. The mean contrast sensitivity was better in the irradiated eyes than in the fellow eyes with late age-related macular degeneration at 24 months. Six of 17 irradiated eyes (35%) could read at least some words at 24 months. Conclusion: Visual function decreases in patients treated with strontium irradiation, but less in eyes showing regression of the CNVM than in eyes with further growth of the CNVM. (au) 20 refs.

  2. Transpupillary Thermotherapy for Classic Subfoveal Choroidal ...

    African Journals Online (AJOL)

    Dr. Oderinlo

    fundus fluorescein angiography were done, a diagnosis of a classic subfoveal choroidal neovascularization secondary to exudative age-related macular degeneration OS with bilateral cataracts and primary open angle glaucoma OU was made. Complete resolution of the choroidal neovascular membrane was achieved ...

  3. Treatment of age-related subfoveal choroidal neovascularization by low-dose external radiation. A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Harino, Seiyo; Oshima, Yusuke; Tsujikawa, Kaoru; Oh, Ami; Sugimoto, Kiyoshi [Yodogawa Christian Hospital, Osaka (Japan); Murayama, Shigeyuki; Inoue, Toshihiko

    1997-04-01

    We applied low dose external beam radiation (6MV) to 17 eyes of 17 patients (Mean age 70.9 years, range 58-85) who had subfoveal choroidal neovascularization associated with age-related macular degeneration. None of the cases were suitable for photocoagulation according to the Macular Photo-coagulation Study protocol, and no feeding vessels underlying choroidal neovascular membrane could be detected. Corrected visual acuity ranged from 0.02 to 0.6 before treatment. The patients were divided into two groups. One group of 11 eyes was treated with 10 Gy and the other group of 6 eyes with 21 Gy. Mean follow up period was 347{+-}89 (mean{+-}standard deviation) days in the 10 Gy group and 312{+-}100 days in the 21 Gy group. We evaluated the outcome as `effective` if no progression in neovascular membrane was found by ophthalmoscopic and angiographic examination. Only 3 eyes (21%) of patients in the 10 Gy group and 2 eyes (33%) in 21 Gy group showed any effect. Although the rate of progression in choroidal neovascular membrane was significantly smaller in the 10 and 21 Gy group than in the controls, the corrected visual acuity in the treated group was not improved over that of the controls. No serious complications were seen. Only one case showed a stabilized neovascular membrane in the control group of 7 patients. Although the present results seem to be worse than those in previous reports, the efficacy of this treatment still needs to be evaluated because no beneficial strategies in the treatment of subfoveal neovascularization have been established. (author)

  4. Combination therapy of intravitreal triamcinolone and photodynamic therapy with verteporfin for subfoveal choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Hussain Nazimul

    2006-01-01

    Full Text Available Aim: To evaluate the six months follow-up outcome of combined intravitreal triamcinolone acetonide (IVTA and photodynamic therapy (PDT for subfoveal choroidal neovascularization compared to PDT alone. Study design: Prospective interventional pilot study. Materials and Methods: Patients with six months follow-up of IVTA following PDT (Group I, eight eyes and PDT alone (Group II, eight eyes were included. Four mg/ 0.1 ml of IVTA was injected 7-10 days following PDT. The patients were reevaluated every month for the first two months and every three months thereafter in both the groups. Results: Group I: The mean age was 65.8±11.8 years (range: 47-79 years. Five patients were male. The total treatment sessions in six months were 11 (mean: 1.36. At six months, one eye had ³ 10 letters gain and three eyes had > 10 letters loss. Four eyes had stable vision. Two eyes (25% developed increased intraocular pressure (>40 mmHg during follow-up. Group II: The mean age was 58.7±11.7 years (range: 46-76 years. Five patients were male. The total treatment sessions in six months were 17 (mean: 2.13. At six months, six eyes had ³ 10 letters gain and none had > 10 letters loss. Two eyes had stable vision. Conclusion: The mean number of treatment sessions following combination therapy of IVTA (4 mg and PDT appears relatively less (1.36 at six months compared to PDT alone (mean: 2.13. ( P =0.02

  5. Long-term outcome after radiation therapy for subfoveal choroidal neovascularization associated with age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Mandai, Michiko; Takahashi, Masayo; Miyamoto, Hideki; Hiroshiba, Naoko; Kimura, Hideya; Ogura, Yuichiro; Honda, Yoshihito; Sasai, Keisuke [Kyoto Univ. (Japan). Graduate School of Medicine

    2000-10-01

    The purpose of this study was to investigate the long-term effect of low-dose radiation therapy on subfoveal choroidal neovascularization associated with age-related macular degeneration. The clinical course and visual outcome were compared retrospectively among two treated groups and a control group; 15 patients (15 eyes) received 10 Gy, another 15 patients (15 eyes) received 20 Gy. The control group consisted of 15 patients (15 eyes) without treatment. All patients were followed up for at least 18 months, and most were followed up for 3 years. The macula was irradiated with either 10 Gy in 5 fractions or with 20 Gy in 10 fractions after computed tomography (CT) simulation enabled real-time treatment planning from multiple CT slices. During the 3 years of follow-up, the lesions became better in 5 eyes, unchanged in 1, and worse in 9 with 10 Gy radiation; better in 7 eyes, unchanged in 1, and worse in 7 eyes with 20 Gy; and better in 1 eye and worse in 14 with no treatment. The difference between the groups treated with radiation and the control was statistically significant (P<.05). Visual acuity was also significantly better in the group receiving 20 Gy than in the control group up to 2 years after radiation (P<.01). Radiation may extend the period of good visual function substantially by reducing subfoveal choroidal neovascularization activity. (author)

  6. Transpupillary Thermotherapy for Classic Subfoveal Choroidal ...

    African Journals Online (AJOL)

    exudative age-related macular degeneration OS with bilateral cataracts and primary open angle glaucoma OU was made. Complete resolution of the choroidal neovascular membrane was achieved with transpupillary thermotherapy. Keywords: transpupillary thermotherapy, age-related macular degeneration, subfoveal ...

  7. Transpupillary Thermotherapy for Classic Subfoveal Choroidal ...

    African Journals Online (AJOL)

    Dr. Oderinlo

    exudative age-related macular degeneration OS with bilateral cataracts and primary open angle glaucoma OU was made. Complete resolution of the choroidal neovascular membrane was achieved with transpupillary thermotherapy. Key words: transpupillary thermotherapy, age-related macular degeneration, subfoveal ...

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

    Directory of Open Access Journals (Sweden)

    Sharma Sumita

    2004-01-01

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

  9. Photodynamic Therapy for Subfoveal Choroidal Neovascularization Secondary to Age-related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Mong-Ping Shyong

    2005-09-01

    Conclusion: Of our patients with subfoveal CNV secondary to AMD, 83.3% could maintain or improve their visual acuity 1 year after verteporfin PDT. The risk of deterioration in visual acuity due to subfoveal CNV could be reduced by verteporfin PDT. Baseline visual acuity is significantly correlated with the final proportion of visual outcome.

  10. 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....

  11. Terapia fotodinâmica com verteporfirina em neovascularização coroidiana subfoveal secundária a coriorretinopatia serosa central: relato de caso Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in central serous chorioretinopathy: case report

    Directory of Open Access Journals (Sweden)

    Hugo Soares Maia

    2005-08-01

    Full Text Available Relatamos o uso da terapia fotodinâmica com verteporfirina em neovascularização coroidiana subfoveal secundária a coriorretinopatia serosa central. O paciente apresentou melhora da acuidade visual (0,5 para 1,0 30 dias após a primeira sessão. Depois de 141 dias, apresentou reativação da membrana, sendo submetido a nova sessão, obtendo melhora da acuidade visual (0,5 para 1,0 após 30 dias. O quadro mantém-se inalterado há 20 meses. A terapia fotodinâmica pode ser eficiente no tratamento de neovascularização coroidiana secundária a coriorretinopatia serosa central.We report the use of photodynamic therapy with verteporfin for subfoveal choroidal neovacularization in central serous chorioretinopathy. Visual acuity improved (0.5 to 1.0 30 days after the first session. After 141 days, the choroidal neovascularization reactivated and the patient was retreated. Again, visual acuity improved (0.5 to 1.0 30 days afterwards. It remains stable after 20 months. Photodynamic therapy can be efficient in the treatment of choroidal neovascularization in central serous chorioretinopathy.

  12. Focal choroidal excavation complicated by choroidal neovascularization.

    Science.gov (United States)

    Xu, Haifeng; Zeng, Fanxing; Shi, Depeng; Sun, Xiaolei; Chen, Xiuli; Bai, Yao

    2014-01-01

    To evaluate the clinical findings of focal choroidal excavation (FCE) complicated by choroidal neovascularization (CNV). Retrospective, observational case series. Twelve patients (15 eyes) with FCE and CNV. The medical records of the patients were reviewed. Clinical findings including age, sex, refraction, color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (OCT) were analyzed. Fundus fluorescein angiography, ICGA, and OCT findings. The 12 patients included 6 women and 6 men. The mean age was 46.8±13.4 years (range, 26-64 years). One half of the patients were emmetropic, and the others were myopic (-0.5 to -3.0 diopters). All subjects were Chinese. Before CNV development, normal appearance or nonspecific pigment disturbance could be seen around the choroidal excavation. Corresponding to the excavation, window defects were observed by FFA, whereas hypofluorescence was found on ICGA images. Choroidal neovascularization in all eyes was classic as revealed by FFA. The OCT images showed that all eyes had a single choroidal excavation. In 7 of the 15 eyes, the choroidal excavation was located subfoveally, and in the other 8 eyes, it was eccentric. All CNV lesions grew from the bottom or slope of the excavation. Three patients had bilateral involvement. Choroidal neovascularization occurred in both conforming and nonconforming type FCEs, regardless of whether the excavation was shallow or deep, subfoveal or eccentric. All CNV lesions responded well to intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents. After a single injection, CNV regressed in 13 of 15 eyes. Two eyes received an additional injection. Nonconforming FCE changed to the conforming type after successful treatment of CNV. Focal choroidal excavation is not always stable. Choroidal neovascularization commonly can be seen in patients with FCE and responds well to intravitreal anti-VEGF agents

  13. Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin in the ocular histoplasmosis syndrome: one-year results of an uncontrolled, prospective case series.

    Science.gov (United States)

    Saperstein, David A; Rosenfeld, Philip J; Bressler, Neil M; Rosa, Robert H; Sickenberg, Michel; Sternberg, Paul; Aaberg, Thomas M; Aaberg, Thomas M; Reaves, Troy A

    2002-08-01

    To evaluate the safety and effect on visual acuity of photodynamic therapy with verteporfin (Visudyne, Novartis AG) in patients with subfoveal choroidal neovascularization (CNV) secondary to the ocular histoplasmosis syndrome (OHS). Open-label, three-center, noncomparative prospective case series. OHS patients with subfoveal CNV lesions no larger than 5400 micro m in greatest linear dimension (GLD) with classic or occult CNV extending under the geometric center of the foveal avascular zone and best-corrected visual acuity letter score of 73 to 34 (approximate Snellen equivalent 20/40-20/200). Twenty-six patients received verteporfin (6 mg/m(2)) infused IV over 10 minutes. Fifteen minutes after the start of infusion, a laser light at 689 nm delivered 50 J/cm(2) at an intensity of 600 mW/cm(2) over 83 seconds using a spot size with a diameter 1000 micro m larger than the GLD of the lesion. At 3-month follow-up examinations, retreatment with the same regimen was applied if angiography showed fluorescein leakage. Safety assessments were also made. Visual function measurements were the changes from baseline in visual acuity and contrast sensitivity scores and the proportion of patients who, based on best-corrected visual acuity scores, (1) gained 7 or more letters, (2) lost 8 or more letters, and (3) lost 15 or more letters. One patient was omitted from the study at the month 3 examination for not meeting the visual acuity eligibility requirements at baseline. By the month 12 examination, but excluding any retreatment at that visit, patients had received an average of 2.9 treatments of a maximum of 4 possible treatments. The month 12 median improvement from baseline in visual acuity of the remaining 25 patients was 7 letters, and median contrast sensitivity improved by 2 letters. Median visual acuity improvement was also 7 letters when three patients, who failed to meet all photographic eligibility requirements at baseline, were excluded. At the month 12 examination, 14

  14. Intravitreal triamcinolone with transpupillary therapy for subfoveal choroidal neovascularization in age related macular degeneration. A randomized controlled pilot study [ISRCTN74123635

    Directory of Open Access Journals (Sweden)

    Jager Rama D

    2005-11-01

    Full Text Available Abstract Background To assess the effect of intravitreal triamcinolone acetonide (iTA as an adjunctive treatment to transpupillary therapy (TTT for new subfoveal choroidal neovascular membranes (CNV in age-related macular degeneration (AMD. Methods This prospective randomized controlled pilot study comprised 26 patients scheduled to receive TTT, due to either absent indications for photodynamic therapy or financial issues. Patients were assigned into; Group A (n = 14 received TTT alone and Group B (n = 12 received iTA (4 mg followed by TTT within one week. Follow ups were at 2 weeks, and 1, 3 and 6 months for; best-corrected visual acuity (BCVA by ETDRS chart at 4 meters, intraocular pressures (IOP, fluorescein angiography (FAG, and central foveal thickness by optical coherence tomography (OCT. Results All 26 patients completed 6 months of follow ups. The average age for both groups was 74 years. Occult CNV formed 64% and 41%; classis/predominately classic 21% and 16.6%; and minimally classic 15% and 42.4% of group A and B respectively. At baseline; the mean BCVA was 0.045 for group A and 0.04 for group B; mean CNV size was 6.15 disc diameter (DD and 2.44 DD; mean OCT foveal thickness was 513 um and 411 um for group A and B respectively with no statistical differences (P = 0.8, 0.07, and 0.19. At six months the proportion of patients gained ≥ 1 lines was 14% and 25% (P = 0.136 and stabilization was 86% and 66% (P = 0.336; the mean size of the CNV was 5.63 DD and 2.67 DD (P = 0.162; rate of CNV closure was 64% and 83% (P = 0.275; and the mean OCT central foveal thickness was 516.36 um and 453.67 um (P = 0.341, for group A and B respectively. Conclusion The use of iTA as an adjunctive to TTT for new subfoveal CNV in AMD showed a tendency towards better functional results. However due to the small sample size of the study a statistically significant results could not be reached.

  15. Long-term results of radiotherapy for subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyong; Kim, Il Han [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    We performed this prospective randomized study to evaluate the efficacy and the complications of radiotherapy for Subfoveal CNV in ARMD and to compare the treatment results at two dosages (14.4 Gy and 19.8 Gy). 60 eyes of 55 patients were enrolled, and randomized into 14.4 Gy (31 eyes) or 19.8 Gy (29 eyes) groups. CT was used to plan the radiotherapy. All patients received radiotherapy with a 1.8 Gy daily dose using 4 MV photon. We categorized treatment results as improved, stable, or deteriorated based on visual acuity changes of more than 2 lines on the ETDRS chart. Median follow-up period was 33.5 months. At 12 months, visual acuity improved in 9 (16.7%), stable in 41 (75.9%), and aggravated in 4 (7.4%) of 54 evaluated eyes. At 24 months, 49 eyes (81.7%) were evaluated. Visual acuity improved in 6 (12.2%), was stable in 33 (67.4%), and deteriorated in 10 (20.4%). At 36 months, 37 eyes were evaluated. Six (16.2%) eyes were improved, 21 (56.8%) stable, and 10 (27.0%) deteriorated. No significant difference in response was observed between the 14.4 Gy and 19.8 Gy groups (Mantel-Haenszel {chi} {sup 2} = 0.4756). The proportion of eyes with a vision of 20/100 {<=} increased from 28.3% initially to 32.7% after 24 months of radiotherapy. There were no severe acute or chronic complications. External beam radiotherapy with doses of 14.4 or 19.8 Gy may be an effective treatment for subfoveal CNV in ARMD. No dose-response relationships with respect to treatment response or toxicity were observed between the 14.4 Gy and 19.8 Gy groups.

  16. Visual acuity and scar size in eyes with age-related subfoveal choroidal neovascular lesions, 30 months after radiation therapy

    NARCIS (Netherlands)

    G.-J. Bergink (Gerrit-Jan); C. Hoyng (Carel); R.W. van der Maazen (Richard); A.F. Deutman; W.A.J. van Daal (Willem)

    1996-01-01

    textabstractPurpose: In a study to determine the effectiveness of ionizing radiation on the deterioration of visual acuity (VA) due to choroidal neovascularisation (CNV) the affected eyes of 10 patients were treated with a total dose of 24 Gy (6 Gy fractions). A special lenssparing technique was

  17. Patients' perceptions of the value of current vision: assessment of preference values among patients with subfoveal choroidal neovascularization--The Submacular Surgery Trials Vision Preference Value Scale: SST Report No. 6.

    Science.gov (United States)

    Bass, Eric B; Marsh, Marsha J; Mangione, Carol M; Bressler, Neil M; Childs, Ashley L; Dong, Li Ming; Hawkins, Barbara S; Jaffee, Harris A; Miskala, Päivi

    2004-12-01

    To improve understanding and awareness of the impact of subfoveal choroidal neovascularization (CNV) on health-related quality of life, we sought to measure the preference value that patients with subfoveal CNV assigned to their health and vision status. Patients with subfoveal CNV completed telephone interviews about their quality of life prior to enrollment and random treatment assignment in the Submacular Surgery Trials, a set of multicenter randomized controlled trials evaluating outcomes of submacular surgery compared with observation. The interviewers asked patients to rate their current vision on a scale from 0 (completely blind) to 100 (perfect vision). The interviewers also asked them to rate complete blindness and then perfect vision, assuming their health otherwise was the same as it was at the time of the interview, on a scale from 0 (dead) to 100 (perfect health with perfect vision). Scores were converted to a 0 to 1 preference value scale for health and vision status, where 0 represents death and 1 represents perfect health and vision. Of 1015 participants enrolled in the Submacular Surgery Trials, 996 completed interviews that included the rating questions, and 792 (80%) answered all 3 rating questions in a manner permitting calculation of a single overall preference value for their current health and vision status on a scale from 0 (dead) to 1 (perfect). The mean preference value was 0.64 (median, 0.68; interquartile range, 0.51-0.80). The preference values correlated with age (Pearson correlation coefficient, -0.11; P = .002), patients' self-rated perception of overall health (Spearman correlation coefficient, 0.36; Pperception of vision (Spearman correlation coefficient, 0.47; PDepression Scale or the Physical or Mental Component Summary scales of the Short Form-36 Health Survey but did not differ significantly by gender or other baseline characteristics such as race, treatment assignment, or size of the CNV lesion. Vision loss from subfoveal CNV

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

    Directory of Open Access Journals (Sweden)

    Neeraj Pandey

    2010-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Samuray Tuncer

    2013-01-01

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

  20. FOCAL CHOROIDAL EXCAVATION AND CHOROIDAL NEOVASCULARIZATION WITH ASSOCIATED PACHYCHOROID.

    Science.gov (United States)

    Ghadiali, Quraish; Dansingani, Kunal K; Freund, K Bailey

    2016-01-01

    To report a case of focal choroidal excavation and choroidal neovascularization in the setting of pachychoroid disease. Multimodal imaging, including fundus photography, fundus autofluorescence, enhanced depth imaging optical coherence tomography, indocyanine green angiography, and en face structural and angiographic optical coherence tomography. The authors describe a 39-year-old female with moderately high myopia presenting with focal choroidal excavation and associated choroidal neovascularization. Multimodal imaging demonstrated pachychoroid features with dilated choroidal vessels surrounding the lesion. Optical coherence tomography angiography showed Type 2 neovascularization. Some cases of focal choroidal excavation and associated neovascularization may be related to structural abnormalities of the associated choroidal vasculature.

  1. Choroidal neovascularization associated with focal choroidal excavation.

    Science.gov (United States)

    Lee, Jae Hyung; Lee, Won Ki

    2014-03-01

    To describe the clinical and imaging characteristics of choroidal neovascularization (CNV) accompanied by focal choroidal excavation. Retrospective, interventional case series. The medical records of 16 patients (16 eyes) were reviewed. Imaging findings including fluorescein angiography (FA), indocyanine green angiography, and spectral-domain optical coherence tomography (SD OCT) were analyzed. CNV complexes were primarily located beneath the retinal pigment epithelium (type 1 CNV) in 9 eyes and in the subneurosensory retinal space (type 2 CNV) in 7 eyes, as assessed by SD OCT. Seven of 8 patients over 50 years old had type 1 CNV, and 6 of 8 patients under 50 had type 2 lesions. All 7 eyes with type 2 CNV exhibited classic CNV on FA. Additionally, 7 of 9 eyes with type 1 CNV had the classic pattern, and in these eyes, the CNV complexes were confined to the concavity of choroidal excavation. In 15 patients treated by anti-vascular endothelial growth factor (anti-VEGF) injections, the mean best-corrected visual acuity improved from 20/44 to 20/26 with a mean of 3.7 injections during a mean follow-up period of 14.5 months. The CNV growth pattern and extent seem to be determined by the degree of damage to the retinal pigment epithelium/Bruch membrane complex resulting from choroidal excavation, as well as age. Neovascular complexes tend to be located within the boundary of choroidal excavation and are revealed as classic patterns on FA, even in type 1 CNV. Anti-VEGF was notably effective for treating these lesions, with a low rate of recurrence. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Choroidal excavation in choroidal osteoma complicated by choroidal neovascularization.

    Science.gov (United States)

    Pierro, L; Marchese, A; Gagliardi, M; Introini, U; Battaglia Parodi, M; Casalino, G; Bandello, F

    2017-12-01

    PurposeTo describe multimodal imaging features of choroidal osteoma (CO) complicated by choroidal neovascularization (CNV) and focal choroidal excavation (FCE).MethodsPatients presenting with CO and CNV between January and October 2016 were considered for this study. Diagnosis of CO was confirmed by ultrasound examination. All patients underwent multimodal imaging including optical coherence tomography (OCT), swept-source OCT angiography (DRI OCT Triton, Topcon, Inc., Tokyo, Japan) and fluorescein angiography (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany).ResultsTwo patients (one with bilateral CO) were included in the study. OCT showed a FCE in two eyes of two patients (one in correspondence of the CNV and the other adjacent to the CNV). OCT-A demonstrated presence of microvascular flow within neovascular network of the CNVs. Decalcification of the tumor was noted in correspondence of one eye with FCE.ConclusionsFCE may be found in eyes with choroidal osteoma and CNV. OCT-A was a valuable tool for detection of CNV complicating choroidal osteoma. Decalcification of choroidal osteoma may represent a common pathogenic pathway for development of FCE and CNV in choroidal osteoma.

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

    Directory of Open Access Journals (Sweden)

    Rodney J Morris

    2011-01-01

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

  4. CHOROIDAL NEVI WITH FOCAL CHOROIDAL EXCAVATION AND POLYPOIDAL CHOROIDAL NEOVASCULARIZATION.

    Science.gov (United States)

    Simhaee, Daniel; Dolz-Marco, Rosa; Freund, K Bailey

    2017-08-10

    To report two cases of choroidal nevi associated with focal choroidal excavation (FCE) and polypoidal choroidal neovascularization (PCN). Report of two patients with choroidal nevi showing FCE and PCN who underwent multimodal imaging including color fundus photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, spectral domain optical coherence tomography, swept-source optical coherence tomography, and optical coherence tomography angiography. Two patients presented with choroidal nevi associated with FCE and PCN. In the first case, a 74-year-old woman, the nevus had sharp margins, a deep FCE, surrounding drusen, and subretinal exudation at its inferior edge due to PCN that responded well to intravitreal anti-vascular endothelial growth factor therapy. In the second case, a 64-year-old woman, the nevus had ill-defined margins, a shallow FCE, and angiographic evidence of PCN without associated exudation. There have been several reports showing an association of either choroidal nevi or FCE with PCN. To our knowledge, there have been no previous reports of FCE identified within choroidal nevi, with or without associated PCN. Since, in one of our cases, the FCE was not apparent on clinical examination, the prevalence of FCE within nevi may be underdiagnosed.

  5. Choroidal Neovascularization in a Patient with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Giuseppe Casalino

    2014-08-01

    Full Text Available Purpose: To report a case of subfoveal choroidal neovascularization (CNV in a patient with Crohn's disease (CD and to discuss a possible association between these two conditions. Methods: This is an observational case report. Results: A 69-year-old male affected by CD was referred to our department because of sudden visual acuity drop in the left eye. A subfoveal CNV was diagnosed based on slit-lamp fundus biomicroscopy and fluorescein angiography. Color fundus photography, infrared autofluorescence and spectral-domain optical coherence tomography imaging of both eyes were also performed. Following six intravitreal ranibizumab injections, visual improvement was obtained with no related adverse events. Conclusion: We report a case of CNV as a possible rare extraintestinal manifestation of CD. The use of ranibizumab successfully impacted on CNV, while not affecting CD, which remained quiescent.

  6. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Larsen, Michael; Munch, Inger Christine

    2011-01-01

    To investigate the association between subfoveal choroidal thickness and ocular axial length, refractive error, and blood pressure in healthy young women and men.......To investigate the association between subfoveal choroidal thickness and ocular axial length, refractive error, and blood pressure in healthy young women and men....

  7. Does pupil dilation influence subfoveal choroidal laser Doppler flowmetry?

    Science.gov (United States)

    Palanisamy, Nithiyanantham; Riva, Charles E; Rovati, Luigi; Cellini, Mauro; Gizzi, Corrado; Strobbe, Ernesto

    2013-11-01

    The aim of this study was to assess (i) whether pupil dilation with tropicamide influences subfoveal choroidal blood flow, as assessed by continuous laser Doppler flowmetry (LDF) and (ii) if this is the case, whether the effect is due to a haemodynamic response of the drug-induced dilation. Following the instillation of one drop of 1% tropicamide in one eye of 18 healthy, nonsmoking volunteers (age 20-25 years), the subfoveal choroidal LDF parameters (Vel, Vol and ChBF) were recorded during 30 min, at 3-min intervals under two paradigms: through an artificial pupil (4 mm diameter) placed in front of the cornea (P1) and without this artificial pupil (P2). Tropicamide increased the pupil diameter from 3.3 ± 0.4 mm (mean ± SD) to 8.3 ± .4 mm. Full dilation was reached at ~24 min. During this period of time, linear regression analysis demonstrated that none of the LDF parameters varied significantly (p > 0.05), either under P1 or P2. Based on a group of 12 subjects, the smallest (%) change in the mean value of ChBF (ChBFm ) that would be detectable (sensitivity of the method, S) was found to be 2% for P1 and 6% for P2. The average coefficient of variation of ChBFm based on eight measurements during dilation was greater for P2 than for P1 by a factor of approximately 2. Tropicamide had no significant influence on the subfoveal choroidal LDF parameters measured by continuous LDF during pupil dilation. Furthermore, pupil dilation did not affect ChBFm by more than the calculated minimum percentage change of 6% detectable with our method. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Optical coherence tomography angiography artifactual choroidal neovascularization in optic disc pit maculopathy

    Directory of Open Access Journals (Sweden)

    Marina Roizenblatt

    Full Text Available ABSTRACT This case report describes a 19-year-old Caucasian man presented with decreased visual acuity in the right eye for 3 months. Dilated funds exam revealed optic disk pit associated with serous macular detachment. Optical coherence tomography identified communication between the optic disk pit and the macular serous detachment, and optical coherence tomography angiography displayed a subfoveal area suggestive of subfoveal choroidal neovascularization. However, there was no evidence of leakage in the fluorescein angiogram and no evidence of choroidal neovascularization in optical coherence tomography in the area corresponding to the suspicious subfoveal choroidal neovascularization. The patient underwent 23-gauge pars plana vitrectomy in the right eye. Six weeks after surgery, multimodal imaging was repeated and there was near-complete resorption of the subretinal fluid. Optical coherence tomography angiography signal superimposed on optical coherence tomography B-scan also demonstrated normal choriocapillaris signal throughout the macula. In conclusion, optical coherence tomography angiography may produce artifacts in optic disk pit maculopathy that simulate choroidal neovascularization.

  9. Single intravitreal ranibizumab for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Shatriah I

    2011-08-01

    Full Text Available Saidin Nor-Masniwati, Ismail Shatriah, Embong ZunainaDepartment of Ophthalmology, Universiti Sains Malaysia, Kelantan, MalaysiaAbstract: We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks’ duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.Keywords: myopia, choroidal neovascularization, antivascular endothelial growth factor

  10. Dye-enhanced diode laser photocoagulation of choroidal neovascularizations

    Science.gov (United States)

    Klingbeil, Ulrich; Puliafito, Carmen A.; McCarthy, Dan; Reichel, Elias; Olk, Joseph; Lesiecki, Michael L.

    1994-06-01

    Dye-enhanced diode laser photocoagulation, using the dye indocyanine green (ICG), has shown some potential in the treatment of choroidal neovascularizations (CNV). A diode laser system was developed and optimized to emit at the absorption maximum of ICG. In a clinical study at two retinal centers, more than 70 patients, the majority of which had age-related macular degeneration, were treated. Eighteen cases with ill-defined subfoveal CNV were followed an average of 11 months after laser treatment. The results show success in resolving the CNV with an average long-term preservation of visual function equal to or superior to data provided by the Macular Photocoagulation Study for confluent burns of low intensity applied to the CNV. Details of the technique and discussion of the controversies inherent in such a treatment strategy will be presented.

  11. Subfoveal Choroidal Thickness and Axial Length in Preschool Children with Hyperopic Anisometropic Amblyopia.

    Science.gov (United States)

    Mori, Takafumi; Sugano, Yukinori; Maruko, Ichiro; Sekiryu, Tetsuju

    2015-09-01

    To investigate the relationship between subfoveal choroidal thickness and axial length in Japanese preschool children with hyperopic anisometropic amblyopia. Twenty-four children between the age of 3 and 6 years exhibiting hyperopic anisometropic amblyopia were examined. Differences in spherical equivalent between the two eyes were over 1.5 D in all children. Twenty-four eyes in 12 children without anisometropia and amblyopia were examined as age-matched normal controls. Subfoveal choroidal thickness was measured by using enhanced depth imaging optical coherence tomography. Axial length was measured with noncontact optical biometer. The spherical equivalent ranged from +3.50 to +7.25 D in amblyopic eyes and from +0.75 to +3.50 D in fellow eyes. The subfoveal choroidal thickness was significantly greater in the amblyopic eyes than that in the fellow eyes (407.3 ± 54.2 μm versus 357.7 ± 54.3 μm, Paired t-test, p amblyopia was greater than that in age matched normal children, although this difference did not reach statistical significance (326.0 ± 62.1 μm, p = 0.07). The subfoveal choroidal thickness in amblyopic children was negatively correlated with their axial length (r = -0.50, p < 0.01). The subfoveal choroidal thickness of amblyopic children abnormally increased and the thicker subfoveal choroid is mildly correlated with their shorter axial length. The anomalous subfoveal choroidal thicknesses in our amblyopic children may reflect a delay in emmetropization.

  12. Single intravitreal ranibizumab for myopic choroidal neovascularization.

    Science.gov (United States)

    Nor-Masniwati, Saidin; Shatriah, Ismail; Zunaina, Embong

    2011-01-01

    We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks' duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no improvement with pinhole. The right fundus showed myopic maculopathy at the posterior pole with subretinal hemorrhage at the inferotemporal fovea. The optic disc was tilted with inferotemporal peripapillary atrophy. There was a myopic maculopathy appearance in the macula of the left eye. Fundus fluorescein angiography revealed choroidal neovascularization at the fovea of the right eye. A diagnosis of right eye choroidal neovascularization secondary to myopic maculopathy was made. A single intravitreal injection of ranibizumab 0.05 mL was given. Ten weeks following intravitreal injection, vision had improved to 6/7.5, and repeated fundus fluorescein angiography showed absence of choroidal neovascularization. Follow-up at 6 months showed visual acuity had normalized to 6/6 with glasses, which was maintained up to 12 months following treatment. The right fundus showed no further subretinal hemorrhage with no new lesions.

  13. Torpedo Maculopathy Associated with Choroidal Neovascularization.

    Science.gov (United States)

    Jurjevic, D; Böni, C; Barthelmes, D; Fasler, K; Becker, M; Michels, S; Stemmle, J; Herbort, C; Zweifel, S A

    2017-04-01

    Background Torpedo maculopathy is a very rare, congenital, usually unilateral hypopigmented lesion in the temporal macula. Material and Methods This retrospective case series describes three patients with torpedo maculopathy. Results The first two cases demonstrate typical clinical and imaging findings of torpedo maculopathy in asymptomatic patients. The third case relates to a symptomatic young patient with a torpedo lesion, a smaller satellite lesion, and evidence of choroidal neovascularization confirmed by fluorescence angiography. In the area of the clinically visible torpedo lesion, spectral domain optical coherence tomography showed atrophy of the outer retina with increased choroidal signalling and a hyperreflective lesion above the retinal pigment epithelium suggestive of choroidal neovascularization. Fundus autofluorescence imaging revealed a hyperautofluorescent rim along the margin of the hypoautofluorescent torpedo lesion. Conclusion In the literature, torpedo lesions are usually regarded as benign lesions with no tendency for progression. The third case demonstrates that torpedo lesions may be associated with choroidal neovascularization, which has been successfully treated with anti-VEGF therapy. Georg Thieme Verlag KG Stuttgart · New York.

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

    Directory of Open Access Journals (Sweden)

    Ya Xing Wang

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

  15. The effect of consumption of ethanol on subfoveal choroidal thickness in acute phase.

    Science.gov (United States)

    Kang, Hae Min; Woo, Young Jae; Koh, Hyoung Jun; Lee, Christopher Seungkyu; Lee, Sung Chul

    2016-03-01

    To investigate the acute effect of ethanol consumption on subfoveal choroidal thickness. This prospective interventional study included the right eyes of 30 healthy subjects (30 eyes). Ethanol (1.0 g/kg) was administered orally on the first visit. A matching volume of water was administered orally on the second visit. Oral administration of ethanol and water was performed at 14:00, and choroidal thickness was measured every 30 min until 16:00. Change of choroidal thickness after oral administration of ethanol and water was the main outcome measure. At baseline, choroidal mean subfoveal thickness was 299.0±73.4 µm (range, 186.5-472.5 µm) before ethanol consumption and 297.1±71.1 µm (range, 187.0-470.5 µm) before water consumption. After consumption of ethanol, mean subfoveal choroidal thickness increased during the first 60 min and then decreased during the next 60 min, which was a significant change over time (pthickness over time (p=0.310). Comparison of changes in the mean subfoveal choroidal thickness during 120 min showed significant difference between ethanol and water consumption (pthickness. Mean subfoveal choroidal thickness increased during the first 60 min and then decreased during the next 120 min after ethanol consumption. 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/

  16. Single intravitreal ranibizumab for myopic choroidal neovascularization

    OpenAIRE

    Nor-Masniwati, Saidin; Shatriah, Ismail; Zunaina, Embong

    2011-01-01

    Saidin Nor-Masniwati, Ismail Shatriah, Embong ZunainaDepartment of Ophthalmology, Universiti Sains Malaysia, Kelantan, MalaysiaAbstract: We report a case of myopic choroidal neovascularization that showed improvement after a single injection of ranibizumab. A 45-year-old Chinese man with high myopia presented with sudden onset painless central scotoma of his right eye of 2 weeks’ duration. There was no history of trauma. His right eye vision on presentation was 6/30 which showed no ...

  17. CLINICAL COURSE OF INFLAMMATORY CHOROIDAL NEOVASCULARIZATION ASSOCIATED WITH FOCAL CHOROIDAL EXCAVATION.

    Science.gov (United States)

    Corbelli, Eleonora; Sacconi, Riccardo; Querques, Lea; Carnevali, Adriano; Giuffrè, Chiara; Rabiolo, Alessandro; Bandello, Francesco; Querques, Giuseppe

    2017-10-23

    To report the clinical course of focal choroidal excavation associated with choroidal neovascularization in a case of choroidal inflammation. Case report. A 41-year-old man presented with blurred vision and metamorphopsia in his left eye. Multimodal imaging including optical coherence tomography angiography showed nonconforming focal choroidal excavation in the setting of choroidal inflammation and the presence of choroidal neovascularization at the border of the excavation, nicely visualized by optical coherence tomography angiography. Pattern alteration from nonconforming to conforming focal choroidal excavation and choroidal neovascularization involution were observed after treatment with oral steroids. Multimodal imaging, including optical coherence tomography angiography, allowed to detect and monitor pattern focal choroidal excavation transformation and choroidal neovascularization reduction after treatment with oral steroids.

  18. Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review

    Directory of Open Access Journals (Sweden)

    Al-Rashaed S

    2012-07-01

    Full Text Available Saba Al-Rashaed, J Fernando ArevaloKing Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaBackground: The purpose of this paper is to report the clinical course of choroidal neovascularization (CNV secondary to angioid streaks and the outcomes in response to different treatment modalities.Methods: This was a case series of two consecutive patients (four eyes with CNV secondary to angioid streaks. Visual acuity, ophthalmological examination, color photographs, fluorescein angiography, and optical coherence tomography were used to assess the outcomes of treatment.Results: Two eyes were treated with photodynamic therapy for subfoveal choroidal neovascular membrane, one eye underwent thermal laser photocoagulation for extrafoveal CNV followed by intravitreal bevacizumab for subfoveal CNV, and one eye underwent intravitreal bevacizumab for subfoveal CNV. The follow-up period was 4–6 years. The final visual acuities of all eyes were 20/300 or worse with large submacular fibrosis.Conclusion: CNV secondary to angioid streaks in these two patients had a poor prognosis despite undergoing different types of treatment. Poor outcome was likely related to frequent recurrence and newly developed CNV, which remained a clinical concern in these cases.Keywords: choroidal neovascular membrane, angioid streaks, intravitreal bevacizumab, photodynamic therapy

  19. Choroidal Osteoma and Secondary Choroidal Neovascularization Treated with Ranibizumab

    Directory of Open Access Journals (Sweden)

    Almila Sarıgül Sezenöz

    2017-08-01

    Full Text Available A 47-year-old female patient presented with a complaint of decreased vision in the right eye. Her visual acuity was 0.16 in the right eye and 1.0 in the left eye. Fundus examination revealed a slightly elevated, yellowish-white lesion with regular borders at the macula of the right eye. Early and late hyperfluorescence related with choroidal neovascularization (CNV was detected in the right eye on fundus fluorescein angiography. B-scan ultrasonography revealed a hyperechoic choroidal lesion with acoustic shadowing. The lesion was diagnosed as choroidal osteoma. The patient received 3 injections of intravitreal ranibizumab. After 4 months, the visual acuity of the right eye was 0.9 and the CNV had regressed. Follow-up at about 7 months revealed reduced visual acuity in the right eye with an increase in subretinal fluid. An additional ranibizumab injection was administered. In this case report, we discuss the findings and treatment of a rare case of choroidal osteoma with secondary CNV.

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

    Directory of Open Access Journals (Sweden)

    Ann Q. Tran

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ilias Georgalas

    2008-12-01

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

  2. Beals–Hecht syndrome and choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Roberto Gallego-Pinazo

    2010-07-01

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

  3. Surgical induction of choroidal neovascularization in a porcine model

    DEFF Research Database (Denmark)

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

    2007-01-01

    PURPOSE: To develop a reproducible surgical technique for the induction of choroidal neovascularization (CNV) in the subretinal space of porcine eyes and to analyse the resulting CNV clinically and histologically. METHODS: Two different modifications of a surgical technique previously described...

  4. Keratoconus associated with choroidal neovascularization: a case report

    Directory of Open Access Journals (Sweden)

    Oh Joo

    2010-02-01

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

  5. Optical coherence tomography angiography in pediatric choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Chiara Veronese

    2016-07-01

    Conclusion: Distinct choroidal neovascular patterns were visualized in these two cases of pediatric CNV when compared to adult subtypes. OCTA is a noninvasive imaging modality capable of evaluating and characterizing pediatric CNV and their associated vascular patterns.

  6. Blue flicker modifies the subfoveal choroidal blood flow in the human eye.

    Science.gov (United States)

    Lovasik, John V; Kergoat, Hélène; Wajszilber, Marcelo A

    2005-08-01

    The objective of the present study was to reveal an interaction between choroidal blood flow (ChBF) and light-induced photoreceptor activity, a physiological coupling that has been already demonstrated for retinal blood flow but rejected for ChBF. Ten healthy adults volunteered for this study. A real-time recording near-infrared laser-Doppler flowmeter was used to quantify the subfoveal ChBF while the luminance of blue flicker between 1 and 64 Hz was first increased and then decreased by 4.0 log units in 1.0-log unit steps between 0.0375 and 375 cd/m2. In separate testing, flash electroretinograms (ERGs) provided electrophysiological indexes of the relative response of short-wave cones (s-cones) and rods to blue light stimulation. Group-averaged, normalized ChBF measurements revealed that it was modulated by approximately 9% by flicker frequency. Increasing the blue flicker luminance from low to high attenuated the subfoveal ChBF, volume, and velocity by approximately 32%, approximately 30%, and approximately 5%, respectively. Decreasing the luminance from high to low over the same range had no effect on the subfoveal choroidal hemodynamics. The markedly different effects of reversed directions of change in blue flicker luminance on the subfoveal ChBF were linked to transitions between rod-dominated and s-cone-dominated retinal responses. Collectively, these findings indicate that the blue light-induced photoreceptor response is associated with a differential distribution of the ChBF across the ocular fundus according to the degree and type of retinal photoreceptor stimulated.

  7. The effect of topical anti-muscarinic agents on subfoveal choroidal thickness in healthy adults.

    Science.gov (United States)

    Öner, V; Bulut, A; Öter, K

    2016-07-01

    PurposeTo investigate the effects of tropicamide and cyclopentolate, which are two anti-muscarinic agents commonly used in the ophthalmologic practice, on subfoveal choroidal choroidal thickness (ChT) in healthy adults.MethodsA total of 74 healthy adult subjects were enrolled in the study. Subjects were randomly divided into two groups: (1) cyclopentolate group (n=37) in which the right eye (study eye) of each subject received topical cyclopentolate 1%, and the fellow eye (control eye) received artificial tears and (2) tropicamide group (n=37) in which the right eye (study eye) of each subject received topical tropicamide 1% and the fellow eye (control eye) received artificial tears. Each topical medication was applied three times with 10-min intervals. ChT measurements were performed at baseline and 40 min after the last drops of the topical medications by enhanced depth imaging (EDI) optical coherence tomography (OCT).ResultsIn the cyclopentolate group, subfoveal ChT significantly increased in the study eyes (P=0.013), whereas it did not significantly change in the control eyes (P=0.417). On the other hand, in the tropicamide group, no significant subfoveal ChT changes were observed in either the study eyes (P=0.715) or the control eyes (P=0.344).ConclusionsThe current study demonstrated that cyclopentolate caused significant choroidal thickening, whereas tropicamide had no significant effect on ChT in healthy adults. As a result, mydriasis by cyclopentolate may complicate ChT measurements by EDI OCT. Use of tropicamide may provide more reliable results for evaluation of ChT in ocular pathologies.

  8. FGF21 Administration Suppresses Retinal and Choroidal Neovascularization in Mice

    Directory of Open Access Journals (Sweden)

    Zhongjie Fu

    2017-02-01

    Full Text Available Pathological neovascularization, a leading cause of blindness, is seen in retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration. Using a mouse model of hypoxia-driven retinal neovascularization, we find that fibroblast growth factor 21 (FGF21 administration suppresses, and FGF21 deficiency worsens, retinal neovessel growth. The protective effect of FGF21 against neovessel growth was abolished in adiponectin (APN-deficient mice. FGF21 administration also decreased neovascular lesions in two models of neovascular age-related macular degeneration: very-low-density lipoprotein-receptor-deficient mice with retinal angiomatous proliferation and laser-induced choroidal neovascularization. FGF21 inhibited tumor necrosis α (TNF-α expression but did not alter Vegfa expression in neovascular eyes. These data suggest that FGF21 may be a therapeutic target for pathologic vessel growth in patients with neovascular eye diseases, including retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration.

  9. Subfoveal Choroidal Thickness in 1323 Children Aged 11 to 12 Years and Association With Puberty

    DEFF Research Database (Denmark)

    Li, Xiao Qiang; Jeppesen, Pia; Larsen, Michael

    2014-01-01

    coherence tomography (EDI-SD-OCT), ocular interferometric biometry, blood pressure manometry, and measurement of height, weight, nonmydriatic refraction, and best-corrected visual acuity. Self-reported stage of pubertal development was classified as Tanner stages 1 through 4. RESULTS: Mean subfoveal.......14) after adjusting for age and axial length. In girls, the choroid was thickest in participants in the more advanced stage of pubertal development (54.2 [95% CI 20.7-87.7] μm for Tanner 4 versus Tanner 1, P = 0.0015) and increased with body height (19.2 [95% CI 10.8-27.5] μm/10 cm, P

  10. Does the treatment of amblyopia normalise subfoveal choroidal thickness in amblyopic children?

    Science.gov (United States)

    Öner, Veysi; Bulut, Asker

    2017-03-01

    Recent studies have found a choroidal thickening in amblyopic eyes and suggested that there might be a relationship between the choroid and amblyopia. The present study aimed to evaluate the effect of a six-month treatment of amblyopia on choroidal thickness in anisometropic hyperopic amblyopic children. Thirty-two anisometropic hyperopic children with unilateral amblyopia were included in this prospective study. Subfoveal choroidal thickness was measured as the distance between the retinal pigment epithelium and the chorioscleral edge, by using spectral domain enhanced depth imaging optical coherence tomography. The treatment of amblyopia was performed based on the full correction of the refractive error with eyeglasses, a refractive adaptation phase and occlusion by patching the fellow eye. The mean visual acuity of the amblyopic eyes significantly increased from 0.35 ± 0.3 to 0.16 ± 0.2 logMAR after the treatment (p treatment mean choroidal thickness in the amblyopic eyes (p = 0.428) and in the fellow eyes (p = 0.343). The mean choroidal thickness was still higher in the amblyopic eyes than in the fellow eyes after the treatment (p = 0.006). Although a six-month treatment of amblyopia increased the visual acuity of the anisometropic hyperopic amblyopic eyes, it could not significantly change choroidal thickness. Our results were in accordance with the conventional explanation, which suggests visual cortex and lateral geniculate nucleus abnormalities in the pathophysiology of amblyopia. © 2016 Optometry Australia.

  11. Choroidal neovascularization associated with coloboma of the choroid: A series of three cases

    Directory of Open Access Journals (Sweden)

    Bhende Muna

    2011-01-01

    Full Text Available Choroidal neovascularization (CNV is a rare complication associated with coloboma of the choroid. We describe three cases of coloboma choroid where there was loss of vision due to CNV development at the edge of the coloboma. One was managed by photodynamic therapy alone and two were managed by a combination of reduced fluence PDT and intravitreal bevacizumab. Significantly we noted that one treatment session was sufficient to achieve regression of the CNV and improvement in visual acuity.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  13. Radiation therapy for small choroidal neovascularization in age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Matsuhashi, Hideaki; Noda, Yasuko; Takahashi, Daisuke; Mariya, Yasushi [Hirosaki Univ., Aomori (Japan). School of Medicine

    1999-06-01

    Radiation therapy for age-related macular degeneration with subfoveal or juxtafoveal choroidal neovascularization smaller than or equal to 1 disc area was evaluated. Fourteen eyes received a total radiation dose of 10-20 Gy in 5-10 fractions. The mean follow-up time was 22 months. Ten eyes in a control group were followed for an average of 16 months without any treatment. At a 12-month follow-up examination, funduscopic and angiographic findings had improved in 7 eyes (50%), were unchanged in 1 eye (7%) and, had deteriorated in 6 eyes (43%) among the treated patients. The same findings had improved in 1 eye (10%), were unchanged in 2 eyes (20%), and had deteriorated in 7 eyes (70%) among the control patients. There was a statistically significant difference by Mann-Whitney U test between the two groups. Visual acuity had improved in 4 eyes (29%), was unchanged in 6 eyes (43%), and had declined in 4 eyes (29%) among the treated patients. Among the control patients visual acuity had improved in none of the eyes (0%), was unchanged in 6 eyes (60%), and had declined in 4 eyes (40%). The difference between the two groups was not statistically significant. Of the 7 cases whose fundus had improved by 12 months, 4 cases maintained a favorable status through the following 2 years. Radiation therapy had an inhibitory effect on small choroidal neovascularization when viewed by funduscopy and angiography, but, the efficacy for visual prognosis was not always identified. (author)

  14. Radiation therapy for small choroidal neovascularization in age-related macular degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Matsuhashi, Hideaki; Noda, Yasuko; Takahashi, Daisuke; Mariya, Yasushi [Hirosaki Univ., Aomori (Japan). School of Medicine

    2000-12-01

    The purpose of this study was to evaluate the effects of radiation therapy on age-related macular degeneration with subfoveal or juxtafoveal choroidal neovascularization {<=}1 disc area. Fourteen patients (14 eyes) received a total radiation dose of 10-20 Gy in 5-10 fractions. The mean follow-up time was 22 months. Ten patients (10 eyes) in a control group were followed up for an average of 16 months without treatment. At a 12-month posttreatment examination, funduscopic and angiographic findings showed improvement in 7 eyes (50%), no change in 1 eye (7%), and deterioration in 6 eyes (43%) among the treated patients. The same findings demonstrated improvement in 1 eye (10%), no change in 2 eyes (20%), and deterioration in 7 eyes (70%) among the control patients. This difference was determined to be statistically significant between the two groups by the Mann-Whitney U-test. Visual acuity had improved in 4 eyes (29%), was unchanged in 6 eyes (43%), and had declined in 4 eyes (29%), among the treated patients. Among the control patients, visual acuity had improved in none of the eyes (0%), was unchanged in 6 eyes (60%), and had declined in 4 eyes (40%). The difference in visual acuity between the two groups was not statistically significant. Radiation therapy inhibited small choroidal neovascularization, as seen by funduscopy and angiography, but its effectiveness in improving visual prognosis was not always evident. (author)

  15. Assessment of Choroidal Microstructure and Subfoveal Thickness Change in Eyes With Different Stages of Age-Related Macular Degeneration.

    Science.gov (United States)

    Lu, Linna; Xu, Shiqiong; He, Fangling; Liu, Yan; Zhang, Yidan; Wang, Jing; Wang, Zhiliang; Fan, Xianqun

    2016-03-01

    Age-related macular degeneration (AMD) is a major cause of irreversible blindness. Choroidal structural changes seem to be inevitable in AMD pathogenesis. Our study revealed associated choroidal microstructural changes in AMD eyes.The aim of the study was to compare choroidal microstructural changes in eyes with AMD of different stages.The study was a retrospective, cross-sectional case series.The participants comprised of 32 age-matched normal eyes as controls, and 26 fellow uninvolved eyes of intermediate/late AMD, 29 of early AMD, 28 of intermediate AMD, and 39 of late AMD.All subjects underwent comprehensive ophthalmologic examination. The choroid images, including subfoveal choroidal thickness, percentage of Sattler layer area, and en face images of the choroid, were obtained using spectral-domain optical coherence tomography.The main outcome measures were subfoveal choroidal thickness changes, percentage of Sattler layer area changes, and en face images of the choroid in AMD eyes.One hundred fifty-four eyes of 96 individuals with mean age of 67.1±9.2 years were included. The mean subfoveal choroidal thickness was 295.4 ± 56.8 μm in age-matched normal eyes, 306.7 ± 68.4 μm in fellow uninvolved eyes with AMD, 293.8 ± 80.4 μm in early AMD, 215.6 ± 80.4 μm in intermediate AMD, and 200.4 ± 66.6 μm in late AMD (F = 14.2, all P change was related to atrophy of the microstructural changes of underlying capillaries and medium-sized vessels.

  16. Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Associated With Focal Choroidal Excavation.

    Science.gov (United States)

    Chawla, Rohan; Mittal, Kanhaiya; Vohra, Rajpal

    2016-10-01

    The authors report the use of optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) to localize, characterize, and confirm the presence of a choroidal neovascular membrane in a patient of focal choroidal excavation (FCE) with recent-onset metamorphopsia and visual blurring. En face OCTA images just above the level of the retinal pigment epithelium-Bruch's membrane complex typically showed the presence of a glomerulus-like neovascular network with an adjacent dark area suggestive of a Type 2 choroidal neovascularization (CNV). OCTA was found to be a very useful, noninvasive, and quick imaging modality to detect secondary CNV formation in a case of FCE. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:969-971.]. Copyright 2016, SLACK Incorporated.

  17. 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.

  18. Current and emerging treatment options for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    El Matri L

    2015-04-01

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

  19. [Intravitreal bevacizumab for choroidal neovascularization associated with Best's disease].

    Science.gov (United States)

    Velazquez-Villoria, D; Macià Badia, C; Rigo Quera, J; Velez-Escola, L; Arcos-Algaba, G; Martínez-Castillo, V; García-Arumí, J

    2014-10-01

    A 27-year old woman presented with loss of vision in the right eye (20/200). Ophthalmoscopic examination showed intrarretinal hemorrhage in the macular region with neurosensory detachment in the right eye, and viteliform deposit on the left eye. Fluorescein angiography and the electrooculogram confirmed the diagnosis of choroidal neovascularization associated with Best's disease. Four weeks after a single bevacizumab intravitreal injection, visual acuity was restored (20/25) and remained stable after a 12 month follow-up. Intravitreal bevacizumab appears to be an effective treatment for choroidal neovascularization associated to Best's disease. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  20. Phosphorothioate oligonucleotides induction into experimental choroidal neovascularization by HVJ-liposome system.

    Science.gov (United States)

    Ogata, N; Otsuji, T; Matsushima, M; Kimoto, T; Yamanaka, R; Takahashi, K; Wada, M; Uyama, M; Kaneda, Y

    1999-04-01

    The purpose of this study was to determine whether the inactivated hemagglutinating virus of Japan (HVJ)-liposome method can induce phosphorothioate oligonucleotides effectively into an experimentally-induced choroidal neovascularization of rats. We also examined whether antisense phosphorothioate oligonucleotides against VEGF could be induced into choroidal neovascularization as a therapeutic agent by the HVJ-liposome method. The experiments were conducted on a rat model of choroidal neovascularization. FITC-labeled phosphorothioate oligonucleotides were coencapsulated in liposomes. The liposomes were coated with the envelope of inactivated HVJ and injected into the vitreous cavity following photocoagulation of pigmented rat eyes. The eyes were removed following injection, fixed, frozen and cut into thin sections. Induction of oligonucleotides was observed under a laser confocal scanning microscope for fluorescence and the development of choroidal neovascularization was evaluated histopathologically. Phosphorothioate oligonucleotides were effectively induced into ganglion cells and into the cells of the choroidal neovascularization induced by laser photocoagulation. Highly effective induction of oligos was observed 3 to 14 days after intravitreal injection of HVJ-liposomes after which the level decreased. Antisense oligonucleotides against VEGF were induced specifically into cells in the choroidal neovascularization, however neovascularization was still observed. Phosphorothioate oligonucleotides can be effectively induced into ganglion cells, and specifically into cells in choroidal neovascularization. Although antisense oligonucleotides against VEGF failed to prevent choroidal neovascularization, the HVJ-liposome method provided a highly effective means of inducing antisense oligos for in vivo antisense therapy.

  1. Subfoveal choroidal thickness measured by Cirrus HD optical coherence tomography in myopia

    Directory of Open Access Journals (Sweden)

    Li-Li Chen

    2014-09-01

    Full Text Available ATM: To measure the subfoveal choroidal thickness(SFCTin myopia using Cirrus HD optical coherence tomography(OCT, and to explore the relationship between the SFCT, axial length and myopic refractive spherical equivalent.METHODS: One-hundred thirty-three eyes of 70 healthy volunteers were recruited, and were divided into emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group. SFCT were measured by Cirrus HD OCT, and the relationship between the SFCT, axial length and myopic refractive spherical equivalent were evaluated.RESULTS: 1Average SFCT was(275.91±55.74μm in normals, that in emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group were(290.03±34.82μm,(287.64±51.51μm,(274.95±56.83μm,(248.37±67.98μm; 2the SFCT of high-degree myopia group was significant thinner than that of emmetropia group(PPPCONCLUSION: the SFCT is inversely correlated with increasing axial length and myopic refractive error.

  2. Treatment of age-related subfoveal neovascular membranes by teletherapy. Results of a non-randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Subasi, M.; Akmansu, M.; Or, M. [Gazi Univ., Ankara (Turkey). Medical Faculty

    1999-03-01

    This investigation was designed to determine whether low-dose radiation to the macular region could influence the natural course of age-related subfoveal neovascularization. Thirty-one patients with subfoveal membranes due to age-related macular degeneration (ARMD) were treated with 12 Gy of 6 MV X-rays, and 72 patients who were untreated served as a control group. Both groups were followed-up. At six months of follow-up visual acuity was maintained in 54.8% and improved 25.8% of patients treated by radiotherapy. In the control group, visual acuity showed deterioration in 55.5%. There was a significant difference between the treated and untreated groups (p<0.01). Significant neovascular membrane regression or stabilization was recorded in 61.3% of treated patients at six months post-radiation, whereas the membranes in all. 72 control patients showed progressive enlargement. This non-randomized study suggested that low doses of radiation may be an alternative treatment for ARMD without an immediate drop in visual acuity or significant radiation morbidity. (author)

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

    Directory of Open Access Journals (Sweden)

    Ahmad M. Mansour

    2014-01-01

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

  4. RAGE regulates immune cell infiltration and angiogenesis in choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Mei Chen

    Full Text Available PURPOSE: RAGE regulates pro-inflammatory responses in diverse cells and tissues. This study has investigated if RAGE plays a role in immune cell mobilization and choroidal neovascular pathology that is associated with the neovascular form of age-related macular degeneration (nvAMD. METHODS: RAGE null (RAGE-/- mice and age-matched wild type (WT control mice underwent laser photocoagulation to generate choroidal neovascularization (CNV lesions which were then analyzed for morphology, S100B immunoreactivity and inflammatory cell infiltration. The chemotactic ability of bone marrow derived macrophages (BMDMs towards S100B was investigated. RESULTS: RAGE expression was significantly increased in the retina during CNV of WT mice (p<0.001. RAGE-/- mice exhibited significantly reduced CNV lesion size when compared to WT controls (p<0.05. S100B mRNA was upregulated in the lasered WT retina but not RAGE-/- retina and S100B immunoreactivity was present within CNV lesions although levels were less when RAGE-/- mice were compared to WT controls. Activated microglia in lesions were considerably less abundant in RAGE-/- mice when compared to WT counterparts (p<0.001. A dose dependent chemotactic migration was observed in BMDMs from WT mice (p<0.05-0.01 but this was not apparent in cells isolated from RAGE-/- mice. CONCLUSIONS: RAGE-S100B interactions appear to play an important role in CNV lesion formation by regulating pro-inflammatory and angiogenic responses. This study highlights the role of RAGE in inflammation-mediated outer retinal pathology.

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

    Directory of Open Access Journals (Sweden)

    Zenith H.Y. Wu

    2012-06-01

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

  6. Outcomes of anti-vascular endothelial growth factor therapy in the management of choroidal neovascularization associated with choroidal osteoma.

    Science.gov (United States)

    Khan, Mohammed A; DeCroos, Francis C; Storey, Philip P; Shields, Jerry A; Garg, Sunir J; Shields, Carol L

    2014-09-01

    To investigate the efficacy of serial anti-vascular endothelial growth factor injections for choroidal neovascularization associated with choroidal osteoma. In this retrospective interventional case series, eyes with choroidal osteoma and associated choroidal neovascularization were treated with intravitreal ranibizumab or bevacizumab with or without photodynamic therapy consolidation. Resolution of subretinal fluid on optical coherence tomography and best-corrected visual acuity were assessed. Eight eyes in eight patients were treated with monthly intravitreal anti-vascular endothelial growth factor injections with or without photodynamic therapy. Resolution of subretinal fluid on optical coherence tomography was achieved in 7 of 8 eyes (87%) with a mean of 12.3 ± 12.6 injections (range, 1-40). Four eyes (50%) experienced at least 1 recurrence of exudation at a mean interval of 10 months (median, 7.5; range, 5-21 months), necessitating further therapy. The mean Snellen visual acuity improvement was 1 ± 4 lines (range, loss 3 to gain 7 lines) at a mean of 32-months follow-up. Serial anti-vascular endothelial growth factor therapy alone or with photodynamic therapy consolidation for choroidal neovascularization due to choroidal osteoma resulted in anatomical improvement and modest visual gain.

  7. Idiopathic polypoidal choroidal vasculopathy in Thai patients with clinical and angiographic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Bhoomibunchoo C

    2017-02-01

    Full Text Available Chavakij Bhoomibunchoo,1 Yosanan Yospaiboon,1 Somanus Thoongsuwan,2 Duangnate Rojanaporn,3 Nawat Watanachai,4 Pichai Jirarattanasopa,5 Nattapon Wongcumchang,6 Atchara Amphornphruet,7 Sritatath Vongkulsiri,8 Eakkachai Arayangkoon9 1Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 2Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 3Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 4Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 5Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla, 6Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathum Thani, 7Department of Ophthalmology, Rajavithi Hospital, Bangkok, 8Department of Ophthalmology, Phramongkutklao Hospital, Bangkok, 9Department of Ophthalmology, Mettapracharak Hospital, Nakhon Pathom, Thailand Objective: This study aimed to study the prevalence and characteristics of idiopathic polypoidal choroidal vasculopathy (IPCV in Thai patients with clinical and angiographic choroidal neovascularization (CNV.Patients and methods: A consecutive case study of 140 patients presenting with CNV was conducted in nine large referral eye centers throughout Thailand. The demographic data, fundus photographs, fundus fluorescein angiography and indocyanine green angiography of the patients were analyzed.Results: Of 129 patients with clinical and angiographic CNV, IPCV was diagnosed in 100 patients (77.52%, idiopathic CNVs in 16 patients (12.40% and age-related macular degeneration (AMD in 12 patients (9.30%. Of the 107 eyes with IPCV, 90 eyes (84.11% had both branching venous networks (BVNs and polypoidal lesions. Most IPCV patients (93% had unilateral involvement and were at a younger age than AMD patients. In all, 79 eyes (73.83% had lesions found in the macular area, 14 eyes (13.08% in the

  8. Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats.

    Directory of Open Access Journals (Sweden)

    Jeong Hun Bae

    Full Text Available Choroidal neovascularization (CNV is a major cause of severe visual loss in patients with age-related macular degeneration (AMD. Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS as controls. On day 14 after laser induction, fluorescein angiography (FA was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2 mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA. Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p<0.001 for CNV area and volume. Quantitative RT-PCR showed significantly lower expression of VEGFR2 mRNA in the RPE-choroid complexes of itraconazole-injected eyes than those of BSS-injected eyes on days 7 and 14 (p = 0.003 and p = 0.006. Western blots indicated that VEGFR2 was downregulated after itraconazole treatment. ELISA showed a significant difference in VEGF level between itraconazole-injected and BSS-injected eyes on days 7 and 14 (p = 0.04 and p = 0.001. Our study demonstrated that intravitreal itraconazole significantly inhibited the development of laser-induced CNV in rats. Itraconazole had anti-angiogenic activity along with the reduction of VEGFR2 and VEGF levels. Itraconazole may prove beneficial for treating CNV as an alternative or

  9. Laser-Induced Choroidal Neovascularizations: Clinical Study of 3 Cases

    Directory of Open Access Journals (Sweden)

    Wipada Laovirojjanakul

    2017-08-01

    Full Text Available Background: We report 3 patients with laser-induced choroidal neovascularization (CNV. Method: Retrospective, observational case series. Medical charts and photographs were reviewed. Results: Two patients with central serous chorioretinopathy who developed iatrogenic CNV after focal laser photocoagulation were treated with intravitreal ranibizumab injections. One patient with CNV secondary to thermal laser photocoagulation for diabetic macular edema was treated with photodynamic therapy (PDT. Visual improvement has been demonstrated in the patients treated with intravitreal ranibizumab injections, and their successful visual outcome was stable for more than 2 years. Stable visual acuity was also observed in the patient treated with PDT, no visual improvement was observed possibly due to the macular scar and macular ischemia. No systemic or ocular complications were detected among the 3 cases. Conclusion: To prevent a laser-induced CNV, it is critical to avoid heavy small-spot laser burns and repeated application. Patients should be monitored carefully for CNV after laser treatment. In our cases, PDT and intravitreal ranibizumab injections were effective for the treatment of laser-induced CNV.

  10. In vivo gene transfer into choroidal neovascularization by the HVJ liposome method.

    Science.gov (United States)

    Otsuji, T; Ogata, N; Takahashi, K; Matsushima, M; Uyama, M; Kaneda, Y

    2000-02-01

    To evaluate the efficacy of the HVJ liposome method for gene transfer in rats with experimentally induced choroidal neovascularization. Plasmid DNA containing the LacZ reporter gene, or fluorescein isothiocyanate (FITC)-labeled double-stranded phosphorothioate oligodeoxynucleotides (S-ODNs), was encapsulated in liposomes. The liposomes were coated with the envelope of inactivated hemagglutinating virus of Japan (HVJ). Intense laser burns were applied to the posterior pole of the retina of pigmented rats to induce choroidal neovascularization. Following photocoagulation, HVJ liposome suspension was injected into the vitreous. On days 3, 7, 14, and 28 after injection, the eyes were removed and fixed. The eyes injected with LacZ gene were reacted with X-gal, frozen, and cut into thin sections. The sections were examined for the expression of the LacZ gene by light microscopy. The enucleated eyes injected with double-stranded S-ODNs were frozen, cut into thin sections, and examined a confocal scanning laser microscope for FITC labeling. Eyes without injection of HVJ liposomes served as controls. Expression of LacZ genes (beta-galactosidase activity), or localization of FITC labeling, was observed mainly in the laser-induced choroidal neovascular tissue from 3 to 28 days after the intravitreal injection of HVJ liposome. We conclude that the HVJ liposome method achieved effective gene transfer into choroidal neovascular tissue. Thus, this method can be used as a nonviral gene therapy system for the treatment of choroidal neovascularization in vivo.

  11. Evaluation of the effect of intracameral cefuroxime on macular and subfoveal choroidal thickness and macular sensitivity in diabetic patients after cataract surgery.

    Science.gov (United States)

    Ma, Bo; Liu, Yan; Liu, Shaorui; Luo, Min

    2017-02-01

    To evaluate the macular and subfoveal choroidal thickness variation and macular sensitivity changes in diabetic patients after intracameral cefuroxime in cataract surgery. Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, China. Prospective case series. Diabetic patients with visually significant cataract were divided into a treatment group, which received an intracameral injection of 1 mg/0.1 mL cefuroxime, and a control group, which received an equal volume of 0.9% saline solution. The macular thickness and subfoveal choroidal thickness were measured by optical coherence tomography. The macular sensitivity was assessed by microperimetry using the MP-1. The study comprised 46 eyes of 38 patients. The macular thickness increased significantly both in the treatment group (P thickness was 262.86 ± 37.02 μm and 279.70 ± 54.68 μm, respectively (P = .497). No statistical difference was found in the macular thickness variation (P = .338) or subfoveal choroidal thickness variation (P = .491) between the 2 groups. For macular sensitivity, there was no significant difference in the variation between the treatment group and the control group (6.05 ± 2.37 dB versus 5.52 ± 4.17 dB) (P = .772). Intracameral cefuroxime did not significantly influence the thickening of macula or the subfoveal choroidal thickness in diabetic patients after uneventful cataract surgery. The functional improvement in macular sensitivity was also not affected. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians

    Directory of Open Access Journals (Sweden)

    Milani P

    2016-09-01

    Full Text Available Paolo Milani,1 Amedeo Massacesi,1 Stefania Moschini,1 Marco Setaccioli,1 Ennio Bulone,1 Gemma Tremolada,1 Stefano Ciaccia,1 Elena Mantovani,1 Daniela Morale,2 Fulvio Bergamini1 1Ophthalmology Department, Istituto Auxologico, 2Institute of Mathematics, Universita’ degli Studi di Milano, Milan, Italy Purpose: To investigate myopic choroidal neovascularization (mCNV by fluorescein angio­graphy (FA, spectral-domain optical coherence tomography (SD-OCT, near-infrared (NIR reflectance, and autofluorescence (AF. Methods: This retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63–70 years and a mean refraction of -9.72 diopters (95% CI -8.74 to -10.70 diopters. Results: Most of the mCNV cases were foveal-juxtafoveal (60/65, 92.3%, with thickening of the corresponding retina (62/65, 95.3% and leakage on FA (44/65, 67.6%. No retinal fluid was detectable in 32 (49.2% eyes and there was no hemorrhage in 25 (38.4% eyes. Papillary chorio­retinal atrophy was evident in 58 (89.2%, a shadowing effect in 48 (73.8%, and an epiretinal membrane in 38 (58.4% eyes. If an area of macular chorioretinal atrophy was present, mCNV frequently developed adjacent to it and was hyperfluorescent rather than with leakage (P<0.001. In eyes with edema or hemorrhage, hyper-reflective foci were more frequent (P<0.005. NIR and AF features were indeterminable in 19 (29.2% and 27 (41.5% eyes, respectively. The predominant feature was black or grayish on NIR (34/65, 52.3% and patchy (hypo- and hyperfluorescence was observed on AF (25/65, 38.4%. FA and SD-OCT correctly detected mCNV in 49 (75.3% and 48 (73.8% eyes, respectively, whereas NIR and AF exhibited limited diagnostic sensitivity. Doubtful diagnosis was associated with hyperfluorescent mCNV (P<0.001, absence of retinal fluid and epiretinal membrane (P<0.05, and presence of macular chorioretinal atrophy (P<0.01. Conclusion: Tomographic, angiographic, AF

  13. Sensitivity and Specificity of OCT Angiography to Detect Choroidal Neovascularization.

    Science.gov (United States)

    Faridi, Ambar; Jia, Yali; Gao, Simon S; Huang, David; Bhavsar, Kavita V; Wilson, David J; Sill, Andrew; Flaxel, Christina J; Hwang, Thomas S; Lauer, Andreas K; Bailey, Steven T

    2017-01-01

    To determine the sensitivity and specificity of optical coherence tomography angiography (OCTA) in the detection of choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Prospective case series. Prospective series of seventy-two eyes were studied, which included eyes with treatment-naive CNV due to AMD, non-neovascular AMD, and normal controls. All eyes underwent OCTA with a spectral domain (SD) OCT (Optovue, Inc.). The 3D angiogram was segmented into separate en face views including the inner retinal angiogram, outer retinal angiogram, and choriocapillaris angiogram. Detection of abnormal flow in the outer retina served as candidate CNV with OCTA. Masked graders reviewed structural OCT alone, en face OCTA alone, and en face OCTA combined with cross-sectional OCTA for the presence of CNV. The sensitivity and specificity of CNV detection compared to the gold standard of fluorescein angiography (FA) and OCT was determined for structural SD-OCT alone, en face OCTA alone, and with en face OCTA combined with cross-sectional OCTA. Of 32 eyes with CNV, both graders identified 26 true positives with en face OCTA alone, resulting in a sensitivity of 81.3%. Four of the 6 false negatives had large subretinal hemorrhage (SRH) and sensitivity improved to 94% for both graders if eyes with SRH were excluded. The addition of cross-sectional OCTA along with en face OCTA improved the sensitivity to 100% for both graders. Structural OCT alone also had a sensitivity of 100%. The specificity of en face OCTA alone was 92.5% for grader A and 97.5% for grader B. The specificity of structural OCT alone was 97.5% for grader A and 85% for grader B. Cross-sectional OCTA combined with en face OCTA had a specificity of 97.5% for grader A and 100% for grader B. Sensitivity and specificity for CNV detection with en face OCTA combined with cross-sectional OCTA approaches that of the gold standard of FA with OCT, and it is better than en face OCTA alone. Structural OCT alone

  14. Lactoferrin Reduces Chorioretinal Damage in the Murine Laser Model of Choroidal Neovascularization.

    Science.gov (United States)

    Montezuma, Sandra R; Dolezal, Luke D; Rageh, Abrar A; Mar, Kevin; Jordan, Michael; Ferrington, Deborah A

    2015-09-01

    To determine whether lactoferrin, specifically endogenous mouse lactoferrin and exogenous intraperitoneal lactoferrin treatment, plays a role in reducing the chorioretinal damage in the laser-induced model of choroidal neovascularization. Four 532-nm argon laser spots were placed between the retinal vessels of each eye. At Day 7, Fluorescein Angiography was performed to grade the lesions. The mice were perfused with fluorescein-labeled tomato lectin and sacrificed. The retinal pigment epithelium-choroid-sclera complex was flat-mounted and analyzed with a confocal microscope to measure the volume of the lesions. The effect of endogenous lactoferrin was studied by comparing lactoferrin knockout and wild-type (WT) mice. The effect of exogenous lactoferrin treatment was studied by comparing lactoferrin knockout and WT mice treated with lactoferrin for seven days to their respective controls. Lactoferrin knockout mice demonstrated 47% larger lesion volumes than WT mice (p Lactoferrin reduced the lesion volume in Lactoferrin knockout mice by 26% (p lactoferrin knockout mice compared with control WT mice (16% versus 5%). Intraperitoneal treatment with Lactoferrin reduced the grade 2B lesions from 16% to 2% in Lactoferrin knockout mice. The endogenous lactoferrin present in WT mice appears to reduce the choroidal neovascularization in the laser-induced choroidal neovascularization model in mice. Treatment with exogenous lactoferrin is capable of reducing the choroidal neovascularization in lactoferrin knockout mice but does not add a significant protective effect to WT.

  15. Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

    Directory of Open Access Journals (Sweden)

    T. Y. Alvin Liu

    2018-01-01

    Full Text Available A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV due to presumed ocular histoplasmosis syndrome (POHS. Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA or spectral-domain optical coherence tomography (SD-OCT at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA. OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.

  16. Long-term changes in subfoveal choroidal thickness and central macula thickness after Nd:YAG laser capsulotomy.

    Science.gov (United States)

    Yilmaz, Tolga; Yilmaz, Ahu

    2017-08-01

    To evaluate changes in central macula thickness (CMT), subfoveal choroid thickness (SCT), and intraocular pressure (IOP) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. 42 eyes of 42 patients who underwent Nd:YAG laser capsulotomy were included in this prospective study. CMT, SCT, and IOP were evaluated preoperatively and at postoperative week 1 and postoperative months 1, 3, 6, and 12. CMT was 238.1 ± 27.6 μm (mean ± SD) preoperatively, then 239.7 ± 29.8, 241.3 ± 28.7, 242.7 ± 27.2, 238.8 ± 23.7, and 238.3 ± 21.7 μm at postoperative week 1 and months 1, 3, 6, and 12, respectively. SCT was 263.3 ± 21.6 μm preoperatively, and 265.5 ± 24.8, 266.2 ± 25.7, 267.1 ± 26.3, 269.1 ± 24.2, and 269.9 ± 21.4 μm at postoperative week 1 and months 1, 3, 6, and 12, respectively. There were no significant differences between preoperative and postoperative results for CMT, SCT, or IOP (all p > 0.05). Although there were slight changes in choroid thickness in the long term, treatment of posterior capsule opacification with a low-energy Nd:YAG laser is a safe procedure that increases visual acuity without creating a significant increase in IOP, CMT, and SCT.

  17. Bone Marrow Transplantation Transfers Age-Related Susceptibility to Neovascular Remodeling in Murine Laser-Induced Choroidal Neovascularization

    Science.gov (United States)

    Espinosa-Heidmann, Diego G.; Malek, Goldis; Mettu, Priyatham S.; Caicedo, Alejandro; Saloupis, Peter; Gach, Sarah; Dunnon, Askia K.; Hu, Peng; Spiga, Maria-Grazia; Cousins, Scott W.

    2013-01-01

    Purpose. Neovascular remodeling (NVR), the progression of small capillaries into large-caliber arterioles with perivascular fibrosis, represents a major therapeutic challenge in neovascular age-related macular degeneration (AMD). Neovascular remodeling occurs after laser-induced choroidal neovascularization (CNV) in aged but not young mice. Additionally, bone marrow–derived cells, including macrophages, endothelial precursor cells, and mesenchymal precursor cells, contribute to CNV severity. In this study, we investigated the impact of aged bone marrow transplantation (BMT) on the degree of fibrosis, size, and vascular morphology of CNV lesions in a mouse model of laser-induced CNV. Methods. Young (2 months) and old (16 months) mice were transplanted with green fluorescent protein (GFP)-labeled bone marrow isolated from either young or old donors. Laser CNV was induced 1 month following transplant, and eyes were analyzed via choroidal flat mounts and immunohistochemistry 1 month postlaser. The identity of cells infiltrating CNV lesions was determined using specific markers for the labeled transplanted cells (GFP+), macrophages (F4/80+), perivascular mesenchymal-derived cells (smooth muscle actin, SMA+), and endothelial cells (CD31+). Results. Bone marrow transplantation from aged mice transferred susceptibility to NVR into young recipients. Inversely, transplantation of young marrow into old mice prevented NVR, preserving small size and minimal fibrosis. Mice with NVR demonstrated a greater relative contribution of marrow-derived SMA+ perivascular mesenchymal cells as compared to other cells. Conclusions. Our findings indicate that the status of bone marrow is an important determining factor of neovascular severity. Furthermore, we find that perivascular mesenchymal cells, rather than endothelial cells, derived from aged bone marrow may contribute to increased CNV severity in this murine model of experimental neovascularization. PMID:24135751

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    PURPOSE: To study an expanded time course of surgically induced choroidal neovascularization (CNV) in a porcine model applying fluorescence angiography and immunohistology. METHODS: Twenty-two porcine eyes underwent vitrectomy, a retinal bleb was raised and the detached retina perforated using en...

  19. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS BLOOD FLOW IN CHOROIDAL NEOVASCULAR MEMBRANE IN REMISSION PHASE OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Ichiyama, Yusuke; Sawada, Tomoko; Ito, Yuka; Kakinoki, Masashi; Ohji, Masahito

    2017-04-01

    The aim of the study was to investigate blood flow in choroidal neovascular membrane in remission phase of neovascular age-related macular degeneration using optical coherence tomography (OCT) angiography. OCT angiography was obtained in eyes with remission phase of neovascular age-related macular degeneration after treatments, defined as no exudative change (such as macular edema, subretinal fluid, and subretinal hemorrhage) observed in eyes without any treatment for neovascular age-related macular degeneration within the previous 6 months. Irregular blood flows shown in the segmentation of outer retina detected by OCT angiography were considered as blood flows in choroidal neovascular membrane. The vascular area and vessel density were obtained from OCT angiography images. Twenty eyes of 20 patients were included in this analysis. The blood flows in choroidal neovascular membrane were observed in all eyes (100%) using OCT angiography. The mean vascular area was 3.81 ± 3.41 mm and the mean vessel density of lesion was 28.9 ± 8.2%. The vessel density was significantly correlated with best-corrected visual acuity and duration of remission (best-corrected visual acuity: P = 0.008, r = -0.576; duration of remission: P = 0.017, r = -0.525, respectively). Optical coherence tomography angiography revealed that blood flows in choroidal neovascular membrane remained in eyes with clinically inactive neovascular age-related macular degeneration.

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

    Directory of Open Access Journals (Sweden)

    Alvaro Velazquez-Villoria

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

  1. Choroidal neovascularization secondary to ocular penetration during retrobulbar anesthesia and its treatment.

    Science.gov (United States)

    Dikci, Seyhan; Yılmaz, Turgut; Gök, Zarife Ekici; Demirel, Soner; Genç, Oğuzhan

    2017-01-01

    Retrobulbar anesthesia is still used before ocular surgery; however, it has various complications including ocular penetration. The penetration/perforation of the globe can cause complications such as endophthalmitis, retinal detachment, and scotoma. Choroidal neovascularization (CNV) is rarely seen, following choroidal rupture in penetrating eye injuries. Here, we present a patient who underwent a pars plana vitrectomy for vitreous hemorrhage secondary to ocular penetration during a retrobulbar injection for cataract surgery. This patient later developed CNV at the penetration site during follow-up. Physicians should remember that CNV can occur as an unusual late complication of ocular penetration during retrobulbar anesthesia.

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

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nikunj J Shah

    2011-01-01

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

  4. Transpupillary thermotherapy in chinese patients with choroidal neovascularization secondary to age-related macular degeneration: emphasis on the influence of power setting.

    Science.gov (United States)

    Kuo, Hsi-Kung; Kao, Min-Tse; Chen, Yung-Jen; Chen, Chih-Hsin; Wu, Pei-Chang; Kao, Min-Lun

    2008-01-01

    To perform a safety and efficacy study of transpupillary thermotherapy (TTT) in Chinese patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (ARMD). In a prospective study, patients with subfoveal or juxtafoveal CNV secondary to ARMD underwent TTT with fixed treatment and follow-up protocols. From August 2002 to December 2004, 26 patients (27 eyes) completed > or =6 months of follow-up and were included in this report. Fourteen eyes (52%) had improved or stable visual acuity (loss of or =3 lines. The serial mean visual acuity initially decreased during follow-up, then stabilized by 6 months. In the subgroup of occult or minimally classic CNV (20 eyes), 13 eyes (65%) had improved or stable vision. The major complication of TTT included laser-related retinal pigment epithelium (RPE) atrophy in 10 eyes (37%). Six eyes had mild RPE atrophy, 4 eyes had severe RPE-choroid atrophy (macular burn). Analysis of possible risk factors for macular burn showed that 3 eyes had to have the power amplified due to nuclear sclerosis, and 1 pseudophakic eye had regular power. TTT in Chinese ARMD patients with occult or minimally classic CNV, according to our protocol, prevented severe vision loss in the majority of patients, but power amplification due to medium lens opacity induced RPE atrophy or burn in some patients. Copyright 2008 S. Karger AG, Basel.

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

    Directory of Open Access Journals (Sweden)

    Agarwal Manisha

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    T Lekha

    2015-01-01

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

  7. Heparanase-1 activities in the development of laser induced choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Bao-Ke Hou

    2013-04-01

    Full Text Available AIM:To investigate the role of heparanase-1 in laser-induced choroidal neovascularization (CNV.METHODS:Experimental CNV was induced by krypton laser photocoagulation in 15 male Brown Norway rats. Fundus fluorescein angiography and histopathological examination were performed in observing the CNV development. The expression and distribution of heparanase-1 protein in the laser lesions were determined by immunohistochemistry and western blotting analysis.RESULTS:The success rate of laser induced CNV was approximately 75% on 3-4 weeks after laser photocoagulation. The protein levels of heparanase-1 increased significantly in the retina-choroidal complex of CNV models when compared to normal rat eyes (P<0.01. Immunostaining confirmed strong heparanase-1 expressions in all laser lesions, and it displayed to be highest at the newly formed blood vessels within the fibrovascular complex in the subretinal space.CONCLUSION:Heparanase-1 is closely involved in the development of laser induced CNV.

  8. Transscleral sustained vasohibin-1 delivery by a novel device suppressed experimentally-induced choroidal neovascularization.

    Directory of Open Access Journals (Sweden)

    Hideyuki Onami

    Full Text Available We established a sustained vasohibin-1 (a 42-kDa protein, delivery device by a novel method using photopolymerization of a mixture of polyethylene glycol dimethacrylate, triethylene glycol dimethacrylate, and collagen microparticles. We evaluated its effects in a model of rat laser-induced choroidal neovascularization (CNV using a transscleral approach. We used variable concentrations of vasohibin-1 in the devices, and used an enzyme-linked immunosorbent assay and Western blotting to measure the released vasohibin-1 (0.31 nM/day when using the 10 μM vasohibin-1 delivery device [10VDD]. The released vasohibin-1 showed suppression activity comparable to native effects when evaluated using endothelial tube formation. We also used pelletized vasohibin-1 and fluorescein isothiocyanate-labeled 40 kDa dextran as controls. Strong fluorescein staining was observed on the sclera when the device was used for drug delivery, whereas pellet use produced strong staining in the conjunctiva and surrounding tissue, but not on the sclera. Vasohibin-1 was found in the sclera, choroid, retinal pigment epithelium (RPE, and neural retina after device implantation. Stronger immunoreactivity at the RPE and ganglion cell layers was observed than in other retinal regions. Significantly lower fluorescein angiography (FA scores and smaller CNV areas in the flat mounts of RPE-choroid-sclera were observed for the 10VDD, VDD (1 μM vasohibin-1 delivery device, and vasohibin-1 intravitreal direct injection (0.24 μM groups when compared to the pellet, non-vasohibin-1 delivery device, and intravitreal vehicle injection groups. Choroidal neovascularization can be treated with transscleral sustained protein delivery using our novel device. We offer a safer sustained protein release for treatment of retinal disease using the transscleral approach.

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

    Directory of Open Access Journals (Sweden)

    Scott W Cousins

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

  10. A Proinflammatory Function of Toll-Like Receptor 2 in the Retinal Pigment Epithelium as a Novel Target for Reducing Choroidal Neovascularization in Age-Related Macular Degeneration.

    Science.gov (United States)

    Feng, Lili; Ju, Meihua; Lee, Kei Ying V; Mackey, Ashley; Evangelista, Mariasilvia; Iwata, Daiju; Adamson, Peter; Lashkari, Kameran; Foxton, Richard; Shima, David; Ng, Yin Shan

    2017-10-01

    Current treatments for choroidal neovascularization, a major cause of blindness for patients with age-related macular degeneration, treat symptoms but not the underlying causes of the disease. Inflammation has been strongly implicated in the pathogenesis of choroidal neovascularization. We examined the inflammatory role of Toll-like receptor 2 (TLR2) in age-related macular degeneration. TLR2 was robustly expressed by the retinal pigment epithelium in mouse and human eyes, both normal and with macular degeneration/choroidal neovascularization. Nuclear localization of NF-κB, a major downstream target of TLR2 signaling, was detected in the retinal pigment epithelium of human eyes, particularly in eyes with advanced stages of age-related macular degeneration. TLR2 antagonism effectively suppressed initiation and growth of spontaneous choroidal neovascularization in a mouse model, and the combination of anti-TLR2 and antivascular endothelial growth factor receptor 2 yielded an additive therapeutic effect on both area and number of spontaneous choroidal neovascularization lesions. Finally, in primary human fetal retinal pigment epithelium cells, ligand binding to TLR2 induced robust expression of proinflammatory cytokines, and end products of lipid oxidation had a synergistic effect on TLR2 activation. Our data illustrate a functional role for TLR2 in the pathogenesis of choroidal neovascularization, likely by promoting inflammation of the retinal pigment epithelium, and validate TLR2 as a novel therapeutic target for reducing choroidal neovascularization. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  11. Mobile Laser Indirect Ophthalmoscope: For the Induction of Choroidal Neovascularization in a Mouse Model.

    Science.gov (United States)

    Weinberger, Dov; Bor-Shavit, Elite; Barliya, Tilda; Dahbash, Mor; Kinrot, Opher; Gaton, Dan D; Nisgav, Yael; Livnat, Tami

    2017-11-01

    This study aims to evaluate and standardize the reliability of a mobile laser indirect ophthalmoscope in the induction of choroidal neovascularization (CNV) in a mouse model. A diode laser indirect ophthalmoscope was used to induce CNV in pigmented male C57BL/6J mice. Standardization of spot size and laser intensity was determined using different aspheric lenses with increasing laser intensities applied around the optic disc. Development of CNV was evaluated 1, 5, and 14 days post laser application using fluorescein angiography (FA), histology, and choroidal flat mounts stained for the endothelial marker CD31 and FITC-dextran. Correlation between the number of laser hits to the number and size of developed CNV lesions was determined using flat mount choroid staining. The ability of intravitreally injected anti-human and anti-mouse VEGF antibodies to inhibit CNV induced by the mobile laser was evaluated. Laser parameters were standardized on 350 mW for 100 msec, using the 90 diopter lens to accomplish the highest incidence of Bruch's membrane rupture. CNV lesions' formation was validated on days 5 and 14 post laser injury, though FA showed leakage on as early as day 1. The number of laser hits was significantly correlated with the CNV area. CNV growth was successfully inhibited by both anti-human and mouse VEGF antibodies. The mobile laser indirect ophthalmoscope can serve as a feasible and a reliable alternative method for the CNV induction in a mouse model.

  12. Effects of ginkgo biloba extract on laser-induced choroidal neovascularization in rats

    Directory of Open Access Journals (Sweden)

    Chao Chen

    2013-11-01

    Full Text Available AIM: To investigate the effects of ginkgo biloba extract(EGb 761on laser-induced choroidal neovascularization(CNVin rats.METHODS: Totally 60 BN rats were randomly divided into 4 groups: normal control group, model group, experimental group, physiological saline group with 15 in each group. All CNV models were made by krypton laser. Rats in experimental group were intraperitoneally injected with 0.35% EGb761(100mg/kgevery day after laser exposure until they were sacrificed. Rats in physiological saline group were intraperitoneally injected physiological saline every day after laser exposure until they were sacrificed. Fundus fluorescein angiography(FFAwas performed on every rat on the 7th day, 14th day and the 21st day after laser exposure, then the rats were sacrificed immediately. The eyes were enucleated and processed for histopathologic examination.RESULTS: There was no choroidal fluorescein leakage staining in normal rats. There were obviously less choroidal fluorescein leakage points in experimental groups than that in the corresponding model groups(PCONCLUSION: EGb761 len inhibit the formation of laser-induced CNV in rats. The longer the time, the better curative effect.

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

    Directory of Open Access Journals (Sweden)

    Haibo Wang

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

  14. Suppression and regression of choroidal neovascularization in mice by a novel CCR2 antagonist, INCB3344.

    Directory of Open Access Journals (Sweden)

    Ping Xie

    Full Text Available PURPOSE: To investigate the effect of an intravitreally administered CCR2 antagonist, INCB3344, on a mouse model of choroidal neovascularization (CNV. METHODS: CNV was induced by laser photocoagulation on Day 0 in wild type mice. INCB3344 or vehicle was administered intravitreally immediately after laser application. On Day 14, CNV areas were measured on retinal pigment epithelium (RPE-choroid flat mounts and histopathologic examination was performed on 7 µm-thick sections. Macrophage infiltration was evaluated by immunohistochemistry on RPE-choroid flat mounts and quantified by flow cytometry on Day 3. Expression of vascular endothelial growth factor (VEGF protein in RPE-choroid tissue was examined by immunohistochemistry and ELISA, VEGF mRNA in sorted macrophages in RPE-choroid tissue was examine by real-time PCR and expression of phosphorylated extracellular signal-regulated kinase (p-ERK 1/2 in RPE-choroid tissue was measured by Western blot analysis on Day 3. We also evaluated the efficacy of intravitreal INCB3344 to spontaneous CNV detected in Cu, Zn-superoxide dismutase (SOD1 deficient mice. Changes in CNV size were assessed between pre- and 1week post-INCB3344 or vehicle administration in fundus photography and fluorescence angiography (FA. RESULTS: The mean CNV area in INCB3344-treated mice decreased by 42.4% compared with the vehicle-treated control mice (p<0.001. INCB3344 treatment significantly inhibited macrophage infiltration into the laser-irradiated area (p<0.001, and suppressed the expression of VEGF protein (p = 0.012, VEGF mRNA in infiltrating macrophages (p<0.001 and the phosphorylation of ERK1/2 (p<0.001. The area of spontaneous CNV in Sod1⁻/⁻ mice regressed by 70.35% in INCB3344-treated animals while no change was detected in vehicle-treated control mice (p<0.001. CONCLUSIONS: INCB3344 both inhibits newly forming CNV and regresses established CNV. Controlling inflammation by suppressing macrophage infiltration and

  15. Photodynamic therapy for treatment subretinal neovascularization

    Science.gov (United States)

    Avetisov, Sergey E.; Budzinskaja, Maria V.; Kiseleva, Tatyana N.; Balatskaya, Natalia V.; Gurova, Irina V.; Loschenov, Viktor B.; Shevchik, Sergey A.; Kuzmin, Sergey G.; Vorozhtsov, Georgy N.

    2007-07-01

    This work are devoted our experience with photodynamic therapy (PDT) with > for patients with choroidal neovascularization (CNV). 18 patients with subfoveal CNV in age-related macular degeneration (AMD), 24 patients with subfoveal CNV in pathological myopia (PM) and 4 patients with subfoveal CNV associated with toxoplasmic retinochoroiditis were observed. CNV was 100% classic in all study patients. Standardized protocol refraction, visual acuity testing, ophthalmologic examinations, biomicroscopy, fluorescein angiography, and ultrasonography were performed before treatment and 1 month, 3 months, 6 months, and 1 year after treatment; were used to evaluate the results of photodynamic therapy with > (0.02% solution of mixture sulfonated aluminium phtalocyanine 0.05 mg/kg, intravenously). A diode laser (>, Inc, Moscow) was used operating in the range of 675 nm. Need for retreatment was based on fluorescein angiographic evidence of leakage at 3-month follow-up intervals. At 3, 6, 9 month 26 (56.5%) patients had significant improvement in the mean visual acuity. At the end of the 12-month minimal fluorescein leakage from choroidal neovascularization was seen in 12 (26.1%) patients and the mean visual acuity was slightly worse than 0.2 which was not statistically significant as compared with the baseline visual acuity. Patients with fluorescein leakage from CNV underwent repeated PDT with >. 3D-mode ultrasound shown the decreasing thickness of chorioretinal complex in CNV area. Photodynamic therapy with > can safely reduce the risk of severe vision loss in patients with predominantly classic subfoveal choroidal neovascularization secondary to AMD, PM and toxoplasmic retinochoroiditis.

  16. Health- and vision-related quality of life among patients with ocular histoplasmosis or idiopathic choroidal neovascularization at enrollment in a randomized trial of submacular surgery: Submacular Surgery Trials Report No. 5.

    Science.gov (United States)

    2005-01-01

    To (1) summarize vision-targeted and general health-related quality-of-life scores at baseline and quantify the effect of the ophthalmic problem, (2) evaluate the strength of relations between visual acuity and interview scores, and (3) compare scores for patients who also had choroidal neovascular lesions in the fellow eye (bilateral cases) with those of patients who had choroidal neovascularization in only the study eye (unilateral cases) at time of enrollment in a randomized trial of surgical removal of subfoveal choroidal neovascularization, either associated with the ocular histoplasmosis syndrome or of idiopathic origin. Eligible patients had subfoveal choroidal neovascularization (including some classic choroidal neovascularization) and a visual acuity of 20/50 to 20/800 (Snellen equivalent), inclusive, in the eye to be assigned randomly to surgery or observation. Interviews that incorporated the 39-item version of the National Eye Institute Visual Function Questionnaire (NEI-VFQ) and 2 other instruments were conducted by telephone by trained interviewers before patients enrolled and were assigned randomly to surgery or observation. Information from baseline clinical examinations and fluorescein angiograms interpreted centrally by masked readers was used to classify patients as unilateral or bilateral cases and to provide potential explanations for variability of interview responses using linear regression models. The median overall NEI-VFQ score was 75 (interquartile range, 60-84). The median scores on individual subscales ranged from 55 (general vision) to 100 (color vision). The visual acuity of the better-seeing eye accounted for much of the variability in scores on most NEI-VFQ subscales; a 3-line difference in visual acuity was associated with a 10-point or greater difference in scores on 5 subscales after adjustment for other characteristics of patients and eyes. Scores on most scales of all 3 instruments differed between unilateral cases (n = 167

  17. Nonrigid registration of 3D longitudinal optical coherence tomography volumes with choroidal neovascularization

    Science.gov (United States)

    Wei, Qiangding; Shi, Fei; Zhu, Weifang; Xiang, Dehui; Chen, Haoyu; Chen, Xinjian

    2017-02-01

    In this paper, we propose a 3D registration method for retinal optical coherence tomography (OCT) volumes. The proposed method consists of five main steps: First, a projection image of the 3D OCT scan is created. Second, the vessel enhancement filter is applied on the projection image to detect vessel shadow. Third, landmark points are extracted based on both vessel positions and layer information. Fourth, the coherent point drift method is used to align retinal OCT volumes. Finally, a nonrigid B-spline-based registration method is applied to find the optimal transform to match the data. We applied this registration method on 15 3D OCT scans of patients with Choroidal Neovascularization (CNV). The Dice coefficients (DSC) between layers are greatly improved after applying the nonrigid registration.

  18. Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy

    Directory of Open Access Journals (Sweden)

    Carreras A

    2012-02-01

    Full Text Available Barbara Delas, Lorena Almudí, Anabel Carreras, Mouafk AsaadOphthalmology Service, Hospital de Terrassa, Barcelona, SpainObjective: To report a good clinical outcome in a patient with bilateral choroidal neovascularization (CNV associated with optic nerve head drusen (ONHD treated with intravitreal ranibizumab injection.Methods: A 12-year-old girl was referred for loss of right eye vision detected in a routine check-up. Best-corrected visual acuity (BCVA was hand movements in the right eye and 0.9 in the left eye. Funduscopy revealed the presence of superficial and buried bilateral ONHD, which was confirmed by ultrasonography and computed tomography, and the study was completed with perimetry. The presence of bilateral CNV, active in the right eye, was observed and subsequently confirmed using fluorescein angiography and optical coherence tomography.Results: Treatment with two consecutive injections of intravitreal ranibizumab resulted in inactivation of the neovascular membrane with subretinal fluid reabsorption and improved right eye BCVA. After 12 months’ follow-up, this was 20/60 and stable.Conclusion: Although there are no published studies of safety in children, antiangiogenic therapy for CNV secondary to ONHD may be useful and safe. A search of the literature produced only one previously reported case of ONHD-associated CNV treated with antivascular endothelial growth factor alone.Keywords: optic nerve head drusen, anti-vegf, children, neovascularisation

  19. Gut microbiota influences pathological angiogenesis in obesity-driven choroidal neovascularization.

    Science.gov (United States)

    Andriessen, Elisabeth Mma; Wilson, Ariel M; Mawambo, Gaelle; Dejda, Agnieszka; Miloudi, Khalil; Sennlaub, Florian; Sapieha, Przemyslaw

    2016-12-01

    Age-related macular degeneration in its neovascular form (NV AMD) is the leading cause of vision loss among adults above the age of 60. Epidemiological data suggest that in men, overall abdominal obesity is the second most important environmental risk factor after smoking for progression to late-stage NV AMD To date, the mechanisms that underscore this observation remain ill-defined. Given the impact of high-fat diets on gut microbiota, we investigated whether commensal microbes influence the evolution of AMD Using mouse models of NV AMD, microbiotal transplants, and other paradigms that modify the gut microbiome, we uncoupled weight gain from confounding factors and demonstrate that high-fat diets exacerbate choroidal neovascularization (CNV) by altering gut microbiota. Gut dysbiosis leads to heightened intestinal permeability and chronic low-grade inflammation characteristic of inflammaging with elevated production of IL-6, IL-1β, TNF-α, and VEGF-A that ultimately aggravate pathological angiogenesis. © 2016 The Authors. Published under the terms of the CC BY 4.0 license.

  20. Inhibition of the recombinant human endostatin adenavirus on experimental choroidal neovascularization in rats

    Directory of Open Access Journals (Sweden)

    Li-Juan Chen

    2017-06-01

    Full Text Available AIM: To investigate the inhibition of the recombinant human endostatin adenavirus(Ad-Eson the experimental choroidal neovascularization(CNVmodels by intravitreous injection. METHODS: Experimental CNV models were induced by semiconductor laser in 30 male Brown Norway(BNrats and randomly divided into 3 groups with 10 rats in each group. At 21d after photocoagulation, the single administration group were given intravitreous injection with Ad-Es 0.01mL; the repeated administration group were given intravitreous injection with Ad-Es 0.01mL and a repeated injection 7d later; the saline control group were given intravitreous injection with saline 0.01mL. At 7d after final administration, the leakage of fundus fluorescein angiography(FFAwas observed. Various CNV areas were measured by using laser confocal microscopy of choroidal flatmount method. Pathology and ultrastructure were observed with light microscopy, the expressions of CD105 were measured by immunohistochemistry. RESULTS: The leakage of CNV of the administration group abviously decreased as compared with those in the saline group, the leakage of repeated administration group decreased compared with that of single administration group(PPCONCLUSION: Ad-Es can effectively inhibit semiconductor laser induced CNV in BN rats, and the inhibition effect of repeated administration group is better than that of single administration group. It may be a useful new method in the treatment of CNV.

  1. T-cell differentiation and CD56+ levels in polypoidal choroidal vasculopathy and neovascular age-related macular degeneration.

    Science.gov (United States)

    Subhi, Yousif; Nielsen, Marie Krogh; Molbech, Christopher Rue; Oishi, Akio; Singh, Amardeep; Nissen, Mogens Holst; Sørensen, Torben Lykke

    2017-11-20

    Polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (AMD) are prevalent age-related diseases characterized by exudative changes in the macula. Although they share anatomical and clinical similarities, they are also distinctly characterized by their own features, e.g. vascular abnormalities in PCV and drusen-mediated progression in neovascular AMD. PCV remains etiologically uncharacterized, and ongoing discussion is whether PCV and neovascular AMD share the same etiology or constitute two substantially different diseases. In this study, we investigated T-cell differentiation and aging profile in human patients with PCV, patients with neovascular AMD, and age-matched healthy control individuals. Fresh venous blood was prepared for flow cytometry to investigate CD4 + and CD8 + T-cell differentiation (naïve, central memory, effector memory, effector memory CD45ra + ), loss of differentiation markers CD27 and CD28, and expression of aging marker CD56. Patients with PCV were similar to the healthy controls in all aspects. In patients with neovascular AMD we found significantly accelerated T-cell differentiation (more CD28 - CD27 - cells) and aging (more CD56 + cells) in the CD8 + T-cell compartment. These findings suggest that PCV and neovascular AMD are etiologically different in terms of T cell immunity, and that neovascular AMD is associated with T-cell immunosenescence.

  2. A peptide derived from type 1 thrombospondin repeat-containing protein WISP-1 inhibits corneal and choroidal neovascularization.

    Science.gov (United States)

    Cano, Marisol del Valle; Karagiannis, Emmanouil D; Soliman, Mohamed; Bakir, Belal; Zhuang, Wenjuan; Popel, Aleksander S; Gehlbach, Peter L

    2009-08-01

    Ocular neovascularization is the primary cause of blindness in a wide range of prevalent ocular diseases including proliferative diabetic retinopathy, exudative age-related macular degeneration, and retinopathy of prematurity, among others. Antiangiogenic therapies are starting to give promising results in these diseases. In the present study the antiangiogenic potential of an 18-mer peptide derived from type 1 thrombospondin repeat-containing protein WISP-1 (wispostatin-1) was analyzed in vitro with human retinal endothelial cell proliferation and migration assays. The peptide was also tested in vivo in the corneal micropocket and the laser-induced choroidal neovascularization (CNV) mouse models. Human retinal endothelial cells were treated with the WISP-1 peptide and in vitro migration and proliferation assays were performed. Also evaluated was the antiangiogenic effect of this peptide in vivo using the corneal micropocket assay and the laser-induced CNV model. Wispostatin-1 derived peptide demonstrated antimigratory and antiproliferative activity in vitro. Wispostatin-1 completely abolished bFGF-induced neovascularization in the corneal micropocket assay. The peptide also demonstrated significant inhibition of laser-induced CNV. An inhibitory effect of Wispostatin-1 on ocular neovascularization was found in vitro and in vivo. The identification of novel and potent endogenous peptide inhibitors provides insight into the pathogenesis of corneal and choroidal neovascularization. The results demonstrate potential for therapeutic application in prevalent ocular disease.

  3. Correlation between neovascular lesion type and clinical characteristics of nonneovascular fellow eyes in patients with unilateral, neovascular age-related macular degeneration.

    Science.gov (United States)

    Marsiglia, Marcela; Boddu, Sucharita; Chen, Christine Y; Jung, Jesse J; Mrejen, Sarah; Gallego-Pinazo, Roberto; Freund, K Bailey

    2015-05-01

    To investigate the association between the type of neovascularization (NV) and the clinical characteristics of nonneovascular fellow eyes in patients with unilateral, neovascular age-related macular degeneration. Eighty-three patients with treatment-naive, unilateral, neovascular age-related macular degeneration were retrospectively analyzed. Neovascular lesions were classified using both fluorescein angiography and optical coherence tomography as Type 1 (subretinal pigment epithelium), 2 (subretinal), 3 (intraretinal), or mixed NV. The associations between NV lesion type and baseline clinical and imaging characteristics of the fellow eye, including central geographic atrophy, noncentral geographic atrophy, pigmentary changes, soft drusen, cuticular drusen, reticular pseudodrusen, and subfoveal choroidal thickness, were examined. Subfoveal choroidal thickness was defined as thin if thickness was macular degeneration, Type 3 NV had an increased adjusted odds ratio of reticular pseudodrusen (15.361, P macular degeneration, certain nonneovascular features of the fellow eye correlate with the NV lesion composition based on type, as anatomically classified utilizing both fluorescein angiography and optical coherence tomography. Patients with Type 3 NV were more likely to have reticular pseudodrusen and/or thin subfoveal choroidal thickness in the fellow eye compared with those with Type 1 NV. Patients with Type 3 NV also showed a trend toward increased central geographic atrophy in the fellow eye.

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

    Directory of Open Access Journals (Sweden)

    Patrícia Correa de Mello

    2016-06-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...... leaking on FA, whereas only one of five bevacizumab-injected eyes exhibited leakage. On histological examination, all 11 eyes contained CNV membranes of similar size, regardless of treatment. The number of vascular endothelial cells was significantly reduced (p = 0.03) in CNV membranes from eyes that had...... been injected with bevacizumab when compared with CNV membranes from placebo-injected eyes. There was a trend towards more retinal pigment epithelium cells (p = 0.16) and fewer glial fibres (p = 0.08) in membranes from bevacizumab-treated eyes compared with placebo-treated eyes. Bevacizumab...

  6. A new animal model of choriodal neovascularization

    DEFF Research Database (Denmark)

    Kiilgaard, J.F.; Andersen, Mads V. Nis; Wiencke, A.K.

    2005-01-01

    ophthalmology, age-related macular degeneration, Bruch's membrane, retinal pigment epithelium, choroidal neovascularization, subretinal neovascularization......ophthalmology, age-related macular degeneration, Bruch's membrane, retinal pigment epithelium, choroidal neovascularization, subretinal neovascularization...

  7. Comparative role of intravitreal ranibizumab versus bevacizumab in choroidal neovascular membrane in age-related macular degeneration

    OpenAIRE

    Biswas, Partha; Sengupta, Subhrangshu; Choudhary, Ruby; Home, Subhankar; Paul, Ajoy; Sinha, Sourav

    2011-01-01

    Context: Ranibizumab and bevacizumab are used widely for treating patients with choroidal neovascular membrane (CNVM) secondary to age-related macular degeneration (AMD). Aims: To determine and compare the efficacy and safety of intravitreal ranibizumab and bevacizumab in treatment of CNVM due to AMD. Settings and Design: Prospective comparative case series carried out in an eye institute and eye department of a hospital in Kolkata, India. Materials and Methods: One hundred and four eyes with...

  8. Evaluation of choroidal thickness in cases with age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Erkan Unsal

    2014-09-01

    Full Text Available AIM: To compare subfoveal choroidal thickness(SFCTbetween cases with non-neovascular age-related macular degeneration(AMDand neovascular AMD by optical coherence tomography(OCTand to evaluate the contribution of choroidal thickness(CTmeasurements to the understanding of pathogenesis of neovascularization in AMD.METHODS: Fourty-eigth eyes of 24 patients who had neovascular AMD in one eye and non-neovascular AMD in the other eye were included in this retrospective, cross- sectional study as study group. Forty eyes of healthy,age and axial length matched individuals were selected as the control group. Eyes with drusen and/or pigmentary changes were included in the non-neovascular AMD subgroup. Eyes with subretinal or intraretinal fluid and/orlipid exudation due to the choroidal neovascularization were included in the neovascular AMD subgroup. OCT measurements were performed with RTVue 100-2(V 5.1, Optovue, Fremont, CA, USAperpendicularly from the outer part of the hyperreflective line(retinal pigment epithelial layerto the line corresponding to the choroido- scleral junction. Choroidal thickness was measured at 7 different points, 500μm intervals up to 1500μm temporal and nasal to the fovea in the study group and compared statistically between subgroups.RESULTS: The mean age of patients was 72.4±8.97(60- 82y. The mean age of healthy individuals was 71.2±8.8(58-81y. Mean SFCT of neovascular AMD group were significantly thicker than non-neovascular AMD group(PP>0.05. In neovascular AMD group, there was a statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness(PCONCLUSION: Choroidal thickness measurements with OCT device can make a contribution to the understanding the phatophysiology of AMD and large prospective studies should be conducted to understand why SFCT was thicker in neovascular AMD.

  9. The Chinese medicine formula HB01 reduces choroidal neovascularization by regulating the expression of vascular endothelial growth factor

    Directory of Open Access Journals (Sweden)

    Jin Ming

    2012-06-01

    Full Text Available Abstract Background Choroidal neovascularization (CNV remains the leading cause of newly acquired blindness in the developed world. Currently anti-vascular endothelial growth factor (VEGF therapies are broadly used to treat neovascular ocular disorders. Here we demonstrate the effect of a traditional Chinese medicine formula, HB01, on CNV. Methods A rat model of laser-induced CNV was used to investigate the effect of HB01 in vivo. The CNV lesions in the eye were evaluated using fundus fluorescein angiography and visualized/quantified using confocal microscopy. Expression of VEGF in the choroidal and retinal tissues was measured using quantitative real-time PCR and immunohistochemistry. Results We demonstrated that a traditional Chinese Medicine formula, named HB01, significantly reduced neovascularization in a rat CNV model. The effect of HB01 on CNV was comparable to the intravitreal injection of bevacizumab (Avastin. Our results also suggested that HB01 may reduce CNV partially through inhibiting the expression of VEGF. Conclusions These data support HB01 as an alternative therapy for ocular neovascular disorders.

  10. Study of krypton laser-induced choroidal neovascularization in a Guinea pig model of high anisometropia.

    Science.gov (United States)

    Wang, Jianghui; Jiang, Wei; Kang, Zefeng; Liang, Lina; Liu, Xiaoman; Tian, Nannan; Zhang, Qing

    2012-06-01

    To investigate the association between high anisometropia and the area of choroidal neovascularization (CNV) induced by krypton laser in guinea pigs and better understand the pathogenesis and prevention of myopic CNV. Nine 3-week old male guinea pigs with anisometropia >6.00D were randomly assigned to three groups according to examination date after laser photocoagulation (7d, 14d and 28d). All animals underwent refraction. The eye with higher myopia was used as the experimental eye, and the other as the control eye. All eyes received repeated multi-wavelength krypton laser photocoagulation treatments (wavelength: 532nm; laser power: 400mW; spot diameter: 50μm; exposure time: 0.1s). Fundus photography and indocyanine green angiography (ICGA) were performed. Afterwards, the animals were sacrificed immediately, and the eyes were enucleated and processed for histopathologic examination and flat mounts. CNV appeared at 7d after laser treatment. The area of CNV peaked at 14d, and decrease in area and the presence of scarring was noted at 28 d. CNV was present in 66.7% of eyes by ICGA at 14 d. CNV could be observed under light microscopy at all three time points. At 14d, flat mount showed the neovascular plexus around the lesion. Semi-quantitative analysis revealed that the area of CNV in treated eyes was greater than that of control eyes. Since the mechanism of CNV in this study resembles that of CNV in pathological myopia, this model can be used to investigate the etiology, pathogenesis and treatment of CNV in pathological myopia.

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

    Directory of Open Access Journals (Sweden)

    Yan Gong

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

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

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2015-07-01

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

  13. Melissa officinalis extract inhibits laser-induced choroidal neovascularization in a rat model.

    Directory of Open Access Journals (Sweden)

    Eun Kyoung Lee

    Full Text Available This study investigated the effect of Melissa officinalis extract on laser-induced choroidal neovascularization (CNV in a rat model. The mechanism by which M. officinalis extract acted was also investigated.Experimental CNV was induced by laser photocoagulation in Brown Norway rats. An active fraction of the Melissa leaf extract was orally administered (50 or 100 mg/kg/day beginning 3 days before laser photocoagulation and ending 14 days after laser photocoagulation. Optical coherence tomography and fluorescein angiography were performed in vivo to evaluate the thickness and leakage of CNV. Choroidal flat mount and histological analysis were conducted to observe the CNV in vitro. Vascular endothelial growth factor (VEGF, matrix metalloproteinase (MMP-2, and MMP-9 expression were measured in retinal and choroidal-scleral lysates 7 days after laser injury. Moreover, the effect of M. officinalis extract on tertiary-butylhydroperoxide (t-BH-induced VEGF secretion and mRNA levels of VEGF, MMP-2, and MMP-9 were evaluated in human retinal epithelial cells (ARPE-19 as well as in human umbilical vein endothelial cells (HUVECs.The CNV thickness in M. officinalis-treated rats was significantly lower than in vehicle-treated rats by histological analysis. The CNV thickness was 33.93±7.64 µm in the high-dose group (P<0.001, 44.09±12.01 µm in the low-dose group (P = 0.016, and 51.00±12.37 µm in the control group. The proportion of CNV lesions with clinically significant fluorescein leakage was 9.2% in rats treated with high-dose M. officinalis, which was significantly lower than in control rats (53.4%, P<0.001. The levels of VEGF, MMP-2, and MMP-9 were significantly lower in the high-dose group than in the control group. Meanwhile, M. officinalis extract suppressed t-BH-induced transcription of VEGF and MMP-9 in ARPE-19 cells and HUVECs.Systemic administration of M. officinalis extract suppressed laser-induced CNV formation in rats. Inhibition of

  14. Choroidal neovascularization induced by immunogenic alteration of the retinal pigment epithelium in dengue Fever.

    Science.gov (United States)

    Veloso, Carlos Eduardo; Schmidt-Erfurth, Ursula; Nehemy, Márcio B

    2015-01-01

    To report the first case of choroidal neovascularization (CNV) secondary to dengue fever. A 54-year-old female was referred to our department with blurred vision and metamorphopsia in her left eye. Two weeks earlier, she had presented all of the classic symptoms of dengue fever including a positive serology. Her best-corrected visual acuity (BCVA) was 20/150 in the left eye. She underwent a fundus examination, fluorescein angiography (FA) and spectral domain optical coherence tomography. All findings were consistent with CNV secondary to dengue fever. FA revealed a classic CNV associated with focal retinal pigment epithelium (RPE) destruction and detachment. Three consecutive monthly injections of intravitreal ranibizumab resulted in functional and anatomical improvement for as long as 6 months with a BCVA of 20/25. However, CNV recurred 2 years later, again with an improvement after ranibizumab therapy, but with persistence of a fibrovascular RPE detachment, highlighting the pathomechanism of a classic CNV formation. Maculopathy in dengue fever may be followed by CNV as a result of the immunologic alteration of the RPE. Physicians should be aware of this manifestation to be able to initiate adequate treatment with excellent functional and anatomical results.

  15. Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

    Directory of Open Access Journals (Sweden)

    Ryan B. Rush

    2015-01-01

    Full Text Available Purpose. To examine the clinical implications of change in choroidal neovascularization (CNV size on indocyanine green (ICG angiography in subjects with idiopathic CNV undergoing bevacizumab therapy. Methods. The charts of subjects with an idiopathic CNV treated by a modified PRN regimen with intravitreal bevacizumab over a 12-month period were retrospectively reviewed. Results. There were 34 subjects included in the analysis. Baseline CNV sizes of less than 1.0 mm2 on ICG angiography correlated with complete CNV resolution (P=0.0404, fewer injections delivered (P=0.0002, and better Snellen visual acuity (P=0.0098 at 12 months. Subjects that experienced a 33% or more reduction in CNV size on ICG angiography at 2 months had complete CNV resolution (P=0.0047 and fewer injections (P<0.0001 at 12 months compared to subjects that did not experience a 33% or more reduction in CNV size on ICG angiography at 2 months. Conclusions. Smaller baseline CNV size on ICG angiography resulted in better visual acuity and fewer injections at 12 months, and a reduction of 33% or more in CNV size after 2 months may predict a better clinical course in subjects with idiopathic CNV undergoing bevacizumab therapy.

  16. [Effect of photodynamic therapy with ATX-S 10 (Na) on experimental choroidal neovascularization].

    Science.gov (United States)

    Hirose, Tokihito; Nakajima, Masami; Kyou, Tetsuhiro; Yuzawa, Mitsuko

    2006-06-01

    To evaluate an appropriate irradiative condition for selective occlusion of experimental choroidal neovascularization(CNV) with photodynamic therapy (PDT) using ATX-S 10 (Na). Experimental CNV was induced in monkey eyes by laser photocoagulation. PDT(dose of irradiative energy 40 to 80J/cm2) was performed after 3.5 mg/kg of body weight intravenous injections of ATX-S 10(Na). CNV and retinal vessel occlusion induced by PDT was evaluated by fluorescein angiography (FA) at 1 and 7 days after irradiation. If FA showed no fluorescein dye leakage from CNV at 1 and 7 days after irradiation, CNV was evaluated by histopathological analysis at 7 days after irradiation. Within 30 to 33 minutes after ATX-S 10(Na) injection and irradiation with 50 to 60 J/ cm2, FA showed no fluorescein dye leakage from CNV and no closure of retinal vessels at 1 and 7 days after irradiation. Light micrographs showed occluded CNV, and retinal vessels remained patent and there was no apparent change in the inner layer of the retina. Irradiative condition of ATX-S10 (Na) 3.5 mg/kg was appropriate 30 to 33 minutes after ATX-S 10(Na) injection and irradiation with 50 to 60 J/cm2.

  17. Ranibizumab in Myopic Choroidal Neovascularization: A Subgroup Analysis by Ethnicity, Age, and Ocular Characteristics in RADIANCE.

    Science.gov (United States)

    Holz, Frank G; Tufail, Adnan; Leveziel, Nicolas; Lai, Timothy Y Y; Lanzetta, Paolo; Wong, Tien Y; Yu, Hyeong Gon; Chen, You Xin; Heinrichs, Nikol; Pilz, Stefan; Ohno-Matsui, Kyoko

    2016-01-01

    To assess the impact of ethnicity, age, and ocular characteristics on ranibizumab efficacy in myopic choroidal neovascularization (CNV). In this post hoc subgroup analysis from the phase III RADIANCE study, best-corrected visual acuity (BCVA) outcomes and treatment exposure were analyzed in 105 patients treated with ranibizumab 0.5 mg. Baseline categories included ethnicity, age, baseline BCVA, lesion area, CNV lesion area, refraction sphere, axial length, subretinal fluid, and location of CNV. At month 12, the mean change in BCVA was numerically higher in East-Asians than in Caucasians (17.0 vs. 14.1 letters). The median number of injections varied with ethnicity (East-Asians vs. Caucasians: 2 vs. 3), baseline BCVA (highest vs. lowest: 1 vs. 4), CNV lesion area and lesion area (largest vs. smallest: 5 vs. 1 and 5 vs. 2). East-Asians showed numerically higher BCVA gains than Caucasians. The number of injections varied across subgroups, emphasizing the need for individualized treatment. © 2016 S. Karger AG, Basel.

  18. Near-infrared autofluorescence in patients with idiopathic submacular choroidal neovascularization.

    Science.gov (United States)

    Toju, Ryoko; Iida, Tomohiro; Sekiryu, Tetsuju; Saito, Masaaki; Maruko, Ichiro; Kano, Mariko

    2012-02-01

    To investigate near-infrared autofluorescence (IR-AF) patterns and related changes in patients with idiopathic choroidal neovascularization (CNV) treated with intravitreal bevacizumab (IVB). Retrospective observational consecutive case series. Bevacizumab was intravitreally injected into 12 eyes of 12 patients with idiopathic CNV as the primary treatment. Color fundus photographs, optical coherence tomography (OCT), fluorescein angiography and indocyanine green angiography (ICGA), and autofluorescence imaging short-wavelength and near-infrared autofluorescence (SW-AF and IR-AF) were performed at baseline. Changes in the autofluorescence patterns were evaluated after IVB. All 12 eyes had classic CNV on fluorescein angiography at baseline. OCT showed CNV above the retinal pigment epithelium (RPE) in all eyes. After treatment, the final best-corrected visual acuity improved significantly (P autofluorescence and its contrast increased as the CNV regressed. The contrast of the ring-shaped autofluorescence partially decreased in all 3 eyes with a recurrence. Ring-shaped hyperautofluorescence on IR-AF in the eyes with idiopathic CNV may indicate an involutional process of CNV enveloped by the RPE because its area corresponded to the dark rim on ICGA that reflects regression of idiopathic CNV. IR-AF can be a useful noninvasive adjunctive examination to evaluate the involution of CNV. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Sean D. Adrean

    2017-01-01

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

  20. Therapeutic effects of photodynamic therapy for treating choroidal neovascularization by optic coherent tomography

    Directory of Open Access Journals (Sweden)

    Li Song

    2014-08-01

    Full Text Available AIM: To evaluate the clinical efficacy and safety of photodynamic therapy(PDTon choroidal neovascularization(CNVcaused by age-related macular degeneration(AMD, pathological myopia(PM, and central exudative chorioretinopathy(CEC. METHODS: A retrospective observation on the clinical data of 53 AMD patients(53 eyesfrom January 2010 to December 2012, diagnosed CNV through fundus fluorescein angiography(FFA, indocyanine green angiography(ICGAand optic coherence tomography(OCT, treated with PDT. The changes of best corrected visual acuity(BCVAand central macular thickness(CMTwere compared before and 1a after treatment. RESULTS: At the last follow-up, the BCVA was improved in 35 cases, stabilized in 15 cases and decreased in 3 cases. Fundus hemorrhage and exudation reduction after PDT was observed in all patients. FFA and OCT showed complete closure of CNV in 42 cases, partial closure in 11 cases. The visual acuity and CMT changes were statistically significant. No serious adverse event related to PDT. CONCLUSION: PDT is helpful for maintaining the visual acuity of wet-AMD within 1a and the incidence of the adverse response is low, which suggest that PDT is an effective and safe treatment for CNV in patients of AMD.

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

    Directory of Open Access Journals (Sweden)

    Balaratnasingam C

    2015-12-01

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

  2. Pattern dystrophy with high intrafamilial variability associated with Y141C mutation in the peripherin/RDS gene and successful treatment of subfoveal CNV related to multifocal pattern type with anti-VEGF (ranibizumab) intravitreal injections.

    Science.gov (United States)

    Vaclavik, Veronika; Tran, Hoai V; Gaillard, Marie-Claire; Schorderet, Daniel F; Munier, Francis L

    2012-10-01

    To identify disease causing mutation in three generations of a Swiss family with pattern dystrophy and high intrafamilial variability of phenotype. To assess the effect of intravitreal ranibizumab injections in the treatment of subfoveal choroidal neovascularization associated with pattern dystrophy in one patient. Affected family members were ascertained for phenotypic and genotypic characterization. Ophthalmic evaluations included fundus photography, autofluorescence imaging, optical coherence tomography, and International Society for Clinical Electrophysiology of Vision standard full-field electroretinography. When possible family members had genetic testing. The proband presented with choroidal neovascularization and had intravitreal injections as needed according to visual acuity and optical coherence tomography. Proband had a multifocal type pattern dystrophy, and his choroidal neovascularization regressed after four intravitreal injections. The vision improved from 0.8 to 1.0, and optical coherence tomography showed complete anatomical restoration. A butterfly-shaped pattern was observed in her cousin, whereas a fundus pulverulentus pattern was seen in a second cousin. Aunt had a multifocal atrophic appearance, simulating geographic atrophy in age-related macular degeneration. The Y141C mutation was identified in the peripherin/RDS gene and segregated with disease in the family. This is the first report of marked intrafamilial variation of pattern dystrophy because of peripherin/RDS Y141C mutation. Intravitreal ranibizumab injections might be a valuable treatment for associated subfoveal choroidal neovascularization.

  3. Comparison of endostatin(endostarand avastin's inhibition effect on mice choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Jing Li

    2014-06-01

    Full Text Available AIM:To observe the inhibition effect of endostatin(endostaron mice choroidal neovascularization model(CNVand compare with the Avastin.METHODS: Using 532nm laser photocoagulation to establish a mouse model of CNV. We observed the formation of CNV by histopathological examination after 2wk later. Forty successful models of mice were randomly divided into control group(group 1, 10 rats, normal saline group(group 2, 10 rats, endostatin group(group 3, 10 ratsand avastin group(group 4, 10 rats. The drugs were injected into the mice' vitreous after photocoagulation 2wk later. Then 1wk later, we took the mice eyeballs to perform the HE and immunohistochemical staining to observe. The statistical analysis of ANOVA was done by SPSS 16.0 and the LSD-t test was used for multiple samples, taking PRESULTS: Two weeks later, HE histopathological examination was done, light microscope showed large amount of new vessels' formation, the positive rate for CNV was 72.8%. The blank control group compared with the normal saline group P>0.05, had no inhibitory effect on CNV; endostatin treated group compared with control group, PPt was performed on Avastin group and endostatin group, P(-overxAvastin =26.90,(-overxendostatin=29.13,(-overxAvastin(-overxendostatin, we can infer that endostar had lower inhibitory effect on mice CNV than Avastin.CONCLUSION: Laser-induced CNV animal models of colored mice C57BL/6J is of short time and high rate establishment and it is an ideal model for CNV study. Endostar has certain inhibitory effect on CNV, and it is likely to become one of the important drugs for CNV-related diseases in the future.

  4. Focal Choroidal Excavation.

    Science.gov (United States)

    Cebeci, Zafer; Bayraktar, Şerife; Oray, Merih; Kır, Nur

    2016-12-01

    Focal choroidal excavation is a choroidal pit that can be detected by optical coherence tomography. Central serous chorioretinopathy, choroidal neovascularization and polypoidal choroidal vasculopathy are pathologies associated with focal choroidal excavation. In this article, we present the follow-up and treatment outcomes of three eyes of two patients with focal choroidal excavation.

  5. Inflammatory choroidal neovascularization in Indian eyes: Etiology, clinical features, and outcomes to anti-vascular endothelial growth factor

    Directory of Open Access Journals (Sweden)

    Rupak Roy

    2017-01-01

    Full Text Available Background and Objectives: The aim was to study the clinical profile of inflammatory choroidal neovascularization (CNV and its treatment response to intravitreal bevacizumab or ranibizumab on pro re nata (PRN basis in Indian eyes. Materials and Methods: This was a retrospective case series of consecutive patients with inflammatory CNV treated with anti-vascular endothelial growth factor (anti-VEGF in a tertiary eye care center in Eastern India between 2009 and 2014. The data about clinical features, investigations, treatment, and outcomes were obtained from the medical records. We included patients with active inflammatory CNV but with no evidence of inflammation and were treated with anti-VEGF alone, with a minimum follow-up of 6 months. Main outcome measures were a clinical and etiological profile of inflammatory CNV in Indian eyes and their response to treatment. Results: Thirty eyes of 28 patients were included in the study. The mean follow-up was 17.93 ± 14.28 months (range 6–53 months. In our cohort, seven (23.33% eyes had inflammatory CNV secondary to idiopathic choroiditis, four (13.33% eyes had toxoplasmosis, idiopathic panuveitis, and Vogt Koyanaki Harada's disease each. Three (10% eyes had geographic helicoid peripapillary choroidopathy and tubercular choroiditis each. Remaining two (6.66% eyes had punctate inner choroidopathy, while multifocal choroiditis with panuveitis, resolved endogenous endophthalmitis and Hansen's diseases were the etiology in one (3.33% case of inflammatory CNV each. The mean number of injections were 2.76 (range 1–5. Among thirty eyes of inflammatory CNV, 16 (53.3% eyes showed improvement, eight (26.6% maintained the same vision, whereas six (20% eyes showed deterioration of vision. Interpretations and Conclusion: Idiopathic choroiditis was the most common cause of inflammatory CNV and PRN intravitreal anti-VEGF (ranibizumab or bevacizumab appears to have effective treatment response.

  6. Inflammatory choroidal neovascularization in Indian eyes: Etiology, clinical features, and outcomes to anti-vascular endothelial growth factor

    Science.gov (United States)

    Roy, Rupak; Saurabh, Kumar; Bansal, Aditya; Kumar, Amitabh; Majumdar, Anindya Kishore; Paul, Swakshyar Saumya

    2017-01-01

    Background and Objectives: The aim was to study the clinical profile of inflammatory choroidal neovascularization (CNV) and its treatment response to intravitreal bevacizumab or ranibizumab on pro re nata (PRN) basis in Indian eyes. Materials and Methods: This was a retrospective case series of consecutive patients with inflammatory CNV treated with anti-vascular endothelial growth factor (anti-VEGF) in a tertiary eye care center in Eastern India between 2009 and 2014. The data about clinical features, investigations, treatment, and outcomes were obtained from the medical records. We included patients with active inflammatory CNV but with no evidence of inflammation and were treated with anti-VEGF alone, with a minimum follow-up of 6 months. Main outcome measures were a clinical and etiological profile of inflammatory CNV in Indian eyes and their response to treatment. Results: Thirty eyes of 28 patients were included in the study. The mean follow-up was 17.93 ± 14.28 months (range 6–53 months). In our cohort, seven (23.33%) eyes had inflammatory CNV secondary to idiopathic choroiditis, four (13.33%) eyes had toxoplasmosis, idiopathic panuveitis, and Vogt Koyanaki Harada's disease each. Three (10%) eyes had geographic helicoid peripapillary choroidopathy and tubercular choroiditis each. Remaining two (6.66%) eyes had punctate inner choroidopathy, while multifocal choroiditis with panuveitis, resolved endogenous endophthalmitis and Hansen's diseases were the etiology in one (3.33%) case of inflammatory CNV each. The mean number of injections were 2.76 (range 1–5). Among thirty eyes of inflammatory CNV, 16 (53.3%) eyes showed improvement, eight (26.6%) maintained the same vision, whereas six (20%) eyes showed deterioration of vision. Interpretations and Conclusion: Idiopathic choroiditis was the most common cause of inflammatory CNV and PRN intravitreal anti-VEGF (ranibizumab or bevacizumab) appears to have effective treatment response. PMID:28513493

  7. Adhesion Failures Determine the Pattern of Choroidal Neovascularization in the Eye: A Computer Simulation Study

    Science.gov (United States)

    Shirinifard, Abbas; Glazier, James Alexander; Swat, Maciej; Gens, J. Scott; Family, Fereydoon; Jiang, Yi; Grossniklaus, Hans E.

    2012-01-01

    Choroidal neovascularization (CNV) of the macular area of the retina is the major cause of severe vision loss in adults. In CNV, after choriocapillaries initially penetrate Bruch's membrane (BrM), invading vessels may regress or expand (CNV initiation). Next, during Early and Late CNV, the expanding vasculature usually spreads in one of three distinct patterns: in a layer between BrM and the retinal pigment epithelium (sub-RPE or Type 1 CNV), in a layer between the RPE and the photoreceptors (sub-retinal or Type 2 CNV) or in both loci simultaneously (combined pattern or Type 3 CNV). While most studies hypothesize that CNV primarily results from growth-factor effects or holes in BrM, our three-dimensional simulations of multi-cell model of the normal and pathological maculae recapitulate the three growth patterns, under the hypothesis that CNV results from combinations of impairment of: 1) RPE-RPE epithelial junctional adhesion, 2) Adhesion of the RPE basement membrane complex to BrM (RPE-BrM adhesion), and 3) Adhesion of the RPE to the photoreceptor outer segments (RPE-POS adhesion). Our key findings are that when an endothelial tip cell penetrates BrM: 1) RPE with normal epithelial junctions, basal attachment to BrM and apical attachment to POS resists CNV. 2) Small holes in BrM do not, by themselves, initiate CNV. 3) RPE with normal epithelial junctions and normal apical RPE-POS adhesion, but weak adhesion to BrM (e.g. due to lipid accumulation in BrM) results in Early sub-RPE CNV. 4) Normal adhesion of RBaM to BrM, but reduced apical RPE-POS or epithelial RPE-RPE adhesion (e.g. due to inflammation) results in Early sub-retinal CNV. 5) Simultaneous reduction in RPE-RPE epithelial binding and RPE-BrM adhesion results in either sub-RPE or sub-retinal CNV which often progresses to combined pattern CNV. These findings suggest that defects in adhesion dominate CNV initiation and progression. PMID:22570603

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

    DEFF Research Database (Denmark)

    Hanumunthadu, Daren; Ilginis, Tomas; Restori, Marie

    2017-01-01

    BACKGROUND: The aim was to determine the intrasession repeatability of swept-source optical coherence tomography (SS-OCT)-derived retinal and choroidal thickness measurements in eyes with neovascular age-related macular degeneration (nAMD). METHODS: A prospective study consisting of patients...... macular subfields. Repeatability was calculated according to methods described by Bland and Altman. RESULTS: 39 eyes of 39 patients with nAMD were included with a mean (±SD) age of 73.9 (±7.2) years. The mean (±SD) retinal thickness of the central macular subfield was 225.7 μm (±12.4 μm...... with active nAMD enrolled in the Distance of Choroid Study at Moorfields Eye Hospital, London. Patients underwent three 12×9 mm macular raster scans using the deep range imaging (DRI) OCT-1 SS-OCT (Topcon) device in a single imaging session. Retinal and choroidal thicknesses were calculated for the ETDRS...

  9. Study on choroidal neovascularization with anti-VEGF treatment in the mouse retina using optical coherence tomography angiography (Conference Presentation)

    Science.gov (United States)

    Park, Jang Ryul; Choi, WooJhon; Kim, Jaeryung; Hong, Hye Kyong; Kim, Yongjoo; Hwang, Yoonha; Park, Sang Jun; Woo, Se Joon; Kim, Pilhan; Park, Kyu Hyung; Koh, Gou Young; Oh, Wang-Yuhl

    2017-02-01

    To understand the pathogenesis of ophthalmic disease, utilizing small animal models such as mouse is necessary because of their ease of maintenance and availability. For identifying pathophysiology and drug development of retinal diseases in mouse model, optical coherence tomography angiography (OCTA) is promising imaging modality visualizing not only microstructure but also microvasculature. In this study, we serially imaged 3D structure and angiography of laser-induced choroidal neovascularization (CNV) in the mouse retina with/without anti-VEGF treatment. Also, the volume changes of CNV and avascular region in choroid layer are measured for identifying effects of anti-VEGF. A lab-built high-speed OCTA prototype using the wavelength-swept laser centered at 1040 nm with 230 kHz A-scan rate acquired 3-D volumetric data consisted of 1024 x 1024 x 3 A-scans. The OCTA scanned 1.7 mm x 1.7 mm area around ONH. For obtaining angiography, amplitude decorrelation from 3 consecutive B-scans at each position was generated. Seven days after the laser photocoagulation at mouse retina for generation of the laser-induced CNV, intravitreal administration of Fc and VEGF-Trap was given in the therapeutic arm. The OCTA were performed at 6, 14, 21 and 35 days after laser photocoagulation. Vasculatures of inner retina, outer retina and choroid layers were separately visualized after RPE flattening and layer segmentation. To investigate therapeutic effects of anti-VEGF treatment, the relative area and volume of CNV in outer retina layer is measured. Also, total volume of avascular zone surrounding the laser injury site in choroid layer is also analyzed.

  10. Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Azevedo de Freitas

    2013-06-01

    Full Text Available PURPOSE: To evaluate the feasibility of the combined use of bevacizumab (Avastin® and combined with infliximab (Remicade® in the treatment of naive choroidal neovascularization due to age-related macular degeneration eyes. METHODS: Intravitreal injections of bevacizumab combined with infliximab in 6 neovascular age-related macular degeneration eyes. All patients underwent complete ophthalmologic examination on the initial visit and at days 1, 30, 60, 90, 120, 150 and 180 following the first injection. Optical coherence tomography and fluorescein angiography were performed during at initial visit and monthly during the 6 months follow-up period. Electroretinography was performed before and 30 days after initial injection, in order to evaluate retinal toxicity induced by such treatment. RESULTS: Thirty days after the first injection, 5 eyes (83% shown decrease in macular thickness. No change was seen in electroretinogram in any eyes compared to initially performed electroretinogram. All phakic eyes developed cataract. One patient developed vitritis and was submitted to medical treatment successfully. At the end of the 6 months follow-up period, 4 patients showed significant improvement in the exudative process of choroidal neovascularization. One eye had mild persistent submacular fluid without active choroidal neovascularization, and another eye had persistent amount of intraretinal fluid due to active choroidal neovascularization. CONCLUSION: The combined use of bevacizumab with infliximab in eyes with neovascular age-related macular degeneration was effective in reducing leakage and improving the macular thickness. However, it is not possible to assert that the results were related to synergic effects of the combination therapy. A controlled study with more cases is necessary to precisely define the complication rates; however the dosage and/or association of drugs studied in this research should not be recommended in clinical practice due to

  11. 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....

  12. Antiproliferative, Apoptotic, and Autophagic Activity of Ranibizumab, Bevacizumab, Pegaptanib, and Aflibercept on Fibroblasts: Implication for Choroidal Neovascularization

    Directory of Open Access Journals (Sweden)

    Lyubomyr Lytvynchuk

    2015-01-01

    Full Text Available Purpose. Choroidal neovascularization (CNV is one of the most common complications of retinal diseases accompanied by elevated secretion of vascular endothelial growth factor (VEGF. Intravitreal anti-VEGFs (ranibizumab, bevacizumab, pegaptanib, and aflibercept can suppress neovascularization, decrease vascular permeability and CNV size, and, thereby, improve visual function. The antiproliferative, apoptotic, and autophagic effect of anti-VEGF drugs on fibroblasts found in CNVs has not been yet explored. Methods. Concentration-dependent cellular effects of the four anti-VEGFs were examined in L929 fibroblasts over a 5-day period. The cell survival, mitotic and polykaryocytic indices, the level of apoptosis and autophagy, and the cellular growth kinetics were all assessed. Results. The anti-VEGFs could inhibit the survival, mitotic activity, and proliferation as well as increase the cellular heterogeneity, apoptosis, and autophagy of the fibroblasts in a dose-dependent manner. Cellular growth kinetics showed ranibizumab to be less aggressive, but three other anti-VEGFs showed higher antiproliferative and apoptotic activity and expressed negative cellular growth kinetics. Conclusions. The antiproliferative, apoptotic, and autophagic activity of anti-VEGFs upon fibroblasts may explain the cellular response and the etiology of CNV involution in vivo and serve as a good study model for CNV in vitro.

  13. Plasma-activated medium suppresses choroidal neovascularization in mice: a new therapeutic concept for age-related macular degeneration.

    Science.gov (United States)

    Ye, Fuxiang; Kaneko, Hiroki; Nagasaka, Yosuke; Ijima, Ryo; Nakamura, Kae; Nagaya, Masatoshi; Takayama, Kei; Kajiyama, Hiroaki; Senga, Takeshi; Tanaka, Hiromasa; Mizuno, Masaaki; Kikkawa, Fumitaka; Hori, Masaru; Terasaki, Hiroko

    2015-01-09

    Choroidal neovascularization (CNV) is the main pathogenesis of age-related macular degeneration (AMD), which leads to severe vision loss in many aged patients in most advanced country. CNV compromises vision via hemorrhage and retinal detachment on account of pathological neovascularization penetrating the retina. Plasma medicine represents the medical application of ionized gas "plasma" that is typically studied in the field of physical science. Here we examined the therapeutic ability of plasma-activated medium (PAM) to suppress CNV. The effect of PAM on vascularization was assessed on the basis of human retinal endothelial cell (HREC) tube formation. In mice, laser photocoagulation was performed to induce CNV (laser-CNV), followed by intravitreal injection of PAM. N-Acetylcysteine was used to examine the role of reactive oxygen species in PAM-induced CNV suppression. Fundus imaging, retinal histology examination, and electroretinography (ERG) were also performed to evaluate PAM-induced retinal toxicity. Interestingly, HREC tube formation and laser-CNV were both reduced by treatment with PAM. N-acetylcysteine only partly neutralized the PAM-induced reduction in laser-CNV. In addition, PAM injection had no effect on regular retinal vessels, nor did it show retinal toxicity in vivo. Our findings indicate the potential of PAM as a novel therapeutic agent for suppressing CNV.

  14. Prophylactic laser treatment hastens choroidal neovascularization in unilateral age-related maculopathy: final results of the drusen laser study.

    Science.gov (United States)

    Owens, Sarah L; Bunce, Catey; Brannon, Alan J; Xing, Wen; Chisholm, Iain H; Gross, Mirjam; Guymer, Robyn H; Holz, Frank G; Bird, Alan C

    2006-02-01

    The Drusen Laser Study evaluated macular laser to prevent choroidal neovascularization (CNV) and vision loss in high-risk age-related maculopathy (ARM). Prospective, interventional, randomized, controlled clinical trial in five hospital centers. Patients in the unilateral group had neovascular ARM and drusen in the study eye. Study eyes were randomized to laser-treated or no-laser groups. For patients in the bilateral drusen group, eyes were randomized to right eye, laser or no laser; and left eye, alternative. Laser treatment comprised 12 argon spots. Outcome was best-corrected visual acuity and CNV signs, which were monitored for 3 years. In the unilateral group, vision loss occurred in 21 (28.8%) of 73 patients in laser vs 13 (19.7%) of 66 no-laser patients (P=.214). Incidence of CNV was 27 (29.7%) of 91 in laser vs 15 (17.65%) of 85 no-laser patients (P=.061). CNV onset was approximately 6 months earlier in laser-treated compared with no-laser patients (P=.05). In the bilateral group, vision loss occurred in six (8.3%) of 72 laser-treated vs 10 (13.9%) of 72 fellow eyes (P=.3877). CNV incidence was 12 (11.6%) of 103 in laser-treated vs seven (6.8%) of 103 fellow eyes (P=.225). There was no difference in onset of CNV. Results do not support prophylactic laser of the fellow eye of patients with neovascular ARM. Its role in patients with bilateral drusen remains unclear.

  15. Effect of Brimonidine on Retinal and Choroidal Neovascularization in a Mouse Model of Retinopathy of Prematurity and Laser-Treated Rats

    Science.gov (United States)

    Kusari, Jyotirmoy; Padillo, Edwin; Zhou, Sheila X.; Bai, Yanyan; Wang, Juanjuan; Song, Zhiming; Zhu, Meili; Le, Yun-Zheng; Gil, Daniel W.

    2011-01-01

    Purpose. To determine whether chronic treatment with brimonidine (BRI) attenuates retinal vascular leakage and neovascularization in neonatal mice after exposure to high oxygen in a mouse model of retinopathy of prematurity (ROP), and choroidal neovascularization (CNV) in rats after laser treatment. Methods. Experimental CNV was induced by laser treatment in Brown Norway (BN) rats. BRI or vehicle (VEH) was administered by osmotic minipumps, and CNV formation was measured 11 days after laser treatment. Oxygen-induced retinopathy was generated in neonatal mice by exposure to 75% oxygen from postnatal day (P)7 to P12. BRI or VEH was administered by gavage, and vitreoretinal vascular endothelial growth factor (VEGF) concentrations and retinal vascular leakage, neovascularization, and vaso-obliteration were measured on P17. Experimental CNV was induced in rabbits by subretinal lipopolysaccharide/fibroblast growth factor-2 injection. Results. Systemic BRI treatment significantly attenuated laser-induced CNV formation in BN rats when initiated 3 days before or within 1 hour after laser treatment. BRI treatment initiated during exposure to high oxygen significantly attenuated vitreoretinal VEGF concentrations, retinal vascular leakage, and retinal neovascularization in P17 mice subjected to oxygen-induced retinopathy. Intravitreal treatment with BRI had no effect on CNV formation in a rabbit model of nonischemic angiogenesis. Conclusions. BRI treatment significantly attenuated vitreoretinal VEGF concentrations, retinal vascular leakage, and retinal and choroidal neovascularization in animal models of ROP and CNV. BRI may inhibit underlying event(s) of ischemia responsible for upregulation of vitreoretinal VEGF and thus reduce vascular leakage and retinal-choroidal neovascularization. PMID:21482645

  16. 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 age-related 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.

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

    Directory of Open Access Journals (Sweden)

    Varsha V Prabhu

    2011-01-01

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

  18. Effect of modified Zhu Jing prescriptions on the expression of VEGF in pathological myopia with choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Nan-Nan Tian

    2013-08-01

    Full Text Available AIM: To observe the effect of traditional medicine to the expression of vascular endothelium growth factor(VEGF, and explore the intervention effect to the pathological myopia with choroidal neovascularization(CNVthrough experimental model of lasers -induced CNV in guinea pigs with pathological myopia induced by form deprivation. METHODS: Fifteen of the forty-five 3-week old female guinea pigs were randomly selected as the blank control group, the rest 30 guinea pigs were using facemask to induce high myopia in 4 weeks, then randomly assigned to model group and treatment group, then induced CNV by different wavelength laser. The treatment group gavaged with modified Zhu Jing prescriptions while the control group was gavaged with distill water. 21 days after treatment, histopathologic choroidal flat mounts, HE stain,immunofluorescence stain and immuno- histochemistry for VEGF in the experimental eyes and control eyes were performed.RESULTS:All the 30 guinea pigs were successfully induced high myopia and the axial length of the right eyes were significantly greater than the non-facemask eyes and the eyes of control group. Immunofluorescence stain and immunohistochemistry for VEGF showed that the expression of VEGF of the treatment group was less than the model group. The average optical density(AODof the form deprivation eye in the treatment group(0.0589±0.0146was higher than that in the model group(0.0972±0.0507(PCONCLUSION: Modified Zhu Jing prescriptions has a positive effect to the reduction of the VEGF expression in the CNV with pathological myopia and thus it can inhibit the growth of CNV.

  19. TNF-α mediates choroidal neovascularization by upregulating VEGF expression in RPE through ROS-dependent β-catenin activation.

    Science.gov (United States)

    Wang, Haibo; Han, Xiaokun; Wittchen, Erika S; Hartnett, M Elizabeth

    2016-01-01

    Inflammation, oxidative stress, and angiogenesis have been proposed to interact in age-related macular degeneration. It has been postulated that external stimuli that cause oxidative stress can increase production of vascular endothelial growth factor (VEGF) in retinal pigment epithelial (RPE) cells. In this study, we tested the hypothesis that the inflammatory cytokine, tumor necrosis factor alpha (TNF-α), contributed to choroidal neovascularization (CNV) by upregulating VEGF in RPE through intracellular reactive oxygen species (ROS)-dependent signaling and sought to understand the mechanisms involved. In a murine laser-induced CNV model, 7 days after laser treatment and intravitreal neutralizing mouse TNF-α antibody or isotype immunoglobulin G (IgG) control, the following measurements were made: 1) TNF-α protein and VEGF protein in RPE/choroids with western blot, 2) CNV volume in RPE/choroidal flatmounts, and 3) semiquantification of oxidized phospholipids stained with E06 antibody within CNV with immunohistochemistry (IHC). In cultured human RPE cells treated with TNF-α or PBS control, 1) ROS generation was measured using the 2',7'-dichlorodihydrofluorescein diacetate (DCFDA) fluorescence assay, and 2) NOX4 protein and VEGF protein or mRNA were measured with western blot or quantitative real-time PCR in cells pretreated with apocynin or nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) inhibitor, VAS 2870, or transfected with p22phox siRNA, and each was compared to its appropriate control. Western blots of phosphorylated p65 (p-p65), total p65 and β-actin, and quantitative real-time PCR of VEGF mRNA were measured in human RPE cells treated with TNF-α and pretreatment with the nuclear factor kappa B inhibitor, Bay 11-7082 or control. Western blots of β-catenin, VEGF, and p22phox and coimmunoprecipitation of β-catenin and T-cell transcriptional factor were performed in human RPE cells treated with TNF-α following pretreatment with

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

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vivek Dave

    2013-01-01

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

  2. Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy

    Directory of Open Access Journals (Sweden)

    Bettina Hohberger

    2015-11-01

    Full Text Available Purpose: Choroidal neovascularization (CNV associated with punctate inner choroidopathy (PIC is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported. Case Report: A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yielded hyperfluorescent signals in the affected areas with a diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial layer, consistent with the diagnosis of PIC. Additionally a classic CNV was observed. Results: Anti-inflammatory therapy with local prednisolone acetate eye drops in combination with intravitreal injection of anti-vascular endothelial growth factor (VEGF, bevacizumab yielded an increased best-corrected visual acuity. As CNV reappeared, systemic medication with prednisone and azathioprine in combination with two further intravitreal injections of anti-VEGF stabilized CNV and increased visual acuity again. Conclusion: Combined therapy of immunosuppression with intravitreal anti-VEGF injections can be considered as therapeutic strategy in the management of recurrent CNV associated with PIC.

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

    Directory of Open Access Journals (Sweden)

    Jonathan P Wigg

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

  4. Cerebrovascular accidents in patients treated for choroidal neovascularization with ranibizumab in randomized controlled trials.

    Science.gov (United States)

    Bressler, Neil M; Boyer, David S; Williams, David F; Butler, Steven; Francom, Steven F; Brown, Benton; Di Nucci, Flavia; Cramm, Timothy; Tuomi, Lisa L; Ianchulev, Tsontcho; Rubio, Roman G

    2012-10-01

    To analyze cerebrovascular accidents (CVAs) pooled from large, randomized, controlled clinical trials of ranibizumab treatment for neovascular age-related macular degeneration. Events in five trials (FOCUS, MARINA, ANCHOR, PIER, and SAILOR) were analyzed using a standard safety monitoring process. Exact methods, stratified by study, were used to test for treatment differences based on odds ratios. A stepwise logistic regression model was fit to classify subjects' risk for CVA based on medical history. Treatment differences in CVA rates at 1 year or 2 years were evaluated within risk groups using stratified exact methods. Pooled 2-year CVA rates were <3%; odds ratios (95% confidence intervals) for CVA risk were 1.2 (0.4-4.4) for ranibizumab 0.3-mg versus control, 2.2 (0.8-7.1) for 0.5 mg versus control, and 1.5 (0.8-3.0) for 0.5-mg versus 0.3-mg ranibizumab. No substantial increased risk of CVA for 0.5 mg versus 0.3 mg was identified in pooled analyses or any of the individual trials. In pooled analyses, the difference between 0.5-mg ranibizumab and control was larger (7.7 [1.2-177]) among high-risk CVA patients. This analysis provided some evidence, although not definitive, of a potential increased risk of CVA with ranibizumab versus control or with 0.5-mg versus 0.3-mg ranibizumab. Continued monitoring for CVA within clinical trials seems warrented.

  5. Retinal injury thresholds for 532, 578, and 630 nm lasers in connection to photodynamic therapy for choroidal neovascularization.

    Science.gov (United States)

    Chen, Hongxia; Yang, Zaifu; Zou, Xianbiao; Wang, Jiarui; Zhu, Jianguo; Gu, Ying

    2014-01-01

    The purpose of this study was to explore the retinal injury thresholds in rabbits and evaluate the influence of retinal pigmentation on threshold irradiance at laser wavelengths of 532, 578, and 630 nm which might be involved in hypocrellin B (HB) and hematoporphyrin monomethyl ether (HMME) photodynamic therapy (PDT) for choroidal neovascularization (CNV). The eyes of pigmented and non-pigmented rabbits were exposed to 532, 578, and 630 nm lasers coupled to a slit lamp biological microscope. The exposure duration was 100 seconds and the retinal spot size was 2 mm throughout the experiment. The minimum visible lesions were detected by funduscopy at 1 and 24 hours post exposure. Bliss probit analysis was performed to determine the ED50 thresholds, fiducial limits and probit slope. In pigmented rabbits, the 24-hour retinal threshold irradiances at 532, 578, and 630 nm were 1,003, 1,475, and 1,720 mW/cm(2) , respectively. In non-pigmented rabbits, the 24-hour threshold irradiances were 1,657, 1,865, and 15,360 mW/cm(2) , respectively. The ED50 for 24-hour observation differed very little from the ED50 for 1-hour observation. The non-pigmented rabbits required a ninefold increase in threshold irradiance at 630 nm comparing to the pigmented rabbits. This study will contribute to the knowledge base for the limits of laser irradiance in application of HB or HMME PDT for CNV. © 2013 Wiley Periodicals, Inc.

  6. Comparative role of intravitreal ranibizumab versus bevacizumab in choroidal neovascular membrane in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Partha Biswas

    2011-01-01

    Full Text Available Context: Ranibizumab and bevacizumab are used widely for treating patients with choroidal neovascular membrane (CNVM secondary to age-related macular degeneration (AMD. Aims: To determine and compare the efficacy and safety of intravitreal ranibizumab and bevacizumab in treatment of CNVM due to AMD. Settings and Design: Prospective comparative case series carried out in an eye institute and eye department of a hospital in Kolkata, India. Materials and Methods: One hundred and four eyes with CNVM due to AMD were randomized into two groups. Group A (n=54; 24 occult received monthly intravitreal ranibizumab injections (0.5 mg in 0.05 ml and Group B (n=50; 22 occult received monthly bevacizumab injections (1.25 mg in 0.05 ml for 3 consecutive months and then as per study criteria. Data analysis done using SPSS software. P-value of <0.05 was considered statistically significant. Results: The mean best corrected visual acuity (BCVA in the ranibizumab group increased from 58.19 Early Treatment Diabetic Retinopathy Study (ETDRS letters at baseline to 64 ETDRS letters at month 3 (P<0.001. In bevacizumab group mean BCVA increased from 56.80 to 61.72 ETDRS letters at month 3 (P<0.001. At the end of 18 months, there was no statistically significant difference between groups A and B with respect to change in BCVA (P=0.563 or central macular thickness (CMT; P=0.281, as measured by optical coherence tomography (Stratus OCT 3000. No significant sight-threatening complications developed. Conclusions: Ranibizumab and bevacizumab are equally safe and efficacious in treating CNVM due to AMD.

  7. RETICULAR PSEUDODRUSEN ARE NOT A PREDICTIVE FACTOR FOR THE 1-YEAR RESPONSE TO INTRAVITREAL RANIBIZUMAB IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Nghiem-Buffet, Sylvia; Giocanti-Auregan, Audrey; Jung, Camille; Dubois, Lise; Dourmad, Pauline; Galbadon, Lea; Fajnkuchen, Franck; Quentel, Gabriel; Cohen, Salomon Y

    2017-01-01

    To investigate reticular pseudodrusen (RPD) as a potential baseline factor predictive of a poor 1-year response to intravitreal ranibizumab in eyes with neovascular age-related macular degeneration. Retrospective, monocentric case series including 98 consecutive naive neovascular age-related macular degeneration patients. Presence of RPD was assessed by two graders based on color, blue-light, fundus autofluorescence pictures, and spectral-domain optical coherence tomography. A correlation between the presence of RPD and the visual change was investigated. Other baseline characteristics studied in a monovariate and multivariate analysis were the following: age, gender, affected side, loading dose, type of neovascularization, presence of retinal pigment epithelial detachment >250 μm, subretinal or intraretinal fluid, blood over >50% of the lesion, and subfoveal choroidal thickness. The presence of RPD was not associated with a visual change (P = 0.96), but with a thin subfoveal choroidal thickness at baseline (P macular degeneration. Studies with a longer follow-up may be needed to assess the impact of RPD on the visual prognosis of eyes with neovascular age-related macular degeneration.

  8. Clinical validation of a genetic model to estimate the risk of developing choroidal neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Hageman Gregory S

    2011-07-01

    Full Text Available Abstract Predictive tests for estimating the risk of developing late-stage neovascular age-related macular degeneration (AMD are subject to unique challenges. AMD prevalence increases with age, clinical phenotypes are heterogeneous and control collections are prone to high false-negative rates, as many control subjects are likely to develop disease with advancing age. Risk prediction tests have been presented previously, using up to ten genetic markers and a range of self-reported non-genetic variables such as body mass index (BMI and smoking history. In order to maximise the accuracy of prediction for mainstream genetic testing, we sought to derive a test comparable in performance to earlier testing models but based purely on genetic markers, which are static through life and not subject to misreporting. We report a multicentre assessment of a larger panel of single nucleotide polymorphisms (SNPs than previously analysed, to improve further the classification performance of a predictive test to estimate the risk of developing choroidal neovascular (CNV disease. We developed a predictive model based solely on genetic markers and avoided inclusion of self-reported variables (eg smoking history or non-static factors (BMI, education status that might otherwise introduce inaccuracies in calculating individual risk estimates. We describe the performance of a test panel comprising 13 SNPs genotyped across a consolidated collection of four patient cohorts obtained from academic centres deemed appropriate for pooling. We report on predictive effect sizes and their classification performance. By incorporating multiple cohorts of homogeneous ethnic origin, we obtained >80 per cent power to detect differences in genetic variants observed between cases and controls. We focused our study on CNV, a subtype of advanced AMD associated with a severe and potentially treatable form of the disease. Lastly, we followed a two-stage strategy involving both test model

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

    Directory of Open Access Journals (Sweden)

    Xiao Dong

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

  10. Bevacizumab (Avastin® no tratamento da membrana neovascular coroidal secundária à degeneração macular relacionada à idade: relato de caso Bevacizumab (Avastin® in treatment of choroidal neovascularization secondary to age-related macular degeneration: a case report

    Directory of Open Access Journals (Sweden)

    Tiago Eugênio Faria e Arantes

    2007-12-01

    Full Text Available As drogas anti-angiogênicas foram introduzidas recentemente no arsenal terapêutico das membranas neovasculares coroidais. O objetivo deste relato é descrever um caso de membranas neovasculares coroidais oculta com extenso descolamento do epitélio pigmentado da retina, tratada com bevacizumab (Avastin® intravítrea. A eficácia da medicação foi avaliada por meio da acuidade visual e de exames complementares (angiografia fluoresceínica, videoangiografia com indocianina verde e tomografia de coerência óptica. Após três injeções intravítreas de bevacizumab, obteve-se uma resposta anatômica e visual satisfatória, denotando benefícios da droga, apesar do extenso descolamento do epitélio pigmentado da retina associada a membranas neovasculares coroidais oculta.The antiangiogenic drugs have been recently introduced in the therapeutic armamentarium of choroidal neovascularization. The purpose of this report is to describe a case of occult choroidal neovascularization with extensive retinal pigment epithelial detachment treated with intravitreal bevacizumab (Avastin®. The efficacy of the medication was evaluated by means of visual acuity and complementary exams (fluorescein angiography, indocyanine green video angiography and optical coherence tomography. After three intravitreal injections of bevacizumab a satisfactory anatomic and visual response was achieved, showing benefits of the drug, despite the extensive retinal pigment epithelial detachment associated with occult choroidal neovascularization.

  11. [The treatment of the exsudative age-related macular degeneration with choroidal neovascular membrane, its possibilities and economical indexes].

    Science.gov (United States)

    Karel, I

    2007-09-01

    To establish the probable prevalence and incidence of the exsudative (wet) age-related macular degeneration (AMD) in the Czech Republic and to compare possibilities and the expensiveness of the photodynamic therapy (PDT) and the treatment with substances blocking the vascular endothelial growth factor (anti-VEGF). The calculation of the probable prevalence and incidence of the exsudative AMD in the Czech Republic (CR) was based on the world epidemiological studies. The expenses of the PDT and the anti-VEGF treatment for the patient and for the health insurances were based on the calculation of the Visudyne and anti-VEGF substances' prices in CR and worldwide. If the European prevalence of the exsudative AMD in patients over 65 years of age is 2.3% and the prevalence of the risk soft drusen is 15 %, so in the CR out of 1.44 millions of inhabitants older than 65 years have approximately 33 000 the AMD, and the drusen at risk 216.000 inhabitants. If the 5-years incidence of the exsudative AMD in patients with drusen at risk is 3.4%, it may be expected the turn of the soft drusen into the exsudative AMD during the 5-years period in 7340 patients, or 1460 patients a year. The PDT is indicated in approx. 20% of exsudative AMD with the classical or predominantly classical choroid neovascularization (CNV), i.e. approx. 300 patients a year. If, at the average, 5.6 PDT sessions during 2 years are needed and the price is 42.500 CZK (Czech Crowns; 1 USD = approx. 20-22 CZK; 1 Euro = approx. 27-29 CZK) for one injection of Visudyne, so the average cost per patient is 238,000 CZK and the costs for all of them 71.4 millions of CZK. If the patient's participation is 7395 CZK per one dose of Visudyne, then the average patient's expense for the PDT during the 2 years period is 41 412 CZK. Anti-VEFG drugs as intravitreal injections are effective in all forms of exsudative AMD. Macugen (pegaptanib), already registered in the CR, should be applied in six-weeks intervals, during the two

  12. 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......) macular subfields. Center point thickness and total macular volume were also included in the analysis. Manual subfoveal choroidal thickness measurements were made by a masked observer. RESULTS: A total of 40 eyes of 40 patients were included in this analysis (mean [± standard deviation] age: 74.1 [± 7......: 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...

  13. Choroidal Thickness Influences Near-Infrared Reflectance Intensity in Eyes With Geographic Atrophy Due To Age-Related Macular Degeneration.

    Science.gov (United States)

    Dolz-Marco, Rosa; Gal-Or, Orly; Freund, K Bailey

    2016-11-01

    To evaluate the effects of retinal and choroidal thickness on near-infrared reflectance (NIR) scanning laser ophthalmoscopy in eyes with geographic atrophy (GA) secondary to non-neovascular age-related macular degeneration (AMD). This was a cross-sectional review of the clinical records and multimodal imaging data of eyes diagnosed with GA secondary to non-neovascular AMD. Imaging modalities included color fundus photography, fundus autofluorescence, NIR, and structural spectral-domain optical coherence tomography (SD-OCT). On SD-OCT images, the foveal retina thickness and the subfoveal choroidal thickness were measured by two independent readers. Near-infrared reflectance intensity within areas of GA was subjectively graded as hyperreflective, isoreflective, or hyporeflective and objectively estimated by using ImageJ to calculate the mean gray scale value within each GA area. A linear regression analysis was performed to model the relationship between mean NIR gray scale value and retinal and choroidal thickness. One hundred four eyes of 104 patients with a mean age of 81.3 years (SD: ±8.3) were included. The area of GA was hyperreflective on NIR in 88 eyes (85%), isoreflective in 13 eyes (12%), and hyporeflective in 3 eyes (3%). The mean foveal retinal thickness was 101.5 μm (SD: ±54) showing no significant relationship with mean NIR (P = 0.464); and the mean subfoveal choroidal thickness was 172.6 μm (SD: ±114.7) showing a statistically significant relationship with mean NIR intensity in the linear regression analysis (r = 0.590; r2 = 0.348; P < 0.00001). Variations in choroidal thickness appear to influence NIR intensity in areas of GA and have the potential to affect image interpretation. The recognition of this relationship may provide useful information regarding choroidal thickness.

  14. SUBFOVEAL NODULE IN COATS' DISEASE: Toward an Updated Classification Predicting Visual Prognosis.

    Science.gov (United States)

    Daruich, Alejandra L; Moulin, Alexandre P; Tran, Hoai V; Matet, Alexandre; Munier, Francis L

    2017-08-01

    To determine the prevalence, clinical characteristics and nature of subfoveal nodules in Coats' disease and the associated impact on the long-term visual outcome. Consecutive cases of Coats' disease with foveal exudation were retrospectively reviewed. The presence of a subfoveal nodule or macular fibrosis was recorded. Clinical characteristics, retinal imaging, and outcome were analyzed by comparative analysis. The histopathological description of an enucleated eye with subfoveal nodule was performed. Among 40 patients presenting unilateral Stage 2B or 3A1 Coats' disease, a subfoveal nodule was detected in 21 patients (52.5%). The median follow-up was 4.7 years. Nineteen patients (47.5%) did not present a subfoveal nodule. Three patients (15.8%) without subfoveal nodule and 21 patients (100%) with subfoveal nodule progressed to a macular fibrotic scar (P < 0.0001), and the mean time of macular fibrosis onset was 11.0 ± 2.6 months. Final visual acuity was significantly worse in patients who presented a subfoveal nodule at diagnosis (P = 0.01). Of 18 cases with subfoveal nodule who underwent fluorescein angiography, retinal-retinal anastomosis and neovascularization were detected in 13 (72.2%) and 2 eyes (11.1%), respectively. Histopathological analysis of a subfoveal nodule revealed an aggregate of proteinaceous material including fibrin, spindle cells, macrophages, and pigmented cells. The presence of a subfoveal nodule at presentation is a predictive factor for macular fibrosis development and worse visual outcome in patients with Coats' disease. These observations suggest an updated classification introducing two subcategories within Stage 2B: without subfoveal nodule (Stage 2B1) and with subfoveal nodule (Stage 2B2).

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

    Directory of Open Access Journals (Sweden)

    M Naseripour

    2008-04-01

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

  16. Choroidal neovascularization reduced by targeted drug delivery with cationic liposome-encapsulated paclitaxel or targeted photodynamic therapy with verteporfin encapsulated in cationic liposomes

    Science.gov (United States)

    Gross, Nikolai; Ranjbar, Mahdy; Evers, Charlotte; Hua, Jing; Martin, Gottfried; Schulze, Brita; Michaelis, Uwe; Hansen, Lutz L.

    2013-01-01

    Purpose Intravitreal antivascular endothelial growth factor (anti-VEGF) application has revolutionized the treatment of choroidal neovascularization (CNV), a hallmark of wet age-related macular degeneration. However, additional treatment options are desirable as not all CNV lesions respond to anti-VEGF injections. Here, we assessed the feasibility of targeted delivery of cationic liposome-encapsulated paclitaxel (EndoTAG-1) in treating CNV. Furthermore, we investigated whether a new formulation of verteporfin encapsulated in cationic liposomes (CL-VTP) enhances the effect of photodynamic therapy (PDT). Methods EndoTAG-1, LipoSPA, and CL-VTP were produced by encapsulating paclitaxel, succinyl-paclitaxel, or verteporfin in cationic liposomes (CL). Mice underwent argon laser coagulations at day 0 (D0) to induce CNV. EndoTAG-1 and LipoSPA were injected into the tail vein at D1, D3, D5, D7, and D9. Taxol, CL, or trehalose buffer alone was injected in control animals. At D10, all animals were perfused with fluorescein isothiocyanate (FITC)-dextran. Flatmounts comprising the retinal pigment epithelium, choroid, and sclera were prepared for quantifying the CNV by measuring the area of lesions perfused with FITC-dextran. For PDT, mice received an injection with CL-VTP or Visudyne at D10. One eye was treated with PDT while the other served as a control. Evaluation of RPE-choroid-scleral and retinal flatmounts was performed at D12, D14, or D17. Perfusion with FITC-dextran and tetramethylrhodamine-5-(and 6)-isothiocyanate-lectin staining was used to distinguish between perfused and non-perfused choroidal vessels. Results EndoTAG-1 or LipoSPA significantly reduced CNV size to 15% compared to trehalose controls. The mean CNV area of mice treated with CL was reduced (though not significantly) to about one-half of the value of the trehalose control group. The same was observed for paclitaxel. Thus, the reduction in the CNV size between treatment with CL and treatment with Endo

  17. COL8A1 rs13095226 polymorphism shows no association with neovascular age-related macular degeneration or polypoidal choroidal vasculopathy in Chinese subjects.

    Science.gov (United States)

    Yu, Yang; Huang, Lvzhen; Wang, Bin; Zhang, Chunfang; Bai, Yujing; Li, Xiaoxin

    2015-01-01

    Age-related macular degeneration (AMD) is the main cause of visual impairment and legal blindness in older individuals. COL8A1 rs13095226 variants have recently been implicated associated with neovascular age-related macular degeneration (nAMD) and Polypoidal Choroidal Vasculopathy (PCV) in American studies. The aim of this study was to investigate the association between the COL8A1 rs13095226 Polymorphism and neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) in Chinese people. 900 Chinese subjects-300 cases with nAMD, 300 cases with PCV and 300 controls, were enrolled in a cross-sectional observational study. The diagnoses of nAMD and PCV were confirmed by Fundus photography, Fluorescence Fundus Angiography (FFA) and Indocyanine Green Angiography (ICGA). Genomic DNA was extracted from venous blood leukocytes and genotypes of rs13095226 were determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Differences in allele distribution between cases and controls were tested by chi-square tests, with age and gender adjusted by logistic regression analysis. The COL8A1 rs13095226 polymorphism was not statistically significantly different from the nAMD or PCV to the normal controls (P>0.05) in Chinese Population. The association remained insignificant after adjustment for age and gender differences (P>0.05). This case-control study indicated that the COL8A1 rs13095226 polymorphism is not associated with nAMD or PCV, which suggesting this gene maybe not a susceptibility gene locus for nAMD or PCV in Chinese subjects.

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

    Science.gov (United States)

    Kanavi, Mozhgan Rezaie; Darjatmoko, Soesiawati; Wang, Shoujian; Azari, Amir A.; Farnoodian, Mitra; Kenealey, Jason D.; van Ginkel, Paul R.; Albert, Daniel M.; Sheibani, Nader; Polans, Arthur S.

    2015-01-01

    The objective of this study was to determine whether resveratrol or a defined, reconstituted grape powder can attenuate the formation of new blood vessels in a mouse model of choroidal neovascularization (CNV). To accomplish this objective, C57BL/6J mice were randomized into control or treatment groups which received either resveratrol or grape powder by daily oral gavage, resveratrol or grape powder delivered ad libitum through the drinking water, or resveratrol by slow release via implanted osmotic pumps. A laser was used to rupture Bruch’s membrane to induce CNV which was then detected in sclerochoroidal eyecups stained with antibodies against intercellular adhesion molecule-2. CNV area was measured using fluorescence microscopy and Image J software. Ad libitum delivery of both resveratrol and grape powder was shown to significantly reduce the extent of CNV by 68% and 57%, respectively. Parallel experiments conducted in vitro demonstrated that resveratrol activates p53 and inactivates Akt/protein kinase B in choroidal endothelial cells, contributing to its anti-proliferative and anti-migratory properties. In addition resveratrol was shown to inhibit the formation of endothelial cell networks, augmenting its overall anti-angiogenic effects. The non-toxic nature of resveratrol makes it an especially attractive candidate for the prevention and/or treatment of CNV. PMID:25361423

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

    Directory of Open Access Journals (Sweden)

    Mozhgan Rezaie Kanavi

    2014-10-01

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

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

    Science.gov (United States)

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

    2015-11-01

    Choroidal neovascularization (CNV) associated with the 'wet' form of age related macular degeneration (AMD) is one of the most common causes of central vision loss among the elderly. The 'wet' form of AMD is currently treated by intravitreal delivery of anti-VEGF agents. However, intravitreal injections are associated with complications and long-term inhibition of VEGF leads to macular atrophy. Thus, there is currently an unmet need for the development of therapies for CNV that target molecules other than VEGF. Here, we describe nucleolin as a novel target for the 'wet' form of AMD. Nucleolin was found on the surface of endothelial cells that migrate from the choroid into the subretinal space in the laser-induced model of 'wet' AMD. AS1411 is a previously described G-quartet oligonucleotide that has been shown to bind nucleolin. We found that AS1411 inhibited the formation of tubes by human umbilical vein endothelial cells (HUVECs) by approximately 27.4% in vitro. AS1411 co-localized with the site of laser induced CNV in vivo. Intravitreally injected AS1411 inhibited laser-induced CNV by 37.6% and attenuated infiltration of macrophages by 40.3%. Finally, topical application of AS1411 led to a 43.4% reduction in CNV. Our observations have potential implications for the development of therapies for CNV and specifically for the 'wet' form of AMD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Clinical and spectral-domain optical coherence tomography findings in patients with focal choroidal excavation.

    Science.gov (United States)

    Lee, Christopher Seungkyu; Woo, Se Joon; Kim, Yong-Kyu; Hwang, Duck Jin; Kang, Hae Min; Kim, Hyesun; Lee, Sung Chul

    2014-05-01

    To describe the clinical and spectral-domain optical coherence tomography (SD-OCT) findings in patients with focal choroidal excavation (FCE). Retrospective case series. Forty-one eyes of 38 patients with FCE identified in 2 tertiary medical centers in Korea. Clinical features, SD-OCT findings, and associated macular disorders of FCE were analyzed and detailed. Statistical associations among clinical features, including lesion type, size, and choroidal thickness, and frequency of association with central serous chorioretinopathy (CSC), choroidal neovascularization (CNV), and polypoidal choroidal vasculopathy (PCV). Mean patient age was 50.1 years (range, 25-76 years). The mean spherical equivalent of refractive error was -3.7 diopters (range, -10.0 to +1.5 diopters). Three patients (8%) had bilateral lesions, and 1 patient (3%) had 2 distinct lesions in the same eye. The mean FCE width and depth were 757 μm and 107 μm, respectively, with a positive correlation between width and depth (P = 0.003). The mean subfoveal choroidal thickness of FCE eyes was 284 μm, which was not statistically different from that of age-, sex-, and refractive error-matched normal subjects. Choroidal thickness in FCE was less in eyes with hyperreflective choroidal tissue under the excavation that was present in 22 eyes (54%) versus eyes without excavation (128 vs. 190 μm, respectively; P = 0.009). Twelve FCEs (29%) were the nonconforming type, revealing separation between the photoreceptor tips and the retinal pigment epithelium on SD-OCT. Nonconforming FCE was associated with visual symptoms (P excavation, and the excavated area in 1 eye with PCV enlarged slightly during follow-up. Focal choroidal excavation is a relatively common entity and frequently associated with choroidal diseases, including CSC, CNV, and PCV. Although FCE is classically thought to be a congenital malformation, acquired FCE forms possibly exist. Copyright © 2014 American Academy of Ophthalmology. Published by

  2. The impact of typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy on vision-related quality of life in Asian patients.

    Science.gov (United States)

    Fenwick, Eva K; Cheung, Chui Ming Gemmy; Ong, Peng Guan; Tan, Gavin; Lee, Shu Yen; Yeo, Ian; Cheng, Ching Yu; Wong, Tien Y; Lamoureux, Ecosse L

    2017-05-01

    To determine the impact of neovascular age-related macular degeneration (nAMD) on vision-related quality of life (VRQoL) in an Asian population. In this cross-sectional study, 162 subjects with nAMD from the Asian AMD Phenotyping Study and 105 randomly sampled age-matched and gender-matched controls from the population-based Singapore Chinese Eye Study were recruited. nAMD was categorised as either polypoidal choroidal vasculopathy (PCV) or 'typical' AMD (tAMD). The reading, mobility and emotional well-being subscales of the impact of vision impairment (IVI) scale were validated using Rasch analysis and used as the main outcome measures and collectively referred to as VRQoL. Multivariate linear regression analyses were performed to assess the impact of nAMD overall, and PCV and tAMD subtypes, on the three IVI domains. Of the 162 with nAMD, 103 (63.6%) had PCV and 59 (36.4%) had tAMD. In multivariate models, nAMD overall was independently associated with a 21% reduction in reading (β=-1.08; CI -1.58 to -0.57); 16% reduction in mobility (β=-0.74; -1.14 to -0.33) and 44% reduction in emotional well-being (β=-2.15; -2.83 to -1.47) compared with controls. There were significant VRQoL deficits (p0.05). Neovascular AMD, including both PCV and tAMD subtypes, has a detrimental impact on VRQoL in Asian subjects independent of level of vision impairment. Interventions to increase reading capacity, enhance mobility and independence and improve mental health outcomes for subjects with neovascular AMD further address the impact of the condition on VRQoL in addition to pharmacological therapies. 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/.

  3. Sensitivity and specificity of optical coherence tomography angiography (OCT-A) for detection of choroidal neovascularization in real-life practice and varying retinal expertise level.

    Science.gov (United States)

    Souedan, Vaël; Souied, Eric H; Caillaux, Violaine; Miere, Alexandra; Ameen, Ala El; Blanco-Garavito, Rocio

    2017-05-25

    To evaluate the diagnostic accuracy of OCT angiography (OCT-A) detecting or predicting choroidal neovascularization (CNV), by ophthalmologists of disparate degrees of skills in retinal diseases, using spectral domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) as a standard reference. Retrospective observational case series. Patient presenting maculopathy and complete imaging were included. FA, SD-OCT, OCT-A and FA coupled to SD-OCT images were graded independently for presence or absence of CNV by ophthalmologists with varying expertise levels. Overall sensitivity of OCT-A was 85.62% (95% CI 79.04-90.76%) and specificity was 81.51% (95% CI 73.36-88.03). Sensitivity of FA was 74.51% (95% CI 66.84-81.20), and specificity was 82.35% (95% CI 74.30-88.73). Sensitivity of FA + SD-OCT was 92.72% (95% CI 87.34-96.30), and specificity was 90.91% (95% CI 84.31-95.37). OCT-A has good sensitivity and specificity for the detection of CNV in all expertise level groups. OCT-A may soon become a routine tool for CNV diagnosis and follow-up.

  4. Choroidal thickness evaluation in paediatric patients with adenotonsillar hypertrophy.

    Science.gov (United States)

    Yenigun, A; Elbay, A; Hafiz, A M; Ozturan, O

    2017-09-01

    To investigate choroidal thickness using enhanced-depth imaging optical coherence tomography in paediatric patients with adenotonsillar hypertrophy, with comparison to healthy children, three months after adenotonsillectomy. The patients were assigned to three groups: an adenotonsillar hypertrophy group, an adenotonsillectomy group and a healthy control group. In all groups, subfoveal, temporal and nasal choroidal thickness measurements were taken. In the subfoveal, temporal and nasal regions, choroidal tissue was found to be significantly thinner in adenotonsillar hypertrophy children than healthy children (p = 0.012, p = 0.027 and p = 0.020). The subfoveal and temporal choroidal thickness measurements of adenotonsillar hypertrophy group cases were significantly decreased compared to those in the adenotonsillectomy group (p = 0.038 and p = 0.048). There was a significant association between decreased choroidal thickness and adenotonsillar hypertrophy. Adenotonsillar hypertrophy may play an important role in decreased choroidal thickness.

  5. Verteporfin PDT for subfoveal occult CNV in AMD: two-year results of a randomized trial.

    Science.gov (United States)

    Kaiser, Peter K

    2009-08-01

    To determine whether verteporfin photodynamic therapy (PDT) can safely reduce the risk of vision loss in patients with subfoveal occult with no classic choroidal neovascularization (CNV) due to age-related macular degeneration. Eligible patients were > or =50 years of age with lesion size or =15 and > or =30 letters of visual acuity (VA) from baseline at 12 and 24 months. This study was registered with ClinicalTrials.gov on 20 July 2005. ClinicalTrials.gov identifier: NCT00121407. A total of 37% and 47% of verteporfin-treated patients versus 45% and 53% of placebo recipients lost > or =15 letters of VA at month 12 and month 24, respectively; 16% and 23% of verteporfin-treated patients versus 17% and 25% of placebo recipients lost > or =30 letters at month 12 and month 24, respectively. These differences were not statistically significant. Four (1.6%) verteporfin-treated patients and one placebo patient (who received verteporfin in error) experienced an acute severe VA decrease; all five patients recovered some degree of vision. No unexpected ocular or systemic adverse events were identified. Verteporfin PDT in the treatment of occult with no classic CNV was safe and well-tolerated. The differences between the two groups in the primary efficacy variables were not significant. Baseline characteristics and patient selection methods may have contributed to the small treatment effect.

  6. Choroidal changes after cardiopulmonary bypass.

    Science.gov (United States)

    Pekel, G; Alur, I; Alihanoglu, Y I; Yagci, R; Emrecan, B

    2014-11-01

    Choroid, which is the vascular tissue responsible for blood supply to the outer parts of the retina, might be affected by hemodynamic events. We aimed to reveal choroidal thickness and ocular pulse amplitude changes after cardiopulmonary bypass in which gross hemodynamic alterations occur. Forty-two eyes of 42 patients who underwent heart surgery with cardiopulmonary bypass were examined in this prospective, cross-sectional case series. The spectral domain optical coherence tomography (Spectralis, Heidelberg, Germany) was used to analyze sub-foveal choroidal thickness. The ocular pulse amplitude, the surrogate of gross choroidal blood flow, was measured with the Pascal dynamic contour tonometer (Pascal DCT, Swiss Microtechnology AG, Port, Switzerland).. The intraocular pressure was also measured with this tonometer. The examinations were performed pre-operatively and post-operatively at the first week and first month. The mean age of the patients was 58.8 ± 12.4 years. The mean sub-foveal choroidal thickness and ocular pulse amplitude values did not change statistically significantly after the operations at the follow-up visits (p>0.05). Also, there were no important correlations between cardiopulmonary bypass time and mean sub-foveal choroidal thickness and ocular pulse amplitude changes at the post-operative first week (p>0.05). The intraocular pressure values were decreased markedly at the control visits (pcardiopulmonary bypass. © The Author(s) 2014.

  7. Changes in Fundus Autofluorescence after Anti-vascular Endothelial Growth Factor According to the Type of Choroidal Neovascularization in Age-related Macular Degeneration.

    Science.gov (United States)

    Lee, Ji Young; Chung, Hyewon; Kim, Hyung Chan

    2016-02-01

    To describe the changes of fundus autofluorescence (FAF) in patients with age-related macular degeneration before and after intravitreal injection of anti-vascular endothelial growth factor according to the type of choroidal neovascularization (CNV) and to evaluate the correlation of FAF with spectral domain optical coherence tomography (SD-OCT) parameters and vision. This was a retrospective study. Twenty-one treatment-naïve patients with neovascular age-related macular degeneration were included. Study eyes were divided into two groups according to the type of CNV. Fourteen eyes were type 1 CNV and seven eyes were type 2 CNV. All eyes underwent a complete ophthalmologic examination, including an assessment of best-corrected visual acuity, SD-OCT, fluorescein angiography, and FAF imaging, before and 3 months after intravitreal anti-vascular endothelial growth factor injection. Gray scales of FAF image for CNV areas, delineated as in fluorescein angiography, were analyzed using the ImageJ program, which were adjusted by comparison with normal background areas. Correlation of changes in FAF with changes in SD-OCT parameters, including CNV thickness, photoreceptor inner and outer segment junction disruption length, external limiting membrane disruption length, central macular thickness, subretinal fluid, and intraretinal fluid were analyzed. Eyes with both type 1 and type 2 CNV showed reduced FAF before treatment. The mean gray scales (%) of type 1 and type 2 CNV were 52.20% and 42.55%, respectively. The background values were 106.72 and 96.86. After treatment, the mean gray scales (%) of type 1 CNV and type 2 CNV were changed to 57.61% (p = 0.005) and 57.93% (p = 0.008), respectively. After treatment, CNV thickness, central macular thickness, and inner and outer segment junction disruption length were decreased while FAF increased. FAF was noted to be reduced in eyes with newly diagnosed wet age-related macular degeneration, but increased after anti

  8. Incidence of outer retinal tubulation in eyes with choroidal neovascularization under intravitreal anti-vascular endothelial growth factor therapy in a Japanese population

    Directory of Open Access Journals (Sweden)

    Takagi S

    2017-06-01

    Full Text Available Seiji Takagi,1–3 Michiko Mandai,1,4 Noriko Miyamoto,1,2 Akihiro Nishida,1,2 Yasuhiko Hirami,1,2 Hirofumi Uyama,1,2 Midori Yamamoto,1,2 Masayo Takahashi,1,2,4 Goji Tomita,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Translational Research, Division of Ophthalmology, Institute of Biomedical Research and Innovation, Kobe, Hyogo, 3Department of Ophthalmology, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, 4RIKEN Center for Developmental Biology, Kobe, Hyogo, Japan Purpose: The purpose of this study was to investigate the occurrence of outer retinal tubulation (ORT among patients with different types of choroidal neovascularization (CNV over time. Materials and methods: In this retrospective chart review, disease type was classified as typical age-related macular degeneration (t-AMD, polypoidal choroidal vasculopathy (PCV, retinal angiomatous proliferation (RAP, or myopic CNV (mCNV. Spectral domain-optical coherence tomography (SD-OCT images were evaluated for the appearance of ORT and subretinal fibrosis and fluid. Furthermore, the association of the presence of ORT with clinical data and OCT findings was investigated. Results: Among the 136 eyes studied, the overall rates of occurrence of ORT were 7.8%, 18.8%, and 31.6% after 12, 24, and 36 months from baseline, respectively. Among patients with t-AMD, RAP, and mCNV, the occurrence of ORT increased soon after the initial visit. In contrast, among patients with PCV, the occurrence of ORT increased slowly over time. Patients with and without ORT – ORT(+ and ORT(- groups, respectively – differed significantly in terms of sex ratio and presence of intraretinal fluid at the initial visit and presence of subretinal fibrosis at 3 years from baseline. The ORT(+ group exhibited lower visual acuity (VA; 0.67±0.43 than that of the ORT(- group (0.41±0.36; P<0.001.Conclusion: The occurrence of ORT tended to increase more slowly

  9. Inhibition of APE1/Ref-1 redox activity rescues human retinal pigment epithelial cells from oxidative stress and reduces choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    Y. Li

    2014-01-01

    Full Text Available The effectiveness of current treatment for age related macular degeneration (AMD by targeting one molecule is limited due to its multifactorial nature and heterogeneous pathologies. Treatment strategy to target multiple signaling pathways or pathological components in AMD pathogenesis is under investigation for better clinical outcome. Inhibition of the redox function of apurinic endonuclease 1/redox factor-1 (APE1 was found to suppress endothelial angiogenesis and promote neuronal cell recovery, thereby may serve as a potential treatment for AMD. In the current study, we for the first time have found that a specific inhibitor of APE1 redox function by a small molecule compound E3330 regulates retinal pigment epithelium (RPEs cell response to oxidative stress. E3330 significantly blocked sub-lethal doses of oxidized low density lipoprotein (oxLDL induced proliferation decline and senescence advancement of RPEs. At the same time, E3330 remarkably decreased the accumulation of intracellular reactive oxygen species (ROS and down-regulated the productions of monocyte chemoattractant protein-1 (MCP-1 and vascular endothelial growth factor (VEGF, as well as attenuated the level of nuclear factor-κB (NF-κB p65 in RPEs. A panel of stress and toxicity responsive transcription factors that were significantly upregulated by oxLDL was restored by E3330, including Nrf2/Nrf1, p53, NF-κB, HIF1, CBF/NF-Y/YY1, and MTF-1. Further, a single intravitreal injection of E3330 effectively reduced the progression of laser-induced choroidal neovascularization (CNV in mouse eyes. These data revealed that E3330 effectively rescued RPEs from oxidative stress induced senescence and dysfunctions in multiple aspects in vitro, and attenuated laser-induced damages to RPE–Bruch׳s membrane complex in vivo. Together with its previously established anti-angiogenic and neuroprotection benefits, E3330 is implicated for potential use for AMD treatment.

  10. Nonconforming Deep Focal Choroidal Excavation in a Patient With Choroidal Osteoma: A Diagnostic Dilemma.

    Science.gov (United States)

    Chawla, Rohan; Azad, Shorya Vardhan; Takkar, Brijesh; Sharma, Anu; Kashyap, Bibhuti

    2017-11-01

    Evolution of an osteoma may result in neurosensory detachment, deossification, and choroidal neovascularization (CNV). The authors report a rare case of choroidal osteoma with CNV associated with a deep non-conforming focal choroidal excavation. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:944-947.]. Copyright 2017, SLACK Incorporated.

  11. Is there any relationship between photodynamic therapy for exudative age-related macular degeneration and choroidal neovascolarization recurrence? A rationale for combined treatments.

    Science.gov (United States)

    Piermarocchi, S; Sartore, M; Lo Giudice, G; Monterosso, G; Pilotto, E; Segato, T

    2006-01-01

    Photodynamic therapy (PDT) is the treatment of choice for subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). Interpretation of PDT mechanism of action is not yet fully understood and causes of CNV recurrences are unclear. The authors have conducted a retrospective analysis of fluorescein and indocyanine green angiographies in patients treated with multiple PDT in order to identify risk factors for recurrence. A total of 342 eyes of 342 patients (207 women and 135 men) with ARMD and subfoveal CNV were treated with at least two PDT. Angiographic (fluorescein and indocyanine green) features of recurrences were confronted to pretreatment examinations in all patients. Post-PDT angiographies showed in all eyes a dark circle corresponding to the laser spot even 1 year after treatment. Persistence or progressive regrowth of CNV developed in an area adjacent or corresponding to the original lesion, without any specific relationship with the location of fluorescein and indocyanine green late leakage or with presence of abnormal fluorescence due to pigment abnormalities. At the 3-month angiographic follow-up, 23 patients (6.7%) showed a recurrent CNV resembling shape and dimension of the laser spot used for the PDT treatment. The authors failed to identify angiographic signs helpful to predict the risk of CNV persistence or recurrence. PDT leaves minor but persistent changes in the choroidal vasculature within the treatment area. In some cases, the recurrent CNV seems to be related to the laser spot of the PDT.

  12. THE EXPANDING CLINICAL SPECTRUM OF CHOROIDAL EXCAVATION IN MACULAR DYSTROPHIES.

    Science.gov (United States)

    Battaglia Parodi, Maurizio; Casalino, Giuseppe; Iacono, Pierluigi; Introini, Ugo; Adamyan, Tatevik; Bandello, Francesco

    2017-08-09

    To assess the prevalence and the clinical course of focal choroidal excavation (FCE) in patients affected by macular dystrophies. Prospective case series. All the patients underwent a complete ophthalmologic examination, including best-corrected visual acuity and spectral domain optical coherence tomography. The presence of choroidal neovascularization (CNV) was assessed on the basis of the leakage detected on fluorescein angiography. A total of 162 eyes from 81 patients with macular dystrophy were included in the study. FCE was diagnosed in seven eyes (4.3% of the eyes), including four eyes with Best vitelliform dystrophy, two eyes with pattern dystrophy associated with pseudoxanthoma elasticum, and one case of Stargardt disease. In eyes with FCE and macular dystrophy, the mean best-corrected visual acuity was 0.4 ± 0.1 logarithm of the minimum angle of resolution (approximately corresponding to 20/50 Snellen equivalent) at baseline and was stable to 0.41 ± 0.1 logarithm of the minimum angle of resolution (approximately corresponding to 20/50 Snellen equivalent) at the final visit. In four of these seven eyes, FCE was associated with a subfoveal CNV. The CNV was managed with one intravitreal anti-vascular endothelial growth factor injection, achieving the complete anatomical stabilization of the CNV and recovery of the best-corrected visual acuity. Focal choroidal excavation can be infrequently encountered in patients with macular dystrophies. The presence of CNV may complicate FCE in these patients, and anti-vascular endothelial growth factor seems to be an effective treatment with no progression of FCE over time.

  13. 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.

  14. 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

  15. Long-term Results of Carbon Ion Radiation Therapy for Locally Advanced or Unfavorably Located Choroidal Melanoma: Usefulness of CT-based 2-Port Orthogonal Therapy for Reducing the Incidence of Neovascular Glaucoma

    Energy Technology Data Exchange (ETDEWEB)

    Toyama, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Department of Heavy Particle Therapy and Radiation Oncology, Faculty of Medicine, Saga University, Saga (Japan); Tsuji, Hiroshi, E-mail: h_tsuji@nirs.go.jp [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Mizoguchi, Nobutaka; Nomiya, Takuma; Kamada, Tadashi [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Tokumaru, Sunao [Department of Heavy Particle Therapy and Radiation Oncology, Faculty of Medicine, Saga University, Saga (Japan); Mizota, Atsushi [Department of Ophthalmology, Teikyo University School of Medicine, Tokyo (Japan); Ohnishi, Yoshitaka [Department of Ophthalmology, Wakayama Medical University, Wakayama (Japan); Tsujii, Hirohiko [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)

    2013-06-01

    Purpose: To determine the long-term results of carbon ion radiation therapy (C-ion RT) in patients with choroidal melanoma, and to assess the usefulness of CT-based 2-port irradiation in reducing the risk of neovascular glaucoma (NVG). Methods and Materials: Between January 2001 and February 2012, a total of 116 patients with locally advanced or unfavorably located choroidal melanoma received CT-based C-ion RT. Of these patients, 114 were followed up for more than 6 months and their data analyzed. The numbers of T3 and T2 patients (International Union Against Cancer [UICC], 5th edition) were 106 and 8, respectively. The total dose of C-ion RT varied from 60 to 85 GyE, with each dose given in 5 fractions. Since October 2005, 2-port therapy (51 patients) has been used in an attempt to reduce the risk of NVG. A dose-volume histogram analysis was also performed in 106 patients. Results: The median follow-up was 4.6 years (range, 0.5-10.6 years). The 5-year overall survival, cause-specific survival, local control, distant metastasis-free survival, and eye retention rates were 80.4% (95% confidence interval 89.0%-71.8%), 82.2% (90.6%-73.8%), 92.8% (98.5%-87.1%), 72.1% (81.9%-62.3%), and 92.8% (98.1%-87.5%), respectively. The overall 5-year NVG incidence rate was 35.9% (25.9%-45.9%) and that of 1-port group and 2-port group were 41.6% (29.3%-54.0%) and 13.9% (3.2%-24.6%) with statistically significant difference (P<.001). The dose-volume histogram analysis showed that the average irradiated volume of the iris-ciliary body was significantly lower in the non-NVG group than in the NVG group at all dose levels, and significantly lower in the 2-port group than in the 1-port group at high dose levels. Conclusions: The long-term results of C-ion RT for choroidal melanoma are satisfactory. CT-based 2-port C-ion RT can be used to reduce the high-dose irradiated volume of the iris-ciliary body and the resulting risk of NVG.

  16. Structure versus function: correlation between outer retinal and choroidal thicknesses measured by swept-source OCT with multifocal electroretinography and visual acuity.

    Science.gov (United States)

    Flores-Moreno, Ignacio; Arias-Barquet, Luis; Rubio-Caso, Marcos J; Muñoz-Blanco, Alex; Vidal-Martí, María; Catala-Mora, Jaume; Ruiz-Moreno, José M; Duker, Jay S; Caminal, Josep M

    2017-01-01

    To correlate retina-choroidal anatomy as assessed via swept-source OCT (SS-OCT) with retinal function as determined by best-corrected visual acuity (BCVA) and multifocal electroretinogram (mfERG). Thirty-three eyes from 33 patients including 16 with neovascular AMD (nvAMD) and 17 controls were included. Patients were included in the present study after a complete ophthalmologic examination, including BCVA, slit-lamp study, intraocular pressure measurement, dilated fundus examination after tropicamide instillation, SD-OCT, SS-OCT, fundus photographs and mfERG. Age, sex, BCVA, number of anti-VEGF intravitreal injections in the nvAMD group, were recollected. Outer retinal and choroidal thickness were determined at the fovea and 500 μm temporal, superior, nasal and inferior. First-order response from mfERG was collected. P1 amplitude was recorded in R1, R2 and the average of R1 + R2. The measurements recollected from the SS-OCT, mfERG and BCVA were compared. Better BCVA was found with thicker outer retina foveal thickness (r = 0.349; P = 0.047), with thicker subfoveal choroidal thickness (r = 0.443; P = 0.010), and with higher amplitude in P1 at R1 (r = 0.346; P = 0.037). Outer retina foveal thickness did not correlate with P1 amplitude at R1 (r = 0.072; P = 0.692), R2 (r = 0.265; P = 0.137) either with the average P1 amplitude at R1 + R2 (r = 0.253; P = 0.156). A thicker subfoveal choroidal thickness was related with higher amplitude in P1 at R1 (r = 0.383; P = 0.028), R2 (r = 0.409; P = 0.018) and the average of R1 + R2 (r = 0.419; P = 0.015). Choroidal thickness demonstrated a positive correlation with retinal function in the sample studied, so a thicker choroid is related to a better retinal function measured with mfERG and BCVA.

  17. Systolic blood pressure, choroidal thickness, and axial length in patients with myopic maculopathy.

    Science.gov (United States)

    Hsu, Chih-Chien; Chen, Shih-Jen; Li, An-Fei; Lee, Fenq-Lih

    2014-09-01

    In the population-based Shihpai Eye Study, patients aged >65 years with myopic maculopathy were found to have higher systolic blood pressure. This finding deserved further exploration because this is the only correctable factor for preventing maculopathy in patients with high myopia. Therefore, we investigated the association between myopic maculopathy and systolic blood pressure, as well as other ocular parameters in this study. A clinic-based, retrospective cross-sectional study at a medical center was conducted between February 2011 and October 2012. Patients with high myopia were included and medical charts were reviewed. High myopia was defined as axial length ≥26.5 mm in at least one eye. Myopic maculopathy was defined as the presence of lacquer cracks, focal areas of deep choroidal atrophy, diffuse chorioretinal atrophy, and macular choroidal neovascularization or geographic atrophy in the presence of high myopia. Systolic blood pressure measurements were collected, and fundus photography and optical coherence tomography were performed. Subfoveal choroidal thickness (SFCT) shown on optical coherence tomography was measured and recorded. The medical records of 187 high-myopic patients (87 without and 100 with maculopathy) were reviewed. Patients with maculopathy were older (56.96 years vs. 42.95 years, p maculopathy. After multivariate adjustment, SFCT and axial length were the only significant factors for maculopathy. Thinner SFCT and longer axial length are significant risk factors for myopic maculopathy. Unlike previous epidemiological surveys, results of this clinic-based study suggested that systolic blood pressure is not a significant factor for maculopathy. Copyright © 2014. Published by Elsevier B.V.

  18. The effect of strabismus surgery on choroidal thickness.

    Science.gov (United States)

    Inan, Kamil; Niyaz, Leyla

    2017-09-07

    To determine the effects of strabismus surgery on choroidal thickness. This was a prospective randomized study. The measurements of subfoveal and macular choroidal thickness of patients who underwent strabismus surgery were obtained by enhanced depth imaging optic coherence tomography. The patients were grouped as patients who had 1 horizontal muscle surgery (group 1), 1 oblique muscle surgery (group 2), 2 horizontal muscle surgeries (group 3), or 1 horizontal and 1 oblique muscle surgery (group 4). Choroidal thickness of the patients was measured preoperatively and on the postoperative first day, second week, first month, and third month. Choroidal thickness was measured at subfoveal area (S) and at the nasal (N1, N2) and temporal (T1, T2) fovea with 500-μm intervals. The average age of the 37 patients was 15.59 ± 13.84 years. In preoperative and postoperative first day comparison, a decrease in choroidal thickness was found in all areas in group 1. In group 2, a significant decrease was found in N2, N1, and S values. In group 3, a significant decrease was found in N2, N1, and T2 values. In group 4, a significant decrease was found in N1 value. The second week comparison of all groups showed significant postoperative decrease in choroidal thickness in all areas. On the postoperative first month, a significant decrease in choroidal thickness was found only in the subfoveal area of group 1 and the N1 area of group 2. At the postoperative third month, there was no change in any group. Strabismus surgery causes a decrease in choroidal thickness in the early postoperative period.

  19. Choroid Plexus

    Science.gov (United States)

    ... of Tumors Astrocytoma Atypical Teratoid Rhaboid Tumor (ATRT) Chondrosarcoma Choroid Plexus Craniopharyngioma Cysts Ependymoma Germ Cell Tumor ... of Tumors Astrocytoma Atypical Teratoid Rhaboid Tumor (ATRT) Chondrosarcoma Choroid Plexus Craniopharyngioma Cysts Ependymoma Germ Cell Tumor ...

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

    Directory of Open Access Journals (Sweden)

    Francesco Parmeggiani

    2015-08-01

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

  1. Focal Choroidal Excavation in Best Vitelliform Macular Dystrophy: Case Report.

    Science.gov (United States)

    Esfahani, Mohammad Riazi; Esfahani, Hamid Riazi; Mahmoudi, Alireza; Johari, Mohammad Karim; Hemati, Karim

    2015-05-01

    Focal choroidal excavation (FCE) was first reported as a choroidal posteriorly excavated zone without any scleral change. Choroidal excavation also divided into conforming and nonconforming type. Numerous reports demonstrated association between FCE and other disease such as choroidal neovascularization and central serous choroidoretinopathy. Here, we report a rare case of FCE in a patient with Best disease. The patient was diagnosed by spectoral domain optical coherence tomography (SD-OCT). To the best of our knowledge, our patient is the second report of choroidal excavation in Best vitelliform macular dystrophy.

  2. Parstatin Suppresses Ocular Neovascularization and Inflammation

    Science.gov (United States)

    Huang, Hu; Vasilakis, Panagiotis; Zhong, Xiufeng; Shen, Ji-Kui; Geronatsiou, Katerina; Papadaki, Helen; Maragoudakis, Michael E.; Gartaganis, Sotirios P.; Vinores, Stanley A.

    2010-01-01

    Purpose. Parstatin is a 41-mer peptide formed by proteolytic cleavage on activation of the PAR1 receptor. The authors recently showed that parstatin is a potent inhibitor of angiogenesis. The purpose of the present study was to evaluate the therapeutic effect of parstatin on ocular neovascularization. Methods. Choroidal neovascularization was generated in mice using laser-induced rupture of Bruch's membrane and was assessed after 14 days after perfusion of FITC-dextran. Oxygen-induced retinal neovascularization was established in neonatal mice by exposing them to 75% O2 at postnatal day (P)7 for 5 days and then placing them in room air for 5 days. Evaluation was performed on P17 after staining with anti-mouse PECAM-1. The effect of parstatin was tested after intravitreal administration. The effects of subconjunctival-injected parstatin on corneal neovascularization and inflammation in rats were assessed 7 days after chemical burn-induced corneal neovascularization. Retinal leukostasis in mice was assessed after perfusion with FITC-conjugated concanavalin A. Results. Parstatin potently inhibited choroidal neovascularization with an IC50 of approximately 3 μg and a maximum inhibition of 59% at 10 μg. Parstatin suppressed retinal neovascularization with maximum inhibition of 60% at 3 μg. Ten-microgram and 30-μg doses appeared to be toxic to the neonatal retina. Subconjunctival parstatin inhibited corneal neovascularization, with 200 μg the most effective dose (59% inhibition). In addition, parstatin significantly inhibited corneal inflammation and VEGF-induced retinal leukostasis. In all models tested, scrambled parstatin was without any significant effect. Conclusions. Parstatin is a potent antiangiogenic agent of ocular neovascularization and may have clinical potential in the treatment of angiogenesis-related ocular disorders. PMID:20538980

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    weight children (2500-4500 g, n = 1194, mean 361 ± 78 μm), the difference being -37 (CI95 -60 to -15) μm, P = 0.001 after adjusting for age, sex, height, Tanner stage by sex, axial length, anterior chamber depth, and spherical equivalent refractive error. The subfoveal choroid in high birth weight...

  4. Correlation of Aging and Segmental Choroidal Thickness Measurement using Swept Source Optical Coherence Tomography in Healthy Eyes.

    Directory of Open Access Journals (Sweden)

    Yu Wakatsuki

    Full Text Available To assess and compare choroidal thickness changes related to aging, we determined whether changes are due to thinning of the choriocapillaris plus Sattler's (CS layer and/or the large vessel layer in healthy eyes using swept-source optical coherence tomography (SS-OCT at a wavelength of 1,050-nm.We studied 115 normal eyes of 115 healthy volunteers, all with refractive errors of less than -6 diopters. All 115 eyes underwent analysis of choroidal thickness at the fovea, the CS layer and the large choroidal vessel layer. In 68 of the 115 eyes, choroidal thickness was determined at five sites (the fovea, and superior, inferior, nasal, and temporal sites using SS-OCT with an Early Treatment of Diabetic Retinopathy grid scan.Total choroidal thicknesses at each of the five sites were related to subject age (P<0.0001. The choroid was thinnest at the nasal site, followed by the temporal, inferior, superior and finally the subfoveal site itself. The total choroidal thickness at the nasal site was significantly less than those at the other four sites (p<0.05. The CS layer showed thinning which correlated with age (P<0.0001. The thickness of the choroidal large vessel layer also decreased with age (p = 0.02. Subfoveal choroidal thickness was calculated as follows: 443.89-2.98×age (μm (P<0.0001.Subfoveal choroidal thickness decreases by 2.98 μm each year. Total choroidal thickness diminishes with age. The CS and large vessel layers of the choroid at the subfovea showed significant decreases, though only the former correlated strongly with age.

  5. The effect of allergic rhinitis with positive skin prick test on choroidal thickness.

    Science.gov (United States)

    Yenigun, Alper; Elbay, Ahmet; Dogan, Remzi; Ozturan, Orhan; Ozdemir, Mehmet Hakan

    2017-06-01

    Allergic rhinitis is an inflammatory disease that develops through immunoglobulin E in the rhino-ocular mucosa due to allergy. The main symptoms are runny nose, nasal congestion, sneezing and itchy nose. This study was designed to investigate the effect of allergic rhinitis on choroidal thickness. This study was planned as a case-control study. This study performed in a tertiary referral center. The study included 61 patients with allergic rhinitis and 35 healthy subjects. Patients in both groups underwent skin prick test. In allergic rhinitis patients and healthy persons; subfoveal, temporal and nasal choroidal thickness measurement was performed. The choroidal thicknesses were measured without pupil dilation using the Spectralis Optical Coherence Tomography. In the subfoveal and temporal region, choroidal tissue was followed up significantly thicker in allergic rhinitis patients statistically compared to healthy persons (p = 0.031, p = 0.049). However, no significant difference was followed up between the nasal choroidal thickness measurements statistically (p = 0.54). Runny nose (67.2%), sneeze (65.5%), stuffiness (62.2%), itching of the nose (40.9%), and nasal discharge (21.3%) complaints were observed significantly higher in the group having allergic rhinitis. The effect of allergic rhinitis on choroidal thickness were assessed and compared with the control group. Our study revealed that there was significant association between increased choroidal thickness and allergic rhinitis. Allergic sensitivity may play an important role in increased choroidal thickness.

  6. Focal choroidal excavation in eyes with central serous chorioretinopathy.

    Science.gov (United States)

    Ellabban, Abdallah A; Tsujikawa, Akitaka; Ooto, Sotaro; Yamashiro, Kenji; Oishi, Akio; Nakata, Isao; Miyake, Masahiro; Akagi-Kurashige, Yumiko; Ueda-Arakawa, Naoko; Arichika, Shigeta; Yoshitake, Shin; Takahashi, Ayako; Yoshimura, Nagahisa

    2013-10-01

    To study the prevalence and 3-dimensional (3-D) tomographic features of focal choroidal excavations in eyes with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (OCT). Prospective, cross-sectional study. We examined 116 consecutive eyes with CSC with a prototype 3-D swept-source OCT. 3-D images of the shape of the macular area, covering 6 × 6 mm(2), were reconstructed by segmentation of the outer surface of the retinal pigment epithelium (RPE). The 3-D swept-source OCT detected focal choroidal excavations in 9 eyes (7.8%). The 3-D scanning protocol, coupled with en face scans, allowed for clear visualization of the excavation morphology. In 5 eyes with focal excavations, unusual choroidal tissue was found beneath the excavation, bridging the bottom of the excavation and the outer choroidal boundary. Additionally, 3 of those 5 eyes showed a suprachoroidal space below the excavation, as if the outer choroidal boundary is pulled inward by this bridging tissue. The focal choroidal excavations were located within fluorescein leakage points and areas of choroidal hyperpermeability. Eyes with focal choroidal excavations were more myopic (-4.42 ± 2.92 diopters) than eyes without excavations (-0.27 ± 1.80 diopters, P = .001). Subfoveal choroidal thickness was significantly thinner (301.3 ± 60.1 μm) in eyes with focal excavations than in eyes without the excavations (376.6 ± 104.8 μm, P = .036). Focal choroidal excavations were present in 7.8% of eyes with CSC. In these eyes, focal choroidal excavations may have formed from RPE retraction caused by focal scarring of choroidal connective tissue. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Is there a relationship between outer retinal destruction and choroidal changes in cone dystrophy?

    Directory of Open Access Journals (Sweden)

    Onder Ayyildiz

    Full Text Available ABSTRACT Purpose: The aim of the present study was to use enhanced depth imaging optical coherence tomography (EDI-OCT to investigate choroidal changes in patients with cone dystrophy (CD and to correlate these findings with clinical and electroretinography (ERG findings. Methods: This case-control study included 40 eyes of 20 patients with CD and 40 eyes of 40 age- and refraction-matched healthy individuals. Choroidal thickness (CT measurements were obtained under the foveal center and at 500 and 1,500 μm from the nasal and temporal regions to the center of the fovea, respectively. EDI-OCT and ERG data were analyzed, and the correlations of CT with the best-corrected visual acuity (BCVA and the central foveal thickness (CFT were evaluated. Results: The mean subfoveal CTs in the CD and control groups were 240.70 ± 70.78 and 356.18 ± 48.55 μm, respectively. The subfoveal CT was significantly thinner in patients with CD than in the controls (p<0.001. The patients with CD also had significantly thinner choroids than the controls at each measurement location relative to the fovea (p<0.001. The subfoveal CT in the CD group correlated with CFT (p=0.012, but no significant correlation was found between the subfoveal CT and BCVA or photopic ERG responses. Conclusions: The present study demonstrated a significant thinning of the choroid in patients with CD. EDI-OCT is a useful technique for describing the choroidal changes occurring in CD. Future studies investigating the association between choroidal changes and outer retinal destruction or the disease stage may provide a better understanding of the pathophysiology of CD.

  8. Retinal and choroidal thickness in myopic anisometropia.

    Science.gov (United States)

    Vincent, Stephen J; Collins, Michael J; Read, Scott A; Carney, Leo G

    2013-04-03

    We compared the retinal thickness (RT) and choroidal thickness (ChT) between the fellow eyes of nonamblyopic myopic anisometropes. The eyes of 22 nonamblyopic myopic anisometropes (≥ 1 diopter [D] spherical equivalent refraction [SER] anisometropia) were examined using spectral domain optical coherence tomography (SD-OCT). Customized software was used to register, align, and average multiple foveal OCT B-scan images from each subject to enhance image quality. Two independent masked observers manually determined the RT and ChT from each SD-OCT image up to 2.5 mm nasal and temporal to the fovea. Axial length (AXL) was measured using optical low coherence biometry during relaxed accommodation. The mean SER anisometropia was 1.74 ± 0.95 D and the mean interocular AXL difference was 0.58 ± 0.41 mm. There was no significant difference in foveal RT between the fellow eyes (P > 0.05). Mean subfoveal ChT was significantly thinner in the more myopic eye (252 ± 46 μm) compared to the fellow, less myopic eye (286 ± 58 μm) (P < 0.001). There was a moderate correlation between the interocular difference in subfoveal ChT and the interocular difference in AXL (r = -0.50, P < 0.01). Asian anisometropes displayed more regionally symmetrical (nasal-temporal) interocular differences in ChT profile compared to Caucasians. RT was similar between the fellow eyes of myopic anisometropes; however, the subfoveal choroid was significantly thinner in the more myopic (longer) eye of this anisometropic cohort. The interocular asymmetry in ChT correlated with the interocular difference in AXL.

  9. Pseudovitelliform Subfoveal Deposit in Waldenström's Macroglobulinemia.

    Science.gov (United States)

    Brolly, Aurélie; Janon, Claire; Precausta, Flavien; Baudet, Jean-Marie; Cohen, Salomon Yves

    2012-05-01

    Waldenström's macroglobulinemia may be complicated by retinal hemorrhages, retinal vein occlusion, serous macular detachment or macular edema. We report a patient with pseudovitelliform subfoveal deposit complicating Waldenström's macroglobulinemia. A 56-year-old man presented with hyperviscosity syndrome due to Waldenström's macroglobulinemia. After systemic therapy, a large serous retinal detachment persisted in the left eye. A pseudovitelliform subfoveal deposit was observed in the right eye. Pseudovitelliform subfoveal deposits may be part of the spectrum of ocular complications in Waldenström's macroglobulinemia. They could be due to accumulation of macroglobulins.

  10. FOCAL CHOROIDAL EXCAVATION AND ITS ASSOCIATION WITH PACHYCHOROID SPECTRUM DISORDERS: A Review of the Literature and Multimodal Imaging Findings.

    Science.gov (United States)

    Chung, Hyewon; Byeon, Suk Ho; Freund, K Bailey

    2017-02-01

    To review the literature regarding focal choroidal excavation and show its association with pachychoroid features through case examples. The clinical manifestations of focal choroidal excavation are illustrated with various imaging modalities inclusive of fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography (OCT), enhanced depth imaging OCT, and swept-source OCT. Diffuse or focal areas of choroidal thickening with dilated choroidal vessels (pachyvessels) on OCT and choroidal hyperpermeability on indocyanine green angiography are present in many eyes with focal choroidal excavation. Clinical and imaging features of associated comorbidities including central serous chorioretinopathy and choroidal neovascularization are described. Focal choroidal excavation appears to be a manifestation of pachychoroid spectrum disease associated with choroidal thickening and pachyvessels on structural OCT and choroidal hyperpermeability on indocyanine green angiography.

  11. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    Multifocal choroiditis is a vision‑threatening disease causing inflammation at the level of retinal pigment epithelium and outer retina. We present a unique case of unilateral multifocal choroiditis in a young nonmyopic male and its subsequent course. The patient developed visual loss due to the sub-retinal neovascular ...

  12. An Unusual Case of Unilateral Multifocal Choroiditis in a Young Male

    African Journals Online (AJOL)

    Multifocal choroiditis is a vision‑threatening disease causing inflammation at the level of retinal pigment epithelium and outer retina. We present a unique case of unilateral multifocal choroiditis in a young nonmyopic male and its subsequent course. The patient developed visual loss due to the sub‑retinal neovascular ...

  13. Removal of retained subfoveal perfluoro-n-octane liquid.

    Science.gov (United States)

    Roth, Daniel B; Sears, Jonathan E; Lewis, Hilel

    2004-08-01

    To report a novel technique to remove retained submacular perfluorocarbon liquid. Retrospective cases series. Two patients with retained subfoveal perfluorocarbon liquid were treated with this technique. With a three-port pars plana approach, a 39-gauge flexible cannula was used to perform a retinotomy adjacent to the subfoveal perfluorocarbon bubble. The tip of the cannula was inserted into the bubble, which was removed with active suction. Both patients underwent successful removal of the perfluorocarbon liquid without complications. In one patient, visual acuity improved from 20/70 to 20/30, with resolution of his preoperative central scotoma. The second patient required removal of subfoveal perfluorocarbon liquid at the time of silicone oil removal. The preoperative vision of finger counting improved to 20/60. Subretinal perfluorocarbon can be removed using a flexible 39-gauge cannula without inducing retinal detachment or making a large retinotomy. This technique may benefit patients with retained subfoveal perfluorocarbon liquid.

  14. Peripapillary retinal nerve fiber layer and choroidal thickness in cirrhosis patients

    Directory of Open Access Journals (Sweden)

    M.Orcun Akdemir

    2015-12-01

    Full Text Available ABSTRACT Purpose: To evaluate the effect of cirrhosis on peripapillary retinal nerve fiber layer and choroidal thickness with enhanced depth imaging optical coherence tomography. Methods: This cross sectional, single center study was undertaken at Bulent Ecevit University Ophthalmology department with the participation of internal medicine, Gastroenterology department. Patients who were treated with the diagnosis of cirrhosis (n=75 were examined in the ophthalmology clinic. Age and sex matched patients (n=50 who were healthy and met the inclusion, exclusion criteria were included in the study. Complete ophthalmological examination included visual acuity with Snellen chart, intraocular pressure measurement with applanation tonometry, biomicroscopy of anterior and posterior segments, gonioscopy, axial length measurement, visual field examination, peripapillary retinal nerve fiber layer, central macular and subfoveal choroidal thickness measurements. Results: The difference between intraocular pressure values was not statistically significant between cirrhosis and control group (p=0.843. However, mean peripapillary retinal nerve fiber layer thickness was significantly thinner in cirrhosis group in all regions (p<0.001 and subfoveal choroidal thickness was significantly thinner in cirrhosis group also (p<0.001. Moreover, central macular thickness of cirrhosis group was significantly thicker than the control group (p=0.001. Conclusion: Peripapillary retinal nerve fiber layer and subfoveal choroidal thickness was significantly thinner in cirrhosis patients.

  15. The expanded spectrum of focal choroidal excavation.

    Science.gov (United States)

    Margolis, Ron; Mukkamala, Sri Krishna; Jampol, Lee M; Spaide, Richard F; Ober, Michael D; Sorenson, John A; Gentile, Ronald C; Miller, Joel A; Sherman, Jerome; Freund, K Bailey

    2011-10-01

    To describe the clinical and imaging findings in patients with focal choroidal excavation. Retrospective observational case series. The medical records of 12 patients (13 eyes) with focal choroidal excavation were reviewed. Clinical histories and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and enhanced depth imaging spectral-domain optical coherence tomography) were analyzed. The mean age of the patients was 45 years (range, 22-62 years). Four patients were Asian. Mean visual acuity was 20/31 (range, 20/20 to 20/100). Mean refractive error was -3.54 diopters (D) (range, 6.00 to -8.00 D). One patient had bilateral involvement. All patients manifested varying degrees of foveal pigmentary changes that were usually hypoautofluorescent on fundus autofluorescence images. Fluorescein angiographic findings varied with degree of retinal pigment epithelial alterations. Indocyanine green angiography revealed relative hypofluorescence. In 7 eyes, spectral-domain optical coherence tomography revealed outer retinal layers conforming to retinal pigment epithelial alterations within the excavation. In the other 6 eyes, spectral-domain optical coherence tomography revealed a separation between the outer retina and the retinal pigment epithelium within the excavation. In 7 eyes studied with enhanced depth imaging spectral-domain optical coherence tomography, there was no evidence of scleral ectasia. Mean choroidal thickness of the uninvolved choroid was thicker than normal at 319 μm (range, 244-439 μm). All lesions remained stable except for in 1 eye, which had findings of central serous chorioretinopathy and secondary type 2 (subretinal) neovascularization. Focal choroidal excavation is a newly described idiopathic entity in eyes having 1 or more focal areas of choroidal excavation. In some patients, there may be an association with central

  16. Results of laser treatment for sub-retinal neovascular membranes ...

    African Journals Online (AJOL)

    A retrospective study was carried out to determine the results of laser treatment for choroidal neovascular membranes in age-related macular degeneration in 92 patients in whom fluorescein angiography was performed for this condition over a 7-year period. Twenty-nine of these patients, treated with the argon laser, were ...

  17. Results of laser treatment for sub-retinal neovascular membranes

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... A retrospective study was carried out to determine the results of laser treatment for choroidal neovascular membranes in age-related macular degeneration in 92 patients in whom fluorescein angiography was performed for this condition over a 7-year period. Twenty-nine of these patients, treated with the ...

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

    Directory of Open Access Journals (Sweden)

    Mário Junqueira Nóbrega

    2007-02-01

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

  19. Increased choroidal blood flow velocity with regression of unilateral acute idiopathic maculopathy.

    Science.gov (United States)

    Hashimoto, Yuki; Saito, Wataru; Saito, Michiyuki; Hirooka, Kiriko; Mori, Shohei; Noda, Kousuke; Ishida, Susumu

    2015-07-01

    The pathogenesis of unilateral acute idiopathic maculopathy (UAIM) is unknown. The aim of this study was to quantitatively examine changes in choroidal circulation hemodynamics in patients with UAIM. This was a retrospective observational case-series which included five eyes of four patients with UAIM. All UAIM eyes and the fellow eyes in remaining three patients were studied using laser speckle flowgraphy (LSFG) to evaluate the mean blur rate (MBR), a quantitative index of relative blood flow velocity. The changes in MBR between the initial visit and after 1 and 3 months were statistically analyzed. Subfoveal choroidal thickness was measured in three UAIM eyes by enhanced depth imaging optical coherence tomography. The mean logMAR value of best-corrected visual acuity in the UAIM eyes significantly improved (P = 0.04) with recovery of outer retinal morphology. The average MBR of the UAIM eyes significantly increased at 1 (+21.7% baseline value; P = 0.003) and 3 months (+32.5% baseline value; P = 0.001), whereas the fellow eyes did not show this tendency. The mean values of subfoveal choroidal thickness decreased with time (316.0 µm at baseline, 186.6 µm at 1 month, and 167.3 µm at 3 months). These results reveal that there is a significant elevation of choroidal blood flow velocity and substantial reduction of choroidal thickness with regression of UAIM, suggesting that impaired choroidal circulation may be involved in the pathogenesis of UAIM.

  20. Choroidal Thickness in Turkish Children with Anisometric Amblyopia.

    Science.gov (United States)

    Karaca, Emine Esra; Çubuk, Mehmet Özgür; Akçam, Hanife Tuba; Uzun, Feyzahan; Yüksel, Erdem

    2017-01-01

    To assess macular choroidal thickness (CT) and axial length measurements in children with anisometropic amblyopia and to compare the measurements with that of fellow non-amblyopic eyes and age-sex matched controls. Forty patients with anisometropic amblyopia and 40 age-/sex-matched controls were evaluated in this study. Eyes were classified into three groups as follows: amblyopic eyes (n = 40), fellow non-amblyopic eyes, and healthy eyes (n = 40). All subjects underwent complete ophthalmic examination and macular choroidal thickness measurements by enhanced depth imaging method of the Spectralis optical coherence tomography system. CT was measured at the fovea and at 1000-μm intervals from the foveal center in both temporal and nasal directions. The statistical assessment was performed with the assistance of one-way analysis of variance (ANOVA) and Pearson's correlation test. The mean subfoveal CT was 389.35, 349.07, and 315.8 μm in the amblyopic, fellow non-amblyopic and healthy eyes, respectively. Choroid was thickest in subfoveal and thinnest in nasal regions among all groups. Both amblyopic and fellow non-amblopic eyes were more hyperopic than healthy eyes. While the subfoveal and nasal CT in amblyopic eyes and fellow eyes were significantly higher than healthy eyes, the temporal CT in amblyopic eyes was significantly higher than in healthy eyes. There was a significant positive correlation between the CT of the subfoveal, nasal, and temporal regions and the refractive state (r = 0.432 p = 0.001; r = 0.324 p = 0.001; r = 0.215 p = 0.01, respectively). The macular choroidal thickness-not only in amblyopic eyes but also in non-amblyopic fellow eyes-was significantly thicker than in the healthy subjects. The thick choroid in amblyopic and non-amblyopic fellow eyes may indicate bilateral delay of emmetropization, which probably means amblyopia affecting the visual feedback of both eyes.

  1. [Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment].

    Science.gov (United States)

    Akkoyun, I; Pınarcı, E Y; Yesilirmak, N; Yılmaz, G

    2014-10-01

    Enhanced depth imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after scleral buckling surgery (SBS) is rare. The medical charts of 122 patients (122 eyes) who underwent SBS for macula-off rhegmatogenous retinal detachment (RRD) were retrospectively analyzed. Patients with a follow-up ≥ 6 months were included. Postoperative EDI-OCT images concerning CT were evaluated 1 week, 1 month and 6 months postoperatively in 4 groups: group 1 cerclage + cryopexy (n = 39 eyes), group 2 cerclage + cryopexy + sponge (n = 28 eyes), group 3 SBS + subretinal fluid drainage (SRD) (n = 25 eyes) and group 4 SBS + sponge + SRD (n = 30 eyes). Subfoveal CT was compared between the groups and with the non-operated fellow eye. Subfoveal CT in groups 1, 2, 3 and 4 was thicker 1 week postoperatively. There were no significant differences between the groups or when comparing the operated eye with the fellow eye 1 and 6 months postoperatively. There were no differences in subfoveal CT 1 and 6 months after SBS between the eye with macula-off RRD and the fellow eye. The use of a sponge or SRD induced no differences concerning subfoveal CT.

  2. Phenotype Characteristics of Fellow Eyes in Patients With Early Onset of Neovascular Age-Related Macular Degeneration

    NARCIS (Netherlands)

    Schick, T.; Ersoy, L.; Hoyng, C.B.; Kirchhof, B.; Liakopoulos, S.

    2015-01-01

    PURPOSE: To investigate phenotype characteristics of fellow eyes in patients with early onset of neovascular age-related macular degeneration (NVAMD). METHODS: Patients with new-onset unilateral NVAMD between 50 and 65 years (n = 57, early-onset choroidal neovascularization [CNV] group) or >80

  3. Effect of Reduced Meal Frequency during Ramadan Fasting on Retinal and Choroidal Thickness.

    Science.gov (United States)

    Ersan, Ismail; Tufan, Hasan Ali; Arikan, Sedat; Kara, Selcuk; Gencer, Baran; Hondur, Ahmet Murat

    2017-01-01

    To evaluate the effects of Ramadan fasting on central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy individuals using enhanced depth imaging optical coherence tomography (EDI-OCT). The EDI-OCT scans of 42 healthy individuals obtained after about 12 hours of fasting on at least the twenty-first consecutive day of fasting were compared to scans of the same patients taken one month after the last day they had fasted. CFT values were similar for both time periods (p > 0.05). The SFCT was significantly higher after consecutive fasting days towards the end of Ramadan, compared to the SFCT after one month of no fasting (one month after Ramadan ended) (p fasting may lead to a significant increase in subfoveal choroidal thickness without affecting the central foveal thickness.

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

    Science.gov (United States)

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

    2015-01-01

    To portray Usher Syndrome type 2, analyzing choroidal thickness and comparing data reported in published literature on RP and healthy subjects. Methods. 20 eyes of 10 patients with clinical signs and genetic diagnosis of Usher Syndrome type 2. Each patient underwent a complete ophthalmologic examination including Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), axial length (AL), automated visual field (VF), and EDI OCT. Both retinal and choroidal measures were measured. Statistical analysis was performed to correlate choroidal thickness with age, BCVA, IOP, AL, VF, and RT. Comparison with data about healthy people and nonsyndromic RP patients was performed. Results. Mean subfoveal choroidal thickness (SFCT) was 248.21 ± 79.88 microns. SFCT was statistically significant correlated with age (correlation coefficient -0.7248179, p Usher Syndrome type 2. These data are important for the comprehension of mechanisms of disease and for the evaluation of therapeutic approaches.

  5. Choroidal thickness and biometric markers for the screening of lacquer cracks in patients with high myopia.

    Directory of Open Access Journals (Sweden)

    Nan-Kai Wang

    Full Text Available OBJECTIVES: Validation of choroidal thickness and other biometrics measured by spectral domain optical coherence tomography (SD-OCT in predicting lacquer cracks formation in highly myopic eyes. METHODS: Patients with a refractive error worse than -8 diopters and moderate myopic maculopathy were recruited into two groups based on the presence or absence of lacquer cracks (36 eyes without and 33 eyes with lacquer cracks. Choroidal thickness, refractive error, and axial length were measured and subjected to receiver operating characteristic curve analysis to identify the optimal cutoff values at predicting lacquer crack formation. The width of the retinal pigment epithelium (RPE, RPE to the inner segment/outer segment line, RPE to the external limiting membrane were also measured and compared to the subfoveal choroidal thickness to assess their relationships as potential markers of lacquer crack formation. RESULTS: Lacquer crack is associated with decreased choroidal thickness, lower best-corrected visual acuity, longer axial length and higher refractive errors. Choroidal thickness has the strongest association with lacquer crack formation versus axial length and refractive error. In eyes with lacquer cracks, stellate lacquer cracks are associated with thinner choroidal thickness compared to eyes with linear lacquer cracks. Subfoveal choroidal thickness less than the width of the retinal pigment epithelium to the inner segment/outer segment line is also associated with lacquer crack formation (sensitivity 78.8%, specificity 88.3%, and accuracy 81.2%. CONCLUSIONS: This study suggests that choroidal thickness and other SD-OCT measurements could be employed clinically to predict the development and severity of lacquer cracks in patients with high myopia.

  6. Full macular translocation (FMT) versus photodynamic therapy (PDT) with verteporfin in the treatment of neovascular age-related macular degeneration: 2-year results of a prospective, controlled, randomised pilot trial (FMT-PDT).

    Science.gov (United States)

    Lüke, Matthias; Ziemssen, Focke; Völker, Michael; Altpeter, Elke; Beutel, Julia; Besch, Dorothea; Bartz-Schmidt, Karl Ulrich; Gelisken, Faik

    2009-06-01

    To report the outcome of best-corrected visual acuity (BCVA), near visual acuity (NVA), contrast sensitivity (CS) and vision-related quality of life (VRQOL) in patients 2 years after undergoing photodynamic therapy (PDT) or full macular translocation (FMT) for the treatment of neovascular age-related macular degeneration (AMD). Fifty patients with predominantly classic subfoveal choroidal neovascularisation (CNV) secondary to AMD were randomized to PDT or FMT. BCVA was determined according a standardized protocol with ETDRS charts. NVA were calculated after testing with SNAB (Swiss National Association of and for the Blind) visual acuity cards. CS was measured with Pelli-Robson charts. The 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25 plus supplement) was performed. Primary end points were the changes of BCVA, NVA, CS and VRQOL at 24-month examination. A stabilisation of BCVA (+0.3 letters) was found in the FMT group, whereas a decrease of more than 12 letters (-12.6 letters) was found in the PDT group (p = 0.052). Mean NVA improved by 7.0 letters in the FMT group and was superior to the PDT group (-9.6 letters, p = 0.036), while mean CS showed a time-dependent decrease in both treatment groups (FMT: -3.3 letters, PDT: -3.8 letters, p = 0.726). Considering the results of the VRQOL scores, the improvement of the subscales scores for general vision (p = 0.015), mental health (p = 0.028) and near activity (p = 0.020) were significantly higher in the FMT group. FMT can stabilise BCVA and improve NVA over a period of 2 years in patients with subfoveal classic CNV secondary to neovascular AMD, whereas a decrease of BCVA and NVA was found in the PDT group. CS did not differ between FMT and PDT. A significant increase of VRQOL scores was only found in the FMT group and not in the PDT group. FMT seems to be a therapeutic approach that can increase visual function resulting in an improvement of patient's VRQOL, but exhibits a higher number of

  7. Correlation between choroidal thickness and degree of myopia assessed with enhanced depth imaging optical coherence tomography.

    Science.gov (United States)

    El-Shazly, Amany A; Farweez, Yousra A; ElSebaay, Marwa E; El-Zawahry, Walid M A

    2017-08-30

    To assess the choroidal thickness in different degrees of myopia using enhanced depth imaging optical coherence tomography (EDI-OCT) compared with healthy subjects. We included 240 patients with myopia and 60 emmetropes as controls. Participants underwent full ophthalmologic examination, axial length measurement, and EDI-OCT imaging of the choroid. Choroidal thickness (CT) was measured at 5 locations, including subfoveal (SFCT), 2 mm nasal, temporal, upper, and lower to fovea. Choroidal thickness was significantly lower in myopic eyes compared to controls. Regardless of the degree of myopia, nasal regions showed the lowest CT with decremental pattern with advance of myopia (low myopia 279.00 ± 24.50 µm, moderate myopia 269.58 ± 20.69 µm, high myopia 189.58 ± 25.95 µm, advanced myopia 96.75 ± 24.83 µm). Highest CT was variable according to the degree of myopia with decremental pattern with advance of myopia (low myopia in subfoveal region 354.40 ± 35.14 µm, moderate myopia in temporal region 337.87 ± 35.75 µm, high myopia in lower region 312.15 ± 38.90 µm, and advanced myopia in upper region 201.25 ± 18.27 µm). Axial length showed significant negative correlation with SFCT and CT in different studied regions. Different degrees of myopia showed thinner choroidal thickness than that of normal control eyes with decremental thinning with progress of myopia. This might be secondary to the longer axial length, which was the determining factor in some locations such as subfoveal, nasal, and upper CT.

  8. Tomographic and angiographic characteristics of eyes with macular focal choroidal excavation.

    Science.gov (United States)

    Obata, Ryo; Takahashi, Hidenori; Ueta, Takashi; Yuda, Kentaro; Kure, Kayo; Yanagi, Yasuo

    2013-06-01

    To describe detailed clinical features of eyes with focal choroidal excavation. Twenty-one eyes of 17 patients with focal choroidal excavation were retrospectively studied. All eyes underwent thorough examination including funduscopy, visual field analysis, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography. Patients' age ranged between 25 years and 70 years. Four patients (24%) were affected bilaterally. Spherical equivalent of refractive error ranged from 0.5 diopters to -10.0 diopters (D). Funduscopic examination showed hypopigmentation (n = 12) and yellowish plaquelike appearances (n = 2). Indocyanine green angiography showed not only filling defects at the excavation (n = 16) but also choroidal vascular hyperpermeability (n = 7) and punctate hyperfluorescent spots (n = 7). Cicatrized subretinal neovascularization was seen in three eyes. The mean follow-up period was 37 months (6-66 months). There was no change in the appearance of excavation. Central serous chorioretinopathy (n = 1) and choroidal neovascularization (n = 1) developed during follow-up. Background factors and ophthalmic findings are similar to those that have been reported previously, including relatively stable findings even after a long observation and the occurrence of central serous chorioretinopathy and choroidal neovascularization. Bilateral cases are not rare in the current cohort, and choroidal vascular hyperpermeability is frequently observed in indocyanine green angiography, suggesting there were choroidal hemodynamic changes around the excavation.

  9. Retinal and choroidal angiogenesis: a review of new targets.

    Science.gov (United States)

    Cabral, Thiago; Mello, Luiz Guilherme M; Lima, Luiz H; Polido, Júlia; Regatieri, Caio V; Belfort, Rubens; Mahajan, Vinit B

    2017-01-01

    Retinal and choroidal neovascularization are a major cause of significant visual impairment, worldwide. Understanding the various factors involved in the accompanying physiopathology is vital for development of novel treatments, and most important, for preserving patient vision. The intraocular use of anti-vascular endothelial growth factor therapeutics has improved management of the retinal and choroidal neovascularization but some patients do not respond, suggesting other vascular mediators may also contribute to ocular angiogenesis. Several recent studies examined possible new targets for future anti-angiogenic therapies. Potential targets of retinal and choroidal neovascularization therapy include members of the platelet-derived growth factor family, vascular endothelial growth factor sub-family, epidermal growth factor family, fibroblast growth factor family, transforming growth factor-β superfamily (TGF-β1, activins, follistatin and bone morphogenetic proteins), angiopoietin-like family, galectins family, integrin superfamily, as well as pigment epithelium derived factor, hepatocyte growth factor, angiopoietins, endothelins, hypoxia-inducible factors, insulin-like growth factors, cytokines, matrix metalloproteinases and their inhibitors and glycosylation proteins. This review highlights current antiangiogenic therapies under development, and discusses future retinal and choroidal pro- and anti-angiogenic targets as wells as the importance of developing of new drugs.

  10. Impact of vitreomacular adhesion on ranibizumab mono- and combination therapy for neovascular age-related macular degeneration.

    Science.gov (United States)

    Waldstein, Sebastian M; Ritter, Markus; Simader, Christian; Mayr-Sponer, Ulrike; Kundi, Michael; Schmidt-Erfurth, Ursula

    2014-08-01

    To investigate the influence of vitreomacular adhesion on the efficacy of pro re nata (PRN) ranibizumab monotherapy and verteporfin photodynamic therapy (PDT) combination therapy for neovascular age-related macular degeneration. Post hoc analysis of prospective randomized 12-month multicenter clinical trial data. Total of 255 treatment-naïve patients with subfoveal choroidal neovascularization. Assessment of the vitreomacular interface on monthly optical coherence tomography with division of patients into the following categories according to continuous 1-year grading: posterior vitreous detachment (n=154), dynamic release of vitreomacular adhesion (n=32), stable vitreomacular adhesion (n=51). Mean best-corrected visual acuity (BCVA) letter and central retinal thickness changes at month 12 in the vitreomacular interface groups. Mean BCVA changes at month 12 were +3.5 (posterior vitreous detachment), +4.3 (release of vitreomacular adhesion), and +6.3 (vitreomacular adhesion) in patients receiving monotherapy (P=.767), and +0.1 (posterior vitreous detachment), +6.6 (release of vitreomacular adhesion), and +9.2 (vitreomacular adhesion) in patients receiving combination therapy (P=.009). Mean central retinal thickness changes were -113 μm (posterior vitreous detachment), -89 μm (release of vitreomacular adhesion), and -122 μm (vitreomacular adhesion) in monotherapy (P=.725) and -121 μm (posterior vitreous detachment), -113 μm (release of vitreomacular adhesion), and -113 μm (vitreomacular adhesion) in combination therapy (P=.924). Mean ranibizumab retreatments during 12 months were 4.9 (posterior vitreous detachment), 6.6 (release of vitreomacular adhesion), and 5.3 (vitreomacular adhesion) in monotherapy (P=.018) and 4.7 (posterior vitreous detachment), 5.2 (release of vitreomacular adhesion), and 5.8 (vitreomacular adhesion) in combination therapy (P=.942). This study adds evidence that the vitreomacular interface status impacts functional outcomes and

  11. [Choroidal thickness assessment with SD-OCT in high myopia with dome-shaped macula].

    Science.gov (United States)

    Chebil, A; Ben Achour, B; Chaker, N; Jedidi, L; Mghaieth, F; El Matri, L

    2014-03-01

    To measure macular choroidal thickness (CT) using spectral-domain optical coherence tomography (SD-OCT) in highly myopic eyes with dome-shaped macula (DSM), and to investigate whether the choroid is thicker in these eyes compared to highly myopic eyes without MB. A cross-sectional study of 200 eyes was performed between January 2010 and June 2012. Twenty-four highly myopic eyes (12%) had a dome-shaped macula. All patients underwent a complete ophthalmological examination, SD-OCT (TOPCON 2000), and B-scan ultrasonography. OCT scans were analyzed in 7 sections, and subfoveal CT was measured manually between the Bruch's membrane and the internal aspect of the sclera. The 20 eyes with isolated dome-shaped macular were paired by age and axial length (AL) with 20 eyes without macular involvement. In the subgroup with isolated MB, the mean subfoveal CT was 101.86 μm (± 21.35 μm). A statistically significant negative correlation was found between CT and AL (r=-0.623, P=0.0001). The regression equation demonstrated a decrease of 8.3 μm per mm of AL. In the subgroup without MB, matched with the subgroup with MB by age (P=0.591), and AL (P=0.815), the mean subfoveal CT was 89.54 μm (± 20.12 μm). The comparison between the two subgroups found a statistically significant difference in subfoveal CT (Pmacula compared to highly myopic eyes without dome-shaped macula. These findings suggest that abnormalities of the choroid may play a role in the pathogenesis of dome-shaped macula. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. Focal Choroidal Excavation in Retinal Dystrophies.

    Science.gov (United States)

    Braimah, Imoro Zeba; Rapole, Shruthi; Dumpala, Sunila; Chhablani, Jay

    2016-08-17

    To investigate the presence of focal choroidal excavation (FCE) in patients with retinitis pigmentosa (RP), Stargardt's disease (STGD), and Best disease in the Indian population. This retrospective consecutive case series included 309 eyes of 157 patients with RP (183 eyes), STGD (93 eyes), and Best disease (33 eyes) with good-quality, enhanced-depth spectral domain optical coherence tomography scans. Comprehensive ophthalmic examination data were collected. Characteristics of FCE, including location of FCE, type (conforming and non-conforming), maximal width, and depth, were noted. FCE was found in 2 out of 33 (6%) eyes with Best disease and no FCE was found in eyes with RP or STGD. The location of the FCE was extrafoveal in both cases. The first case had non-conforming FCE while the second case had the conforming type and the FCE occurred in association with choroidal neovascularization in the second case. The first case maintained good visual acuity of 20/20 over the entire period of follow-up (14 months), while the second case had a visual acuity of 20/200 at the last follow-up (three years) due to scarred choroidal neovascular membranes. The FCE showed no change in both eyes over the entire duration of follow-up. Focal choroidal excavation was found in 6% of eyes with Best disease, which remained stable throughout follow up. Eyes with RP and STGD did not have any FCE. Further studies are required to determine the role of vitelliform material in FCE development in Best disease.

  13. Morphologic changes of the fovea and visual acuity associated with retinal detachment secondary to circumscribed choroidal hemangioma.

    Science.gov (United States)

    Furuta, Minoru; Sekiryu, Tetsuju; Kasai, Akihito; Oguchi, Yasuharu

    2013-07-01

    To clarify and review the early and late morphologic changes of the macula associating with visual loss in patients with subfoveal fluid secondary to extrafoveal circumscribed choroidal hemangiomas. Previously six non-treated eyes of six patients with subfoveal retinal detachment secondary to extrafoveal circumscribed choroidal hemangioma were included. Visual acuity (VA), duration of visual symptoms, color fundus photography, optical coherence tomography (OCT), fundus autofluorescence, and fluorescein angiography (FA) were evaluated. The mean patient age was 58 years (range, 25-78). The VA and duration of symptoms in each patient was 1.2 (3 days), 0.6 (1 week), 0.4 (3 months), 0.5 (6 months), 0.02 (12 months), and 0.01 (8 years), respectively. Three patients with symptoms for less than 3 months did not have retinal pigment epithelial (RPE) alterations, retinal edema, or thinning of the retinal structure in the fovea. A patient with symptoms for 3 months had subfoveal deposits underneath the detached neurosensory retina with foveal hyperautofluorescence. Two patients with symptoms exceeding 12 months had highly affected RPE and cystoid macular degeneration. The VA was affected in patients with longer visual symptoms, and there are some changes in the retina and RPE in the fovea by FA and OCT. Persistent subretinal fluid secondary to choroidal hemangiomas may result in pathologic changes in the neurosensory retina.

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

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

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

  15. The effect of topical adrenergic and anticholinergic agents on the choroidal thickness of young healthy adults.

    Science.gov (United States)

    Sander, Beata P; Collins, Michael J; Read, Scott A

    2014-11-01

    The human choroid is capable of rapidly changing its thickness in response to a variety of stimuli. However little is known about the role of the autonomic nervous system in the regulation of the thickness of the choroid. Therefore, we investigated the effect of topical parasympatholytic and sympathomimetic agents upon the choroidal thickness and ocular biometrics of young healthy adult subjects. Fourteen subjects (mean age 27.9 ± 4 years) participated in this randomized, single-masked, placebo-controlled study. Each subject had measurements of choroidal thickness (ChT) and ocular biometrics of their right eye taken before, and then 30 and 60 min following the administration of topical pharmacological agents. Three different drugs: 2% homatropine hydrobromide, 2.5% phenylephrine hydrochloride and a placebo (0.3% hydroxypropyl methylcellulose) were tested in all subjects; each on different days (at the same time of the day) in randomized order. Participants were masked to the pharmacological agent being used at each testing session. The instillation of 2% homatropine resulted in a small but significant increase in subfoveal ChT at 30 and 60 min after drug instillation (mean change 7 ± 3 μm and 14 ± 2 μm respectively; both p thickness with time after 2% homatropine (p thickness (LT) and anterior chamber depth (ACD) (p thickness, or ocular biometrics were found after 2.5% phenylephrine or placebo at any examination points (p > 0.05). In human subjects, significant increases in subfoveal and parafoveal choroidal thickness occurred after administration of 2% homatropine and this implies an involvement of the parasympathetic system in the control of choroidal thickness in humans. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    L. Colombo

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ibrahim Koral Onal

    2015-10-01

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

  19. Relationship between Choroidal Thickness and Visual Field Impairment in Acute Zonal Occult Outer Retinopathy

    Directory of Open Access Journals (Sweden)

    Yuki Hashimoto

    2017-01-01

    Full Text Available Purpose. To evaluate sequential changes in choroidal thickness at the affected area in patients with acute zonal occult outer retinopathy (AZOOR. Methods. This retrospective observational case series included 14 affected eyes and 6 unaffected fellow eyes from 10 AZOOR patients with impaired macular area. Using enhanced depth imaging optical coherence tomography, choroidal thicknesses at the subfovea and at nasal and temporal sites 1000 μm away from the fovea were manually measured at baseline and 3 and 6 months thereafter. Changes in the choroidal thicknesses and the average threshold at the affected area on Humphrey perimetry were compared during the 6-month follow-up. Results. In AZOOR eyes, the average threshold at the affected area significantly increased over time, while outer retinal structure ameliorated. The mean choroidal thicknesses at all the sites measured significantly decreased at 3 and 6 months compared with baseline values in AZOOR eyes, but not in fellow eyes. There was an inverse correlation between the changing rates of the average threshold and the subfoveal choroidal thickness at 6 months from baseline. Conclusion. The current data suggest that choroidal thickness at AZOOR-affected area significantly decreased with regression of AZOOR and this anatomical change correlated with the functional recovery.

  20. Doxycycline Inhibits Polarization of Macrophages to the Proangiogenic M2-type and Subsequent Neovascularization*

    Science.gov (United States)

    He, Lizhi; Marneros, Alexander G.

    2014-01-01

    Macrophages occur along a continuum of functional states between M1-type polarized macrophages with antiangiogenic and antitumor activity and M2-type polarized macrophages, which have been implicated to promote angiogenesis and tumor growth. Proangiogenic M2-type macrophages promote various pathologic conditions, including choroidal neovascularization in models of neovascular age-related macular degeneration, or certain cancers, such as glioblastoma multiforme. Thus, a potential novel therapeutic approach to target pathological angiogenesis in these conditions would be to inhibit the polarization of macrophages toward the proangiogenic M2-type. However, no pharmacological inhibitors of M2-type macrophage polarization have been identified yet. Here we performed an unbiased pharmacological and small chemical screen to identify drugs that inhibit proangiogenic M2-type macrophage polarization and block pathologic macrophage-driven neovascularization. We identified the well tolerated and commonly used antibiotic doxycycline as a potent inhibitor of M2-type polarization of macrophages. Doxycycline inhibited, in a dose-dependent manner, M2-type polarization of human and bone marrow-derived mouse macrophages without affecting cell viability. Furthermore, doxycycline inhibited M2-type macrophage polarization and subsequent neovascularization in vivo in a laser injury model of choroidal neovascularization. Thus, doxycycline could be used to enhance current antiangiogenic treatment approaches in various conditions that are promoted by proangiogenic M2-type macrophages, including neovascular age-related macular degeneration and certain cancers. PMID:24505138

  1. Changes in choroidal thickness after prophylactic iridectomy in primary angle closure suspect eyes using enhanced depth imaging optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2015-01-01

    Full Text Available Purpose: The aim of the present study was to evaluate the effect of surgical peripheral iridectomy (SPI on choroidal thickness in primary angle-closure suspect (PACS eyes. Materials and Methods: This was a prospective observational case series of 30 subjects with PACS. Ocular biometry was performed before SPI (baseline and then 1 week later. Choroid was imaged by enhanced depth imaging optical coherence tomography (EDI-OCT. The choroidal thickness of the subfoveal area at 1 and 3 mm diameter around the fovea was determined. Central anterior chamber depth (ACD, lens thickness (LT, vitreous chamber depth (VCD, and axial length (AL were measured by A-scan ultrasound. Parameters were compared before SPI (baseline and 1 week later. Results: Thirty eyes of 30 patients with mean age of 61.53 ± 7.98 years were studied. There was no significant difference in the choroidal thickness at all macular locations before and after SPI (all P > 0.05. Mean subfoveal choroidal thickness was 279.61 μm ± 65.50 μm before and 274.54 μm ± 63.36 μm after SPI (P = 0.308. There was also no significant change in central ACD, LT, VCD, and LT after SPI (all P > 0.05. Conclusions: SPI does not appear to alter choroidal thickness in PACS eyes, as assessed using EDI-OCT. Long-term follow-up of PACS eyes treated with SPI may provide further insight into the effects of this treatment modality on the choroid.

  2. Optical Defocus Rapidly Changes Choroidal Thickness in Schoolchildren.

    Directory of Open Access Journals (Sweden)

    Danyang Wang

    Full Text Available The current study aimed to examine the short-term choroidal response to optical defocus in schoolchildren. Myopic schoolchildren aged 8-16 were randomly allocated to control group (CG, myopic defocus group (MDG and hyperopic defocus group (HDG (n = 17 per group. Children in MDG and HDG received additional +3D and -3D lenses, respectively, to their full corrections on the right eyes. Full correction was given to their left eyes, and on both eyes in the CG. Axial length (AXL and subfoveal choroidal thickness (SFChT were then measured by spectral domain optical coherence tomography. Children wore their group-specific correction for 2 hours after which any existing optical defocus was removed, and subjects wore full corrections for another 2 hours. Both the AXL and SFChT were recorded hourly for 4 hours. The mean refraction of all subjects was -3.41 ± 0.37D (± SEM. SFChT thinned when exposed to hyperopic defocus for 2 hours but less thinning was observed in response to myopic defocus compared to the control group (p < 0.05, two-way ANOVA. Removal of optical defocus significantly decreased SFChT in the MDG and significantly increased SFChT in the HDG after 1 and 2 hours (mean percentage change at 2-hour; control vs. hyperopic defocus vs. myopic defocus; -0.33 ± 0.59% vs. 3.04 ± 0.60% vs. -1.34 ± 0.74%, p < 0.01. Our results showed short-term exposure to myopic defocus induced relative choroidal thickening while hyperopic defocus led to choroidal thinning in children. This rapid and reversible choroidal response may be an important clinical parameter in gauging retinal response to optical defocus in human myopia.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    PURPOSE: To examine the effect of intravitreally injected bevacizumab (Avastin) on the histological and angiographic morphology of choroidal neovascularization (CNV) in a masked and placebo-controlled animal study. METHODS: Choroidal neovascularization was induced surgically in 11 porcine eyes...... leaking on FA, whereas only one of five bevacizumab-injected eyes exhibited leakage. On histological examination, all 11 eyes contained CNV membranes of similar size, regardless of treatment. The number of vascular endothelial cells was significantly reduced (p = 0.03) in CNV membranes from eyes that had...

  4. Our Treatment Results of Circumscribed and Diffuse Choroidal Hemangiomas

    Directory of Open Access Journals (Sweden)

    Esra Savku

    2013-08-01

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

  5. Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography.

    Science.gov (United States)

    Lim, F P M; Loh, B K; Cheung, C M G; Lim, L S; Chan, C M; Wong, D W K

    2014-09-01

    To evaluate imaging findings of patients with focal choroidal excavation (FCE) in the macula using swept-source optical coherence tomography (SS-OCT) and correlate it clinically. Prospective observational case series. Eleven consecutive patients (12 eyes) with FCE were described. Data on demographics and clinical presentation were collected and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and SS-OCT) were analyzed. The primary diagnosis was epiretinal membrane (two eyes), choroidal neovascularization (one eye), polypoidal choroidal vasculopathy (three eyes), central serous chorioretinopathy (one eye), and dry age-related macular degeneration (two eyes). Eleven out of 12 of the lesions were conforming. One presented with a non-conforming lesion that progressed to a conforming lesion. One eye had multiFCE and two had two overlapping choroidal excavations. Using the SS-OCT, we found the choroid to be thinned out at the area of FCE but sclera remained normal. The choroidal tissue beneath the FCE was abnormal, with high internal reflectivity and poor visualization of choroidal vessels. There was loss of contour of the outer choroidal boundary that appeared to be pulled inward by this abnormal choroidal tissue. A suprachoroidal space was noted beneath this choroidal tissue and the choroidal-scleral interface was smooth. Repeat SS-OCT 6 months after presentation showed the area of excavation to be stable in size. FCE can be associated with epiretinal membrane, central serous chorioretinopathy, and age-related macular degeneration. The choroid was thinned out in the area of FCE.

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

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Abalem

    2016-12-01

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

  7. Vitelliform focal choroidal excavation.

    Science.gov (United States)

    Or, Chris; Forooghian, Farzin

    2014-05-30

    Focal choroidal excavations (FCE) are characterized by foveal or perifoveal choroid excavations seen on optical coherence tomography (OCT). The authors report a case of FCE associated with a vitelliform lesion within the excavation. A case of FCE associated with a small vitelliform lesion has been described previously, but the larger extent of the vitelliform lesion observed in the current case has not been previously reported. This may represent a novel category of FCE, vitelliform focal choroidal excavation, in which deposition of vitelliform material is associated with its development. Copyright 2014, SLACK Incorporated.

  8. Choroidal thickness in diabetic patients of Indian ethnicity

    Directory of Open Access Journals (Sweden)

    Aditya Sudhalkar

    2015-01-01

    Full Text Available Purpose: To evaluate choroidal thickness (CT change in various grades of diabetic retinopathy (DR in comparison to age-matched healthy subjects. Methods: This prospective observational study included 227 eyes of 125 subjects with diabetes (study group: 58 females and 197 eyes of 110 age-matched healthy subjects (control group: 66 females. Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on spectral domain ocular coherence tomography using enhanced depth imaging. Results: Mean age in the study group was 57.0 ± 9.37 years (43–73 years. The mean age was 41.48 ± 5.43 years in the control group. Subjects with diabetes with (252.8 ± 55.6 microns and without (261.71 ± 51.8 microns retinopathy had significantly thinner choroids when compared to the control group (281.7 ± 47.7 microns; P = 0.032. Seventy-four of 227 eyes did not have any evidence of DR, 89 eyes had features of nonproliferative diabetic retinopathy (NPDR, and 33 eyes had treatment naïve proliferative diabetic retinopathy (PDR. Thirty-one PDR eyes had received previous laser photocoagulation. Subjects with diabetes without retinopathy had a greater subfoveal choroidal thickness (SFCT than subjects with diabetes with retinopathy (P < 0.001. Eyes with PDR (243.9 ± 56.2 microns had thinner SFCT than those with NPDR (238.98 ± 111.23 microns. There was no difference in the SFCT between treated (laser photocoagulation done; 251.784 ± 103.72 microns and treatment naïve PDR (258.405 ± 89.47 microns, P = 0.23. Conclusions: Control eyes had greater SFCT compared to subjects with diabetes, with and without retinopathy. The thinning progressed with increasing severity of DR. Choroidal thinning may contribute to DR pathogenesis.

  9. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis.

    Science.gov (United States)

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

    2017-05-01

    To describe the findings seen on optical coherence tomography angiography (OCTA) in patients with punctate inner choroidopathy (PIC) and multifocal choroiditis and panuveitis (MCP) complicated by choroidal neovascular membranes. This was an Institutional Review Board-approved prospective, descriptive case series. 12 patients with PIC and MCP complicated by choroidal neovascularisation (CNV) were included. Each patient underwent slit-lamp examination by a uveitis specialist followed by conventional spectral domain OCT imaging of the macula. OCTA images of the macula were then obtained. 12 patients were enrolled in the study, out of which 9 patients were followed longitudinally. CNV was identified in 11 of the 12 patients. In all patients where fluorescein angiography (FA) was inconclusive for presence of CNV, OCTA identified CNV. Various lesions on OCT suggestive of activity correlated with changes in the vascular structure of OCTA to confirm suspicion of clinical activity. In patients with PIC and MCP complicated by CNV, OCTA successfully identified underlying CNV. Given the difficulty of differentiating inflammatory lesions from early CNV on OCT and FA, OCTA may provide a valuable method of monitoring patients with posterior uveitis highly correlated with development of CNV. 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/.

  10. Evaluation of focal choroidal excavation in the macula using swept-source optical coherence tomography

    Science.gov (United States)

    Lim, F P M; Loh, B K; Cheung, C M G; Lim, L S; Chan, C M; Wong, D W K

    2014-01-01

    Purpose To evaluate imaging findings of patients with focal choroidal excavation (FCE) in the macula using swept-source optical coherence tomography (SS-OCT) and correlate it clinically. Methods Prospective observational case series. Eleven consecutive patients (12 eyes) with FCE were described. Data on demographics and clinical presentation were collected and imaging findings (including color photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and SS-OCT) were analyzed. Results The primary diagnosis was epiretinal membrane (two eyes), choroidal neovascularization (one eye), polypoidal choroidal vasculopathy (three eyes), central serous chorioretinopathy (one eye), and dry age-related macular degeneration (two eyes). Eleven out of 12 of the lesions were conforming. One presented with a non-conforming lesion that progressed to a conforming lesion. One eye had multiFCE and two had two overlapping choroidal excavations. Using the SS-OCT, we found the choroid to be thinned out at the area of FCE but sclera remained normal. The choroidal tissue beneath the FCE was abnormal, with high internal reflectivity and poor visualization of choroidal vessels. There was loss of contour of the outer choroidal boundary that appeared to be pulled inward by this abnormal choroidal tissue. A suprachoroidal space was noted beneath this choroidal tissue and the choroidal–scleral interface was smooth. Repeat SS-OCT 6 months after presentation showed the area of excavation to be stable in size. Conclusion FCE can be associated with epiretinal membrane, central serous chorioretinopathy, and age-related macular degeneration. The choroid was thinned out in the area of FCE. PMID:24946847

  11. The Acute Effect of Hemodialysis on Choroidal Thickness

    Directory of Open Access Journals (Sweden)

    Osman Çelikay

    2015-01-01

    Full Text Available Objective. To determine the effect of hemodialysis (HD on choroidal thickness (CT. Methods. The right eyes of 41 patients with end-stage renal disease (ESRD undergoing HD were included. All patients underwent an ophthalmic examination, including CT measurement via optical coherence tomography, intraocular pressure (IOP, blood pressure, and body weight measurement immediately before and after a HD session. Results. Mean subfoveal choroidal thickness (SFCT after HD decreased significantly from 254.59 ± 84.66 µm to 229.34 ± 77.79 µm (p<0.001. CT at the temporal and nasal regions also decreased significantly after HD (both p<0.001. IOP changes after HD were insignificant (p=0.958. CT difference was insignificant in patients with diabetes mellitus (DM and without DM before and after HD, respectively (p=0.285 and p=0.707. Stepwise multivariate linear regression analysis showed that diastolic blood pressure was the best fitted factor to explain the changes in CT (r=0.327 and p=0.040.  Conclusion. CT was decreased in the patients with ESRD following a HD session. This study suggested that the changes in CT may be related to the changes in systemic blood pressure.

  12. Neovascularization in Purtscher's retinopathy

    Directory of Open Access Journals (Sweden)

    Chan A

    2011-11-01

    Full Text Available Annie Chan, Douglas R Fredrick, Theodore Leng Department of Ophthalmology, Byers Eye Institute at Stanford University, Stanford University School of Medicine, Stanford, CA, USA Abstract: We report a case of neovascularization secondary to Purtscher's retinopathy that showed minimal improvement with photocoagulation treatment. A 14-year-old boy with a history of cerebellar medulloblastoma presented with blurry vision and floaters after being struck by a motor vehicle while riding his bike. At presentation, visual acuity was 20/400 in his right eye and counting fingers in his left eye. Fundus examination showed disk edema, retinal whitening, and retinal hemorrhages in both eyes. Optical coherence tomography demonstrated thinning of the temporal retina and disruption of the inner segment–outer segment junction of the photoreceptor layer in the right eye and thickening and edema of the nasal macula, as well as a central foveal hyper-reflectivity, in the left eye. At the initial visit, there was no ischemia or neovascularization (NV. One month later, the patient developed NV of the disk and ischemia in the mid-periphery of the left eye. The patient underwent treatment with pan-retinal photocoagulation. The NV regressed, but visual outcome remained poor at his 5-month follow-up visit. Keywords: Purtscher's retinopathy, neovascularization, laser photocoagulation, disk edema

  13. Two cases of focal choroidal excavation detected by spectral-domain optical coherence tomography.

    Science.gov (United States)

    Katome, Takashi; Mitamura, Yoshinori; Hotta, Fumika; Niki, Masanori; Naito, Takeshi

    2012-01-01

    To report the clinical findings of 2 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). Three eyes of 2 patients with a focal macular choroidal excavation detected by SD-OCT were studied. The eyes were examined by fundus autofluorescence (FAF), fluorescein angiography, fundus-related microperimetry, and multifocal electroretinography (mfERG). In spite of a complaint of metamorphopsia, the visual acuity was normal in 2 eyes. SD-OCT demonstrated a choroidal excavation in the macula but the foveal contour was normal in 3 eyes. The excavation involved the outer retinal layers up to the external limiting membrane in all eyes, and a type 2 secondary choroidal neovascularization (CNV) developed in 1 of the 3 eyes. There were areas of hypoautofluorescence in the FAF images, and areas of decreased retinal sensitivity determined by microperimetry. These areas corresponded to the choroidal excavation in all eyes. The P1 amplitudes of the mfERGs were decreased in the fovea of 1 eye without a CNV. The choroidal excavation remained stable for 3 years in 2 eyes, a secondary CNV developed in 1 eye during the course of the disease. More cases and longer follow-up periods will be necessary to determine the etiology, clinical course, and visual prognosis of eyes with a choroidal excavation.

  14. Broad spectrum antiangiogenic treatment for ocular neovascular diseases.

    Directory of Open Access Journals (Sweden)

    Ofra Benny

    2010-09-01

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

  15. Large choroidal excavation in a patient with rubella retinopathy.

    Science.gov (United States)

    Battaglia Parodi, Maurizio; Romano, Francesco; Montagna, Marco; Bandello, Francesco

    2017-10-17

    To describe a case of rubella retinopathy complicated by bilateral choroidal neovascularization (CNV) and late development of large choroidal excavation (LCE). A 19-year-old woman with a diagnosis of rubella retinopathy underwent her annual ophthalmologic examination, including visual acuity testing and slit-lamp biomicroscopy with dilated fundus examination. Color fundus photography, spectral-domain optical coherence tomography (SD-OCT) scans, and optical coherence tomography angiography were acquired to complete the investigation of her ocular condition. The main findings are described in this case report. This woman came to our attention in 2010 with a history of rubella retinopathy, complicated by bilateral CNV and treated with photodynamic therapy (PDT) in 2006. After 6 years of annual follow-up examinations, her visual acuity remained stable in both eyes (20/100), whereas SD-OCT scans uncovered the development of a bilateral LCE in the macular area, associated with a macular hole in the right eye. Optical coherence tomography angiography revealed a vascular network surrounding the choroidal excavation. Large choroidal excavation is a rare finding that has been described in few chorioretinal diseases, e.g., North Carolina macular dystrophy and toxoplasmosis. We propose to include rubella retinopathy complicated by CNV in the differential diagnosis of LCE, although we recognize the possibility that PDT might have induced or facilitated its formation.

  16. Retinal and choroidal thickness after femtosecond laser-assisted and standard phacoemulsification

    Directory of Open Access Journals (Sweden)

    Asena BS

    2017-08-01

    Full Text Available Bilgehan Sezgin Asena,1 Eyyup Karahan,2 Mahmut Kaskaloglu1 1Department of Ophthalmlolgy, Kaskaloglu Eye Hospital, 2Department of Ophthalmlolgy, Batigoz Eye Hospital, Izmir, Turkey Purpose: The purpose of this study was to compare the short-term changes in retina and choroidal tissue after femtosecond laser-assisted cataract surgery (FLACS and standard phacoemulsification (PE surgery.Methods: In all, 25 eyes undergoing FLACS and 27 eyes undergoing PE surgery were included in this nonrandomized, retrospective, cross-sectional study. Central retinal thickness (CRT and choroidal thickness (CT were measured pre- and postoperatively (at day 1, 1 week later, and after 1 month with spectral domain optical coherence tomography (OCT in all patients and were compared. For group comparisons, chi-square test and independent t-test were used. Postoperative values were compared to the baseline using a paired t-test. The magnitude of the change from baseline to the peak was analyzed by multiple regression models in an attempt to explain possible influence variables. Results: Pre and postoperative CRT measurements were similar in both groups. The mean subfoveal CT at day 1, after 1 week, and 1 month were significantly higher than baseline CT measurements in the PE group. Conclusion: FLACS might have an advantage in regard to postoperative choroidal changes. Keywords: femtosecond laser, cataract, visual acuity, central retinal thickness, choroidal thickness, optical coherence tomography

  17. Circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Saeed Karimi

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Williams PD

    2012-09-01

    Full Text Available Patrick D Williams,1 David Callanan,1 Wayne Solley,1 Robert L Avery,2 Dante J Pieramici,2 Tom Aaberg31Texas Retina Associates, Dallas, TX, 2California Retina Consultants and Research Foundation, Santa Barbara, CA, 3Retinal Associates, Grand Rapids, MI, USAPurpose: This prospective multi-center pilot study compares the use of half-fluence photodynamic therapy combined with ranibizumab with ranibizumab monotherapy for the treatment of neovascular age-related macular degeneration.Methods: All patients presenting with untreated subfoveal neovascular age-related macular degeneration were considered for inclusion. Patients were randomized to receive either ranibizumab with half-fluence photodynamic therapy or ranibizumab alone. Patients in the ranibizumab alone group were given three consecutive monthly ranibizumab injections and were followed monthly. They were treated with ranibizumab as needed, based on clinical discretion, using vision and optical coherence tomography. Patients in the combined group were given one same-day combined ranibizumab and half-fluence (25 j/cm2 photodynamic therapy treatment and were treated monthly as needed. Outcomes included changes in standardized visual acuity, optical coherence tomography foveal thickness, and percentage of as-needed injections to maintenance examinations.Results: Fifty-six out of 60 enrolled patients completed the twelve month primary outcome visit; this consisted of 27 patients receiving ranibizumab alone and 29 receiving combined treatment. The average age was 79.1 for the ranibizumab alone group and 79.3 for the combined group. The mean visual acuity in the ranibizumab alone group improved from 52.9 Early Treatment of Diabetic Retinopathy letters initially to 62.8 letters at twelve months. The mean visual acuity in the combined group improved from 49.2 letters to 51.8 letters at twelve months. The differences in visual acuity improvements were not statistically significant based on a two

  19. Evaluation of choroidal thickness changes after phacoemulsification surgery

    Directory of Open Access Journals (Sweden)

    Aslan Bayhan S

    2016-05-01

    Full Text Available Seray Aslan Bayhan, Hasan Ali Bayhan, Ersin Muhafiz, Kadir Kırboğa, Canan Gürdal Department of Ophthalmology, Faculty of Medicine, Bozok University, Yozgat, Turkey Purpose: The aim of the study was to analyze the effects of uneventful phacoemulsification surgery on choroidal thickness (CT using spectral domain optical coherence tomography (SD-OCT. Methods: In this prospective study, 38 eyes of 38 patients having phacoemulsification surgery were included. All patients underwent detailed ophthalmologic examination, including preo­perative axial length (AXL measurement with optical biometry and intraocular pressure (IOP measurement preoperatively and 1 month postoperatively. The CT was measured perpendicularly at the fovea and 1.5 mm temporal, 3.0 mm temporal, 1.5 mm nasal, and 3.0 mm nasal using SD-OCT preoperatively and 1 month postoperatively. Changes in the CT after surgery and correlation of this change with age, AXL, preoperative IOP, and IOP change were evaluated. Results: There was a statistically significant increase in the CT at all regions evaluated. This increment was more prominent in the nasal and subfoveal regions. The IOP decreased significantly 1 month after surgery (16.14±4.94 mmHg vs 13.91±4.86 mmHg; P<0.001. The change in IOP was correlated with the CT changes at all regions, whereas age, AXL, and preoperative IOP had no significant correlations with the changes in CT. Conclusion: Phacoemulsification surgery may cause significant increase in CT, which is correlated with surgery-induced IOP change in the short term. Long-term follow-up of eyes having phacoemulsification surgery may provide further insight into the effects of cataract surgery on the choroid. Keywords: phacoemulsification, choroidal thickness, optical coherence tomography

  20. Choroidal thickness in patients with reticular pseudodrusen using 3D 1060-nm OCT maps.

    Science.gov (United States)

    Haas, Paulina; Esmaeelpour, Marieh; Ansari-Shahrezaei, Siamak; Drexler, Wolfgang; Binder, Susanne

    2014-04-25

    To map and analyze choroidal thickness (ChT) in AMD patients with reticular pseudodrusen (RPD) using three-dimensional (3D) 1060-nm optical coherence tomography (OCT). Fifty eyes from 25 patients with RPD were grouped according to the severity of AMD and the presence of RPD. All patients were imaged by high-speed (60,000 A-scans/s) 3D 1060-nm OCT over a 36 × 36° field of view. Choroidal thickness maps were automatically generated and compared with RPD areas visualized by fundus autofluorescence and infrared imaging. Retinal thickness maps, ChT maps, Haller's and Sattler's layer thickness were statistically analyzed between groups. The mean ± SD (micrometers) subfoveal ChT was 201 ± 88 μm, 145 ± 48 μm, and 271 ± 130 μm for dry AMD with RPD, wet AMD with RPD, and eyes with wet AMD and no RPD, respectively. Choroidal thickness maps demonstrated the most significant choroidal thinning within eyes with wet AMD and RPD. Sattler's and Haller's layer thickness differed across the Early Treatment Diabetic Retinopathy Study grid when compared between eyes with and without RPD. Within eyes with RPD, ChT maps visualized that ChT was thicker below RDP areas than non-RPD areas. The 3D 1060-nm OCT choroidal maps over a large field of view offer noninvasive visualization for demonstrating local thickening correlation with RPD within each eye and overall thinning owing to AMD severity and RPD. This choroidal thinning was most striking in Sattler's layer, suggesting a choroidopathy of this vascular layer.

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

    DEFF Research Database (Denmark)

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

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Keane PA

    2015-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Hartnett ME

    2011-09-01

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

  4. Radiotherapy of choroidal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Hoogenhout, J.; Gasteren, J.J.M. van; Brink, H.M.A.; Verbeek, A.M.; Beex, L.V.A.M.

    1989-05-01

    With binocular indirect ophthalmoscopy, fluorescin angiography and ultrasonography 68 choroidal metastases in 52 eyes of 39 patients were diagnosed. The primary tumors were mainly breast cancer (81%) and lung cancer (10%). After radiation treatment the visual acuity improved in 17 eyes (38%), stabilized in 15 eyes (33%), whereas in 13 eyes (29%) deterioration could not be prevented (seven eyes unknown). Regression of the lesions or its accompanying secondary retinal detachment was seen in 78% of the eyes treated. Acute transient side effects of radiation therapy were keratoconjunctivitis (nine patients) and acute glaucoma in one patient. No cataractous changes of the lens were observed in the post radiation period (one to 42 months). Irradiation of choroidal metastases can contribute to improvement of the quality of life with a treatment scheme of 30 Gy in ten daily fractions.

  5. Association of focal choroidal excavation with age-related macular degeneration.

    Science.gov (United States)

    Kuroda, Yoshimasa; Tsujikawa, Akitaka; Ooto, Sotaro; Yamashiro, Kenji; Oishi, Akio; Nakanishi, Hideo; Kumagai, Kyoko; Hata, Masayuki; Arichika, Shigeta; Ellabban, Abdallah A; Yoshimura, Nagahisa

    2014-09-04

    To study the prevalence, tomographic features, and clinical characteristics of focal choroidal excavation (FCE) in eyes with exudative age-related macular degeneration (AMD). We examined 243 consecutive eyes with exudative AMD with a prototype swept-source optical coherence tomography (OCT) system. Three-dimensional images of the macular area, covering 6 × 6 mm(2), were reconstructed by segmentation of the outer surface of the retinal pigment epithelium. Three-dimensional swept-source OCT revealed 15 excavations in 12 eyes (4.9%); 10 had a single excavation and 2 had multiple excavations (2 and 3 excavations, respectively). In multiaveraged scans, unusual choroidal tissue was found beneath 5 excavations, bridging the excavation with the outer choroidal boundary. Additionally, the suprachoroidal space was observed beneath 7 excavations-the outer choroidal boundary appeared to be pulled inward by this bridging tissue. In 9 excavations, color fundus photographs showed pigmentary disturbance. Fourteen excavations (93.3%) were located within or adjacent to the choroidal neovascularization area. Compared with eyes without FCE, in eyes with FCE, the mean age was significantly higher (P = 0.040) and mean visual acuity was significantly better (P = 0.014). In addition, polypoidal lesions were observed in 8 of 12 eyes with FCE, but they appeared to have a limited effect on either the rate of FCE (P = 0.44) or the clinical characteristics of the eyes. While FCE may be partially related to the choroidal neovascularization associated with exudative AMD, other factors may also influence this association. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  6. REFRACTORY INTRARETINAL OR SUBRETINAL FLUID IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATED WITH INTRAVITREAL RANIZUBIMAB: Functional and Structural Outcome.

    Science.gov (United States)

    Gianniou, Christina; Dirani, Ali; Jang, Liuna; Mantel, Irmela

    2015-06-01

    To investigate the visual acuity results of eyes with neovascular age-related macular degeneration and refractory fluid despite monthly treatment with ranibizumab, and to investigate differences between refractory subretinal fluid and intraretinal cystic changes. Retrospective chart review of consecutive treatment-refractory neovascular age-related macular degeneration, defined as persistent intraretinal or subretinal fluid despite monthly ranibizumab injections during 12 months or more. Data were evaluated for baseline characteristics, type and location of the refractory fluid, mean visual acuity change, number of injections, and the time point of first complete disappearance of all fluid on spectral domain optical coherence tomography. Seventy-six eyes (74 patients, mean age, 76.8 years) were identified. The mean follow-up was 33.6 months (range, 12-73 months). The mean number of injections was 11.4 in the first year and 27.7 over follow-up. The refractory fluid was located subfoveally in 61.8%. In 27 eyes (35.5%), the fluid resolved after a mean of 21.8 months (range, 13-49 months). Mean visual acuity increased by 9.0, 7.9, and 7.9 letters by Month 12, Month 24, and Month 36, respectively. Subgroup analysis revealed a higher risk for fibrosis (odds ratio, 3.30) or atrophy (odds ratio, 3.34) in patients with refractory cysts as compared with refractory subretinal fluid. Furthermore, refractory cysts showed a higher risk for a 10-letter visual acuity loss (P = 0.018). Fluid refractory to monthly treatment with ranibizumab for neovascular age-related macular degeneration still allowed for well-maintained visual improvement, even in subfoveal location. Late fluid resolution may occur. However, refractory cysts were associated with poorer anatomical and functional outcome than subretinal fluid.

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

    Directory of Open Access Journals (Sweden)

    Sobha Sivaprasad

    2008-06-01

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

  8. The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy.

    Science.gov (United States)

    Preti, Rony C; Mutti, Anibal; Ferraz, Daniel A; Zacharias, Leandro C; Nakashima, Yoshitaka; Takahashi, Walter Y; Monteiro, Mario L R

    2017-02-01

    To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505. Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.

  9. Photochemical Thrombosis Of Retinal And Choroidal Vessels Using Rose Bengal

    Science.gov (United States)

    Lewis, Mary Lou; Winward, Kirk; Watson, Brant D.; Hernandez, Eleut

    1989-09-01

    Rose bengal is an effective photosensitizing agent which interacts with argon green light to induce photochemical thrombosis of irradiated vessels. We used focal, low energy irradiation to occlude retinal and choroidal vessels in both albino and pigmented rabbits. Immediately after intravenous injection of rose bengal at concentrations of 10 and 20 mg/kg, irradiation was performed via a slit lamp-delivered argon green laser (514.5 nm) with the aid of fundus contact lens. In 11 eyes, arteries were treated with 50-100 interrupted bursts of 75u spot size at 0.2 sec and 40-100 mW (9 choroidal vessels, serous elevation of the retina, and disc neovascularization. In eight eyes choroidal vessels were irradiated with 10-20 mW, 15-60 sec, 500u spot size (31 choroidal vessels. There was minimal damage to surrounding tissue. Control eyes in all three groups irradiated utilizing the same parameters, but without rose bengal, demonstrated no evidence of thermal injury.

  10. Evaluation of choroidal thickness in psoriasis using optical coherence tomography.

    Science.gov (United States)

    Türkcü, Fatih Mehmet; Şahin, Alparslan; Yüksel, Harun; Akkurt, Meltem; Uçmak, Derya; Çınar, Yasin; Yıldırım, Adnan; Çaça, İhsan

    2016-12-01

    The purpose of this study was to evaluate choroidal thickness (CT) in patients with psoriasis using enhanced depth imaging optical coherence tomography (EDI-OCT) and to determine its relationship with psoriasis activity indices. In this prospective study, EDI-OCT images were obtained in consecutive patients with psoriasis and in age-gender-matched healthy individuals. Comprehensive ophthalmic examination and EDI-OCT evaluation were performed. CT was measured in the subfoveal area. Correlation analyses were performed to identify the relationship of the CT with disease duration and clinical disease activity score. In total, 65 individuals were evaluated in this study, 35 with psoriasis and 30 controls. The mean disease duration of the patients with psoriasis was 15.7 ± 8.8 years (0.3-34 years). There was no difference between groups with respect to age and gender (p = 0.695 and p = 0.628, respectively). Five of the 35 patients with psoriasis had anterior uveitis. None of the patients with psoriasis had signs of posterior uveitis. CT was significantly higher in the psoriasis group than that of control subjects (p psoriasis patients. Large serial and comparative studies are necessary to evaluate EDI-OCT, an examination that may be helpful in understanding the effects of psoriasis on the eye and its pathophysiology.

  11. Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography.

    Science.gov (United States)

    Esmaeelpour, Marieh; Brunner, Simon; Ansari-Shahrezaei, Siamak; Shahrezaei, Siamak Ansari; Nemetz, Susanne; Povazay, Boris; Kajic, Vedran; Drexler, Wolfgang; Binder, Susanne

    2012-10-03

    To map choroidal (ChT) and retinal thickness (RT) in patients with diabetes type 1 with and without maculopathy and retinopathy in order to compare them with healthy subjects using high speed 3-dimensional (3D) 1060 nm optical coherence tomography (OCT). Thirty-three eyes from 33 diabetes type 1 subjects (23-57 years, 15 male) divided into groups of without pathology (NDR) and with pathology (DR; including microaneurysms, exudates, clinically significant macular-oedema and proliferative retinopathy) were compared with 20 healthy axial eye length and age-matched subjects (24-57 years, 9 male), imaged by high speed (60.000 A-scans/s) 3D 1060 nm OCT performed over 36° × 36° field of view. Ocular health status, disease duration, body mass index, haemoglobin-A1c, and blood pressure (bp) measurements were recorded. Subfoveal ChT, and 2D topographic maps between retinal pigment epithelium and the choroidal/scleral-interface, were automatically generated and statistically analyzed. Subfoveal ChT (mean ± SD, μm) for healthy eyes was 388 ± 109; significantly thicker than all diabetic groups, 291 ± 64 for NDR, and 303 ± 82 for DR (ANOVA P 0.05). Compared with healthy eyes and the NDR, the averaged DR ChT-map demonstrated temporal thinning that extended superiorly and temporal-inferiorly (unpaired t-test, P 0.05). ChT is decreased in diabetes type 1, independent of the absence of pathology and of diabetic disease duration. In eyes with pathology, 3D 1060 nm OCT averaged maps showed an extension of the thinning area matching retinal lesions and suggesting its involvement on onset or progression of disease.

  12. Polarization-Sensitive Optical Coherence Tomographic Documentation of Choroidal Melanin Loss in Chronic Vogt-Koyanagi-Harada Disease.

    Science.gov (United States)

    Miura, Masahiro; Makita, Shuichi; Yasuno, Yoshiaki; Tsukahara, Rintaro; Usui, Yoshihiko; Rao, Narsing A; Ikuno, Yasushi; Uematsu, Sato; Agawa, Tetsuya; Iwasaki, Takuya; Goto, Hiroshi

    2017-09-01

    Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune disorder that affects organs with melanocytes. The sunset glow fundus (SGF) in VKH disease was evaluated with polarization-sensitive optical coherence tomography (PS-OCT). The study involved 28 eyes from 14 patients with chronic VKH disease, 21 eyes from 21 age-matched controls, and 22 eyes from 22 high-myopic patients with a tessellated fundus. VKH eyes were grouped into sunset or non-sunset groups on the basis of color fundus images. The presence of melanin in the choroid was determined by using the degree of polarization uniformity (DOPU) obtained by PS-OCT. The sunset glow index (SGI) was calculated by using color fundus images. Presence of an SGF was evaluated by using DOPU, SGI, subfoveal choroidal thicknesses, near-infrared images, and autofluorescence images at 488 nm (SW-AF) and 785 nm (NIR-AF). There were 16 eyes in the sunset group and 12 eyes in the non-sunset group. For all eyes in the sunset group, the disappearance of choroidal melanin was clearly detected with PS-OCT. Percentage areas of low DOPU in the choroidal interstitial stroma of the sunset group were significantly lower than those of other groups and showed no overlap with other groups. The distribution of choroidal thicknesses and SGI in the sunset group substantially overlapped with other groups. The subjective analyses of the sunset and non-sunset groups, using near infrared, SW-AF, or NIR-AF, showed substantial inconsistencies with the PS-OCT results. PS-OCT provides an in vivo objective evaluation of choroidal melanin loss of the SGF in chronic VKH disease.

  13. Choroidal findings in dome-shaped macula in highly myopic eyes: a longitudinal study.

    Science.gov (United States)

    Viola, Francesco; Dell'Arti, Laura; Benatti, Eleonora; Invernizzi, Alessandro; Mapelli, Chiara; Ferrari, Fabio; Ratiglia, Roberto; Staurenghi, Giovanni; Barteselli, Giulio

    2015-01-01

    To describe choroidal findings in dome-shaped macula associated with high myopia using fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (SD OCT), and to elucidate the mechanism and natural course of serous retinal detachment (RD) associated with dome-shaped macula. Retrospective, observational case series. We reviewed longitudinal imaging results of 52 highly myopic eyes with dome-shaped macula. Changes on FA and ICGA were assessed. Retinal, choroidal, and scleral thicknesses and bulge height were measured on SD OCT. Serous RD was the most common abnormality associated with dome-shaped macula, detected by SD OCT in 44% of the cases with no associated choroidal neovascularization. Significant differences in the proportion of eyes with pinpoint leakage on FA (P macula was likely caused by choroidal vascular changes, similar to central serous chorioretinopathy, but specifically confined in the inward bulge of the staphyloma and secondary to excessive scleral thickening. Serous retinal detachment showed fluctuating changes over time, with alternating active and inactive stages. Angiographic findings in dome-shaped macula suggest the choroid as a target for possible treatment strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Morphologic features of focal choroidal excavation on spectral domain optical coherence tomography with simultaneous angiography.

    Science.gov (United States)

    Shinojima, Ari; Kawamura, Akiyuki; Mori, Ryusaburo; Yuzawa, Mitsuko

    2014-07-01

    To reveal clinically relevant morphologic findings in patients with focal choroidal excavation (FCE) using enhanced depth imaging optical coherence tomography. Thirty-one FCE lesions in 29 eyes of 26 patients (21 men, 23 eyes; 5 women, 6 eyes) were studies. In all 26 patients, color fundus photographs were obtained, and fluorescein angiography and indocyanine green angiography with simultaneous enhanced depth imaging optical coherence tomography were performed. Twenty-five eyes also underwent angiographic video recording. Focal choroidal excavation was detected in eyes with typical age-related macular degeneration, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and idiopathic choroidal neovascularization, whereas in 8 eyes, FCE was considered to be idiopathic. Morphologically, FCE lesions were classified into 3 types: cone-shaped, bowl-shaped, and mixed. The cone-shaped type was detected in 17 lesions, bowl-shaped in 8, and mixed in 6, on optical coherence tomography findings. All bowl-shaped and mixed types had retinal pigment epithelial irregularities within the FCE lesion. The cone-shaped type was not observed in eyes with typical age-related macular degeneration. Morphologically, FCE lesions were classified into cone-shaped, bowl-shaped, and mixed types, based on optical coherence tomography findings. Focal choroidal excavation formation may be associated in part with chorioretinal diseases such as age-related macular degeneration and central serous chorioretinopathy, whereas some eyes are considered to have idiopathic FCE.

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

    Science.gov (United States)

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

    2012-09-03

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

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

    Directory of Open Access Journals (Sweden)

    Marianne Houssier

    2008-02-01

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

  17. Morphologic Criteria of Lesion Activity in Neovascular Age-Related Macular Degeneration: A Consensus Article.

    Science.gov (United States)

    Miotto, Stefania; Zemella, Nicola; Gusson, Elena; Panozzo, Giacomo; Saviano, Sandro; Scarpa, Giuseppe; Boschi, Giorgio; Piermarocchi, Stefano

    2017-11-17

    Intravitreal antivascular endothelial growth factor drugs represent the current standard of care for neovascular age-related macular degeneration (nAMD). Individualized treatment regimens aim at obtaining the same visual benefits of monthly injections with a reduced number of injections and follow-up visits, and, consequently, of treatment burden. The target of these strategies is to timely recognize lesion recurrence, even before visual deterioration. Early detection of lesion activity is critical to ensure that clinical outcomes are not compromised by inappropriate delays in treatment, but questions remain on how to effectively monitor the choroidal neovascularization (CNV) activity. To assess the persistence/recurrence of lesion activity in patients undergoing treatment for nAMD, an expert panel developed a decision algorithm based on the morphological features of CNV. After evaluating all current retinal imaging techniques, the panel identified optical coherent tomography as the most reliable tool to ascertain lesion activity when funduscopy is not obvious.

  18. Effect of myopia onset time for macula choroidal thickness

    Directory of Open Access Journals (Sweden)

    Shi-Ming Wang

    2016-03-01

    Full Text Available AIM:To investigate the effect of onset time(Tfor macula choroidal thickness(CTin myopia patient. METHODS:A prospective cohort study was designed.One hundred and twenty-two myopia patients(244 eyes; 67 male and 55 female; aged 30~41 years, mean 35.1±4.6 years oldwho received preoperative examinations from March 2014 to April 2015 were recruited in this study. The patients were divided into three groups according to onset time(T:group A(T≤5a, group B(5aF=1.56,P>0.05,age(F=2.13,P>0.05,best corrected visual acuity(BCVA, F=1.41,P>0.05,corneal curvature(F=1.65,P>0.05and axial length(F=1.89,P>0.05among the three groups. The choroid in macular region was measured by enhanced depth imaging(EDIusing spectral-domain optical coherence tomography(SD-OCT. This study recorded the CT at subfoveal(SFCT, 1mm at temporal(T1mm, nasal(N1mm, superior(S1mmand inferior(I1mmto the fovea and 3mm temporal(T3mm, nasal(N3mm, superior(S3mmand inferior(I3mmto the fovea, respectively. The differences of CT at the same position among the three groups were analyzed.RESULTS:The mean SFCT for group A,B,C were 238.32±57.95μm, 230.58±67.21μm, 221.63±62.37μm respectively in this study. The CT was found no significant difference in different locations except N3mm(tA-B=4.34,P3mm(tB-C=7.61,P3mm(t=0.76,P>0.05between group A and C. Significant difference was found at N3mm(tA-B=4.31,t B-C=7.59,tA-C=12.18; PCONCLUSION:The choroidal thickness decreases as the myopia onset time is earlier, especially at nasal.

  19. SD-OCT findings in polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Asensio-Sánchez, V M

    2016-01-01

    To examine patients with polypoidal choroidal vasculopathy (PCV), using spectral-domain optical coherence tomography (SD-OCT) to characterise and locate the PCV lesions. A series of 15 eyes of 10 patients diagnosed with PCV were examined. All eyes were imaged with macular SD-OCT. SD-OCT cross-sectional scan findings included atypical and typical pigment epithelial detachments (PEDs). Polyps and neovascularisation were located above Bruch membrane. All 15 eyes (100%) showed sub-retinal fluid (SRF) in association with PEDs. These SD-OCT findings located the vascular lesions of PCV in the sub-retinal pigment epithelium (RPE) space, and strongly suggest that PCV is a variant of type 1 neovascularization. Copyright © 2015. Published by Elsevier España, S.L.U.

  20. Expulsive choroidal haemorrhage

    Directory of Open Access Journals (Sweden)

    Srinivasan M

    1992-01-01

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

  1. Choroidal excavation with polypoidal choroidal vasculopathy: a case report

    Directory of Open Access Journals (Sweden)

    Kobayashi W

    2012-08-01

    Full Text Available Wataru Kobayashi,1 Toshiaki Abe,2 Hiroshi Tamai,1 Toru Nakazawa11Department of Ophthalmology, 2Division of Clinical Cell Therapy, Center for Advanced Medical Research and Development (ART, Tohoku University Graduate School of Medical Science, Sendai, JapanPurpose: This is a report of a case of choroidal excavation accompanied by polypoidal choroidal vasculopathy (PCV and retinal pigment epithelium detachment (PED.Methods: A 57-year-old Japanese woman who had begun complaining of metamorphopsia in her left eye 7 months earlier underwent spectral-domain optical coherence tomography (SD-OCT, fluorescein angiography (FA, and indocyanine green angiography (IA, as well as a routine ophthalmological examination.Results: The patient’s intraocular pressure, visual acuity, and visual field were within normal range. Ophthalmoscopy revealed a serous macular detachment, soft drusen, exudates, and a reddish-orange elevated lesion in the macula of the left eye. The right eye was normal. SD-OCT revealed two lesions in the left eye. One was a PED accompanied by a notch sign, and the other was a choroidal excavation. Additionally, FA revealed a window defect in the PED, and IA showed typical PCV. Three monthly injections of antivascular endothelial growth factor preserved visual acuity, but failed to have any visible effect on the lesion during the 6-month follow up period.Conclusions: This is the first report of choroidal excavation accompanied by PED and PCV. The data suggest that choroidal excavation may be associated with various changes that have not been previously reported. Careful observation of such cases may therefore be necessary.Keywords: choroidal excavation, polypoidal choroidal vasculopathy, anti-vascular endothelial growth factor treatment

  2. Choroidal excavation with polypoidal choroidal vasculopathy: a case report.

    Science.gov (United States)

    Kobayashi, Wataru; Abe, Toshiaki; Tamai, Hiroshi; Nakazawa, Toru

    2012-01-01

    This is a report of a case of choroidal excavation accompanied by polypoidal choroidal vasculopathy (PCV) and retinal pigment epithelium detachment (PED). A 57-year-old Japanese woman who had begun complaining of metamorphopsia in her left eye 7 months earlier underwent spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography (IA), as well as a routine ophthalmological examination. The patient's intraocular pressure, visual acuity, and visual field were within normal range. Ophthalmoscopy revealed a serous macular detachment, soft drusen, exudates, and a reddish-orange elevated lesion in the macula of the left eye. The right eye was normal. SD-OCT revealed two lesions in the left eye. One was a PED accompanied by a notch sign, and the other was a choroidal excavation. Additionally, FA revealed a window defect in the PED, and IA showed typical PCV. Three monthly injections of antivascular endothelial growth factor preserved visual acuity, but failed to have any visible effect on the lesion during the 6-month follow up period. This is the first report of choroidal excavation accompanied by PED and PCV. The data suggest that choroidal excavation may be associated with various changes that have not been previously reported. Careful observation of such cases may therefore be necessary.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Neovascularization of the iris in retinoschisis

    Directory of Open Access Journals (Sweden)

    Geraldine R. Slean

    2017-09-01

    Conclusions and importance: Chronic bullous retinoschisis can be associated with anterior segment neovascularization such as rubeosis iridis, presumably due to non-perfusion within the retinoschisis cavity.

  5. Recent progress of choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Li Miao

    2013-04-01

    Full Text Available Choroidal hemangioma(CHis a benign vascular tumor that occurred in the fundus posterior pole. Although it is a benign tumor, exudation from the lesion can lead to retinal detachment and other complications that make visual loss for patients. CH can occur as a circumscribed choroidal hemangioma(CCH, generally without systemic associations, or as a diffuse choroidal hemangioma(DCHthat is often associated variations of Sturge-weber syndrome(SWS. The management of CH has included laser photocoagulation, radiation therapy, transpupillary thermotherapy(TTT, photodynamic therapy(PDT. This article aims to introduce the current situation and the latest progress of the various therapies, to explore the most safe and effective method for the treatment of CH.

  6. Author Details

    African Journals Online (AJOL)

    Hassan, AO. Vol 12, No 1 (2004) - Articles Visual Outcome after Laser Photocoagulation for Stage 4 Proliferative Sickle Cell Retinopathy Abstract PDF · Vol 15, No 2 (2007) - Articles Transpupillary Thermotherapy for Classic Subfoveal Choroidal Neovascularization: A case report. Abstract PDF · Vol 15, No 2 (2007) - Articles

  7. Association of choroidal thickness with early stages of diabetic retinopathy in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Zhi-Jun Shen

    2017-04-01

    Full Text Available AIM: To assess the correlation between choroidal thickness (CT and the early stages of diabetic retinopathy (DR in type 2 diabetic patients. METHODS: We divided 83 diabetic patients (51-80 years of age; 50 females into non diabetic retinopathy group (NDR and mild/moderate nonproliferative diabetic retinopathy (NPDR group, and compared them with 26 non-diabetic control subjects (51-78 years of age; 16 females. Subfoveal choroidal thickness (SFCT and parafoveal choroidal thickness (PFCT were measured using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT. Ocular health status, disease duration, body mass index, and hemoglobin A1c (HbA1c were recorded. RESULTS: The mean ages of the NDR, NPDR, and control groups were 68.0±6.9y, 67.8±6.4y, and 65.1±6.3y, respectively (P=0.17. Pearson correlation of the right and left eyes for the control subjects was 0.95 and for the NDR subjects was 0.93. SFCT for the right eyes of the controls was 252.77± 41.10 μm, which was significantly thicker than that of the right eyes in NDR group (221.51±46.56 μm and the worse eyes of the NPDR group (207.18±61.87 μm; ANOVA, P<0.01. In the diabetic patients pooled together, age was the only variable significantly associated with SFCT (multiple linear regression analysis, P=0.01. CONCLUSION: CT decreased significantly in the NDR and mild/moderate NPDR eyes compared with the control eyes. Age is significantly associated with SFCT in the diabetic patients. Diabetic choroidopathy may be present before clinical retinopathy.

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

    Directory of Open Access Journals (Sweden)

    Nikolaus Feucht

    2008-06-01

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

  9. Gene therapy with recombinant adeno-associated vectors for neovascular age-related macular degeneration: 1 year follow-up of a phase 1 randomised clinical trial.

    Science.gov (United States)

    Rakoczy, Elizabeth P; Lai, Chooi-May; Magno, Aaron L; Wikstrom, Matthew E; French, Martyn A; Pierce, Cora M; Schwartz, Steven D; Blumenkranz, Mark S; Chalberg, Thomas W; Degli-Esposti, Mariapia A; Constable, Ian J

    2015-12-12

    Neovascular, or wet, age-related macular degeneration causes central vision loss and represents a major health problem in elderly people, and is currently treated with frequent intraocular injections of anti-VEGF protein. Gene therapy might enable long-term anti-VEGF therapy from a single treatment. We tested the safety of rAAV.sFLT-1 in treatment of wet age-related macular degeneration with a single subretinal injection. In this single-centre, phase 1, randomised controlled trial, we enrolled patients with wet age-related macular degeneration at the Lions Eye Institute and the Sir Charles Gairdner Hospital (Nedlands, WA, Australia). Eligible patients had to be aged 65 years or older, have age-related macular degeneration secondary to active subfoveal choroidal neovascularisation, with best corrected visual acuity (BCVA) of 3/60-6/24 and 6/60 or better in the other eye. Patients were randomly assigned (3:1) to receive either 1 × 10(10) vector genomes (vg; low-dose rAAV.sFLT-1 group) or 1 × 10(11) vg (high-dose rAAV.sFLT-1 group), or no gene-therapy treatment (control group). Randomisation was done by sequential group assignment. All patients and investigators were unmasked. Staff doing the assessments were masked to the study group at study visits. All patients received ranibizumab at baseline and week 4, and rescue treatment during follow-up based on prespecified criteria including BCVA measured on the Early Treatment Diabetic Retinopathy Study (EDTRS) scale, optical coherence tomography, and fluorescein angiography. The primary endpoint was ocular and systemic safety. This trial is registered with ClinicalTrials.gov, number NCT01494805. From Dec 16, 2011, to April 5, 2012, we enrolled nine patients of whom eight were randomly assigned to receive either intervention (three patients in the low-dose rAAV.sFLT-1 group and three patients in the high-dose rAAV.sFLT-1 group) or no treatment (two patients in the control group). Subretinal injection of r

  10. Inhibition of Corneal Neovascularization by Hydrazinocurcumin ...

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of VEGF polymer 2 mm from the limbus.

  11. Inhibition of Corneal Neovascularization by Hydrazinocurcumin

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor. (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of. VEGF polymer 2 mm from the limbus.

  12. Oral Doxycycline Reduces the Total Number of Intraocular Bevacizumab Injections Needed to Control Neovascular Age-related Macular Degeneration.

    Science.gov (United States)

    Mirshahi, Ahmad; Azimi, Pourya; Abdolahi, Ali; Mirshahi, Romina; Abdollahian, Mahnaz

    2017-01-01

    Tetracyclines, especially doxycycline, play a role in the regulation of inflammation, immunomodulation, cell proliferation, and angiogenesis. Treatment of corneal angiogenesis or choroidal neovascularization with tetracyclines has been shown to be effective in animal models. The aim of this study was to evaluate the efficacy of oral doxycycline in reducing the total number of intraocular injections needed for controlling neovascular age-related macular degeneration in human patients. In this interventional case series, 28 random consecutive patients with neovascular age-related macular degeneration from Farabi Eye Hospital, Tehran, Iran were treated for 4 months with 200 mg doxycycline once a day after the first intravitreal bevacizumab injection in addition to standard therapy in agreement with as-needed regimen. After 12 months of follow-up, total number of injections, foveal thickness and visual acuity were compared to those at baseline and of similar studies. Similar to standard treatment, co-treatment with doxycycline was able to control active disease (intraretinal or subretinal fluid or leakage, new-onset of macular hemorrhage, and reduction of visual acuity more than 5 letters based on Early Treatment Diabetic Retinopathy Study [ETDRS] charts) yet with fewer injections (for current study and standard treatment, respectively 3.14 vs. 5.92, P 0.05). If confirmed in larger studies, the findings of this interventional case series could provide a strategy to control neovascular age-related macular degeneration with fewer intraocular bevacizumab injections by co-administering a well-known oral agent-doxycycline.

  13. MALIGNANT TRANSFORMATION OF A CHOROIDAL NEVUS IN AN EYE TREATED FOR CHOROIDAL MELANOMA.

    Science.gov (United States)

    Fabian, Ido D; Arora, Amit K; Cohen, Victoria M L

    2017-01-01

    To report a case of a choroidal melanoma and a discrete choroidal nevus that has transformed into a malignant melanoma 5 years after initial diagnosis. Retrospective case report. A diffuse macular choroidal melanoma and a discrete choroidal nevus located superonasal to the optic disk were diagnosed in the right eye of a 63-year-old woman in 2009. The patient was treated by ruthenium plaque radiotherapy for the choroidal melanoma, which consequently flattened and scarred. On a routine eye check in 2014, the nevus was found to have been transformed into a choroidal melanoma. It was treated with ruthenium plaque radiotherapy. Although extremely rare, patients with a uveal melanoma can develop an additional discrete uveal melanoma. This case highlights the importance of monitoring benign choroidal nevi in patients with a history of choroidal melanoma.

  14. BILATERAL CHOROIDAL EXCAVATION IN JUVENILE LOCALIZED SCLERODERMA.

    Science.gov (United States)

    Franklin, Mackenzie L; Day, Shelley

    2018-01-01

    To describe a case of bilateral choroidal excavation in a patient with juvenile localized scleroderma. Case report. An asymptomatic 12-year-old boy with localized scleroderma presented for examination and was found to have bilateral areas of choroidal excavation temporal to the fovea. Previous reports of ocular complications of localized scleroderma have primarily described adnexal and anterior segment changes. This is the second report of choroidal changes in a patient with localized scleroderma, and the first in a pediatric patient.

  15. [Transpupillary thermotherapy of choroidal melanomas].

    Science.gov (United States)

    Forte, R; Cennamo, G

    2008-03-01

    To evaluate the effectiveness of transpupillary thermotherapy (TTT) as a single treatment of choroidal melanomas. We studied a series of 50 cases of choroidal melanoma treated with TTT and evaluated them with standardized A-scan and B-scan echography before and after treatment (1 week, 1, 3, and 6 months after treatment, then every 6 months). There were 22 males and 28 females with a mean age of 57 years (range, 22-78). The mean thickness of the lesion was 2.7 +/- 0.6 mm (range, 1.63-3.72). The mean follow-up was 38 months (range, 21-41). In almost all the eyes treated with TTT, substantial regression of tumoral microcirculation was observed after 1 week associated with a 70%-80% reduction in tumor thickness after 6 months (stabilized during follow-up). In one case of juxtapapillary melanoma with a thickness of 3.72 mm, another TTT application was necessary for local relapse. Visual acuity (VA) decreased to 20/30 in two cases (4%) and to 20/200 in four cases (8%) after the development of a cystoid macular edema. These latter patients were treated with two intravitreal injections (range, 1-3) of triamcinolone acetonide, and after a follow-up of 25 months (range, 21-29) VA improved to 20/20 in the first two cases, while two of the four other cases improved to 20/40 and two to 20/30. Transpupillary thermotherapy has visual results similar to those obtained with irradiation for the treatment of choroidal melanomas. Nevertheless, considering the high rate of recurrence at 5 and 10 years after transpupillary thermotherapy alone, most authors think that transpupillary thermotherapy is useful when associated irradiation for the treatment of choroidal melanomas, but its precise indications need to be defined.

  16. Unusual Orange-Colored Choroidal Metastases

    Directory of Open Access Journals (Sweden)

    Hatem Krema

    2013-01-01

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

  17. Clinical applications of choroidal imaging technologies

    Directory of Open Access Journals (Sweden)

    Jay Chhablani

    2015-01-01

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

  18. CHOROIDAL SARCOID GRANULOMA SIMULATING PROSTATE CARCINOMA METASTASIS.

    Science.gov (United States)

    Turkoglu, Elif B; Lally, Sara E; Shields, Carol L

    2017-01-01

    To report a case of choroidal sarcoid granuloma simulating choroidal metastasis in a patient with prostate carcinoma. Case report. A 66-year-old man was found to have an asymptomatic choroidal mass in his left eye. He had known history of pulmonary sarcoidosis without systemic involvement and prostate carcinoma without metastasis. On examination, visual acuity was 20/20 in each eye. Anterior segment was normal, without inflammatory sign in either eye. The right fundus was healthy. The left fundus revealed a yellow choroidal mass of 2 mm diameter, temporal to the foveola and without subretinal fluid, retinitis, or vitritis. Optical coherence tomography demonstrated a homogenous hyporeflective choroidal mass with intact retinal pigment epithelium and compression of choroidal vascular structures. Given the medical history and rarity of prostate metastasis to the uvea, choroidal sarcoid granuloma was considered and oral prednisone with a slow taper was given. After 2 months of therapy, tumor resolution with reduction in size was confirmed on optical coherence tomography. Choroidal sarcoid granuloma is a rare condition that can simulate choroidal metastasis. Treatment with prednisone can assist in establishing the diagnosis.

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

    Directory of Open Access Journals (Sweden)

    Shih Hao Wang

    2017-01-01

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

  20. Short-term effects of intravitreal dexamethasone implant (OZURDEX® on choroidal thickness in patients with naive branch retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Hasan Basri Arifoglu

    Full Text Available ABSTRACT Purpose: The objective of this study was to evaluate subfoveal choroidal thickness (SFCT using enhanced depth imaging optical coherence tomography (EDI-OCT in patients with naïve branch retinal vein occlusion (BRVO before and after intravitreal dexamethasone implant (Ozurdex® injection. Methods: Thirty-nine patients with unilateral BRVO and 35 healthy subjects were included in this prospective study. Choroidal thickness was evaluated by EDI-OCT at baseline and 1 month after dexamethasone implant. Results: The mean SFCT measured in 39 patients with BRVO was 299.41 ± 55.86 µm, significantly greater than that in contralateral eyes (283.76 ± 57.44 µm; p=0.009 and control eyes (276.14 ± 39.06 µm; p=0.044. The mean SFCT after the treatment was 279.64 ± 50.96 µm, significantly thinner than that before intravitreal dexamethasone therapy (p=0.004. Conclusions: SFCT in treatment-naive BRVO eyes was significantly greater than that in contralateral eyes and healthy eyes and decreased significantly after intravitreal dexamethasone implantation.

  1. Time-Course of Changes in Choroidal Thickness after Complete Mydriasis Induced by Compound Tropicamide in Children.

    Science.gov (United States)

    Li, Zhouyue; Zeng, Junwen; Jin, Wei; Long, Wen; Lan, Weizhong; Yang, Xiao

    2016-01-01

    The aim of this study was to investigate the time-course of changes in choroidal thickness (ChT) following complete mydriasis induced by compound tropicamide. ChT was measured by OCT with the enhanced-depth imaging technique (Spectralis HRA+OCT, Heidelberg Engineering, Germany) at nine locations of the fundus: subfoveal ChT (SFChT) and ChT at 1 mm and 3 mm from the fovea in four quadrants. Mydriasis was induced with compound tropicamide (0.5% tropicamide plus 0.5% phenylephrine hydrochloride, three doses at 5-minute intervals). Measurements were conducted prior to the instillation and at 0, 30, and 60 min following complete mydriasis. Results at different time-points were compared using repeated-measures ANOVA to investigate the time-course of the changes. Thirty-nine subjects (mean age 11.9±2 years; 16 males and 23 females) were enrolled in the study. Compound tropicamide resulted in a statistically significant decrease in SFChT at 0, 30, and 60 min after complete mydriasis, as compared to baseline (-5±4 μm, -12±4 μm, and -13±4 μm, respectively; all Ptropicamide led to choroidal thinning, and the magnitude varied over time.

  2. Neural control of choroidal blood flow.

    Science.gov (United States)

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

    2017-12-08

    The choroid is richly innervated by parasympathetic, sympathetic and trigeminal sensory nerve fibers that regulate choroidal blood flow in birds and mammals, and presumably other vertebrate classes as well. The parasympathetic innervation has been shown to vasodilate and increase choroidal blood flow, the sympathetic input has been shown to vasoconstrict and decrease choroidal blood flow, and the sensory input has been shown to both convey pain and thermal information centrally and act locally to vasodilate and increase choroidal blood flow. As the choroid lies behind the retina and cannot respond readily to retinal metabolic signals, its innervation is important for adjustments in flow required by either retinal activity, by fluctuations in the systemic blood pressure driving choroidal perfusion, and possibly by retinal temperature. The former two appear to be mediated by the sympathetic and parasympathetic nervous systems, via central circuits responsive to retinal activity and systemic blood pressure, but adjustments for ocular perfusion pressure also appear to be influenced by local autoregulatory myogenic mechanisms. Adaptive choroidal responses to temperature may be mediated by trigeminal sensory fibers. Impairments in the neural control of choroidal blood flow occur with aging, and various ocular or systemic diseases such as glaucoma, age-related macular degeneration (AMD), hypertension, and diabetes, and may contribute to retinal pathology and dysfunction in these conditions, or in the case of AMD be a precondition. The present manuscript reviews findings in birds and mammals that contribute to the above-summarized understanding of the roles of the autonomic and sensory innervation of the choroid in controlling choroidal blood flow, and in the importance of such regulation for maintaining retinal health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Transport across the choroid plexus epithelium.

    Science.gov (United States)

    Praetorius, Jeppe; Damkier, Helle Hasager

    2017-06-01

    The choroid plexus epithelium is a secretory epithelium par excellence. However, this is perhaps not the most prominent reason for the massive interest in this modest-sized tissue residing inside the brain ventricles. Most likely, the dominant reason for extensive studies of the choroid plexus is the identification of this epithelium as the source of the majority of intraventricular cerebrospinal fluid. This finding has direct relevance for studies of diseases and conditions with deranged central fluid volume or ionic balance. While the concept is supported by the vast majority of the literature, the implication of the choroid plexus in secretion of the cerebrospinal fluid was recently challenged once again. Three newer and promising areas of current choroid plexus-related investigations are as follows: 1) the choroid plexus epithelium as the source of mediators necessary for central nervous system development, 2) the choroid plexus as a route for microorganisms and immune cells into the central nervous system, and 3) the choroid plexus as a potential route for drug delivery into the central nervous system, bypassing the blood-brain barrier. Thus, the purpose of this review is to highlight current active areas of research in the choroid plexus physiology and a few matters of continuous controversy. Copyright © 2017 the American Physiological Society.

  4. Decalcified choroidal osteoma found in the retina

    Directory of Open Access Journals (Sweden)

    Yoshikawa T

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Mário Junqueira Nóbrega

    2005-10-01

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

  6. AAV2 Delivery of Flt23k Intraceptors Inhibits Murine Choroidal Neovascularization

    OpenAIRE

    Zhang, Xiaohui; Das, Subrata K.; Passi, Samuel F.; Uehara, Hironori; Bohner, Austin; Chen, Marcus; Tiem, Michelle; Archer, Bonnie; Ambati, Balamurali K

    2014-01-01

    Long-term inhibition of extracellular vascular endothelial growth factor (VEGF) in the treatment of age-related macular degeneration (AMD) may induce retinal neuronal toxicity and risk other side effects. We developed a novel strategy which inhibits retinal pigment epithelium (RPE)-derived VEGF, sparing other highly sensitive retinal tissues. Flt23k, an intraceptor inhibitor of VEGF, was able to inhibit VEGF in vitro. Adeno-associated virus type 2 (AAV2)–mediated expression of Flt23k was main...

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

    National Research Council Canada - National Science Library

    Qi, Jian Hua; Ebrahem, Quteba; Ali, Mariya; Cutler, Alecia; Bell, Brent; Prayson, Nicholas; Sears, Jonathan; Knauper, Vera; Murphy, Gillian; Anand-Apte, Bela

    2013-01-01

    .... To identify and characterize the anti-angiogenic domain of TIMP-3, structure function analyses and synthetic peptide studies were performed using VEGF-mediated receptor binding, signaling, migration and proliferation...

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

    Directory of Open Access Journals (Sweden)

    Guang-Hui Liu

    2015-06-01

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

  9. Clinical features, management and visual outcome of polypoidal choroidal vasculopathy in Indian patients

    Directory of Open Access Journals (Sweden)

    Anantharaman Giridhar

    2010-01-01

    Full Text Available Aims: To present the clinical, indocyanine green angiography (ICGA features and results of treatment for polypoidal choroidal vasculopathy (PCV in Indian patients by a retrospective chart review.Materials and Methods: Forty five patients with PCV underwent complete ocular examination, fluorescein angiography (FFA and ICGA. Treatment was advised for patients with macular involvement and progressive loss of visual acuity. Demographic data, clinical features and results of treatment were analyzed.Results: Mean age at presentation was 61.06 years. Mean follow up was 18 months. The disease was more prevalent in males. Forty three patients had unilateral disease. The most common location of polyps in ICGA was subfoveal (42.5%. Exudative form was seen in 34 of the 47 eyes and the remaining 13 eyes had a hemorrhagic presentation. Thirty four eyes underwent treatment which included thermal laser (n = 11, photodynamic therapy (PDT (n = 11 and transpupillary thermo therapy (TTT (n = 12. Statistical analysis was done using the Chi-square test. Subgroup analysis of visual outcome following various modalities of treatment showed that the results of PDT (P < 0.001 and thermal laser (P < 0.001 were statistically significant. Conclusions: PCV is an important differential diagnosis in patients presenting with serosanginous maculopathy and submacular hemorrhage. The disease was more prevalent in males and was unilateral in the Indian population. Timely intervention in cases with symptomatic polyps could achieve stabilization of visual acuity. Thermal laser and PDT were safe and effective.

  10. Choroidal changes in pre-eclampsia during pregnancy and the postpartum period: comparison with healthy pregnancy

    Directory of Open Access Journals (Sweden)

    Necati Duru

    2016-06-01

    Full Text Available ABSTRACT Purpose: To investigate subfoveal choroidal thickness (SFCT in patients with pre-eclampsia using enhanced depth imaging optical coherence tomography (EDI-OCT. Methods: A sample of 73 pregnant women was studied over 28 weeks of gestation. The sample was divided into two groups: one comprising pre-eclamptic pregnant women (n=32, and the other comprising healthy pregnant women (n=41. The SFCT was determined for all patients using EDI-OCT during pregnancy and at the third month of the postpartum period. Results: The SFCTs in pre-eclamptic pregnant women were 351.97 ± 22.44 and 332.28 ± 20.32 µm during the pregnancy and postpartum periods (p<0.001, respectively, whereas these values in healthy pregnant women were 389.73 ± 49.64 and 329.78 ± 22.36 µm (p<0.001, respectively. During pregnancy SFCT in pre-eclamptic pregnant women was significantly thinner than that in healthy pregnant women (p<0.001. However, there was no statistically significant difference during the postpartum period (p=0.623. Conclusions: The results suggest that SFCT is significantly decreased in pre-eclamptic pregnant women than in healthy pregnant women, despite no statistically significant difference in SFCT existing between the groups during the postpartum period.

  11. The effect of single dose of brimonidine-purite 0.15% on choroidal thickness in healthy volunteers

    Directory of Open Access Journals (Sweden)

    Suleyman Demircan

    2017-11-01

    Full Text Available AIM: To evaluate the potential posterior segment effects of topical application of brimonidine-purite 0.15% through measurement of choroidal thickness(CTin healthy eyes using enhanced depth imaging spectral-domain optical coherence tomography(EDI-SD-OCT.METHODS: Thirty-two eyes of 32 healthy subjects were included in this prospective, placebo-controlled interventional clinical trial. They received one drop of topical preservative-free artificial tears as placebo for the first day and one drop of brimonidine-purite 0.15% for the second day. Intraocular pressure, ocular perfusion pressure(OPP, and EDI-SD-OCT were performed at baseline, at 1, 3 and 5h after the treatments.RESULTS: Compared to the measurements obtained at baseline, the CT measurements obtained after the topical application of brimonidine-purite 0.15% significantly increased at the sub-fovea(P=0.001, at temporal 1500 μm to the fovea(P=0.003and at nasal 1500 μm to the fovea(P=0.003. Choroidal thickness was unchanged in placebo group during the study(P >0.05. There was no significant reduction in the OPP in both groups(P >0.05. There were no adverse events during the study.CONCLUSIONS: Contrary to expectations, topical administration of brimonidine-purite 0.15% resulted with thickening of sub-foveal, temporal and nasal CT. This might be related to altered auto-regulation mechanisms in choroidal vessels.

  12. A simplified method to measure choroidal thickness using adaptive compensation in enhanced depth imaging optical coherence tomography.

    Directory of Open Access Journals (Sweden)

    Preeti Gupta

    Full Text Available PURPOSE: To evaluate a simplified method to measure choroidal thickness (CT using commercially available enhanced depth imaging (EDI spectral domain optical coherence tomography (SD-OCT. METHODS: We measured CT in 31 subjects without ocular diseases using Spectralis EDI SD-OCT. The choroid-scleral interface of the acquired images was first enhanced using a post-processing compensation algorithm. The enhanced images were then analysed using Photoshop. Two graders independently graded the images to assess inter-grader reliability. One grader re-graded the images after 2 weeks to determine intra-grader reliability. Statistical analysis was performed using intra-class correlation coefficient (ICC and Bland-Altman plot analyses. RESULTS: Using adaptive compensation both the intra-grader reliability (ICC: 0.95 to 0.97 and inter-grader reliability (ICC: 0.93 to 0.97 were perfect for all five locations of CT. However, with the conventional technique of manual CT measurements using built-in callipers provided with the Heidelberg explorer software, the intra- (ICC: 0.87 to 0.94 and inter-grader reliability (ICC: 0.90 to 0.93 for all the measured locations is lower. Using adaptive compensation, the mean differences (95% limits of agreement for intra- and inter-grader sub-foveal CT measurements were -1.3 (-3.33 to 30.8 µm and -1.2 (-36.6 to 34.2 µm, respectively. CONCLUSIONS: The measurement of CT obtained from EDI SD-OCT using our simplified method was highly reliable and efficient. Our method is an easy and practical approach to improve the quality of choroidal images and the precision of CT measurement.

  13. Human tears reveal insights into corneal neovascularization.

    Science.gov (United States)

    Zakaria, Nadia; Van Grasdorff, Sigi; Wouters, Kristien; Rozema, Jos; Koppen, Carina; Lion, Eva; Cools, Nathalie; Berneman, Zwi; Tassignon, Marie-José

    2012-01-01

    Corneal neovascularization results from the encroachment of blood vessels from the surrounding conjunctiva onto the normally avascular cornea. The aim of this study is to identify factors in human tears that are involved in development and/or maintenance of corneal neovascularization in humans. This could allow development of diagnostic tools for monitoring corneal neovascularization and combination monoclonal antibody therapies for its treatment. In an observational case-control study we enrolled a total of 12 patients with corneal neovascularization and 10 healthy volunteers. Basal tears along with reflex tears from the inferior fornix, superior fornix and using a corneal bath were collected along with blood serum samples. From all patients, ocular surface photographs were taken. Concentrations of the pro-angiogenic cytokines interleukin (IL)-6, IL-8, Vascular Endothelial Growth Factor (VEGF), Monocyte Chemoattractant Protein 1 (MCP-1) and Fas Ligand (FasL) were determined in blood and tear samples using a flow cytometric multiplex assay. Our results show that the concentration of pro-angiogenic cytokines in human tears are significantly higher compared to their concentrations in serum, with highest levels found in basal tears. Interestingly, we could detect a significantly higher concentration of IL- 6, IL-8 and VEGF in localized corneal tears of patients with neovascularized corneas when compared to the control group. This is the first study of its kind demonstrating a significant difference of defined factors in tears from patients with neovascularized corneas as compared to healthy controls. These results provide the basis for future research using animal models to further substantiate the role of these cytokines in the establishment and maintenance of corneal neovascularization.

  14. THE SPECTRUM OF AMALRIC TRIANGULAR CHOROIDAL INFARCTION.

    Science.gov (United States)

    Nemiroff, Julia; Phasukkijwatana, Nopasak; Vaclavik, Veronika; Nagiel, Aaron; Holz, Eric R; Sarraf, David

    2017-01-01

    To describe the multimodal imaging findings, including optical coherence tomography angiography analysis, and spectrum of etiologies associated with Amalric triangular choroidal infarction. This study is a multicenter, retrospective, observational case series review of the clinical and multimodal imaging findings for six patients with Amalric triangular choroidal infarction. Six patients (10 eyes) with Amalric triangular choroidal infarction were enrolled. Patients' ages ranged from 7 years to 90 years (mean 54 years, median 60 years). Wedge-shaped or triangular areas of choroidal ischemia were evident with fluorescein angiography in all patients and with indocyanine green angiography in one patient. Optical coherence tomography angiography demonstrated choriocapillaris flow reduction that colocalized with outer retinal structural abnormalities with en face optical coherence tomography and corresponded with the triangular zones of choroidal infarction identified with fluorescein angiography in one patient. Etiologies included giant cell arteritis in three cases: traumatic carotid dissection, traumatic retrobulbar hemorrhage, and malignant hypertension secondary to lupus-associated nephropathy. The Amalric triangular syndrome of choroidal infarction can occur as a result of a spectrum of etiologies, especially giant cell arteritis. Infarction is evident on traditional angiography in all cases. Optical coherence tomography angiography may provide a simple noninvasive tool to evaluate choroidal ischemia.

  15. AMG 386, a selective angiopoietin 1/2-neutralizing peptibody, inhibits angiogenesis in models of ocular neovascular diseases.

    Science.gov (United States)

    Oliner, Jonathan D; Bready, James; Nguyen, Linh; Estrada, Juan; Hurh, Eunju; Ma, Hongjin; Pretorius, James; Fanslow, William; Nork, T Michael; Leedle, Robert A; Kaufman, Stephen; Coxon, Angela

    2012-04-24

    To determine whether systemic treatment with AMG 386, a selective angiopoietin 1/2-neutralizing peptibody, inhibits neovascular processes in animal models of ocular disease. AMG 386 was tested in a laser-induced choroidal neovascularization (CNV) model in monkeys using fluorescein angiography. The biodistribution of (125)I-AMG 386 was determined in cynomolgus monkeys by whole-body autoradiography and radioanalysis of ocular tissues. A murine retinopathy of prematurity (ROP) model was used to examine the effect of AMG 386 on established and newly formed retinal vessels, either as a single agent or when combined with VEGF inhibition.AMG 386 pharmacokinetics were evaluated in each model. In the CNV model, AMG 386 significantly decreased fluorescent angiographic leakage and reduced fibroplasia, indicating an impaired healing response consistent with angiogenesis blockade. Radiolabeled AMG 386 was widely distributed across ocular tissues, with highest concentrations in the choroid, cornea, retinal pigmented epithelium, iris/ciliary body, and sclera. In the ROP model, AMG 386 prevented pathologic retinal angiogenesis when administered from P8 to P16 but transiently impeded regression of these abnormal vessels when administered from P17 to P23. Combining AMG 386 with VEGF inhibition led to cooperative prevention of retinal angiogenesis in this model. No AMG 386-related ocular toxicities occurred, and no treatment-related clinical observations were made in any of the studies. In this study, AMG 386 inhibited angiogenesis in animal models of CNV and ROP, supporting investigation of AMG 386 for the treatment of ocular neovascular diseases in the clinical setting.

  16. Neovascularization of the iris in retinoschisis.

    Science.gov (United States)

    Slean, Geraldine R; Fu, Arthur D; Chen, Judy; Kalevar, Ananda

    2017-09-01

    To report the association of rubeosis iridis with chronic bullous degenerative peripheral retinoschisis. A 63-year-old female presented with acute hyphema and neovascularization of the iris in association with elevated intraocular pressure. Posterior segment examination including imaging revealed no vascular occlusion as a potential cause. However, large, peripheral bullous retinoschisis was noted in the right eye. No nonperfusion aside from that seen within the schism detachment, or neovascularization of the retina on wide-field fundus photography or fluorescein angiography was noted. Bullous retinoschisis was also found in the left eye. The patient was treated conservatively with prednisolone acetate and timolol eye drops. Chronic bullous retinoschisis can be associated with anterior segment neovascularization such as rubeosis iridis, presumably due to non-perfusion within the retinoschisis cavity.

  17. Radiation therapy for metastatic choroidal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Ochiai, Yuko; Sunakawa, Mitsuko (National Kyoto Hospital (Japan)); Hiraoka, Masahiro

    1992-03-01

    We treated 3 eyes in 2 cases of metastatic choroidal malignancy by applying x-ray angled 5deg from a linear accelerator. One case was a 35-year-old female with breast cancer metastasized in both choroids. The second was a 59-year-old male with choroidal metastasis in one eye from malignant lymphoma of the cerebellum. Immediate regression of the tumor followed in all the eyes with resolution of secondary retinal detachment. The treatment was free of complications including cataract or corneal erosion. (author).

  18. Heritability of Choroidal Thickness in the Amish.

    Science.gov (United States)

    Sardell, Rebecca J; Nittala, Muneeswar G; Adams, Larry D; Laux, Reneé A; Cooke Bailey, Jessica N; Fuzzell, Denise; Fuzzell, Sarada; Reinhart-Mercer, Lori; Caywood, Laura J; Horst, Violet; Mackay, Tine; Dana, Debbie; Sadda, SriniVas R; Scott, William K; Stambolian, Dwight; Haines, Jonathan L; Pericak-Vance, Margaret A

    2016-12-01

    To evaluate the heritability of choroidal thickness and its relationship to age-related macular degeneration (AMD). Cohort study. Six hundred eighty-nine individuals from Amish families with early or intermediate AMD. Ocular coherence tomography was used to quantify choroidal thickness, and fundus photography was used to classify eyes into categories using a modified Clinical Age-Related Maculopathy Staging (CARMS) system. Repeatability and heritability of choroidal thickness and its phenotypic and genetic correlations with the AMD phenotype (CARMS category) were estimated using a generalized linear mixed model (GLMM) approach that accounted for relatedness, repeated measures (left and right eyes), and the effects of age, gender, and refraction. Heritability of choroidal thickness and its phenotypic and genetic correlation with the AMD phenotype (CARMS category). Phenotypic correlation between choroidal thickness and CARMS category was moderate (Spearman's rank correlation, rs = -0.24; n = 1313 eyes) and significant (GLMM posterior mean, -4.27; 95% credible interval [CI], -7.88 to -0.79; P = 0.02) after controlling for relatedness, age, gender, and refraction. Eyes with advanced AMD had thinner choroids than eyes without AMD (posterior mean, -73.8; 95% CI, -94.7 to -54.6; P < 0.001; n = 1178 eyes). Choroidal thickness was highly repeatable within individuals (repeatability, 0.78; 95% CI, 0.68 to 0.89) and moderately heritable (heritability, 0.40; 95% CI, 0.14 to 0.51), but did not show significant genetic correlation with CARMS category, although the effect size was moderate (genetic correlation, -0.18; 95% CI, -0.49 to 0.16). Choroidal thickness also varied with age, gender, and refraction. The CARMS category showed moderate heritability (heritability, 0.49; 95% CI, 0.26 to 0.72). We quantify the heritability of choroidal thickness for the first time, highlighting a heritable, quantitative trait that is measurable in all individuals regardless of AMD

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

    Directory of Open Access Journals (Sweden)

    Agarwal A

    2015-06-01

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

  20. Aqueous vascular endothelial growth factor and clinical outcomes correlation after single intravitreal injection of bevacizumab in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Cabral, Thiago; Lima, Luiz H; Polido, Júlia; Duong, Jimmy; Okuda, Érika; Oshima, Akiyoshi; Serracarbassa, Pedro; Regatieri, Caio V; Belfort, Rubens

    2017-01-01

    To evaluate the concentration of vascular endothelial growth factor (VEGF) in aqueous humor after a single intravitreal injection of bevacizumab (IVB) in eyes with neovascular age-related macular degeneration (AMD). In this prospective interventional case series study, 24 eyes of 24 patients with types 1 and 2 choroidal neovascularization secondary to neovascular AMD were treated with a single intravitreal injection of bevacizumab. Aqueous humor samples were obtained before the intravitreal injection and at one week, one month, and three months follow-up periods. Best-corrected visual acuity (BCVA) and three spectral-domain optical coherence tomography parameters (central retinal thickness, macular volume and macular area) were also analyzed and correlated with VEGF expression at the baseline and each follow-up period. All of the ninety-six aqueous humor study taps were well tolerated by the study patients without adverse events. Increased VEGF levels (mean ± SD = 179.7 ± 88.3 pg/mL) were observed in the aqueous humor of all study patients before the intravitreal injection of bevacizumab. At all follow-up periods, compared to baseline, levels of VEGF significantly reduced (P  0.005), CRT, MV and MA also reduced in comparison to baseline. Single intravitreal bevacizumab injection in eyes with neovascular AMD resulted in a substantial decrease of aqueous VEGF levels 1 week after treatment with the greatest improvement of clinical outcomes occurring at 1 month follow-up.

  1. Differential diagnosis of choroidal melanomas and nervi using scanning laser ophthalmoscopical indocyanine green angiography

    DEFF Research Database (Denmark)

    Andersen, Mads V. Nis; Scherfig, Erik; Prause, J.U.

    1995-01-01

    Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography......Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography...

  2. Outcome of Diode Laser Cyclophotocoagulation in Neovascular ...

    African Journals Online (AJOL)

    Aim: To find out the short-term outcome of ciliary ablation with diode laser contact cyclophotocoagulation in Nigerians with neovascular glaucoma. Methods: The study is a retrospective, non-comparative, interventional case series. Demographic data, ocular and systemic history were obtained. Clinical examination included ...

  3. Inhibition of Corneal Neovascularization by Hydrazinocurcumin

    African Journals Online (AJOL)

    This article previously published in Volume 15 Issue 2 of this journal in February 2016 has been retracted in line with the guidelines from the Committee on Publication Ethics (COPE, http://publicationethics.org/resources/guidelines). Retracted: Zhan W, Zhu J, Zhang Y. Inhibition of corneal neovascularization by ...

  4. Retracted: Inhibition of Corneal Neovascularization by ...

    African Journals Online (AJOL)

    This article previously published in Volume 15 Issue 2 of this journal in February 2016 has been retracted in line with the guidelines from the Committee on Publication Ethics (COPE, http://publicationethics.org/resources/guidelines). Retracted: Zhan W, Zhu J, Zhang Y. Inhibition of corneal neovascularization by ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-01

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

  6. Surgical implantation of steroids with antiangiogenic characteristics for treating neovascular age-related macular degeneration.

    Science.gov (United States)

    Geltzer, Arthur; Turalba, Angela; Vedula, Satyanarayana S

    2013-01-31

    Neovascular age-related macular degeneration (AMD) is associated with rapid vision loss due to choroidal neovascularization (CNV), leakage, and scarring. Steroids have gained attention in their role for the treatment of neovascular AMD for their antiangiogenic and anti-inflammatory properties. This review aims to examine effects of steroids with antiangiogenic properties in the treatment of neovascular AMD. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2012), 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 21 November 2012. We included randomized controlled clinical trials of intra- and peri-ocular antiangiogenic steroids in people diagnosed with neovascular AMD. Two authors independently screened abstracts and full-text articles, assessed risk of bias in the included trials, and extracted data. We did not conduct a meta-analysis. We included three trials after screening a total of 1503 abstracts and 21 full-text articles. The three trials included a total of 809 participants. One trial compared different doses of acetonide anecortave acetate with placebo, a second trial compared triamcinolone acetonide versus placebo, and the third trial compared anecortave acetate against photodynamic therapy (PDT). We did not conduct a meta-analysis owing to heterogeneity of interventions and comparisons. The risk ratio for loss of 3

  7. Deoxycytidine transport and metabolism in choroid plexus

    Energy Technology Data Exchange (ETDEWEB)

    Spector, R.; Huntoon, S.

    1983-05-01

    In vitro, the transport into and release of (/sup 3/H)deoxycytidine from the isolated choroid plexus, the anatomical locus of the blood-cerebrospinal fluid barrier, were studied separately. By use of the ability of nitrobenzylthioinosine (NBTI) to inhibit deoxycytidine efflux from choroid plexus, the transport of 1 microM (/sup 3/H)deoxycytidine into choroid plexus at 37 degrees C was measured. Deoxycytidine was transported into choroid plexus against a concentration gradient by a saturable process that depended on intracellular energy production, but not intracellular binding or metabolism. The Michaelis-Menten constant (KT) for the active transport of deoxycytidine into choroid plexus was 15 microM. The active transport system for deoxycytidine was inhibited by naturally occurring nucleosides and deoxynucleosides, but not by 1 mM probenecid and 2-deoxyribose or 100 microM cytosine and cytosine arabinoside. With less than 1 microM (/sup 3/H)deoxycytidine in the medium, the choroid plexus accumulated (/sup 3/H)deoxycytidine against a concentration gradient. However, approximately 50% of the (/sup 3/H)deoxycytidine was phosphorylated to (/sup 3/H)deoxycytidine nucleotides at a low extracellular (/sup 3/H)deoxycytidine concentration (6 nM) in 15-min incubations. This accumulation process depended, in part, on saturable intracellular phosphorylation. These studies provide further evidence that the choroid plexus contains an active nucleoside transport system of low specificity for deoxynucleosides and ribonucleosides, and a separate, saturable efflux system for deoxynucleosides which is very sensitive to inhibition by NBTI.

  8. Stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma: the McGill University experience.

    Science.gov (United States)

    Al-Wassia, Rolina; Dal Pra, Alan; Shun, Kitty; Shaban, Ahmed; Corriveau, Christine; Edelstein, Chaim; Deschenes, Jean; Ruo, Russel; Patrocinio, Horacio; Cury, Fabio L B; DeBlois, François; Shenouda, George

    2011-11-15

    To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  10. Choroid Melanoma Metastasis to Spine: A Rare Case Report

    OpenAIRE

    Hiren Mandaliya; Nandini Singh; Sanila George; Mathew George

    2016-01-01

    Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been t...

  11. Subretinal lipid exudation associated with untreated choroidal melanoma

    Directory of Open Access Journals (Sweden)

    C K Minija

    2011-01-01

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

  12. Bilateral choroidal tumors consistent with metastatic malignant paraganglioma.

    Science.gov (United States)

    Aaberg, Thomas M; Benjamin, Erin P; Biscotti, Charles V; Singh, Arun D

    2013-01-01

    To report a patient with bilateral choroidal metastasis from a malignant paraganglioma. Clinicopathologic case report and literature review. A 68-year-old woman presented with bilateral amelanotic focal choroidal lesions. A thorough systemic work-up for a primary cancer revealed a paraganglioma (extraadrenal pheochromocytoma) and a pheochromocytoma of the left adrenal gland. Fine-needle aspiration biopsy of the choroidal lesion was consistent with metastatic paraganglioma. Metastatic paraganglioma, although rare, has the ability to metastasize to the choroid.

  13. [Disorders of choroidal circulation in diabetic maculopathy].

    Science.gov (United States)

    Takamine, Y

    1998-08-01

    Diabetic maculopathy is classified into 3 types, namely, macular edema, ischemic maculopathy, and pigment epitheliopathy. Blood-retinal barrier disturbance and the influence of the posterior vitreous membrane have been reported as the cause of diabetic maculopathy. However, its association with the choroidal circulation feeding the outer layer of the retina which involves the outer blood-retinal barrier has not been clarified yet. In this work, we studied the presence of the choroidal circulatory disturbance by performing indocyanine green angiography (IA) on patients with diabetic maculopathy. Choroidal circulatory disturbance was also differentiated from fluorescent block with a scanning laser ophthalmoscope (SLO). The proportion of hypofluorescence observed in IA was 4 eyes in 2 patients among 37 eyes in 24 patients (11%) in the macular edema group, 3 eyes in 2 patients among 14 eyes in 10 patients (21%) in the ischemic maculopathy group, and 26 eyes in 17 patients among 33 eyes in 22 patients (79%) in the pigment epitheliopathy group. Of the cases showing hypofluorescence in IA in the pigment epitheliopathy group, 4 eyes in 4 patients had hypofluorescence due to both choroidal circulatory disturbance and fluorescent block. This suggests that the choroidal circulation disturbance is partly involved in diabetic maculopathy mainly in the pigment epitheliopathy group.

  14. Functional and genetic analysis of choroid plexus development in zebrafish

    Science.gov (United States)

    Henson, Hannah E.; Parupalli, Chaithanyarani; Ju, Bensheng; Taylor, Michael R.

    2014-01-01

    The choroid plexus, an epithelial-based structure localized in the brain ventricle, is the major component of the blood-cerebrospinal fluid barrier. The choroid plexus produces the cerebrospinal fluid and regulates the components of the cerebrospinal fluid. Abnormal choroid plexus function is associated with neurodegenerative diseases, tumor formation in the choroid plexus epithelium, and hydrocephaly. In this study, we used zebrafish (Danio rerio) as a model system to understand the genetic components of choroid plexus development. We generated an enhancer trap line, Et(cp:EGFP)sj2, that expresses enhanced green fluorescent protein (EGFP) in the choroid plexus epithelium. Using immunohistochemistry and fluorescent tracers, we demonstrated that the zebrafish choroid plexus possesses brain barrier properties such as tight junctions and transporter activity. Thus, we have established zebrafish as a functionally relevant model to study choroid plexus development. Using an unbiased approach, we performed a forward genetic dissection of the choroid plexus to identify genes essential for its formation and function. Using Et(cp:EGFP)sj2, we isolated 10 recessive mutant lines with choroid plexus abnormalities, which were grouped into five classes based on GFP intensity, epithelial localization, and overall choroid plexus morphology. We also mapped the mutation for two mutant lines to chromosomes 4 and 21, respectively. The mutants generated in this study can be used to elucidate specific genes and signaling pathways essential for choroid plexus development, function, and/or maintenance and will provide important insights into how these genetic mutations contribute to disease. PMID:25426018

  15. Choroid plexus carcinoma in adults: an extremely rare case ...

    African Journals Online (AJOL)

    Choroid plexus tumors are rare intraventricular papillary neoplasms derived from choroid plexus epithelium, which account for approximately 2% to 4% of intracranial tumors in children and 0.5% in adults. Almost all choroid plexus carcinomas are seen in children and are extremely rare in adults. Headache, diplopia, and ...

  16. Comparison of choroidal thickness measurements between spectral-domain OCT and swept-source OCT in normal and diseased eyes

    Directory of Open Access Journals (Sweden)

    Zafar S

    2016-11-01

    Full Text Available Sidra Zafar,1 MA Rehman Siddiqui,2,3 Rida Shahzad1 1Medical College, Aga Khan University Hospital, 2Department of Ophthalmology, Shahzad Eye Hospital, 3South City Hospital, Karachi, Pakistan Purpose: Sub-foveal choroidal thickness (SFCT is affected in many ocular diseases. The aim of this study was to compare SFCT measurements between Topcon 3D 2000 spectral-domain optical coherence tomography (SD-OCT and Topcon swept-source OCT (SS-OCT, with different laser wavelengths, in normal and diseased populations. Materials and methods: This was a prospective, cross-sectional, noninterventional study including 27 normal volunteers and 27 participants with retinal disease. OCT scans were performed sequentially and under standardized conditions using both SD-OCT and SS-OCT. The OCT scans were evaluated by two independent graders. Paired t-tests and intraclass correlation coefficients (ICCs were used to assess the statistically significant difference between SFCT measurements as measured by the two devices. Results: Mean SFCT measurements for all 54 participants were 264.9±103.1 µm using SD-OCT (range: 47–470 µm and 278.5±110.5 µm using SS-OCT (range: 56–502 µm, with an inter-device ICC of 0.850. Greater variability was noted in the diseased eyes. Inter-device ICCs were 0.870 (95% CI; 0.760–0.924 and 0.840 (95% CI; 0.654–0.930 for normal and diseased eyes, respectively. However, the difference was not statistically significant (P=0.132. Conclusion: Both machines reliably measure SFCT. Larger studies are needed to confirm these findings. Keywords: choroidal imaging, diseased, normal, SD-OCT, SS-OCT

  17. Combined photodynamic therapy and intravitreal bevacizumab for idiopathic polypoidal choroidal vasculopathy: one-year follow-up

    Directory of Open Access Journals (Sweden)

    Mario R Romano

    2010-10-01

    Full Text Available Mario R Romano1, Ugo Cipollone2, Francesco Semeraro3, Michele Rinaldi4, Ciro Costagliola11Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso; 2Dipartimento di Oftalmologia, Ospedale G Vietri, Larino, Campobasso; 3Clinica Oculistica, Università degli Studi di Brescia, Brescia; 4Clinica Oculistica, II Università degli Studi di Napoli, Napoli, ItalyObjective: To report the efficacy and safety of combined photodynamic therapy (PDT and intravitreal bevacizumab (IVB injection in the treatment of idiopathic polypoidal choroidal vasculopathy (IPCV.Material and methods: A prospective case series of 10 eyes of 10 consecutive patients affected by IPCV with subfoveal involvement. PDT plus IVB (1.25 mg/0.05 mL injection two weeks later was performed in all patients. Two adjunctive injections of bevacizumab were scheduled at four and eight weeks after the initial treatment. Best-corrected visual acuity (BCVA, fluorescein and indocyanine green angiographies, and optical coherence tomography were obtained at baseline, and at one, three, six, nine, and 12 months.Results: The combined treatment led to an improvement of both neurosensory detachment and pigmented epithelial detachment in all eyes, with a decrease of exudation and regression of macular thickness, which remained stable to the end of follow-up. However, BCVA remained stable over the 12 months of follow-up.Conclusion: These findings demonstrate that PDT/IVB combined therapy is able to achieve morphologic stabilization of the IPCV lesion, through a rapid decrease of macular thickness and regression of the size of polypoidal vascular lesion.Keywords: combined treatment, idiopathic polypoidal choroidal vasculopathy, age-related macular degeneration, intravitreal bevacizumab, photodynamic therapy

  18. Choroidal vasculature characteristics based choroid segmentation for enhanced depth imaging optical coherence tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qiang; Niu, Sijie [School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094 (China); Yuan, Songtao; Fan, Wen, E-mail: fanwen1029@163.com; Liu, Qinghuai [Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029 (China)

    2016-04-15

    Purpose: In clinical research, it is important to measure choroidal thickness when eyes are affected by various diseases. The main purpose is to automatically segment choroid for enhanced depth imaging optical coherence tomography (EDI-OCT) images with five B-scans averaging. Methods: The authors present an automated choroid segmentation method based on choroidal vasculature characteristics for EDI-OCT images with five B-scans averaging. By considering the large vascular of the Haller’s layer neighbor with the choroid-sclera junction (CSJ), the authors measured the intensity ascending distance and a maximum intensity image in the axial direction from a smoothed and normalized EDI-OCT image. Then, based on generated choroidal vessel image, the authors constructed the CSJ cost and constrain the CSJ search neighborhood. Finally, graph search with smooth constraints was utilized to obtain the CSJ boundary. Results: Experimental results with 49 images from 10 eyes in 8 normal persons and 270 images from 57 eyes in 44 patients with several stages of diabetic retinopathy and age-related macular degeneration demonstrate that the proposed method can accurately segment the choroid of EDI-OCT images with five B-scans averaging. The mean choroid thickness difference and overlap ratio between the authors’ proposed method and manual segmentation drawn by experts were −11.43 μm and 86.29%, respectively. Conclusions: Good performance was achieved for normal and pathologic eyes, which proves that the authors’ method is effective for the automated choroid segmentation of the EDI-OCT images with five B-scans averaging.

  19. Proteomic profiling of human retinal and choroidal endothelial cells reveals molecular heterogeneity related to tissue of origin.

    Science.gov (United States)

    Zamora, David O; Riviere, Michael; Choi, Dongseok; Pan, Yuzhen; Planck, Stephen R; Rosenbaum, James T; David, Larry L; Smith, Justine R

    2007-10-30

    The ocular vascular endothelium plays a key role in the development of several leading retinal causes of blindness in Western nations. Choroidal endothelial cells are integral to the subretinal neovascular lesions that characterize the exudative form of late age-related macular degeneration (AMD), and retinal endothelial cells participate in the initiation of diabetic retinopathy and posterior uveitis. Vascular endothelial cells at different sites exhibit considerable molecular diversity. This diversity has implications for understanding the pathogenesis of tissue-specific diseases and for the development of targeted therapies to treat these conditions. Previous work from our group has identified significant differences in the gene transcript profiles of human retinal and choroidal endothelial cells. Because the proteome ultimately determines the behavior of any given cell, however, it is critical to determine whether molecular differences exist at the level of protein expression. Retinal and choroidal endothelial cells were separately isolated from five sets of human eyes by enzymatic digestion with type II collagenase followed by anti-CD31 antibody-conjugated magnetic bead separation. Cells were washed to remove serum peptides in the culture medium, and lysed by sonication in buffer containing 2% sodium dodecyl sulfate. Protein was then precipitated with acetone. Retinal and choroidal endothelial samples from each donor were labeled with Cy3 and Cy5, respectively, mixed with a Cy2-labeled pooled protein sample to facilitate spot matching across gels, and separated by two-dimensional difference gel electrophoresis (2D-DIGE). Following a global normalization, differentially abundant protein spots that were visible in at least four of five donor gels were detected by the significance analysis of microarrays method, with false discovery rate set at 5%. Corresponding spots were excised from additional DIGE-labeled or Coomassie-stained 2D electrophoretic gels. Protein

  20. Intravitreal bevacizumab (avastin for circumscribed choroidal hemangioma

    Directory of Open Access Journals (Sweden)

    Subrata Mandal

    2011-01-01

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

  1. Purtscher's retinopathy followed by neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Kuroda M

    2013-11-01

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

  2. Randomised clinical trials of choroidal melanoma treatment.

    Directory of Open Access Journals (Sweden)

    Straatsma Bradley

    2003-01-01

    Full Text Available Purpose: To illustrate an approach to evidence-based medical practice by reporting the Collaborative Ocular Melanoma Study (COMS randomised clinical trials and cohort studies of choroidal melanoma. Methods: COMS randomised clinical trials of Iodine-125 (I-125 brachytherapy, adjunctive cohort study of visual acuity in eyes treated with brachytherapy and adjunctive natural history study. COMS randomised clinical trial of pre-enucleation radiation. Results: The COMS I-125 brachytherapy trial (N = 1,317 patients of medium-sized choroidal melanoma showed 5-year all-cause mortality of 18% [95% Confidence Interval (CI, 16-20%] and no statistically significant difference in mortality following 1-125 brachytherapy or enucleation. Adjunctive cohort natural history study (N-42 patients of patients eligible for the I-125 brachytherapy trial who deferred treatment or had no melanoma treatment had a 5-year all-cause mortality of 30% (95% CI, 18-47%. The COMS pre-enucleation radiation trial (N = 1,003 patients of large-sized choroidal melanoma showed 5-year all-cause mortality of 40% (95% CI, 37-44%. Conclusions: Evidence derived from randomised clinical trials and cohort studies shows the need for longterm (ž 5 years follow-up to determine the efficacy of treatment for choroidal melanoma by any modality. The rather similar 5-year mortality for treated and untreated medium melanoma patients suggests that metastatic dissemination may occur at an early stage of choroidal melanoma. To increase longterm survival, ocular treatment of choroidal melanoma must strive for diagnosis and treatment of melanoma at an early stage when metastasis is less likely and be combined with measures to detect and treat micrometastasis

  3. Recurrent focal choroidal excavation following multiple evanescent white dot syndrome (MEWDS) associated with acute idiopathic blind spot enlargement.

    Science.gov (United States)

    Jabbarpoor Bonyadi, Mohammad Hossein; Hassanpour, Kiana; Soheilian, Masoud

    2017-04-03

    To present a recurrent case of conforming focal choroidal excavation (FCE) following multiple evanescent white dot syndrome (MEWDS) in a 25-year-old woman. Following spontaneous MEWDS sings resolution our patient noted a recurrent decrease in vision. Repeated OCT revealed elevation and mild disruption of RPE layer at fovea without previous angiographic MEWDS signs. At this time, short-term systemic steroid therapy was started and visual acuity became normal. Following quiescence of the new-onset phase, the conforming type of FCE located in inferior macula appeared in OCT. In the following next 2 years recurrence of presumptive focal subfoveal choriocapillaritis occurred for three times presenting with blurred vision. During every acute attack, above-mentioned FCE disappeared and returned back again after resolution of presumptive focal choriocapillaritis. This is the first and unique case of recurrent type of FCE following MEWDS. It seems to disappear during active phase of presumptive focal choriocapillaritis and then returns after the eye has become quiescent.

  4. Comparison of choroidal thickness measurements between spectral-domain OCT and swept-source OCT in normal and diseased eyes.

    Science.gov (United States)

    Zafar, Sidra; Siddiqui, Ma Rehman; Shahzad, Rida

    2016-01-01

    Sub-foveal choroidal thickness (SFCT) is affected in many ocular diseases. The aim of this study was to compare SFCT measurements between Topcon 3D 2000 spectral-domain optical coherence tomography (SD-OCT) and Topcon swept-source OCT (SS-OCT), with different laser wavelengths, in normal and diseased populations. This was a prospective, cross-sectional, noninterventional study including 27 normal volunteers and 27 participants with retinal disease. OCT scans were performed sequentially and under standardized conditions using both SD-OCT and SS-OCT. The OCT scans were evaluated by two independent graders. Paired t -tests and intraclass correlation coefficients (ICCs) were used to assess the statistically significant difference between SFCT measurements as measured by the two devices. Mean SFCT measurements for all 54 participants were 264.9±103.1 μm using SD-OCT (range: 47-470 μm) and 278.5±110.5 μm using SS-OCT (range: 56-502 μm), with an inter-device ICC of 0.850. Greater variability was noted in the diseased eyes. Inter-device ICCs were 0.870 (95% CI; 0.760-0.924) and 0.840 (95% CI; 0.654-0.930) for normal and diseased eyes, respectively. However, the difference was not statistically significant ( P =0.132). Both machines reliably measure SFCT. Larger studies are needed to confirm these findings.

  5. Choroidal metastasis from leiomyosarcoma in two cases

    Directory of Open Access Journals (Sweden)

    Eric Feinstein

    2014-01-01

    Full Text Available Leiomyosarcoma is a malignant tumor of mesenchymal cells and is the most common soft-tissue sarcoma. Leiomyosarcoma is a notably rare tumor in the ophthalmic region and can be of primary, secondary or metastatic origin. To the best of our knowledge, there has only been one published case of leiomyosarcoma metastasis to the choroid. In this case study, we report two cases of primary leiomyosarcoma with metastasis to the choroid of the eye. Both cases displayed systemic metastasis and showed response to high dose plaque radiotherapy. Despite its prevalence as the leading form of sarcoma, leiomyosarcoma rarely metastasizes to the ocular region.

  6. Natural course of symptomatic focal choroidal excavation.

    Science.gov (United States)

    Pierro, Luisa; Casalino, Giuseppe; Introini, Ugo; Gagliardi, Marco; Sergenti, Jessica; Cascavilla, Maria Lucia; Bandello, Francesco

    2015-01-01

    A 32-year-old man was referred to the authors' department for nonspecified macular dystrophy with persistent metamorphopsia in the right eye diagnosed 10 years before and followed using optical coherence tomography. The patient underwent a comprehensive ocular examination, including multimodal imaging evaluation and electrofunctional testing. The diagnosis was consistent with nonconforming focal choroid excavation. Over 10 years, no complications occurred, visual acuity was stable, and optical coherence tomography showed no progression of the lesion during follow-up. In this case, nonconforming symptomatic focal choroid excavation was a nonprogressive condition with good long-term visual outcome. Copyright 2015, SLACK Incorporated.

  7. OCT-Angiography for monitoring and managing neovascular age-related macular degeneration.

    Science.gov (United States)

    Malamos, P; Tsolkas, G; Kanakis, M; Mylonas, G; Karatzenis, D; Oikonomopoulos, N; Lakoumentas, J; Georgalas, Ilias

    2017-12-01

    To evaluate the combined use of optical coherence tomography and angiography (OCT-A) for imaging choroidal neovascularization (CNV) secondary to neovascular age-related macular degeneration (nAMD). This prospective observational study was conducted from May 2015 to April 2017. Included in the study were 54 patients (n = 63 eyes), all of whom had CNV secondary to nAMD and all of whom had been examined by OCT-A. Angioscans (3x3 and 6 × 6) and conventional B-scan OCT scans were obtained for all patients at baseline and at various times during the 24-month follow-up period. For diagnostic confirmation, conventional imaging methods fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed at baseline. A total of 13 patients (n = 15 eyes) underwent serial imaging during 34 follow-up visits. The main outcomes included (i) determination of OCT-A sensitivity for the detection of CNV (classic and occult) and (ii) the correlation between B-scan OCT and OCT-A vis-à-vis consecutive follow-up changes. At baseline, the detection rate (i.e., overall sensitivity) of OCT-A for detecting CNV was 64.4% (75.7 and 48.0% for classic and occult CNV, respectively), independent of prior treatment status. In terms of quality, 6 × 6 angioscans were superior to 3 × 3. Moreover, specific CNV morphologic patterns by B-scan OCT did not correlate with lesion composition. Correspondence between OCT-A and B-scan OCT was observed in only 53% of the cases. OCT-A may prove to be a valuable adjunctive diagnostic tool for the interpretation of CNV, as it not only reduces the need for invasive angiographic procedures but also facilitates the follow-up process.

  8. Choroid plexus tumors in pediatric patients.

    Science.gov (United States)

    Ogiwara, Hideki; Dipatri, Arthur J; Alden, Tord D; Bowman, Robin M; Tomita, Tadanori

    2012-02-01

    Choroid plexus tumors are rare intraventricular tumors, accounting for less than 1% of all intracranial tumors and 2-4% of brain tumors in children. The authors present their experience in the management of these lesions, and a review of the literature is performed. We retrospectively analyzed the outcome of pediatric patients with choroid plexus tumors treated with surgical resection. The patients' charts were reviewed for demographic data, clinical presentation, surgical therapy and follow-up. This study involves 18 consecutive choroid plexus tumors: 14 papillomas, 2 atypical papillomas and 2 carcinomas. The tumor was located in the lateral ventricles (12), the fourth ventricle (4) and the third ventricle (2). The mean age at presentation was 4.6 years. Surgical resection was performed in all cases and no patients died perioperatively. Survival rate of papilloma patients was 100% without evidence of recurrent disease (mean follow-up for 73 months). Survival rate of carcinoma patients was 50% (mean follow-up for 23.5 months). One carcinoma patient died of disseminated disease 13 months after surgery. The functional outcome in long-term survivors after papilloma surgery was excellent. Postoperative extraventricular drainage (EVD) was performed in 12 patients. Five patients (27.8%) had persistent hydrocephalus after tumor resection and required a ventriculoperitoneal shunt. Choroid plexus papilloma is a surgically curable disease. Postoperative EVD was considered effective in lowering the rate of shunt requirement through releasing the blood-tinged CSF and small particles of tumor residue.

  9. Endoscopic third ventriculostomy and choroid plexus cauterization ...

    African Journals Online (AJOL)

    Background: Endoscopic third ventriculostomy (ETV) and Choroid Plexus Cauterization (CPC) have been recommended as reliable surgical options in developing countries for childhood hydrocephalus owing to reported shunt failures in shunt dependency. Objective: To evaluate outcomes of the ETV and ETV-CPC ...

  10. Evaluation of the effect of intravitreal ranibizumab injections in patients with neovascular age related macular degeneration on retinal nerve fiber layer thickness using optical coherence tomography.

    Science.gov (United States)

    El-Ashry, Mohamed F; Lascaratos, Gerassimos; Dhillon, Baljean

    2015-01-01

    To evaluate the effect of repeated intravitreal ranibizumab injections for neovascular age related macular degeneration (nAMD) on the retinal nerve fiber layer (RNFL) thickness using optical coherence tomography. A prospective observational cohort study of patients with nAMD. Thirty eyes of 30 patients with nAMD were selected. All patients received three ranibizumab injections and underwent scans using the fast RNFL thickness protocol (Stratus optical coherence tomography) before starting the first injection and 1 month after the third injection. The RNFL thickness measurements prior to the injections and after the third injection were used for the analysis. We also evaluated the effect of the lens status as well as the type of choroidal neovascular membrane on RNFL thickness measurements pre- and post-injection. Pre- and post-injection average and individual quadrant RNFL thickness were measured and statistically analyzed. The mean (± standard deviation) pre-injection RNFL thickness was 90.8±18. The mean (± standard deviation) post-injection RNFL thickness was 91.03±15. The pre- and post-injection values of the mean RNFL thickness were not statistically significant. Likewise, the pre- and post-injection values for RNFL thickness in the different quadrants were not statistically significant. There was no statistical significance for the lens status or the type of choroidal neovascular membrane on the RNFL thickness. Repeated ranibizumab injections in nAMD appear to have no harmful effect on the RNFL thickness in the short term, in spite of the proven neurotrophic effect of vascular endothelial growth factor. Nevertheless, the safety profile of ranibizumab injections in nAMD needs to be further evaluated in a large multicenter trial with special emphasis on the long-term effects on the retina and optic nerve.

  11. Transpupillary thermotherapy (TTT) in circumscribed choroidal hemangioma.

    Science.gov (United States)

    Fuchs, Anne V; Mueller, Arthur J; Grueterich, Martin; Ulbig, Michael W

    2002-01-01

    Choroidal hemangioma presents a therapeutic dilemma. Although it is a benign tumor, it may lead to massive exudation of subretinal fluid and a loss of visual function. Argon laser photo-coagulation in a grid pattern may be followed by initial absorption of subretinal fluid, but recurrence is common. Trans-scleral cryotherapy is difficult to apply at the posterior pole of the eye. External beam irradiation may bear a risk of maculopathy and papillopathy. Brachytherapy does not allow placement of radiation to the hemangioma sparing other retinal or choroidal structures. We sought to determine whether transpupillary thermotherapy (TTT) is suitable for treatment of choroidal hemangioma at the posterior pole. We present ten patients with choroidal hemangioma. All of these received TTT. The mean follow-up period was 13.3 months (3-21 months). TTT was delivered via a slitlamp microscope with a diode laser at 810 nm. After TTT, reduction in tumor prominence was observed in eight patients at 3 months after treatment by A scan sonography. Visual acuity improved by more than three lines in four patients, and remained unchanged in all other patients. Two patients were retreated to achieve complete absorption of fluid. Serous retinal detachment persisted in three patients because the hemangioma could not be treated completely because of proximity to the fovea. Our preliminary results suggest that TTT may be used effectively to treat some choroidal hemangiomas in the first instance and prevent fluid leakage provided the lesion does not involve the fovea. However, long-term follow-up and more cases are needed to evaluate the long-term visual outcome and potential risks.

  12. Research on inhibition of corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Zhang-Hui Yang

    2015-12-01

    Full Text Available Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNVmay occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

  13. A neovascularized epiretinal membrane in a patient with terson syndrome.

    Science.gov (United States)

    Toffoli, Daniela; Allaire, Guy S; Barkat, Fayrouz; Sebag, Mikaël

    2010-01-01

    We report on a patient with Terson syndrome in the left eye complicated by a neovascularized epiretinal membrane likely secondary to cocaine use. Case report and literature review using the Medline database (1966-2007). A woman known for cocaine use was seen in the ophthalmology clinic for Terson syndrome in the left eye after subarachnoid hemorrhage. Ten months later, a neovascularized epiretinal membrane was noted in the left eye and confirmed with retinal angiography and optical coherence tomography. After vitrectomy, the neovascular membrane was sent for histopathological examination, revealing neovascular capillaries. Neovascularized epiretinal membranes have never been reported in Terson syndrome and in our patient this likely occurred due to an ischemic retinal environment created by cocaine use and decreased retinal perfusion after subarachnoid hemorrhage.

  14. Digital imaging in differential diagnosis of small choroidal melanoma.

    Science.gov (United States)

    Saari, Jukka M; Kivelä, Tero; Summanen, Paula; Nummelin, Kari; Saari, K Matti

    2006-12-01

    To assess the role of digital imaging and a new subtraction method for differential diagnosis of choroidal nevus and small choroidal melanoma. Of 241 consecutive patients referred to a tertiary referral center for suspected choroidal melanoma, 110 who underwent digital imaging of the ocular fundus were eligible for this study. Digital color, red-free and red light retinal images were evaluated in a randomized and masked manner and by the subtraction method for diagnosis of the fundus lesion. The reference standard was based on the combined results of ophthalmological examination, including mydriatic ophthalmoscopy, B scan ultrasonography, digital imaging and fluorescein angiography of the ocular fundus. Comparative use of digital color, red-free and red light imaging had 85.7% (95%CI 42.1-99.6) sensitivity, 99.0% (95%CI 94.7-99.9) specificity and 98.2% (95%CI 93.6-99.8) exact agreement versus reference standard in differentiation of small choroidal melanoma from pseudomelanoma. Direct comparison between use of digital images and the reference standard showed excellent agreement in detecting small choroidal melanoma from suspected choroidal lesions (K 0.847; 95%CI 0.639-1.0). The subtraction method was useful to show growth in four of 94 melanocytic choroidal tumors. The mean annual incidence of choroidal melanoma in Southwest Finland was 0.80 per 100.000 population. The most frequent choroidal pseudomelanomas were choroidal melanotic and amelanotic nevi, disciform lesions, congenital hypertrophy of the retinal pigment epithelium, and circumscribed choroidal hemangioma. Combined use of digital color, red-free and red light imaging was a suitable adjunct in differentiation of small choroidal melanoma from different pseudomelanomas. The subtraction method may reveal early growth of the melanotic choroidal tumors.

  15. Retinal angiomatous proliferation and polypoidal choroidal vasculopathy – phenotypes of neovascularisation in age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Tomislav Šarenac

    2016-12-01

    Full Text Available Age-related macular degeneration (AMD is the leading cause of loss of visual acuity in developed countries. Antagonists of Vascular Endothelial Growth Factor (anti-VEGF have been successfully used intravitreally in treating the neovascular form of this disease (nAMD and limiting vision loss. With the latest developments in multimodal imaging we can discern multiple types of neovascularization, some of which have an unusual course, despite treatment with anti-VEGF. Indocianine green angiography (ICGA and optical coherence tomography (OCT have been used to distinguish two special forms of nARMD, i.e., retinal angiomatous proliferation (RAP and polypoidal choroidal vasculopathy (PCV. RAP appears in 10–15 % of newly discovered nARMD, usually in older patients and is also known as type 3 neovascularisation, which starts intraretinally. It responds well to anti-VEGF. However, it requires closer monitoring, since in 75 % of patients it requires repeated treatment. In contrast, PCV evolves in the choroid and typically causes hemorrhagic exudative maculopathy, which is relatively unresponsive to anti-VEGF. It appears in 4–14 % of nAMD, and in somewhat younger patients. It requires a specifc approach to treatment, combining anti-VEGF with laser therapy, and close monitoring.Although PCV and RAP are less common forms of nARMD, we should use and properly interpret FA, ICGA and OCT in order to initiate recommended treatments and follow-up. Herewith we can lessen the adverse impact on the visual acuity and increase the quality of life of our patients.

  16. Lonafarnib is a potential inhibitor for neovascularization.

    Directory of Open Access Journals (Sweden)

    Linlin Sun

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

  17. Remodelling of choroidal blood flow in radiation choroidopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hideo; Muraoka, Kanemitsu; Takahashi, Kyoichi; Sutoh, Noriko [Gunma Univ., Maebashi (Japan). School of Medicine

    1997-02-01

    Two males, aged 68 and 34 years each, presented with radiation retinopathy. One had received radiation therapy to the whole brain for intracranial metastasis of lung carcinoma 29 months before. The other underwent surgery and radiation for melanoma of the upper eyelid 15 years before. When examined by indocyanine green angiography. both cases showed vasoocclusive changes in the choroid involving the choriocapillaris and major vessels in the affected fundus area. In one eye with severe retinal vascular lesions in the superior temporal quadrant, the vortex vein in the quadrant had obliterated. The venous blood in this quadrant was drained into the inferior temporal vortex vein crossing the presumed watershed zone temporal to the macula. Collaterals had formed between choroidal arteries and between choroidal veins. These cases illustrate that choroidal vascular lesions may be present in radiation retinopathy, that the former may be more pronounced than the latter and that choroidal vessels may undergo extensive remodelling to compensate for the disturbed choroidal circulation. (author)

  18. CT of malignant choroidal melanoma - morphology and perfusion characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Heller, M.; Hagemann, J.; Jend, H.H.; Guthoff, R.

    1982-03-01

    The computed tomographic morphology of malignant choroidal melanoma and its perfusion characteristics are described. Thirty-three static and serial CT examinations made on 29 patients with choroidal melanoma, three with pseudotumors of the macula and one with choroidal metastasis revealed the choroidal melanoma to be usually a hyperdense, markedly perfused tumor, while the non-contrast, diagnostically undifferentiable pseudotumors and the choroidal metastasis, revealed no significant change in density after the administration of contrast material. Density values or perfusion characteristics of choroidal melanoma that are outside of the normal range are a result of secondary changes within the immediate surroundings of the tumor, such as detachment of the retina, tumor-induced glaucoma, or tumor necrosis.

  19. Choroid Melanoma Metastasis to Spine: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Hiren Mandaliya

    2016-01-01

    Full Text Available Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been treated for primary ocular melanoma three years earlier with radioactive plaque brachytherapy. Synchronously, at the time of metastasis, he was also diagnosed as having a new primary lung adenocarcinoma as well. The only other case reported on vertebral metastasis from malignant melanoma of choroid in literature in which primary choroid melanoma was enucleated.

  20. Photo-mediated ultrasound therapy (PUT): a novel method of selectively treating neovascularization (Conference Presentation)

    Science.gov (United States)

    Zhang, Haonan; Hu, Zi Zhong; Li, Jia; Mordovanakis, Aghapi G.; Yang, Xinmai; Paulus, Yannis M.; Wang, Xueding

    2017-02-01

    Retinal and choroidal neovascularization play a pivotal role in the leading causes of blindness including macular degeneration and diabetic retinopathy (DR). Current therapy by focal laser photocoagulation can damage the normal surrounding cells, such as the photoreceptor inner and outer segments which are adjacent to the retinal pigment epithelium (RPE), due to the use of high laser energy and millisecond pulse duration. Therapies with pharmaceutical agents involve systemic administration of drugs, which can cause adverse effects and patients may become drug-resistant. We have developed a noninvasive photo-mediated ultrasound therapy (PUT) technique as a localized antivascular method, and applied it to remove micro blood vessels in the retina. PUT takes advantage of the high native optical contrast among biological tissues, and has the unique capability to self-target microvessels without causing unwanted damages to the surrounding tissues. This technique promotes cavitation activity in blood vessels by synergistically applying nanosecond laser pulses and ultrasound bursts. Through the interaction between cavitation and blood vessel wall, blood clots in microvessels and vasoconstriction can be induced. As a result, microvessels can be occluded. In comparison with other techniques that involves cavitation, both laser and ultrasound energy needed in PUT is significantly lower, and hence improves the safety in therapy.

  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. Oral Propranolol for Circumscribed Choroidal Hemangioma

    Directory of Open Access Journals (Sweden)

    Empar Sanz-Marco

    2011-02-01

    Full Text Available Introduction: Several therapeutic approaches have been developed to treat choroidal hemangioma. However, all these therapies are associated with a potential risk of damaging the overlying retina. Case Report: We report a case of circumscribed choroidal hemangioma (CCH in a 59-year-old man refractory to laser treatment. Visual acuity was 20/200 and a serous macular detachment was present. The CCH was treated with oral propanolol, whereupon visual acuity improved to 20/20 and the macular detachment resolved without systemic or local adverse effects. Discussion: Propanolol is a β-blocker commonly used in cardiology that may induce endothelium vasoconstriction and inhibit endothelial proliferation. It has been shown to be effective in infantile facial hemangiomas, and proved safe and effective for the CCH in our patient. Further studies are needed to confirm our observation.

  3. Focal choroidal excavation associated with focal retinochoroiditis.

    Science.gov (United States)

    Ohki, Tetsutaro; Sakai, Tsutomu; Tsuneoka, Hiroshi

    2015-01-01

    To describe detailed spectral-domain optical coherence tomography (OCT) findings for two patients with focal choroidal excavation (FCE) associated with focal retinochoroiditis. Three eyes from two patients with FCE associated with focal retinochoroiditis were evaluated by funduscopy, fluorescence angiography, indocyanine green angiography, and spectral-domain OCT during follow-up. Both patients with focal retinochoroiditis developed new FCE after oral steroid treatment and two eyes showed regression of the FCE during the follow-up. Both eyes from one patient transformed from the conforming to the nonconforming type and neither of the eyes were stable during the follow-up. Ultimately, all eyes exhibited the conforming-type FCE. Focal choroidal excavation can be seen as a tomographic phenotype after the treatment of focal retinochoroiditis. Spectral-domain OCT was useful for detecting the development of FCE after the treatment and for observing FCE regression.

  4. Symptomatic bilateral xanthogranuloma of the choroid plexus

    Directory of Open Access Journals (Sweden)

    Selin Tural Emon

    2017-01-01

    Full Text Available Xanthogranulomas (XGRs of the choroid plexus are rare, asymptomatic, and benign lesions usually found incidentally. Here, we present a case of a 47-year-old male with bilateral XGR of the choroid plexus with periventricular edema and discuss our case in relation to a review of existing literature pertaining to the radiology of XGRs. To the best of our knowledge, this is the first reported case of bilateral trigonal XGR causing brain edema without ventricular dilatation. Despite the fact that they can cause hydrocephalus, XGRs are silent and benign lesions. Although the etiopathology of XGRs remains poorly understood, enhanced imaging analyses may provide additional information regarding edema and focal white matter signal changes.

  5. Oral Propranolol for Circumscribed Choroidal Hemangioma

    Science.gov (United States)

    Sanz-Marco, Empar; Gallego, Roberto; Diaz-Llopis, Manuel

    2011-01-01

    Introduction Several therapeutic approaches have been developed to treat choroidal hemangioma. However, all these therapies are associated with a potential risk of damaging the overlying retina. Case Report We report a case of circumscribed choroidal hemangioma (CCH) in a 59-year-old man refractory to laser treatment. Visual acuity was 20/200 and a serous macular detachment was present. The CCH was treated with oral propanolol, whereupon visual acuity improved to 20/20 and the macular detachment resolved without systemic or local adverse effects. Discussion Propanolol is a β-blocker commonly used in cardiology that may induce endothelium vasoconstriction and inhibit endothelial proliferation. It has been shown to be effective in infantile facial hemangiomas, and proved safe and effective for the CCH in our patient. Further studies are needed to confirm our observation. PMID:21475606

  6. Hospitalized cardiovascular diseases in neovascular age-related macular degeneration.

    Science.gov (United States)

    Nguyen-Khoa, Bao-Anh; Goehring, Earl L; Werther, Winifred; Gower, Emily W; Do, Diana V; Jones, Judith K

    2008-09-01

    To compare the incidence rate of hospitalized myocardial infarctions (MIs) and cerebrovascular accidents (CVAs) in subjects with and without neovascular age-related macular degeneration (AMD). A retrospective database cohort study was performed in subjects with neovascular AMD and controls matched for age, sex, geography, and enrollment duration. Healthcare claims for the study period from January 1, 2002, to June 30, 2005, were used to identify subjects and outcomes. Incidence of hospitalized MI and CVA events and rate ratios adjusted for 11 risk factors were calculated. In 7203 subjects with neovascular AMD and 20,208 controls, the rate of MI was 16.2 events per 1000 subjects with neovascular AMD and 23.1 events per 1000 controls. The adjusted rate ratio for MI was 0.58 (95% confidence interval, 0.48-0.72; P < .001) for subjects with neovascular AMD vs controls. The rate of CVA was 14.3 events per 1000 subjects with neovascular AMD and 22.1 events per 1000 controls. The adjusted rate ratio for CVA was 0.56 (95% confidence interval, 0.45-0.70; P < .001). Rates of MI or CVA were significantly lower in subjects with neovascular AMD than in controls. These findings could not be explained by systematic differences in case selection, health care use, or comorbidities, although other possible biases cannot be ruled out.

  7. Focal choroidal excavation: Clinical findings and complications.

    Science.gov (United States)

    Castro Navarro, V; Montero Hernández, J; Navarro Palop, C; Palomares Fort, P; Cervera Taulet, E

    2016-01-01

    To describe the clinical findings and its complications in 2 patients with focal choroidal excavation (FCE). A retrospective case-series including 4 eyes of 2 patients with FCE that underwent a comprehensive ophthalmological examination including slit-lamp examination, colour fundus photography, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography. In the 2 patients, both the anterior and posterior segment evaluations were mostly normal despite the of presence yellowish spots in the macular area of the right eye of patient 1, and of a small yellowish elevated lesion with serous macular detachment in the macular area of the left eye in patient 2. At diagnosis, SD-OCT revealed a conforming FCE in patient 1, and in patient 2, an FCE with perilesional subretinal fluid and a neuroepithelium detachment, suspicious of FCE complicated with central serous retinopathy (CSCR). At one year of follow-up, patient 1 developed choroidal neovascularisation (CNV) over the focal choroidal excavation. FA and indocyanine green angiography examinations revealed areas with hypofluorescence in earlier frames, and a diffuse leakage in late frames. After ranibizumab injections, the SD-OCT of patient 1 revealed no active exudation, while patient 2 showed partial resolution of subretinal fluid. FCE is a newly described entity of unclear aetiology. It is characterised by a choroidal excavation in eyes, with absence of posterior staphyloma, scleral ectasia, trauma, or retinal disease. Although most lesions remain stable, there could be an association with CRSC or CNV. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Another Form of Focal Choroidal Excavation Based on Multimodality Imaging.

    Science.gov (United States)

    Wang, Shiyuan; Zhao, Peiquan

    2016-10-01

    To describe a peculiar choroidal entity using multimodality imaging and to further understand the relationship between focal choroidal excavation and central serous chorioretinopathy. A peculiar entity was detected in both eyes of a 20-year-old male patient who was followed for more than 4 years; one perifoveal focal choroidal excavation and two extrafoveal focal choroidal excavations were noted in each eye. The bilateral perifoveal focal choroidal excavations exhibited progressive development with repeated interconversion between the nonconforming and conforming types. Dilated choroid blood vessels were detected by en face spectral-domain optical coherence tomography (SD-OCT). Although the ellipsoid zone and retinal pigment epithelium layer defect also involved the fovea, a visual acuity of 20/20 was maintained in both eyes, with neither metamorphopsia by Amsler grid nor abnormalities noted by multifocal electroretinogram. However, pigment epithelium detachment finally appeared in the right eye. The microperimetry test revealed reduced threshold sensitivity corresponding to the lesions, and near-infrared autofluorescence revealed increased hyperfluorescence at the latest visit. Idiopathic focal choroidal excavation may convert to the structure of central serous chorioretinopathy alike, which likely indicates another rare condition of focal choroidal excavation or central serous chorioretinopathy. Wide- and deep-scanning modes should be routinely applied in OCT imaging to detect choroidal disorders.

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

    Directory of Open Access Journals (Sweden)

    Rony Carlos Preti

    2015-06-01

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

  10. Analysis and follow-up of type 1 choroidal neovascularisation with optical coherence tomography-angiography after antiangiogenic treatment.

    Science.gov (United States)

    Torrecillas-Picazo, R; Cerdà-Ibáñez, M; Almor Palacios, I; Hervás Hernandis, J M; Ramón-Cosín, R; Ruiz Del Rio, N; Duch-Samper, A

    2017-06-01

    To describe the characteristics of type 1 choroidal neovascularisation (CNV) in age-related macular degeneration (ARMD) using two different optical coherence tomography angiography (OCT-A) devices sequentially during a standard protocol of three intravitreal injections of an anti-vascular endothelial growth factor (anti-VEGF). The study included 6 eyes with naïve neovascular ARMD. Macular OCT-A images were acquired using AngioPlex Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Inc., Dublin, USA) and DRI OCT Triton SS-OCT Angio (Topcon, Medical Systems, Inc. Oakland, NJ, USA). The macular OCT-A scan covered an area of 3×3mm. Distinct morphological patterns and quantifiable features of the neovascular membranes were studied on en face projection images, which were taken at different stages of the follow-up. Treatment response could be estimated using the OCT-A criteria of CNV activity. Higher activity scores before treatment resulted in a greater decrease in the membrane area. The estimated net decline in area ranged from 83.5% to 1.4%. The OCT-A performed one-week after treatment revealed the greatest area reductions. OCT-A provides new possibilities for the non-invasive assessment of features of neovascular networks and CNV structural morphology. Newly described activity criteria can also guide therapeutic decisions, and help in evaluating responses. Quantitative and qualitative information can be provided with this technique. However, further software development and future investigation are essential to define the role of this tool on a daily basis. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

    Directory of Open Access Journals (Sweden)

    Sertan Goktas

    2014-01-01

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

  12. Clinical features of choroidal metastases from carcinoid tumour.

    Science.gov (United States)

    She, Huaning; Zheng, Yuping; Wang, Xiaohua; Quan, Yanlong; Sun, Naixue

    2004-03-01

    To report ophthalmologic and angiographic features of choroidal metastases from carcinoid tumor and analyze their common clinical manifestation. Ophthalmologic examinations and fundus fluorescein angiography (FFA) were performed in 30 patients suffered from carcinoid tumor, and four patients diagnosed of breast cancer (2 cases), lung cancer (1 case) and maxillary sinus cancer (1 case) were confirmed with choroidal metastases. Choroidal metastases were found as the initial manifestations of the malignant tumors on 2 patients whose initial and chief complaints were decreasing vision, their fundus lesions were mainly presented in the posterior pole and FFA showed high density of fluorescence of the lesions. This study indicated choroidal metastasis might be the first sign of metastases for patients with cancer. For patients with unknown metastasic cancers, examinations of the choroids may be useful for diagnosis and prognosis.

  13. Type 1 neovascularization may confer resistance to geographic atrophy amongst eyes treated for neovascular age-related macular degeneration.

    Science.gov (United States)

    Dhrami-Gavazi, Elona; Balaratnasingam, Chandrakumar; Lee, Winston; Freund, K Bailey

    2015-01-01

    To report a series of age-related macular degeneration (AMD) patients in whom progression to geographic atrophy (GA) in one eye receiving frequent intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) therapy for type 1 neovascularization (NV) was slower than that of the fellow eye with non-neovascular AMD. Retrospective, observational case series examining the clinical course and GA progression rate in four consecutive patients in which one eye harbored type 1 neovascular AMD and was receiving anti-VEGF therapy, while the fellow eye manifested signs of non-neovascular AMD only. Eligibility criteria included anti-VEGF therapy duration of over 4 years and over 50 injections. Lesion evolution was documented via multimodal imaging. GA at baseline and final visits was quantified and GA progression rate for each eye was determined. Four consecutive patients were followed for a mean interval of 94 months (range 62-120). One eye harbored type 1 NV while the fellow eye remained non-neovascular. The former received a mean of 65.5 ± 15.2 anti-VEGF injections. Mean rate of GA progression in non-neovascular eyes was 0.076 ± 0.024 mm2/month and in type 1 NV eyes was 0.004 ± 0.005 mm2/month. Difference in GA progression rate between type 1 and non-neovascular eyes was found to be statistically significant (P = 0.001). These findings support previous hypotheses that, unlike type 2 and 3 lesions, type 1 NV may represent a neovascular AMD subtype more resilient to GA formation. This may have implications for anti-VEGF regimens in the management of type 1 NV.

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

    Directory of Open Access Journals (Sweden)

    Tiffany Lau

    2015-01-01

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

  15. Torpedo maculopathy: A primary choroidal capillary abnormality?

    Directory of Open Access Journals (Sweden)

    Rohan Chawla

    2018-01-01

    Full Text Available A 26-year-old healthy male patient's fundus revealed findings consistent with torpedo maculopathy. Swept-source optical coherence tomography (OCT showed a dome-shaped elevation of the retina at the level of ellipsoid zone. On OCT angiography segmented at the level of the choriocapillaris, a cluster of convoluted fine vessels was seen, and further, deeper scans of the larger choroidal vessels showed a slower flow. From these observations along with the embryological correlation of choriocapillaris development, a possibility of an abnormality preventing proper fenestration of the choriocapillaris along the horizontal raphe being responsible for this anomaly is suggested.

  16. Pitfalls in colour photography of choroidal tumours.

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-02-01

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

  17. Pitfalls in colour photography of choroidal tumours

    Science.gov (United States)

    Schalenbourg, A; Zografos, L

    2013-01-01

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

  18. Fibrosis of the Choroid Plexus Filtration Membrane

    Science.gov (United States)

    Parratt, John D. E.; Kirwan, Paul D.

    2016-01-01

    We report a previously undescribed inflammatory lesion consisting of deposition of activated complement (C3d and C9neo) in association with major histocompatibility complex type II (MHC2)-positive activated microglia in choroid plexus villi exhibiting classical fibrous thickening of the pericapillary filtration membrane. The proportion of villi affected ranged from 5% to 90% in 56 adult subjects with diseases of the CNS and 11 subjects with no preexisting disease of the CNS. In 3 of the 4 children studied, 2% or less of examined villi showed stromal thickening, complement deposition, and the presence of MHC2-positive microglia; in adults, the proportion of villi affected increased with age. Other features of the lesion included loss of capillaries and failure by macrophages to clear extracellular particulate electron-dense material by clathrin-mediated phagocytosis. This choroid plexus lesion may relate pathogenetically to age-related macular degeneration and to Alzheimer disease, 2 other conditions with no known risk factors other than increasing age. All 3 conditions are characterized by the presence of damaged capillaries, inflammatory extracellular aggregates of mixed molecular composition and defective clearance of the deposits by macrophages. PMID:27444353

  19. Study of surgical treatment on neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Xiao-Nü Liu

    2014-05-01

    Full Text Available AIM: To compare the effect of two surgical methods on neovascular glaucoma(NVG. METHODS: The clinical date of 46 cases(57 eyeswith NVG underwent surgical treatment were retrospectively analyzed and followed-up. Patients were divided into Ahmed glaucoma valve(AGVimplantation group(group A, 24 cases, 31 eyesand semiconductor diode laser transscleral ciliary body photocoagulation(TSCPCgroup(group B, 22cases, 26 eyesaccording to the surgical approach. The intraocular pressure, visual acuity and postoperative complications were compared before and after operation. RESULTS: The intraocular pressure postoperative in two groups were significantly lower than those preoperative(P P>0.05. The changes of visual acuity postoperative showed no statistical difference between the two groups(P>0.05. The postoperative complications of group A was significantly lower than that in group B, in which the incidence of eye pain, anterior chamber bleeding were significant differences between two groups(P CONCLUSION: AGV implantation treatment and TSCPC for NVG are both valid, but AGV implantation is filtration surgery, and TSCPC isciliary body destructive surgery, and the latter has higher rate of postoperative complications.

  20. Polypoidal Choroidal Vasculopathy Associated with Optic Disc Coloboma

    Directory of Open Access Journals (Sweden)

    Yumiko Nakano

    2018-01-01

    Full Text Available Purpose: To report a case of polypoidal choroidal vasculopathy associated with optic disc coloboma. Methods: Case report. Results: A 50-year-old woman presented with optic disc coloboma and retinochoroidal coloboma associated with subretinal hemorrhage and serous retinal detachment (SRD in her left eye. Optical coherence tomography (OCT confirmed SRD at the macula and showed a sharply elevated retinal epithelial detachment at the choroidal excavation. OCT also revealed choroidal cavitation along the temporal side of the optic coloboma. Fluorescein angiography showed hyperfluorescent dye leakage and indocyanine green angiography revealed polypoidal lesions. We diagnosed polypoidal choroidal vasculopathy (PCV. PCV was located at the end of the choroidal cavitation. Her left eye was treated with an intraocular injection of the anti-vascular endothelial growth factor aflibercept (2 mg. Photodynamic therapy was performed using the standard protocol 1 week after the intravitreal application of aflibercept. One month after the combined treatment, OCT showed completely resolved SRD and her symptoms disappeared. Her best-corrected visual acuity remained stable and no recurrence was found during a 12-month follow-up period. Conclusion: PCV associated with optic disc coloboma has not been previously reported. The morphological abnormality of choroidal cavitation and choroidal excavation connecting with optic disc coloboma may contribute to the development of PCV in this case.

  1. Neovascular age-related macular degeneration without drusen in the fellow eye: clinical spectrum and therapeutic outcome

    Directory of Open Access Journals (Sweden)

    Chung WH

    2016-12-01

    Full Text Available Wing H Chung,1 Elon H C van Dijk,1 Danial Mohabati,1 Greet Dijkman,1 Suzanne Yzer,2 Eiko K de Jong,3 Sascha Fauser,4 Reinier O Schlingemann,5–7 Carel B Hoyng,3 Camiel J F Boon1,5 1Department of Ophthalmology, Leiden University Medical Center, Leiden, 2Rotterdam Eye Hospital, Rotterdam, 3Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; 4Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; 5Department of Ophthalmology, 6Ocular Angiogenesis Group, Departments of Ophthalmology and Cell Biology and Histology, Academic Medical Center, 7Netherlands Institute for Neuroscience, Amsterdam, the Netherlands Purpose: To investigate the clinical characteristics and therapeutic outcome of patients with neovascular age-related macular degeneration (nAMD in 1 eye, without drusen in the fellow eye. Patients and methods: Medical records of 381 patients were analyzed to identify the cases. The main outcomes included Early Treatment Diabetic Retinopathy Study (ETDRS best-corrected visual acuity (BCVA and change in central retinal thickness (CRT. These parameters were reviewed at baseline, first follow-up visit, and after 6, 12, and 24 months. Results: Out of 381 patients, 29 cases (8% were included (of whom 3 had polypoidal choroidal vasculopathy [PCV] who were treated with anti-vascular endothelial growth factor (anti-VEGF therapy which was supplemented by photodynamic therapy (PDT in the PCV patients. Overall, no statistically significant change in mean BCVA was observed during follow-up. BCVA improved or remained stable (defined as a gain in BCVA, a stable BCVA, or a loss of <5 ETDRS letters in 22 patients (76%, and 7 patients (23% had lost ≥5 ETDRS letters at final follow-up. A gain of ≥15 ETDRS letters at final follow-up was seen in 5 patients (17%. Mean CRT had decreased significantly with 99 µm (P<0.001 at 24 months after the

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

    Directory of Open Access Journals (Sweden)

    Pedrosa AC

    2016-03-01

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

  3. Neovascular growth in an experimental alkali corneal burn model.

    Science.gov (United States)

    Figueroa-Ortiz, L C; Martín Rodríguez, O; García-Ben, A; García-Campos, J

    2014-08-01

    To analyse the length and area of corneal surface occupied by vessels, and their location in an experimental model of alkali burn-induced corneal neovascularization. An injury to the central cornea of the right eye in 91 Sprague-Dawley rats was induced using a silver nitrate pencil. The rats were divided in 7 groups that were sacrificed 2, 4, 6, 8, 10, 12 and 14 days post-injury, and then perfused with a mixture of Chinese ink in PBS -phosphate buffer saline-. Corneas were flat-mounted processed and divided in 4 quadrants. Corneal neovascular growth parameters (length and area) and the location of these vessels were performed blind. The results were statistically analysed. Neovascular growth was observed from day 2, reaching its maximum peak in length and area on the 12th day post-injury. A slight reduction in corneal neovascularization was observed after this day. The vessels were initially located in the middle third of the stroma and tended to be observed in the anterior third during the course of the experiment. Neovascularisation was observed on day 2 post-injury in all sectors of corneal surface. Neovascular growth was uniform during the experiment. Neovessels were located in the middle and anterior third of the cornea. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  4. Parametric imaging of tumor perfusion and neovascular morphology using ultrasound

    Science.gov (United States)

    Hoyt, Kenneth

    2015-03-01

    A new image processing strategy is detailed for the simultaneous measurement of tumor perfusion and neovascular morphology parameters from a sequence of dynamic contrast-enhanced ultrasound (DCE-US) images. A technique for locally mapping tumor perfusion parameters using skeletonized neovascular data is also introduced. Simulated images were used to test the neovascular skeletonization technique and variance (error) of relevant parametric estimates. Preliminary DCE-US image datasets were collected in 6 female patients diagnosed with invasive breast cancer and using a Philips iU22 ultrasound system equipped with a L9-3 MHz transducer and Definity contrast agent. Simulation data demonstrates that neovascular morphology parametric estimation is reproducible albeit measurement error can occur at a lower signal-to-noise ratio (SNR). Experimental results indicate the feasibility of our approach to performing both tumor perfusion and neovascular morphology measurements from DCE-US images. Future work will expand on our initial clinical findings and also extent our image processing strategy to 3-dimensional space to allow whole tumor characterization.

  5. Clinical effect of neovascular glaucoma treated by vitrectomy and cyclophotocoagulation

    Directory of Open Access Journals (Sweden)

    Yi-Xuan Jin

    2014-07-01

    Full Text Available AIM: To observe the postoperative intraocular pressure(IOPand operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time. METHODS: A total of 12 neovascular glaucoma cases(14 eyessecondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0.1-0.2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the IOP and complications. RESULTS: IOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average IOP at 1wk was 16.7±14.4mmHg, 15.7±8.8mmHg at 1mo and 12.9±4.5mmHg at 6mo, which compared with untreatment(39.6 ±10.0mmHgwas statistically significant different(PCONCLUSION: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

  6. Neovascularization of the atherosclerotic plaque: interplay between atherosclerotic lesion, adventitia-derived microvessels and perivascular fat

    NARCIS (Netherlands)

    van Hinsbergh, Victor W. M.; Eringa, Etto C.; Daemen, Mat J. A. P.

    2015-01-01

    Neovascularization is a prominent feature in advanced human atherosclerotic plaques. This review surveys recent evidence for and remaining uncertainties regarding a role of neovascularization in atherosclerotic plaque progression. Specific emphasis is given to hypoxia, angiogenesis inhibition, and

  7. Choroid plexus papilloma in a beluga whale (Delphinapterus leucas).

    Science.gov (United States)

    Thomas, Christian; Mergl, June; Gehring, Erica; Paulus, Werner; Martineau, Daniel; Hasselblatt, Martin

    2016-07-01

    We report herein a choroid plexus papilloma in a beluga whale (Delphinapterus leucas). This case was positive for choroid plexus tumor marker Kir7.1 on immunohistochemistry. These results and the high conservation of Kir7.1 across species at the amino acid sequence level strongly suggest that antibodies directed against Kir7.1 not only can be employed for the diagnosis of choroid plexus tumors in cetaceans, but are also likely to be diagnostically useful in other animal species. © 2016 The Author(s).

  8. A modified treat-and-extend regimen of aflibercept for treatment-naïve patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Ohnaka, Masayuki; Nagai, Yoshimi; Sho, Kenichiro; Miki, Katsuaki; Kimura, Motoki; Chihara, Tomoyuki; Takahashi, Kanji

    2017-04-01

    To evaluate a modified treat-and-extend (TAE) regimen of intravitreal aflibercept injection (IAI) for treatment-naïve patients with neovascular age-related macular degeneration (AMD). Thirty-six eyes (36 patients) treated with the modified TAE regimen were evaluated at 12 months retrospectively. The modified TAE regimen consisted of three steps: 1) an induction phase, during which patients were treated with ≥ 3-monthly IAIs until exudative activity disappeared, 2) an observation phase, during which patients were monitored until exudative activity appeared, and 3) a TAE phase, for which the initial treatment interval was determined based on the disease recurrence interval, followed by treatment intervals changing by 2 weeks. Mean logMAR BCVA improved significantly from 0.48 ± 0.51 at baseline to 0.40 ± 0.53 at 12 months (P < 0.01), and was maintained (losing <0.3 logMAR units) in 35 eyes (97.2 %). Mean central retinal thickness and central choroidal thickness decreased significantly after 12 months. In the TAE phase, the distribution of treatment intervals was ≥8 weeks in 64.7 % (11 eyes) at 12 months. The mean number of injections was 4.53. A modified TAE regimen of IAI for neovascular AMD produced good functional outcomes over 12 months with the small number of injections.

  9. Trabeculectomy combined with mitomycin and retinal condensation for neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Yue-Sheng Qiu

    2016-04-01

    Full Text Available AIM:To study the clinical effect of trabeculectomy combined with mitomycin and retinal condensation on neovascular glaucoma and their influence on ocular hemodynamics. METHODS:A total of 45 patients(45 eyeswith neovascular glaucoma treated with trabeculectomy, mitomycin and retinal condensation were selected, and the postoperative clinical effect, visual acuity, intraocular pressure(IOPand complications were observed. The color Doppler imaging technique was used to detect hemodynamics index of contralateral and ipsilateral eye before and 2wk after surgeries. RESULTS:All the patients were followed up for 3~6mo. The successful rate was 84%, the rate of forming functional filtering bleb was 82%, and the complication rate was 27%. The IOP at 1, 3 and 6mo after surgeries decreased significantly compared with pre-operation(PPPCONCLUSION:Trabeculectomy combined with mitomycin and retinal condensation has high success rate on treating neovascular glaucoma, which can effectively control IOP, improve vision and ocular hemodynamics.

  10. Intrastromal delivery of bevacizumab using microneedles to treat corneal neovascularization.

    Science.gov (United States)

    Kim, Yoo C; Grossniklaus, Hans E; Edelhauser, Henry F; Prausnitz, Mark R

    2014-09-11

    This study tested the hypothesis that highly targeted intrastromal delivery of bevacizumab using coated microneedles allows dramatic dose sparing compared with subconjunctival and topical delivery for treatment of corneal neovascularization. Stainless steel microneedles 400 μm in length were coated with bevacizumab. A silk suture was placed in the cornea approximately 1 mm from the limbus to induce corneal neovascularization in the eyes of New Zealand white rabbits that were divided into different groups: untreated, microneedle delivery, topical eye drop, and subconjunctival injection of bevacizumab. All drug treatments were initiated 4 days after suture placement and area of neovascularization was measured daily by digital photography for 18 days. Eyes treated once with 4.4 μg bevacizumab using microneedles reduced neovascularization compared with untreated eyes by 44% (day 18). Eyes treated once with 2500 μg bevacizumab using subconjunctival injection gave similar results to microneedle-treated eyes. Eyes treated once with 4.4 μg subconjunctival bevacizumab showed no significant effect compared with untreated eyes. Eyes treated with 52,500 μg bevacizumab by eye drops three times per day for 14 days reduced the neovascularization area compared with untreated eyes by 6% (day 18), which was significantly less effective than the single microneedle treatment. Visual exam and histological analysis showed no observable effect of microneedle treatment on corneal transparency or microanatomical structure. This study shows that microneedles can target drug delivery to corneal stroma in a minimally invasive way and demonstrates effective suppression of corneal neovascularization after suture-induced injury using a much lower dose compared with conventional methods. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  11. Gelsolin Restores Aβ-Induced Alterations in Choroid Plexus Epithelium

    Directory of Open Access Journals (Sweden)

    Teo Vargas

    2010-01-01

    Full Text Available Histologically, Alzheimer's disease (AD is characterized by senile plaques and cerebrovascular amyloid deposits. In previous studies we demonstrated that in AD patients, amyloid-β (Aβ peptide also accumulates in choroid plexus, and that this process is associated with mitochondrial dysfunction and epithelial cell death. However, the molecular mechanisms underlying Aβ accumulation at the choroid plexus epithelium remain unclear. Aβ clearance, from the brain to the blood, involves Aβ carrier proteins that bind to megalin, including gelsolin, a protein produced specifically by the choroid plexus epithelial cells. In this study, we show that treatment with gelsolin reduces Aβ-induced cytoskeletal disruption of blood-cerebrospinal fluid (CSF barrier at the choroid plexus. Additionally, our results demonstrate that gelsolin plays an important role in decreasing Aβ-induced cytotoxicity by inhibiting nitric oxide production and apoptotic mitochondrial changes. Taken together, these findings make gelsolin an appealing tool for the prophylactic treatment of AD.

  12. Gelsolin Restores Aβ-Induced Alterations in Choroid Plexus Epithelium

    Science.gov (United States)

    Vargas, Teo; Antequera, Desiree; Ugalde, Cristina; Spuch, Carlos; Carro, Eva

    2010-01-01

    Histologically, Alzheimer's disease (AD) is characterized by senile plaques and cerebrovascular amyloid deposits. In previous studies we demonstrated that in AD patients, amyloid-β (Aβ) peptide also accumulates in choroid plexus, and that this process is associated with mitochondrial dysfunction and epithelial cell death. However, the molecular mechanisms underlying Aβ accumulation at the choroid plexus epithelium remain unclear. Aβ clearance, from the brain to the blood, involves Aβ carrier proteins that bind to megalin, including gelsolin, a protein produced specifically by the choroid plexus epithelial cells. In this study, we show that treatment with gelsolin reduces Aβ-induced cytoskeletal disruption of blood-cerebrospinal fluid (CSF) barrier at the choroid plexus. Additionally, our results demonstrate that gelsolin plays an important role in decreasing Aβ-induced cytotoxicity by inhibiting nitric oxide production and apoptotic mitochondrial changes. Taken together, these findings make gelsolin an appealing tool for the prophylactic treatment of AD. PMID:20369065

  13. Diagnosis of Choroidal Melanoma in Dense Asteroid Hyalosis.

    Science.gov (United States)

    Motiani, Meghna V; McCannel, Colin A; Almanzor, Robert; McCannel, Tara A

    2017-01-01

    To demonstrate the utility of Optos ultra-wide field imaging in the diagnosis and management of choroidal melanoma in the setting of asteroid hyalosis. Observational case report. A 52-year-old female was referred for evaluation of floaters, photopsias, and blurry vision in the right eye. Clinical examination revealed dense asteroid hyalosis obscuring the fundus, and a limited view of a pigmented choroidal lesion in the nasal periphery. Optos ultra-wide field fluorescein angiography and ultrasonography facilitated the diagnosis of a choroidal melanoma. The patient underwent Iodine-125 brachytherapy for local tumor control and excellent tumor response was confirmed with serial follow-up Optos imaging and ultrasonography. Ultra-wide field fundus fluorescein angiography facilitated the diagnosis of a choroidal melanoma, which was obscured by dense asteroid hyalosis, allowing for local tumor control with brachytherapy. Optos wide-field imaging may be a valuable tool for detecting potentially life-threatening lesions in the setting of asteroid hyalosis.

  14. Morphological features of choroidal metastases: An OCT analysis

    Directory of Open Access Journals (Sweden)

    Ludovico Iannetti

    2013-01-01

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

  15. Patterns of tumor initiation in choroidal melanoma.

    Science.gov (United States)

    Li, W; Judge, H; Gragoudas, E S; Seddon, J M; Egan, K M

    2000-07-15

    This study attempts to document the occurrence of tumors with respect to clock hour location and distance from the macula and to evaluate tumor location in relation to retinal topography and light dose distribution on the retinal sphere. Analysis of patterns of tumor initiation may provide new evidence to clarify the controversy regarding the possible light-related etiology of choroidal melanoma. Incident cases of choroidal and ciliary body melanoma in Massachusetts residents diagnosed between 1984 and 1993 were the basis for analysis. Conventional fundus drawings and photos were used to assess the initiation site of each tumor. The initiation site was defined as the intersect between the largest tumor diameter and the largest perpendicular diameter of the tumor. Initiation sites were recorded using spherical coordinates. The retinal sphere was divided into 61 mutually exclusive sectors defined according to clock hour and anteroposterior distance from the macula. Rates of initiation were computed for each sector, overall, and according to gender and other clinical factors. Results were similar in left and right eyes; therefore, these were combined in analysis. Tumor initiation had a predilection for the macula (P preference was observed (P = 0.63). However, the parafoveal zone showed a strong circular trend (P eyes, respectively. Concentric zone location did not vary by gender (P = 0.93) or laterality (P = 0.78). However, posterior location was associated with light iris color (P = 0.01). Tumor diameters were largest in the peripheral region of the fundus and smallest in the macular and ciliary body zone (P color (P = 0.84), or tumor diameter (P = 0.73). Results suggest that tumor initiation is not uniformly distributed, with rates of occurrence concentrated in the macular area and decreasing monotonically with distance from the macula to the ciliary body. This pattern is consistent with the retinal topography and correlates positively with the dose distribution of

  16. Choroidal Excavation in Eye with Normal Tension Glaucoma

    Directory of Open Access Journals (Sweden)

    Kazunobu Asao

    2014-05-01

    Full Text Available Purpose: To report the case of an eye with normal tension glaucoma and a choroidal excavation. Methods: This is an observational case report. Results: A 59-year-old woman with normal tension glaucoma had a choroidal excavation in the left eye. Her best-corrected visual acuity and intraocular pressure were within normal limits and had been stable for 5 years. Fundus examination showed a small white lesion inferior to the macula and a nerve fiber layer defect at the inferior edge of the optic disc. Humphrey Field Analyzer (HFA showed visual field defects corresponding to the nerve fiber layer defect with C30-2, and a central scotoma superior to the macula with C10-2. Optical coherence tomography (OCT showed a 150-µm deep choroidal excavation. Disruptions of the IS/OS line were detected only in the area inferior to the choroidal excavation. During the 5 months of follow-up, her best-corrected visual acuity remained at 1.0 and the IOP ranged from 12 to 14 mm Hg in the left eye. The fundus and OCT images did not deteriorate and the choroidal excavation did not enlarge. Conclusions: The disruption of the inner/outer segment (IS/OS line was detected only at the area surrounding the choroidal excavation. OCT examinations are useful in assessing the area of the residual IS/OS line, and HFA can be used to estimate the residual central visual field.

  17. Choroidal excavation in vogt-koyanagi-harada disease.

    Science.gov (United States)

    Hashida, Noriyasu; Fok, Andrew; Nishida, Kohji

    2014-05-01

    To report a case of choroidal excavation accompanied by Vogt-Koyanagi-Harada disease (VKH). A 54-year-old Japanese woman who was complaining of bilateral blurring of vision associated with headache underwent optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography as well as a routine ophthalmological examination. Fundoscopy showed papilloedema and serous retinal detachment in both eyes. Fluorescein angiography detected bilateral multifocal leakage with pooling of dye in the subretinal space. Indocyanine green angiography showed patches of hyperfluorescence and hypofluorescent spots bilaterally. A diagnosis of VKH was reached soon afterwards. OCT of the left eye revealed the presence of a unilateral choroidal excavation under the fovea and subretinal fibrin over the site of the excavation. Treatment successfully resolved VKH symptoms with gradual resolution of subretinal fibrin and fluid; however, the choroidal excavation remained. This case is the first report of choroidal excavation associated with VKH. Our results suggest that choroidal excavation can be induced by choroidal inflammation caused by VKH.

  18. Choroidal excavation in eye with normal tension glaucoma.

    Science.gov (United States)

    Asao, Kazunobu; Morimoto, Takeshi; Nakada, Atsuko; Kawasaki, Yoshimi

    2014-05-01

    To report the case of an eye with normal tension glaucoma and a choroidal excavation. This is an observational case report. A 59-year-old woman with normal tension glaucoma had a choroidal excavation in the left eye. Her best-corrected visual acuity and intraocular pressure were within normal limits and had been stable for 5 years. Fundus examination showed a small white lesion inferior to the macula and a nerve fiber layer defect at the inferior edge of the optic disc. Humphrey Field Analyzer (HFA) showed visual field defects corresponding to the nerve fiber layer defect with C30-2, and a central scotoma superior to the macula with C10-2. Optical coherence tomography (OCT) showed a 150-µm deep choroidal excavation. Disruptions of the IS/OS line were detected only in the area inferior to the choroidal excavation. During the 5 months of follow-up, her best-corrected visual acuity remained at 1.0 and the IOP ranged from 12 to 14 mm Hg in the left eye. The fundus and OCT images did not deteriorate and the choroidal excavation did not enlarge. The disruption of the inner/outer segment (IS/OS) line was detected only at the area surrounding the choroidal excavation. OCT examinations are useful in assessing the area of the residual IS/OS line, and HFA can be used to estimate the residual central visual field.

  19. Avaliação da função macular por eletrorretinografia focal e por angiofluoresceinografia em pacientes com degeneração macular relacionada à idade neovascular submetidos à terapia fotodinâmica com verteporfina Evaluation of the macular function by focal electroretinography and by fluorescein angiography in patients with neovascular age-related macular degeneration submitted to verteporfin photodynamic therapy

    Directory of Open Access Journals (Sweden)

    Akiyoshi Oshima

    2009-02-01

    Full Text Available OBJETIVOS: Avaliar a função macular por eletrorretinografia focal e angiofluoresceinografia em pacientes com degeneração macular relacionada à idade neovascular submetidos à terapia fotodinâmica com verteporfina. MÉTODOS: Estudo prospectivo incluindo 22 pacientes (12 homens com degeneração macular relacionada à idade e lesão neovascular coroídea subfoveal predominantemente clássica, não consecutivos, tratados com terapia fotodinâmica com verteporfina padrão e acompanhados por um período de 12 meses. A acuidade visual melhor corrigida foi medida utilizando tabela ETDRS, as alterações das lesões foram avaliadas pela angiofluoresceinografia e a função dos cones foram obtidas pela eletrorretinografia focal na visita inicial e nas subsequentes a cada três meses. RESULTADOS: Todos os pacientes completaram as visitas programadas. Após uma média de 3,5 sessões por paciente, a variação da acuidade visual melhor corrigida não foi significante no decorrer do estudo. Em 50% dos pacientes a variação da acuidade visual melhor corrigida foi >1 linha. Ao final do estudo observou-se ausência de vazamento em 86% dos pacientes. A média da amplitude e latência do ERG focal na visita inicial foram de, respectivamente, 194,88 nV e 29,19 ms e as variações no decorrer do estudo não foram significantes. CONCLUSÕES: Não foram encontradas diferenças na amplitude e latência do eletrorretinografia focal após um período de 9 meses. A acuidade visual melhor corrigida não sofreu variações significativas ao longo dos 12 meses. A lesão foi significativamente reduzida ao longo do tempo e houve uma correlação negativa entre a amplitude e a acuidade visual melhor corrigida.PURPOSE: To evaluate macular function by focal electroretinography and fluorescein angiography (FA in patients with neovascular age-related macular degeneration submitted to verteporfin photodynamic therapy (VPT. METHODS: Prospective study involving 22 patients

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

  2. Microcomputed tomography characterization of neovascularization in bone tissue engineering applications.

    NARCIS (Netherlands)

    Young, S.; Kretlow, J.D.; Nguyen, C.; Bashoura, A.G.; Baggett, L.S.; Jansen, J.A.; Wong, M.; Mikos, A.G.

    2008-01-01

    Vasculogenesis and angiogenesis have been studied for decades using numerous in vitro and in vivo systems, fulfilling the need to elucidate the mechanisms involved in these processes and to test potential therapeutic agents that inhibit or promote neovascularization. Bone tissue engineering in

  3. Choroidal dendritic cells require activation to present antigen and resident choroidal macrophages potentiate this response.

    Science.gov (United States)

    Forrester, J V; Lumsden, L; Duncan, L; Dick, A D

    2005-03-01

    The uveal compartment of the eye contains extensive networks of resident macrophages and dendritic cells. These cells are now recognised to have a role in many ocular pathologies. The aim of this study was to isolate, characterise, and compare the function of ciliary body/choroid dendritic cells and macrophages from the normal eye. Explants of rat and human ciliary body/choroid were cultured in vitro for various periods of time and cells harvested either from the supernatant fluid or from enzyme digested and washed explants. The cells were then phenotyped by microscopy and flow cytometry, examined by video time lapse photomicroscopy, and analysed functionally in a series of immunoassays. Two main types of dendritic cell were identified: large veil-like MHC class II(mid) motile but relatively non-translocatory cells and small MHC class II(hi) motile and rapidly translocating cells. Tissue macrophages mainly remained associated with the explants in culture but gradually lost their resident tissue marker (ED2) and detached from the explants as clusters of low density, large, CR3 (ED7)(+) cells, some of which underwent apoptosis. Video time lapse studies showed dendritic cells constantly interacting with large single cells and cell clusters by traversing the interstices of the cell clusters. In functional studies, freshly isolated dendritic cells were poor presenters of antigen and required activation by short term culture for acquisition of antigen presenting function. In contrast, dendritic cell depleted choroidal cell preparations containing macrophages and other cells failed to present antigen even after short term culture but augmented the antigen presenting function of dendritic cells when tested in co-culture. At least two types of dendritic cells are present in the normal ciliary body/choroid layer of the eye. It is likely that these cells have different functions based on their motility and potential to migrate to secondary lymphoid tissue either during normal

  4. A pilot study to image the vascular network of small melanocytic choroidal tumors with speckle noise-free 1050-nm swept source optical coherence tomography (OCT choroidal angiography).

    Science.gov (United States)

    Maloca, Peter; Gyger, Cyrill; Hasler, Pascal W

    2016-06-01

    To visualize and measure the vascular network of melanocytic choroidal tumors with speckle noise-free swept source optical coherence tomography (SS-OCT choroidal angiography). Melanocytic choroidal tumors from 24 eyes were imaged with 1050-nm optical coherence tomography (Topcon DRI OCT-1 Atlantis). A semi-automated algorithm was developed to remove speckle noise and to extract and measure the volume of the choroidal vessels from the obtained OCT data. In all cases, analysis of the choroidal vessels could be performed with SS-OCT without the need for pupillary dilation. The proposed method allows speckle noise-free, structure-guided visualization and measurement of the larger choroidal vessels in three dimensions. The obtained data suggest that speckle noise-free OCT may be more effective at identifying choroidal structures than traditional OCT methods. The measured volume of the extracted choroidal vessels of Haller's layer and Sattler's layer in the examined tumorous eyes was on average 0.982463955 mm(3) /982463956 μm(3) (range of 0.209764406 mm(3) /209764405.9 μm(3)to 1.78105544 mm(3) /1781055440 μm(3)). Full thickness obstruction of the choroidal vasculature by the tumor was found in 18 cases (72 %). In seven cases (18 %), choroidal vessel architecture did not show pronounced morphological abnormalities (18 %). Speckle noise-free OCT may serve as a new illustrative imaging technology and enhance visualization of the choroidal vessels without the need for dye injection. OCT can be used to identify and evaluate the choroidal vessels of melanocytic choroidal tumors, and may represent a potentially useful tool for imaging and monitoring of choroidal nevi and melanoma.

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

    Science.gov (United States)

    Williams, Patrick D; Callanan, David; Solley, Wayne; Avery, Robert L; Pieramici, Dante J; Aaberg, Tom

    2012-01-01

    This prospective multi-center pilot study compares the use of half-fluence photodynamic therapy combined with ranibizumab with ranibizumab monotherapy for the treatment of neovascular age-related macular degeneration. All patients presenting with untreated subfoveal neovascular age-related macular degeneration were considered for inclusion. Patients were randomized to receive either ranibizumab with half-fluence photodynamic therapy or ranibizumab alone. Patients in the ranibizumab alone group were given three consecutive monthly ranibizumab injections and were followed monthly. They were treated with ranibizumab as needed, based on clinical discretion, using vision and optical coherence tomography. Patients in the combined group were given one same-day combined ranibizumab and half-fluence (25 j/cm(2)) photodynamic therapy treatment and were treated monthly as needed. Outcomes included changes in standardized visual acuity, optical coherence tomography foveal thickness, and percentage of as-needed injections to maintenance examinations. Fifty-six out of 60 enrolled patients completed the twelve month primary outcome visit; this consisted of 27 patients receiving ranibizumab alone and 29 receiving combined treatment. The average age was 79.1 for the ranibizumab alone group and 79.3 for the combined group. The mean visual acuity in the ranibizumab alone group improved from 52.9 Early Treatment of Diabetic Retinopathy letters initially to 62.8 letters at twelve months. The mean visual acuity in the combined group improved from 49.2 letters to 51.8 letters at twelve months. The differences in visual acuity improvements were not statistically significant based on a two-tailed t-test (P = 0.2). Due to the presence of outliers in each group, a Mann-Whitney U test was performed to confirm the results (U = 325; P = 0.28). The mean optical coherence tomography foveal thickness improved 92.5 microns and 106.7 microns in the ranibizumab alone and the combined group

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

    Directory of Open Access Journals (Sweden)

    Mitsuyoshi Tei

    2014-01-01

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

  7. Gamma Knife Radiosurgery for Choroidal Hemangioma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yun Taek; Kang, Se Woong [Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jung-Il, E-mail: jilee@skku.edu [Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-12-01

    Purpose: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Methods and Materials: Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm{sup 3} (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). Results: The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p = .018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Conclusion: Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.

  8. [Late metastasis development in two cases of small choroidal melanoma].

    Science.gov (United States)

    Svetlošáková, Z; Malclès, A; Pommier, P; Krásnik, V; Grange, J D

    2013-08-01

    To present data pointing out that small tumour size might not be a sufficient predictor of good prognosis of choroidal melanoma and present a new promising therapy of hepatic metastasis. Retrospective, noncomparative case report of two patients with small choroidal melanoma. Two cases of small choroidal melanoma which developed metastases are described. Both patients underwent radiotherapy of the primary tumour. Metastases were treated by combined therapy in patient 1 while in patient 2 a new therapeutic modality of stereotactic radiotherapy, Cyberknife, was applied. Patient 1 died from metastatic spread 7,6 years after primary therapy despite a very good local tumour control. Patient 2 died 11,3 years after primary therapy due to intercurrent disease with a very good local eye findings and hepatic metastasis in regression. Choroidal melanoma of a small size can develop into metastatic disease even long time after satisfactory primary treatment. Further studies are required to assess the risk factors of metastatic spread in small uveal melanomas. Cyberknife stereotactic radiotherapy seems to be a promising therapeutic method of a solitary hepatic metastasis. Key words: choroidal melanoma, metastasis, prognostic factors, stereotactic radiotherapy.

  9. The Choroid Plexus in Healthy and Diseased Brain.

    Science.gov (United States)

    Kaur, Charanjit; Rathnasamy, Gurugirijha; Ling, Eng-Ang

    2016-03-01

    The choroid plexus is composed of epithelial cells resting on a basal lamina. These cells produce the cerebrospinal fluid (CSF), which has many functions including rendering mechanical support, providing a route for some nutrients, removing by-products of metabolism and synaptic activity, and playing a role in hormonal signaling. The choroid plexus synthesizes many growth factors, including insulin-like, fibroblast, and platelet-derived growth factors. The tight junctions located between the apical parts of the choroid plexus epithelial cells form the blood-CSF barrier (BCSFB), which is crucial for the homeostatic regulation of the brain microenvironment along with the blood-brain barrier (BBB). Morphological changes such as atrophy of the epithelial cells and thickening of the basement membrane suggest altered CSF production occurs in aging and in Alzheimer disease. In brain injuries and infections, leukocytes accumulate in the CSF by passing through the choroid plexus. In inflammatory CNS diseases (eg, multiple sclerosis), pathogenic autoreactive T lymphocytes may migrate through the BBB and BCSFB into the CNS. The development of therapeutic strategies to mitigate disruption of the BCSFB may be helpful to curtail the entry of inflammatory cells into the CSF and hence reduce inflammation, thereby overcoming choroid plexus dysfunction in senescence and in various diseases of the CNS. © 2016 American Association of Neuropathologists, Inc. All rights reserved.

  10. The acute effect of pseudoephedrine on choroidal thickness.

    Science.gov (United States)

    Ovet, G; Alpfidan, I; Sakarya, Y; Sakarya, R; Ozcimen, M; Göktaş, S; Erdoğan, E

    2016-01-01

    To investigate the acute effects of pseudoephedrine (PE) on choroidal thickness in healthy young patients. Fifty patients with nasal and sinus congestion who were prescribed 60 mg oral PE at the otolaryngology department were recruited for this study. The enhanced depth imaging (EDI) optic coherence tomography (OCT) (Spectralis OCT; Heidelberg Engineering, Heidelberg, Germany) choroidal thickness measurements were performed at baseline and 1, 3 and 6 hours at 7 points. The right eyes of 50 healthy subjects (22 women and 28 men) were included in this study. The mean choroidal thickness at fovea was 293.12 μm, 279.80 μm, 295.80 μm, and 294.52 μm at baseline, 1, 3 and 6 hours respectively. A significant reduction in choroidal thickness versus baseline was observed at all points at 1 hour. The choroidal thickness decreased 1 hour after oral administration of PE and returned to baseline thickness at 3 hours. We suppose that this transient decrease might be associated with vasoconstriction due to activation of sympathetic alpha adrenoceptors.

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

    Directory of Open Access Journals (Sweden)

    Carol L Shields

    2015-01-01

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

  12. Engorgement of vortex vein and polypoidal choroidal vasculopathy.

    Science.gov (United States)

    Chung, Song Ee; Kang, Se Woong; Kim, Jae Hui; Kim, Yun Taek; Park, Do Young

    2013-04-01

    The purpose of this study was to identify a correlation between engorgement of the vortex vein and the development of polypoidal choroidal vasculopathy (PCV). Engorgement of the vortex vein was evaluated by masked observers using a montage of indocyanine green angiography images. Sixty-three eyes with PCV, 27 uninvolved fellow eyes with PCV, and 30 eyes of age-matched control subjects were included. The incidence and distribution pattern of engorgement were evaluated. Thirty-three eyes (52.4%) of PCV evidenced engorgement of the vortex vein, whereas such engorgement was detected in only 7 of the 30 eyes (30.4%) of the control subjects (P = 0.016). Among 27 fellow eyes with PCV, it was detected in 11 (40.7%) (P = 0.706 vs. control eyes). In all groups, it was most frequently detected at the inferior temporal quadrant. In eyes with PCV, mean (±standard deviation) choroidal thickness of the eyes evidencing vortex vein engorgement was 338.1 ± 131.3 μm and the thickness of those not evidencing vortex vein engorgement was 275.1 ± 107.7 μm. When the choroidal thickness increased to 10 μm in the eyes with PCV, the odds of detecting the engorgement was multiplied by a factor of 1.05 (P = 0.042). The incidence of the engorgement of vortex vein was correlated with the presence of choroidal vascular hyperpermeability (P = 0.009). This study demonstrates that engorgement of the vortex vein was observed more frequently in the eyes with PCV. Such a finding was associated with choroidal thickening and choroidal vascular hyperpermeability. These indicate that the engorgement of the vortex vein might be involved in the pathogenic mechanisms of PCV.

  13. Development of the choroid plexus and blood-CSF barrier

    Science.gov (United States)

    Liddelow, Shane A.

    2015-01-01

    Well-known as one of the main sources of cerebrospinal fluid (CSF), the choroid plexuses have been, and still remain, a relatively understudied tissue in neuroscience. The choroid plexus and CSF (along with the blood-brain barrier proper) are recognized to provide a robust protective effort for the brain: a physical barrier to impede entrance of toxic metabolites to the brain; a “biochemical” barrier that facilitates removal of moieties that circumvent this physical barrier; and buoyant physical protection by CSF itself. In addition, the choroid plexus-CSF system has been shown to be integral for normal brain development, central nervous system (CNS) homeostasis, and repair after disease and trauma. It has been suggested to provide a stem-cell like repository for neuronal and astrocyte glial cell progenitors. By far, the most widely recognized choroid plexus role is as the site of the blood-CSF barrier, controller of the internal CNS microenvironment. Mechanisms involved combine structural diffusion restraint from tight junctions between plexus epithelial cells (physical barrier) and specific exchange mechanisms across the interface (enzymatic barrier). The current hypothesis states that early in development this interface is functional and more specific than in the adult, with differences historically termed as “immaturity” actually correctly reflecting developmental specialization. The advanced knowledge of the choroid plexus-CSF system proves itself imperative to understand a range of neurological diseases, from those caused by plexus or CSF drainage dysfunction (e.g., hydrocephalus) to more complicated late-stage diseases (e.g., Alzheimer's) and failure of CNS regeneration. This review will focus on choroid plexus development, outlining how early specializations may be exploited clinically. PMID:25784848

  14. Neovascular glaucoma in a child: an unusual presentation of medulloepithelioma

    Directory of Open Access Journals (Sweden)

    Kassa, Enoch

    2014-04-01

    Full Text Available [english] A healthy 12 month old infant without significant medical history presented with left eye redness for one week. Ophthalmic examination showed elevated intraocular pressure with iris neovascularization in the affected eye with increased optic nerve cupping. Scleral depression revealed a ciliary body mass in the supratemporal quadrant. A large, non-pigmented, vascular mass was noted; biopsy results showed multilayered cords, tubules, and sheets resembling primitive medullary epithelium arising from the ciliary body. The patient was diagnosed with medulloepithelioma. The patient underwent enucleation of the affected eye. Medulloepithelioma is a rare but important cause of neovascular glaucoma in the pediatric population. This case will focus on the characteristics of medulloepthelioma and the differential diagnosis for a non-pigmented ciliary body mass in a child.

  15. Macular choroidal thickness after vitreoretinal surgery: Long-term effect of pars plana vitrectomy with and without encircling scleral buckling surgery.

    Science.gov (United States)

    Gama, I; Proença, H; Gonçalves, A; Faria, M; Almeida, L; Bernardo, T; Couceiro, R; Monteiro-Grillo, M

    2017-12-01

    To evaluate the macular choroidal thickness (CT) of eyes subjected to pars plana vitrectomy (PPV) whether or not combined with encircling scleral buckling (ESB) surgery for primary rhegmatogenous retinal detachment repair at 6 months or more after surgery. This observational study included: 15 eyes (15 patients) submitted to combined ESB+PPV; 15 eyes submitted to PPV and their respective 30 normal fellow eyes (FE). Two 6mm lineal perpendicular optical coherence tomography B-scans centred on the fovea with enhanced depth imaging were performed on each eye. CT was measured at several macular locations: subfoveal (SF-CT) and at a radius of 1, 2, and 3mm from the fovea. CTs of the eyes in the CE+PPV group were compared to CT in the PPV group and the CTs of all operated eyes were compared to the CTs of their FE. SF-CT of the eyes in the ESB+PPV group was significantly increased compared to their FE (P=.001). CT at a radius of 1, 2, and 3mm from the fovea of the ESB+PPV group were significantly increased (P=.001, P=.005, and P=.001, respectively). The SF-CT of the PPV group was similar to their FE (P=.691). The SF-CT of the ESB+PPV group was significantly increased compared to SF-CT of the PPV group (P=.019). The CT of the eyes subjected to combined ESB and PPV was significantly increased at 6 months or more after surgery compared to the CT of their FE and to the CT of the eyes subjected to PPV alone, which could be explained by a venous engorgement caused by the ESB. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Effect of Ahmed valve implantation on late neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Ping-An Mao

    2013-09-01

    Full Text Available AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma. METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 caseswith late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

  17. Assessment of Retinal and Choroidal Measurements in Chinese School-Age Children with Cirrus-HD Optical Coherence Tomography.

    Directory of Open Access Journals (Sweden)

    Tao Li

    Full Text Available To evaluate retinal thickness (RT, retinal volume (RV and choroidal thickness (ChT in Chinese children using Cirrus-HD optical coherence tomography (OCT, and assess their associations with spherical equivalent (SE, age and gender.This was a prospective study that recruited 193 healthy Chinese children (193 eyes with no ophthalmic disease history between December 2012 and December 2013. RT and RV were acquired using OCT. Subfoveal ChT (SFCT and ChT1-mm and 2-mm temporal, nasal, superior and inferior to the fovea were measured manually.RT in the inner temporal and nasal regionsdiffered significantly between refraction groups (both P<0.05. Significant differences were also found inSFCT andChT 1- and 2-mm inferior to the fovea (all P<0.05. RT differed significantly between males and females in the outer superior region in the emmetropia group (P<0.05. ChT differed significantly between males and females 2-mm temporal to the fovea in the emmetropia group (P<0.05, and 1-mm temporal to the fovea in the mild myopia group (P<0.05. SE correlated positively with RT in the inner temporal (r = 0.230,nasal (r = 0.252 and inferior (r = 0.149 regions (all P<0.05. Age correlated positively with foveolar (r = 0.169, total macular (r = 0.202, inner temporal (r = 0.237, inner nasal (r = 0.248, inner superior (r = 0.378 and inner inferior (r = 0.345 region thicknesses, and with RV (r = 0.207(all P<0.05. SE correlated positively with SFCT (r = 0.195, and with ChT1-mm temporal (r = 0.167, 1- and 2-mm nasal (r = 0.144 and r = 0.162, 2-mm superior (r = 0.175, and 1- and 2-mm inferior (r = 0.207 and r = 0.238 to the fovea (all P<0.05. Age had no significant association with ChT.SE, age and gender did not influence macular RT and ChT in most regions, and correlations of RT with age and ChT with SE were weak.

  18. Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs.

    Science.gov (United States)

    Rätsep, Tõnu; Minajeva, Ave; Asser, Toomas

    2013-11-01

    Lumbar disc degeneration may be associated with intensity of neovascularization in disc herniations. Our study was designed to evaluate how much the severity of histodegeneration is related to the development of neovascularization and to the level of pleiotrophin in the herniated lumbar discs. Surgically excised lumbar disc specimens were obtained from 29 patients with noncontained (i.e., extruding through the posterior longitudinal ligament) and 21 patients with contained disc herniations. The histodegeneration scores and levels of neovascularization were estimated according to semiquantitative analysis in lumbar disc and endplate samples. Immunohistochemical staining were performed to identify the newly formed blood vessels and to detect the presence of pleiotrophin in the specimens. Higher levels of disc and endplate neovascularity were registered in noncontained herniations. The level of neovascularization was significantly related to the score of histodegeneration in the herniated disc tissues but not in the endplate specimens. Both contained and noncontained herniations had the highest values of histodegeneration in conjunction with the highest level of neovascularization but the relations between neovascularity and degenerative changes remained to be significant only in the group of noncontained herniations. Registration or frequency of pleiotrophin positive cells did not correlate significantly with histodegeneration or level of neovascularization in the disc samples. Severe histodegeneration of the lumbar disc herniations is associated with enhanced neovascularization and potentially also spontaneous regression of the herniated tissue.

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

    Science.gov (United States)

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

    2015-09-01

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

  20. Retinal and choroidal intravascular spectral-domain optical coherence tomography

    DEFF Research Database (Denmark)

    Willerslev, Anne; Li, Xiao Qiang; Cordtz, Peter

    2014-01-01

    Purpose:  To examine retinal and choroidal blood vessels using spectral-domain optical coherence tomography (SD-OCT). Methods:  Retrospective case series. Results:  Scans through retinal blood vessels in healthy subjects demonstrated vessel wall reflexes and a tri-layer profile of the blood column...

  1. Choroidal metastases as the initial presentation of lung cancer: A ...

    African Journals Online (AJOL)

    Clinical reports of symptomatic intraocular metastasis as the initial presentation of lung cancer are rare. We report the case of a 49-year-old female patient who presented with loss of vision due to choroidal metastases as the initial manifestation of her disseminated lung cancer. This particular patient was referred to us from ...

  2. Choroidal Metastases as the Initial Presentation of Lung Cancer: A ...

    African Journals Online (AJOL)

    Clinical reports of symptomatic intraocular metastasis as the initial presentation of lung cancer are rare. We report the case of a 49-year-old female patient who presented with loss of vision due to choroidal metastases as the initial manifestation of her disseminated lung cancer. This particular patient was referred to us from.

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

    Directory of Open Access Journals (Sweden)

    Kyoko Hirukawa-Nakayama

    2014-01-01

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

  4. Intraocular malignant melanoma of the choroid presenting as orbital cellulitis.

    Science.gov (United States)

    Nair, Akshay Gopinathan; Kaliki, Swathi; Ali, Mohammed Javed; Naik, Milind N; Vemuganti, Geeta K

    2014-06-01

    We report a case of choroidal melanoma with features suggestive of orbital cellulitis. A 24-year-old Asian Indian male presented with a 20-day history of sudden loss of vision in the right eye. Edematous eyelids with complete mechanical ptosis, complete ophthalmoplegia, gross proptosis accompanied by massive chemosis, and prolapse of the inferior forniceal conjunctiva were noted. He denied perception of light in the right eye. The left eye was unremarkable. B-scan ultrasonography of the right eye showed a large dome-shaped mass filling the posterior segment suggestive of choroidal melanoma. Computed tomography confirmed those findings and showed no extraocular tumor extension. The patient was conservatively treated with systemic steroids following which the inflammation subsided. He underwent enucleation of the right eye and a diagnosis of spindle A cell choroidal melanoma was confirmed by histopathological examination. Although rare, orbital cellulitis is one of the presenting features of choroidal melanoma. Uveal melanoma-associated orbital cellulitis can be well controlled with systemic steroids, does not always indicate extraocular tumor extension, and can occur in spindle A cell melanomas.

  5. OPTIC NERVE MENINGOCELE SIMULATING EXTRAOCULAR EXTENSION OF CHOROIDAL MELANOMA.

    Science.gov (United States)

    Sioufi, Kareem; Say, Emil Anthony T; Gray, Hilary M; Shields, Carol L

    2017-01-01

    To report a case of optic nerve meningocele simulating massive, recurrent extraocular extension of choroidal melanoma. Case report. A 53-year-old white man with choroidal melanoma in his left eye of 7.3-mm thickness was treated with plaque radiotherapy and transpupillary thermotherapy. On 1-year follow-up examination, visual acuity was 20/20 in the right eye and 20/30 in the left eye. The regressed choroidal melanoma scar in the left eye measured 1.5 mm in thickness with stable margins. The optic disk was normal. Ultrasonography demonstrated regressed echogenic choroidal scar, with an echolucent multilobulated retrobulbar mass, suspicious for extraocular extension. On magnetic resonance imaging, the retrobulbar mass corresponded to a distended and kinked optic nerve sheath, filled with extensive subarachnoid fluid and normal-size optic nerve with apposition against the posterior globe. There was no extraocular extension of tumor. Similar but less distended right optic nerve sheath was documented, consistent with optic nerve sheath meningocele in both eyes. Observation was advised and the findings remained stable. Optic nerve sheath meningocele is a benign dilatation of the optic nerve sheath that can simulate orbital tumor or extraocular extension of intraocular tumor. Magnetic resonance imaging can reliably differentiate these conditions.

  6. Choroid Plexus A-V Malformation Presenting with IVH

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-12-01

    Full Text Available A term infant presenting on the second day with apnea and decerebrate posturing had an intraventricular hemorrhage (IVH, the result of an arteriovenous malformation of the choroid plexus demonstrated angiographically on the 3rd day and reported from Johns Hopkins Hospital.

  7. Case Report: Bilateral iris, choroid, optic nerve colobomas and ...

    African Journals Online (AJOL)

    Background: Baraitser–Winter syndrome (BRWS) is a malformation syndrome, characterized by facial dysmorphism, ocular colobomata, pachygyria, and intellectual defects. Case report: A 3.5 year old female child with BRWS has bilateral congenital ptosis, microcornea, iris, choroid, and optic nerve coloboma, retinal ...

  8. Clinical Profile and Outcome of Serpiginous Choroiditis in a Uveitis ...

    African Journals Online (AJOL)

    tulyasys

    understanding of this disease.[10] The current treatment protocol for serpiginous choroiditis also remains controversial.[14,15] Although oral steroid remain the mainstay, there is often a need for immunosuppressive in view of non-response, recurrence, or steroid-induced side effects.[9,10,14,15] Antituberculous therapy was ...

  9. Bilateral pigmented paravenous retino-choroidal degeneration following measles.

    Science.gov (United States)

    Peduzzi, M; Guerrieri, F; Torlai, F; Prampolini, M L

    1984-01-01

    A 26-year-old female showed a bilateral ophthalmoscopic picture of pigmented paravenous retino-choroidal distrophy 19 years after neuro-retinitis following measles. Pigmentary disturbances in the fundus were not reported in 1963 clinical record; however functional tests are at present practically unchanged. Some debated aspects of this condition are discussed.

  10. Autofluorescence quantification of benign and malignant choroidal nevomelanocytic tumors.

    Science.gov (United States)

    Albertus, Daniel L; Schachar, Ira H; Zahid, Sarwar; Elner, Victor M; Demirci, Hakan; Jayasundera, Thiran

    2013-08-01

    Accurate diagnosis of choroidal melanoma is challenging and has important implications for both physicians and patients. We assessed the utility of quantification of fundus autofluorescence in the evaluation and follow-up of choroidal nevomelanocytic tumors. To assess the utility of autofluorescence quantification in distinguishing clinically diagnosed choroidal nevi, melanoma, and indeterminate nevomelanocytic lesions. A retrospective observational study from 2006 to 2012 of patients with choroidal nevomelanocytic lesions who had digital autofluorescence and color fundus imaging performed at the University of Michigan Kellogg Eye Center. ImageJ software was used to output autofluorescence gray-scale values for each pixel of a 500 × 50-pixel region within each lesion and a corresponding adjacent control region. A single value was generated, termed the Index of Retinal Autofluorescence (IRA), to represent the total difference in gray-scale values between the 2 regions in each affected eye. Thirteen of the 14 clinically diagnosed nevi exhibited an IRA less than 150 gray-scale intensity squared (gsi2). Eight of 9 clinically diagnosed melanomas exhibited an IRA more than 150 gsi2. An IRA of 150 gsi2 distinguished nevi from melanomas with a sensitivity of 0.89 and specificity of 0.93. Fifteen of 19 patients with indeterminate nevomelanocytic lesions underwent clinical assessment and initial imaging with clinical follow-up at a median of 10 months. All 3 patients with an IRA less than 150 gsi2 showed no evidence of clinical progression and 6 of 12 lesions with an IRA more than 150 gsi2 showed clinical progression to melanoma. An IRA of 150 gsi2 identifies indeterminate lesions that progressed to melanoma with a sensitivity of 1.00 and specificity of 0.33. Quantification of digital autofluorescence images can differentiate between clinically benign and malignant choroidal nevomelanocytic lesions and may be predictive for clinical progression of indeterminate lesions.

  11. [Transpupillary thermotherapy (TTT) for intraocular metastases in choroid].

    Science.gov (United States)

    Romanowska-Dixon, Bozena; Kowal, Joanna; Pogrzebielski, Arkadiusz; Markiewicz, Anna

    2011-01-01

    Uveal metastases are the most common intraocular malignant tumors. Most patients who develop metastatic carcinoma to the choroid are managed by radiation or chemotherapy. Since TTT is an optional treatment for choroidal melanomas and hemangiomas, we ought to determine whether TIT is suitable for treatment of solitary choroidal metastasis at the posterior pole. To evaluate effectivenes of TTT treatment for intraocular metastases. 45 patients (59 eyes) with intraocular metastases were treated in the Ophthalmological Department of Jagiellonian University in Kraków. There were 30 women and 15 man, at the age 31-84 years (av. 57.5). The primary tumor was a breast cancer in 22 women, lung cancer in 5 men and 2 women, kidney (3), colon (2), uterus (1), larynx (1), testicle (1), esophagus (1). 10 patients had also metastases in other organs. TTT was performed in all treated eyes, in 11 combined with 106Ru brachytherapy (BT). Chemotherapy as adjuvant treatment was performed in 18 patients. The results of treatment were evaluated in mean 14.5 months (1-61) follow-up. After TTT, tumor shrinking was observed in most treated tumors (in 37 eyes, 62.7%), inhibition of tumor growth in 5 (8.4%), and in 4 cases (6.7%) progression of tumor growth. In 3 cases (5.1%) with flat scar and intraocular tumor shrinking, extrascleral extension located close to the tumor base appeared after treatment (TTT in 2 eyes, TTT combined with BT in one case). TTT is an effective treatment method for small choroidal metastases located in the posterior pole. TTT combined with 106Ru brachytherapy can be useful treatment in medium sized choroidal metastases. Efficient results encourage further application of thermotherapy in the treatment of intraocular metastases. It allows for the conservative treatment of the eyeball and also useful visual acuity. Extraocular extension appearing after TT needs further study.

  12. One-year outcome of ranibizumab for neovascular age-related macular degeneration: a thorough analysis in a real-world clinical setting.

    Science.gov (United States)

    Gabai, Andrea; Veritti, Daniele; Lanzetta, Paolo

    2014-01-01

    To verify the safety and efficacy of ranibizumab in neovascular age-related macular degeneration (nAMD) and factors influencing the outcome in a real-world setting. Retrospective 12-month follow-up analysis of 100 naive nAMD eyes treated with as-needed ranibizumab. Changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), lesion, and leakage size were recorded. Type and characteristics of lesions and indicators of protocol adherence were analyzed. Mean BCVA at baseline was 61.6 ± 14.8 Early Treatment Diabetic Retinopathy Study letters and 59.6 ± 16 at 12 months. Sixty-three eyes maintained or improved BCVA; the number of injections and follow-up visits were 4.8 and 5.1, respectively. First injection and pro re nata retreatments were administered 22.7 and 20.5 days after prescription, respectively. Seventy-two eyes received 3 initial monthly injections. Patients were not reinjected despite BCVA loss >5 letters one or more times in 37% of cases. No adverse events were reported. The CRT diminished by 26 ± 101 μm; choroidal neovascularization size and leakage area increased by 0.53 ± 1.31 mm² and 0.34 ± 1.33 mm², respectively. The BCVA gain was correlated with CRT reduction (r = 0.24, p = 0.016), mean baseline BCVA (r = -0.25, p = 0.01), age (r = -0.25, p = 0.01), and decrease in CNV size and leakage area (r = 0.56 and r = 0.59, respectively, p<0.001). Our results compare unfavorably with those of controlled trials. Treatment and follow-up regimens in real-world settings seem to have a major role in determining outcome. Lower age and BCVA at baseline were associated with better response to treatment.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-11-17

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

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

    NARCIS (Netherlands)

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

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

  16. 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...

  17. Neo-Vascular Glaucoma: Etiology and Outcome of Treatment in Lagos

    African Journals Online (AJOL)

    tulyasys

    Objective: To determine the causes and the intraocular pressure (IOP) outcome of neo-vascular glaucoma at the Guinness. Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria. Materials and Methods: The case records of all patients with the diagnosis of neo-vascular glaucoma who presented at Guinness ...

  18. Interleukin-17A neutralization alleviated ocular neovascularization by promoting M2 and mitigating M1 macrophage polarization.

    Science.gov (United States)

    Zhu, Yanji; Tan, Wei; Demetriades, Anna M; Cai, Yujuan; Gao, Yushuo; Sui, Ailing; Lu, Qing; Shen, Xi; Jiang, Chunhui; Xie, Bing; Sun, Xinghuai

    2016-04-01

    Neovascularization (NV), as a cardinal complication of several ocular diseases, has been intensively studied, and research has shown its close association with inflammation and immune cells. In the present study, the role of interleukin-17A (IL-17A) in angiogenesis in the process of ocular NV both in vivo and in vitro was investigated. Also, a paracrine role of IL-17A was demonstrated in the crosstalk between endothelial cells and macrophages in angiogenesis. In the retinas of mice with retinopathy of prematurity, the IL-17A expression increased significantly at postnatal day 15 (P15) and P18 during retinal NV. Mice given IL-17A neutralizing antibody (NAb) developed significantly reduced choroidal NV and retinal NV. Studies on vascular endothelial growth factor (VEGF) over-expressing mice suggested that IL-17A modulated NV through the VEGF pathway. Furthermore, IL-17A deficiency shifted macrophage polarization toward an M2 phenotype during retinal NV with significantly reduced M1 cytokine expression compared with wild-type controls. In vitro assays revealed that IL-17A treated macrophage supernatant gave rise to elevated human umbilical vascular endothelial cell proliferation, tube formation and VEGF receptor 1 and receptor 2 expression. Therefore, IL-17A could potentially serve as a novel target for treating ocular NV diseases. The limitation of this study involved the potential mechanisms, such as which transcription accounted for macrophage polarization and how the subsequent cytokines were modulated when macrophages were polarized. Further studies need to be undertaken to definitively determine the extent to which IL-17A neutralizing anti-angiogenic activity depends on macrophage modulation compared with anti-VEGF treatment. © 2015 John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Rosalia Giustolisi

    2014-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Eduardo Büchele Rodrigues

    2006-10-01

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

  1. Choroidal thinning in high myopia measured by optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Ikuno Y

    2013-05-01

    Full Text Available Yasushi Ikuno, Satoko Fujimoto, Yukari Jo, Tomoko Asai, Kohji NishidaDepartment of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, JapanPurpose: To investigate the rate of choroidal thinning in highly myopic eyes.Patients and methods: A retrospective observational study of 37 eyes of 26 subjects (nine males and 17 females, mean age 39.6 ± 7.7 years with high myopia but no pathologies who had undergone spectral domain optical coherence tomography and repeated the test 1 year later (1 ± 0.25 year at Osaka University Hospital, Osaka, Japan. Patients older than 50 years with visual acuity worse than 20/40 or with whitish chorioretinal atrophy involving the macula were excluded. Two masked raters measured the choroidal thicknesses (CTs at the foveda, 3 mm superiorly, inferiorly, temporally, and nasally on the images and averaged the values. The second examination was about 365 days after the baseline examination. The CT reduction per year (CTRPY was defined as (CT 1 year after - baseline CT/days between the two examinations × 365. The retinal thicknesses were also investigated.Results: The CTRPY at the fovea was −1.0 ± 22.0 µm (range –50.2 to 98.5 at the fovea, –6.5 ± 24.3 µm (range −65.8 to 90.2 temporally, –0.5 ± 22.3 µm (range –27.1 to 82.5 nasally, –9.7 ± 21.7 µm (range –40.1 to 60.1 superiorly, and –1.4 ± 25.5 µm (range –85.6 to 75.2 inferiorly. There were no significant differences in the CTRPY at each location (P = 0.34. The CT decreased significantly (P < 0.05 only superiorly. The superior CTRPY was negatively correlated with the axial length (P < 0.05. The retinal thickness at the fovea did not change. Stepwise analysis for CTRPY selected axial length (P = 0.04, R2 = 0.13 and age (P = 0.08, R2 = 0.21 as relevant factors.Conclusions: The highly myopic choroid might gradually thin and be affected by many factors. Location and axial length are key factors to regulate the rate of choroidal

  2. Resolution of bilateral cystoid macular edema and subfoveal serous retinal detachments after treatment with bortezomib in a patient with "smoldering" multiple myeloma.

    Science.gov (United States)

    Grannis, Charity H; Dewan, Vinay N; Wang, Robert C

    2014-01-01

    To describe a case of a patient with multiple myeloma without extraocular end-organ damage but with cystoid macular edema and macular detachments who was treated with bortezomib and dexamethasone. There was a complete resolution of retinal and subretinal fluid and significant improvement of vision. The patient's ocular disease was monitored with visual acuity, dilated fundus examinations, and optical coherence tomography before, during, and after treatment. The patient in this case report was a 43-year-old African American man with a medical history of untreated, "smoldering" multiple myeloma, hypertension, hyperlipidemia who presented to our clinic with progressive painless loss of vision in both eyes over 6 weeks. Before treatment with bortezomib and dexamethasone, the patient had complaints of confusion, muscle stiffness, joint pain, and 20-lb unintentional weight loss; however, he did not have hypercalcemia, renal insufficiency, anemia, or bone lesions typical of active multiple myeloma. The bilateral cystoid macular edema and subfoveal neurosensory retinal detachments, noted on presentation and confirmed by optical coherence tomography, completely resolved over the course of treatment with bortezomib and dexamethasone. This case of bilateral cystoid macular edema and subfoveal neurosensory retinal detachments is remarkable for both its presentation and response to therapy. The macular edema and macular detachments along with nonspecific complaints of confusion, muscle stiffness, joint pain, and weight loss were the presenting signs and symptoms; signs typically used as guides to initiate treatment for multiple myeloma were not present. Macular edema in the context of paraproteinemia is usually associated with Waldenstrom's macroglobulinemia and has classically been reported as "silent" with respect to fluorescein angiography. Our patient has multiple myeloma and demonstrated leakage on fluorescein angiography. The case is also notable in that there was

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

    Directory of Open Access Journals (Sweden)

    Rameez Hussain

    2015-01-01

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

  4. A choroid plexus cyst in the fourth ventricle of a Sprague-Dawley rat.

    Science.gov (United States)

    Murai, Atsuko; Nakamura, Kenji; Takimoto, Norifumi; Namiki, Kengo; Hibi, Daisuke; Yanagizawa, Yukihiro; Shimouchi, Koji

    2017-07-01

    Choroid plexus cysts are rare lesions in the brain and are reported in humans and dogs. Herein, we report a choroid plexus cyst found in a 10-week-old female Sprague-Dawley rat. Histologically, a cyst measuring approximately 600 μm in diameter was found in the fourth ventricle of the brain. The cyst was lined with a single layer of flattened cells and was present in the connective tissue of the choroid plexus. Next to the cyst, a dilated tube was found with a similar morphology to the epithelium of the choroid plexus. Immunohistochemistry revealed that flattened cells lining the cyst were positive for cytokeratin and vimentin, and negative for GFAP and S-100, which is the same as in the normal choroid plexus, excluding vimentin. We diagnosed the present cyst as a spontaneously occurring choroid plexus cyst that was considered to be undergoing the epithelial-mesenchymal transition.

  5. Osteoma coroideo secundario a trauma ocular Choroidal osteoma secondary to ocular trauma

    Directory of Open Access Journals (Sweden)

    Raúl Rúa Martínez

    2012-06-01

    females. It presents unknown etiology, but it is associated to different factors as inflammatory processes, congenital malformations, hormonal alterations and ocular traumas among others. The patient was a 54 year-old woman with a personal history of rheumatic fibromyalgia (osteoarthrosis and osteoporosis and hypertension. Her ophthalmological antecedent showed myopia and arteriolosclerotic retinopathy. At the beginning of the year, she suffered a traffic accident and was injured in her limbs and periocular region. After this, she began feeling blurred vision of the right eye and she went to our service 6 months later. She was performed an ophthalmologic exam. It was found that the right eye had visual acuity of 0.4, and after correction it reached 1.0 .Funduscopy revealed vascular thinness, incomplete posterior vitreous detachment, and a white-orange lesion of 3 papillary diameters that involved inferior temporary arcade with well-defined borders. An angiography was performed, which showed sustained hyperfluorescence and non neovascularization; and the optic coherence tomography revealed a halo of serous retinal detachment. Additionally, the ocular ultrasound yielded a high reflectivity echogenic image that involves choroids with posterior acoustic shadow. It is for this reason that we affirm the traumatic etiology of the lesion. This is a rare pathology that should be diagnosed by imaging techniques. Notably, it is secondary to an ocular trauma.

  6. Complete Disappearance of Choroidal Metastasis from Lung Adenocarcinoma Treated with Bevacizumab and Chemotherapy

    Directory of Open Access Journals (Sweden)

    Hampig Raphael Kourie

    2015-01-01

    Full Text Available Choroidal metastasis from lung cancer is uncommon. We report a case of choroidal metastasis as an inaugural manifestation of lung adenocarcinoma, successfully treated by docetaxel, cisplatinum, and intravenous bevacizumab as an antiangiogenesis therapy. A complete remission was obtained after 4 cycles and maintained after six cycles. This case report demonstrates the importance of the systemic bevacizumab and chemotherapy in the treatment of choroidal metastasis from adenocarcinoma of the lung.

  7. A CASE OF FULL-THICKNESS MACULAR HOLE IN EYE WITH FOCAL CHOROIDAL EXCAVATION.

    Science.gov (United States)

    Fayyad, Omar Faisal; Al-Hashimi, Mustafa Raad; Fayyad, Faisal Tawfeeq

    2016-12-09

    To report an association between a Stage 4 full-thickness macular hole and focal choroidal excavation. Case report. A 46-year-old male patient with high myopia was referred for macular hole surgery and found to have an associated focal choroidal excavation. The patient underwent uneventful combined procedure with closure of macular hole. Successful macular hole surgery can be achieved even in the presence of focal choroidal excavation.

  8. Conjunctival Microangiopathy in a Patient with Neovascular Glaucoma

    Directory of Open Access Journals (Sweden)

    Anmar M. Abdul-Rahman

    2015-08-01

    Full Text Available Purpose: To report a case of conjunctival microangiopathy secondary to diabetes presenting as a red eye 5 years after glaucoma implant surgery for neovascular glaucoma. Materials and Methods: A 52-year-old Tongan male with a past history of neovascular glaucoma secondary to proliferative diabetic retinopathy underwent slitlamp examination and color photography of the anterior and posterior segment, in addition to anterior segment fluorescein angiography. Results: The conjunctival venules perilimbally demonstrated tortuosity and dilation (saccular, fusiform and tricornuate. Capillaries were tortuous, with sparse microaneurysm formation, and arterioles were attenuated. Anterior segment fluorescein angiography showed generalized iris ischemia, extensive perilimbal microvascular degenerative changes and leakage of fluorescein into the anterior chamber. We are unaware of previous reports in the literature on conjunctival microangiopathy secondary to diabetes presenting as a red eye. Conclusions: We hypothesized that the clinical features in our case may have been modified by a combination of postoperative wound healing and degenerative vascular remodeling, in addition to microvascular alterations secondary to both diabetes and consequent ocular ischemia, which may have played a role.

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

    Science.gov (United States)

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

    2013-03-01

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

  10. CAVERNOUS HEMANGIOMALIKE CHANGES IN A CHOROIDAL MELANOMA AFTER BRACHYTHERAPY.

    Science.gov (United States)

    Lopez, Michael; Johnson, Jean G; Margo, Curtis E; Pavan, Peter R

    2016-01-01

    To describe a degenerative vascular change in a treated choroidal melanoma that clinically simulated late treatment failure. Observational case report. A 79-year-old man with choroidal melanoma treated 15 years earlier with iodine-125 brachytherapy demonstrated substantial increase in size of this once stable tumor. The eye was removed because of concern of late treatment failure. Histologically, the tumor consisted of melanocytes with no mitotic activity and virtually no Ki-67 expression. Roughly half the lesion was composed of cavernous blood-filled spaces lined by bland CD34+ and CD31+ endothelial cells. Late degenerative changes in the vasculature of treated uveal melanoma can result in tumor enlargement, which may raise clinical concerns over treatment failure and neoplastic potential.

  11. Transcriptome of the human retina, retinal pigmented epithelium and choroid

    Science.gov (United States)

    Tian, Lifeng; Kazmierkiewicz, Krista L; Bowman, Anita S; Li, Mingyao; Curcio, Christine A; Stambolian, Dwight E

    2015-01-01

    The retina and its adjacent supporting tissues -- retinal pigmented epithelium (RPE) and choroid -- are critical structures in human eyes required for normal visual perception. Abnormal changes in these layers have been implicated in diseases such as age-related macular degeneration and glaucoma. With the advent of high-throughput methods, such as serial analysis of gene expression, cDNA microarray, and RNA sequencing, there is unprecedented opportunity to facilitate our understanding of the normal retina, RPE, and choroid. This information can be used to identify dysfunction in age-related macular degeneration and glaucoma. In this review, we describe the current status in our understanding of these transcriptomes through the use of high throughput techniques. PMID:25645700

  12. Secondary choroidal lymphoma in a child treated for Burkitt lymphoma.

    Science.gov (United States)

    Ramasubramanian, Aparna; Shields, Carol L; Longmire, Michelle; Hunt, David J

    2011-02-01

    A 9-year-old girl presented with a choroidal tumor 6 years after remission of Burkitt lymphoma with no evidence of systemic recurrence. The tumor regressed after plaque radiotherapy. The second tumor could have been related to previous chemotherapy, caused by Epstein-Barr virus infection, or the result of independent lymphoma cell growth. Copyright © 2011 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  13. Silent polypoidal choroidal vasculopathy in a patient with angioid streaks

    Directory of Open Access Journals (Sweden)

    Zafer Cebeci

    2016-06-01

    Full Text Available ABSTRACT We present a case of silent polypoidal choroidal vasculopathy (PCV in a patient with angioid streaks. PCV was detected during a routine ophthalmic examination and confirmed by fluorescein angiography, indocyanine green angiography, and optical coherence tomography. After 2 years of follow-up, the PCV remained silent without any complications. We report this rare coexistence and review literature on this topic.

  14. Choroidal Coloboma in a Case of Tay-Sachs Disease

    Directory of Open Access Journals (Sweden)

    Nasreen Raees Ahmed

    2014-01-01

    Full Text Available Coloboma as an ocular finding has been documented in various syndromes. Here we have a case of infantile Tay-Sachs disease associated with unilateral choroidal coloboma. To the best of our knowledge, such an association has not been documented in the literature. Whether such an association is a matter of chance or signifies the involvement of ganglioside metabolism in ocular embryogenesis remains to be elucidated.

  15. Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

    Directory of Open Access Journals (Sweden)

    Karim Hammamji

    2017-03-01

    Full Text Available Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

  16. Focal choroidal excavation in patients with central serous chorioretinopathy

    Science.gov (United States)

    Luk, F O J; Fok, A C T; Lee, A; Liu, A T W; Lai, T Y Y

    2015-01-01

    Purpose To evaluate the prevalence and clinical features of focal choroidal excavation (FCE) in patients presenting with central serous chorioretinopathy (CSC). Methods This is a retrospective consecutive case series of consecutive patients with CSC who were referred for spectral domain optical coherence tomography (SD-OCT) between January 2010 and December 2011. Medical records were reviewed and clinical features including presence of FCE in SD-OCT, fluorescence angiography (FA), and indocyanine green angiography (ICGA) were studied. Results Among the 116 CSC patients assessed, FCE was found in 11 eyes of 7 (6.0%) patients. FCE was associated with subretinal fluid in six eyes of six patients and serous pigment epithelial detachment in three eyes of two patients. The mean central subfield retinal thickness of CSC eyes with FCE was 283.7 μm, compared with 377.5 μm for CSC eyes without FCE (Mann–Whitney U-test, P=0.020). Five FCE eyes of five patients had focal leakage on FA. Choroidal hyperpermeability on ICGA was found in seven CSC eyes with FCE, with four eyes showing hypofluorescent spot corresponding to the FCE. After a mean follow-up of 16 months, visual acuity of all 11 eyes with FCE remained stable or improved at the last follow-up. Conclusion FCE is not an uncommon feature in patients with CSC and might be associated with choroidal hemodynamic disturbances. PMID:25853402

  17. Clinicopathologic findings in choroidal melanomas after failed transpupillary thermotherapy.

    Science.gov (United States)

    Zaldivar, Renzo A; Aaberg, Thomas M; Sternberg, Paul; Waldron, Rhonda; Grossniklaus, Hans E

    2003-05-01

    To review the clinicopathologic features of eyes enucleated after failed transpupillary thermotherapy. Retrospective review. Pathology reports in the L.F. Montgomery Laboratory between 1998 and 2002 were searched for enucleated eyes with choroidal melanoma that had been treated only by transpupillary thermotherapy (TTT) prior to enucleation. The clinical features of the patients, including ultrasonography examination, were reviewed and compared with the pathologic findings. Seven eyes from seven patients had been enucleated, representing 8% of eyes treated with TTT at our institute during the period studied. The primary indication for enucleation was tumor growth. The melanomas tended to grow laterally, with minimal if any increase in thickness. Five of the seven eyes histologically demonstrated extrascleral extension, which was detected by ultrasonography prior to enucleation in only one of those eyes. Choroidal melanoma may continue to grow along a path of least resistance after TTT. The melanoma may extend laterally in the choroid and through emissary canals. Early extrascleral extension may be difficult to detect by ultrasonography.

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

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2013-01-01

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

  20. Suppression of Retinal Neovascularization by Lentivirus-Mediated Netrin-1 Small Hairpin RNA

    Science.gov (United States)

    Xu, Huizhuo; Liu, Jiaolian; Xiong, Siqi; Le, Yun-zheng; Xia, Xiaobo

    2012-01-01

    Objectives The function of netrin-1 in pathological angiogenesis and its role in retinal neovascularization were investigated in the retinas of oxygen-induced retinopathy (OIR) mice by inhibition of netrin-1. Methods Expression of netrin-1 mRNA and protein in the retinas of OIR mice was analyzed by quantitative RT-PCR and immunoblotting. Inhibition of retinal neovascularization was achieved by lentivirus-mediated netrin-1 small hairpin RNA (shRNA) infection. Retinal neovascularization was examined by fluorescein angiography and quantification of preretinal neovascular nuclei in retinal sections. Results Both mRNA and protein expression of netrin-1 were significantly upregulated in postnatal day 17 OIR mouse retinas. Treatment of OIR mice with specific lentivirus-mediated netrin-1 shRNA dramatically reduced neovascular outgrowth into the inner limiting membrane. Neovascular tufts and nonperfused areas were also reduced. Conclusions High expression of netrin-1 was detected in the retina under ischemic conditions and played a significant role in pathological retinal angiogenesis. Therefore, netrin-1 represents a potential therapeutic target for diabetic retinopathy, retinopathy of prematurity and other ocular neovascular diseases. PMID:22122983

  1. Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Cham A

    2016-06-01

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

  2. Minocycline inhibits alkali burn-induced corneal neovascularization in mice.

    Directory of Open Access Journals (Sweden)

    Ou Xiao

    Full Text Available The purpose of this study was to investigate the effects of minocycline on alkali burn-induced corneal neovascularization (CNV. A total of 105 mice treated with alkali burns were randomly divided into three groups to receive intraperitoneal injections of either phosphate buffered saline (PBS or minocycline twice a day (60 mg/kg or 30 mg/kg for 14 consecutive days. The area of CNV and corneal epithelial defects was measured on day 4, 7, 10, and14 after alkali burns. On day 14, a histopathological examination was performed to assess morphological change and the infiltration of polymorphonuclear neutrophils (PMNs. The mRNA expression levels of vascular endothelial growth factor (VEGF and its receptors (VEGFRs, basic fibroblast growth factor (bFGF, matrix metalloproteinases (MMPs, interleukin-1α, 1β, 6 (IL-1α, IL-1β, IL-6 were analyzed using real-time quantitative polymerase chain reaction. The expression of MMP-2 and MMP-9 proteins was determined by gelatin zymography. In addition, enzyme-linked immunosorbent assay was used to analyze the protein levels of VEGFR1, VEGFR2, IL-1β and IL-6. Minocycline at a dose of 60 mg/kg or 30 mg/kg significantly enhanced the recovery of the corneal epithelial defects more than PBS did. There were significant decreases of corneal neovascularization in the group of high-dosage minocycline compared with the control group at all checkpoints. On day 14, the infiltrated PMNs was reduced, and the mRNA expression of VEGFR1, VEGFR2, bFGF, IL-1β, IL-6, MMP-2, MMP-9, -13 as well as the protein expression of VEGFR2, MMP-2, -9, IL-1β, IL-6 in the corneas were down-regulated with the use of 60 mg/kg minocycline twice a day. Our results showed that the intraperitoneal injection of minocycline (60 mg/kg b.i.d. can significantly inhibit alkali burn-induced corneal neovascularization in mice, possibly by accelerating corneal wound healing and by reducing the production of angiogenic factors, inflammatory cytokines and MMPs.

  3. Choroidal thickness in non-ocular Behçet's disease – A spectral-domain OCT study

    Directory of Open Access Journals (Sweden)

    Aman Mittal

    2017-09-01

    Conclusion: This study demonstrates that BD may have subclinical manifestations in the choroid, resulting in thinning of the choroid relative to normal eyes, even without overt signs of ocular involvement.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Yong Cheng

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

  6. [Lifestyle-related diseases and anti-aging ophthalmology: suppression of retinal and choroidal pathologies by inhibiting renin-angiotensin system and inflammation].

    Science.gov (United States)

    Ishida, Susumu

    2009-03-01

    Lifestyle-related diseases cause macro-and microangiopathies in the major organs including the brain, heart, kidney, and eye, and as a result, shorten the lifespan. The renin-angiotensin system (RAS) has recently been shown to contribute to the processes of accelerated aging caused by lifestyle-related diseases from visceral obesity in the early stage to late-onset organ damage. Vision-threatening diabetic retinopathy and age-related macular degeneration (AMD), associated with lifestyle-related diseases as risk factors for progression, develop retinal and choroidal neovascularization (CNV), respectively, in their advanced stages. We have found that tissue RAS is activated in the pathogenesis of diabetic retinopathy and CNV, leading to angiotensin type 1 receptor(AT1-R)-mediated expression of inflammation-related molecules including vascular endothelial growth factor (VEGF), intercellular adhesion molecule (ICAM)-1, and monocyte chemotactic protein(MCP)-1. Neuronal dysfunction in diabetic retinopathy is also shown to result from AT1-R-mediated degradation of synaptic proteins. Moreover, we revealed for the first time that the receptor for prorenin [(pro) renin receptor] is expressed in the eye, although prorenin was until recently believed to be just an inactive precursor of renin. Prorenin binds to the receptor that causes dual activation of its intracellular signaling and tissue RAS, and this pathogenic mechanism is termed receptor-associated prorenin system (RAPS)'. We have demonstrated the contribution of RAPS to the pathogenesis of CNV and dual regulation of VEGF and MCP-1 by signal transduction via (pro) renin receptor and AT1-R. Next, we report the potential validity of food factor supplements as a therapeutic strategy for preventing the retinal and choroidal pathologies driven by RAS-induced inflammatory and angiogenic molecules. Functional food factors examined include lutein in yellow-green vegetables, the omega-3 polyunsaturated fatty acid

  7. 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.

  8. Clearance of amyloid-β peptide across the choroid plexus in Alzheimer's disease.

    Science.gov (United States)

    Alvira-Botero, Ximena; Carro, Eva M

    2010-12-01

    Aging and several neurodegenerative diseases bring about changes in the anatomy and physiology of the choroid plexus. The identification of specific membrane receptors that bind and internalize extracellular ligands has revolutionized the traditional roles of this tissue. Amyloid beta peptide (Aβ), the major constituent of the amyloid core of senile plaques in patients with Alzheimer's disease (AD) is known to contribute to disease neuropathology and progression. Recent emphasis on comorbidity of AD and a deficient clearance of Aβ across the blood-brain barrier and blood-cerebrospinal fluid barrier have highlighted the importance of brain Aβ clearance in AD. The megalin receptor has also been implicated in the pathogenesis of AD. Faulty Aβ clearance from the brain across the choroid plexus epithelium by megalin appears to mediate focal Aβ accumulation in AD. Patients with AD have reduced levels of megalin at the choroid plexus, which in turn seem to increase brain levels of Aβ through a decreased efflux of brain Aβ. Therapies that increase megalin expression at the choroid plexus could potentially control accumulation of brain Aβ. This review covers in depth the anatomy and function of the choroid plexus, focusing on the brain barrier at the choroid plexus, as it actively participates in Aβ clearance. In addition, we describe the role of the choroid plexus in brain functions, aging and AD, as well as the role of megalin in the process of Aβ clearance. Finally, we present current data on the use of choroid plexus cells to repair the damaged brain.

  9. Neurogenic effects of β-amyloid in the choroid plexus epithelial cells in Alzheimer's disease.

    Science.gov (United States)

    Bolos, Marta; Spuch, Carlos; Ordoñez-Gutierrez, Lara; Wandosell, Francisco; Ferrer, Isidro; Carro, Eva

    2013-08-01

    β-amyloid (Aβ) can promote neurogenesis, both in vitro and in vivo, by inducing neural progenitor cells to differentiate into neurons. The choroid plexus in Alzheimer's disease (AD) is burdened with amyloid deposits and hosts neuronal progenitor cells. However, neurogenesis in this brain tissue is not firmly established. To investigate this issue further, we examined the effect of Aβ on the neuronal differentiation of choroid plexus epithelial cells in several experimental models of AD. Here we show that Aβ regulates neurogenesis in vitro in cultured choroid plexus epithelial cells as well as in vivo in the choroid plexus of APP/Ps1 mice. Treatment with oligomeric Aβ increased proliferation and differentiation of neuronal progenitor cells in cultured choroid plexus epithelial cells, but decreased survival of newly born neurons. These Aβ-induced neurogenic effects were also observed in choroid plexus of APP/PS1 mice, and detected also in autopsy tissue from AD patients. Analysis of signaling pathways revealed that pre-treating the choroid plexus epithelial cells with specific inhibitors of TyrK or MAPK diminished Aβ-induced neuronal proliferation. Taken together, our results support a role of Aβ in proliferation and differentiation in the choroid plexus epithelial cells in Alzheimer's disease.

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

    Science.gov (United States)

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

    2012-01-01

    We review the cellular and physiological mechanisms responsible for the regulation of blood flow in the retina and choroid in health and disease. Due to the intrinsic light sensitivity of the retina and the direct visual accessibility of fundus blood vessels, the eye offers unique opportunities for the non-invasive investigation of mechanisms of blood flow regulation. The ability of the retinal vasculature to regulate its blood flow is contrasted with the far more restricted ability of the choroidal circulation to regulate its blood flow by virtue of the absence of glial cells, the markedly reduced pericyte ensheathment of the choroidal vasculature, and the lack of intermediate filaments in choroidal pericytes. We review the cellular and molecular components of the neurovascular unit in the retina and choroid, techniques for monitoring retinal and choroidal blood flow, responses of the retinal and choroidal circulation to light stimulation, the role of capillaries, astrocytes and pericytes in regulating blood flow, putative signaling mechanisms mediating neurovascular coupling in the retina, and changes that occur in the retinal and choroidal circulation during diabetic retinopathy, age-related macular degeneration, glaucoma, and Alzheimer's disease. We close by discussing issues that remain to be explored. PMID:22580107

  11. Apelin enhances cardiac neovascularization after myocardial infarction by recruiting aplnr+ circulating cells

    NARCIS (Netherlands)

    Tempel, D.; de Boer, M.; van Deel, E.D.; Haasdijk, R.A.; Duncker, D.J.G.M.; Cheng, C.; Schulte-Merker, S.; Duckers, H.J.

    2012-01-01

    RATIONALE: Neovascularization stimulated by local or recruited stem cells after ischemia is a key process that salvages damaged tissue and shows similarities with embryonic vascularization. Apelin receptor (Aplnr) and its endogenous ligand apelin play an important role in cardiovascular development.

  12. Apelin Enhances Cardiac Neovascularization After Myocardial Infarction By Recruiting Aplnr+ Circulating Cells

    NARCIS (Netherlands)

    Tempel, D.; Boer, de M.; Deel, van E.D.; Haasdijk, A.; Duncker, D.J.; Cheng, C.; Schulte-Merker, S.; Duckers, H.J.

    2012-01-01

    Rationale: Neovascularization stimulated by local or recruited stem cells after ischemia is a key process that salvages damaged tissue and shows similarities with embryonic vascularization. Apelin receptor (Aplnr) and its endogenous ligand apelin play an important role in cardiovascular development.

  13. [Neovascular invasion of the endothelio-descemetic interface occurring after deep anterior lamellar keratoplasty].

    Science.gov (United States)

    Pinsard, L; Malet, F; Colin, J; Touboul, D

    2013-05-01

    The endothelio-descemetic interface (EDI) of a deep anterior lamellar keratoplasty (DALK) may become the locus of a neovascular proliferation. Bevacizumab (Avastin) is an antiangiogenic alternative available for curative treatment in deep corneal neovascularization. We report the case of a 49-year-old woman who had received two arcuate relaxing incisions for high astigmatism after DALK. She developed graft rejection associated with significant neovascular stromal invasion in the EDI of the graft-host interface. Two subconjunctival injections of bevacizumab 1 month apart as well as thermocauterization of the feeding vessel were necessary and effective. No recurrence has been observed after 2 years of follow-up. Corneal neovascularization can be a cause of DALK rejection. A combination of anti-antiangiogenic and physical methods may abort graft rejection and permanently restore graft function. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Cataract surgery in patients with neovascular age-related macular degeneration

    DEFF Research Database (Denmark)

    Kessel, Line; Theil, Pernille Koefoed; Sørensen, Torben Lykke

    2016-01-01

    Purpose To examine the outcome after cataract surgery in patients with neovascular age-related macular degeneration (AMD) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections in routine clinical practice. Methods We extracted information about patients recorded...

  15. MicroRNA-155 Exerts Cell-Specific Antiangiogenic but Proarteriogenic Effects During Adaptive Neovascularization

    NARCIS (Netherlands)

    Pankratz, Franziska; Bemtgen, Xavier; Zeiser, Robert; Leonhardt, Franziska; Kreuzaler, Sheena; Hilgendorf, Ingo; Smolka, Christian; Helbing, Thomas; Höfer, IE; Esser, Jennifer S; Kustermann, Max; Moser, Martin; Bode, Christoph; Grundmann, Sebastian

    2015-01-01

    BACKGROUND: Adaptive neovascularization after arterial occlusion is an important compensatory mechanism in cardiovascular disease and includes both the remodeling of pre-existing vessels to collateral arteries (arteriogenesis) and angiogenic capillary growth. We now aimed to identify regulatory

  16. Multi-functional optical coherence tomography imaging of spontaneous neovascularization in the mouse retina

    Science.gov (United States)

    Augustin, Marco; Wechdorn, Matthias; Pfeiffenberger, Ulrike; Fialová, Stanislava; Werkmeister, René M.; Hitzenberger, Christoph K.; Baumann, Bernhard

    2017-07-01

    A multi-functional OCT approach is used to identify different tissue types during the early development of spontaneous neovascularizations in the mouse retina based on their intrinsic optical properties.

  17. Choroidal malignant melanoma with no extraocular extension presenting as orbital cellulitis.

    Science.gov (United States)

    Nalcaci, Serhad; Palamar, Melis; Yaman, Banu; Akalin, Taner; Mentes, Jale

    2016-10-01

    This report describes a patient with choroidal malignant melanoma presenting as orbital cellulitis without extraocular tumor extension. It is an interventional case report with histopathologic correlation. A 68-year-old male presented with a 3-day history of painful hyperemia and swelling in the right eye. The examination showed edematous eyelids, mechanical ptosis and chemosis with conjunctival injection. B-scan ultrasonography showed a mass with medium level echogenicity that filled the vitreous cavity. Magnetic resonance imaging showed a solid choroidal mass with hemorrhagic and inflammatory changes with no obvious extraocular extension. Due to these suggestive findings of choroidal melanoma the right eye was enucleated. A spindle cell choroidal melanoma including intense pigmentation and necrosis was confirmed by histopathological examination. Although rare; choroidal melanoma may present as orbital cellulitis, particularly when the tumor is necrotic.

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

    Directory of Open Access Journals (Sweden)

    Behera M

    2015-11-01

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

  19. The Effect of Pseudoexfoliation Syndrome on the Retinal Nerve Fiber Layer and Choroid Thickness.

    Science.gov (United States)

    Demircan, Süleyman; Yılmaz, Uğur; Küçük, Erkut; Ulusoy, M Döndü; Ataş, Mustafa; Gülhan, Ahmet; Zararsız, Gökmen

    2017-01-01

    To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. The RNFL thickness was higher in the PEX and control groups compared to the PXG group (pthickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups. PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.

  20. Focal choroidal excavation-morphological features and clinical correlation.

    Science.gov (United States)

    Chung, C Y; Li, S H; Li, K K W

    2017-09-01

    PurposeTo describe and correlate the morphological and clinical features of focal choroidal excavation (FCE).MethodsThis is a consecutive case series from the review of the 4436 optical coherence tomography scans performed by Kowloon East Cluster Ophthalmic Service from 1 August 2014-31 January 2016. Statistical analysis was performed on SPSS 18.0 (SPSS, Chicago, IL, USA). A significance level of P<0.05 was taken.ResultsAll 16 patients with FCE had unilateral involvement. The mean age of diagnosis was 52.56±14.00. The mean greatest linear dimension (GLD) of FCE was 636.25±265.11 μm. The mean choroidal thickness was 183.63±52.39 μm. Fourteen FCEs (87.5%) were conforming and two were non-conforming (12.5%). In the eyes with FCE, concurrent macular pathology was present in four cases (25.0%). Tractional pathologies of macular pucker and macular scar corresponded to the two non-conforming FCEs in the series. Polypoidal choroidal vasculopathy (PCV) and lacquer crack had a close topographic relationship with the FCE. The mean GLD was significantly larger in eyes with concurrent macular pathology than those without (878.00 vs 555.67 μm, P=0.029). In the fellow eyes, concurrent macular pathology was present in 5 cases (31.3%): PCV in 3 cases and chronic central serous chorioretinopathy in 2 cases.ConclusionAs a significant proportion of FCE is associated with concurrent macular pathology in the involved or fellow eye, angiography for both eyes is recommended even for asymptomatic cases. The GLD of FCE may have clinical value in risk stratification.

  1. Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography.

    Directory of Open Access Journals (Sweden)

    WooJhon Choi

    Full Text Available We demonstrate in vivo choriocapillaris and choroidal microvasculature imaging in normal human subjects using optical coherence tomography (OCT. An ultrahigh speed swept source OCT prototype at 1060 nm wavelengths with a 400 kHz A-scan rate is developed for three-dimensional ultrahigh speed imaging of the posterior eye. OCT angiography is used to image three-dimensional vascular structure without the need for exogenous fluorophores by detecting erythrocyte motion contrast between OCT intensity cross-sectional images acquired rapidly and repeatedly from the same location on the retina. En face OCT angiograms of the choriocapillaris and choroidal vasculature are visualized by acquiring cross-sectional OCT angiograms volumetrically via raster scanning and segmenting the three-dimensional angiographic data at multiple depths below the retinal pigment epithelium (RPE. Fine microvasculature of the choriocapillaris, as well as tightly packed networks of feeding arterioles and draining venules, can be visualized at different en face depths. Panoramic ultra-wide field stitched OCT angiograms of the choriocapillaris spanning ∼32 mm on the retina show distinct vascular structures at different fundus locations. Isolated smaller fields at the central fovea and ∼6 mm nasal to the fovea at the depths of the choriocapillaris and Sattler's layer show vasculature structures consistent with established architectural morphology from histological and electron micrograph corrosion casting studies. Choriocapillaris imaging was performed in eight healthy volunteers with OCT angiograms successfully acquired from all subjects. These results demonstrate the feasibility of ultrahigh speed OCT for in vivo dye-free choriocapillaris and choroidal vasculature imaging, in addition to conventional structural imaging.

  2. The Pediatric Choroidal and Ciliary Body Melanoma Study

    DEFF Research Database (Denmark)

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

    2016-01-01

    to 24 years of age, females, and those with CBI. DESIGN: Retrospective, multicenter observational study. PARTICIPANTS: Two hundred ninety-nine patients from 24 ocular oncology centers, of whom 114 were children (median age, 15.1 years; range, 2.7-17.9 years) and 185 were young adults. METHODS: Data were......PURPOSE: To collect comprehensive data on choroidal and ciliary body melanoma (CCBM) in children and to validate hypotheses regarding pediatric CCBM: children younger than 18 years, males, and those without ciliary body involvement (CBI) have more favorable survival prognosis than young adults 18...

  3. Magnetic resonance imaging characteristics of posterior scleritis mimicking choroidal mass

    Energy Technology Data Exchange (ETDEWEB)

    Osman Saatci, A.; Saatci, Isil E-mail: cekirgesaatci@superonline.com; Kocak, Niluefer; Durak, Ismet

    2001-08-01

    We present imaging findings in a case of posterior scleritis, which may mimic tumoral mass lesion resulting in unnecessary enucleation. Magnetic resonance imaging was remarkable for a subretinal mass hypointense on T2 and hyperintense on T1 weighted images. A peripheral rim of hypointensity was noteworthy, suggestive of sclerouveal thickening. There was an ill-defined area of increased T2 signal intensity adjacent to globe at the site of nodular lesion implying an inflammatory process. A linear contrast enhancement was seen within the bulbus oculi which may represent detached retina by exudation or displaced retina due to thickened sclera and choroidal layers. The CSF space around the optic nerve was enlarged.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-01-15

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

  5. [Relationship between corneal neovascularization and various relevant biological factors in surrounding cornea stroma of rats].

    Science.gov (United States)

    Wang, Ting; Shi, Wei-yun; Li, Su-xia; Liu, Ming-na

    2009-02-01

    To study the relationship between corneal neovascularization and various biological factors in corneal stroma of rats. It was an experimental study. Corneal neovascularization was induced by alkali burn in 40 rats. Transforming growth factor-beta1 (TGF-beta1), alpha-smooth muscle actin (alpha-SMA) and fibroblast activation protein (FAP) in the stroma surrounding corneal neovascularization were detected by immunohistochemical studies on day 1, 3 and 7 after chemical burn. Platelet-endothelial cell adhesion molecule-1 (CD31) was used to identify the vascular endothelial cells. RT-PCR was used to identify FAP in the cornea 3 and 7 days after chemical burn. Picrosirius staining and polarization microscopy were used to detect changes of collagen types I and III in the cornea. After alkali burn, TGF-beta1 was first expressed in the cornea stroma. Then, some stroma cells expressed both alpha-SMA and FAP. The FAP(+) keratocytes were found surrounding the CD31(+) endothelium of angiogenesis. RT-PCR study showed that FAP mRNA was only present in neovascularized cornea and not in normal cornea. Polarization microscopy revealed that the collagen types I and III were rearranged in neovascularized cornea. Various biological factors in corneal stroma are changed when the cornea shows neovascularization. FAP(+) keratocytes are present in the stroma, and the appearance of these cells parallels the growth of vascular endothelial cells. Collagen types I and III are rearranged during the process of angiogenesis.

  6. Apatinib-loaded nanoparticles suppress vascular endothelial growth factor-induced angiogenesis and experimental corneal neovascularization.

    Science.gov (United States)

    Lee, Jung Eun; Kim, Koung Li; Kim, Danbi; Yeo, Yeongju; Han, Hyounkoo; Kim, Myung Goo; Kim, Sun Hwa; Kim, Hyuncheol; Jeong, Ji Hoon; Suh, Wonhee

    2017-01-01

    Pathological angiogenesis is one of the major symptoms of severe ocular diseases, including corneal neovascularization. The blockade of vascular endothelial growth factor (VEGF) action has been recognized as an efficient strategy for treating corneal neovascularization. In this study, we aimed to investigate whether nanoparticle-based delivery of apatinib, a novel and selective inhibitor of VEGF receptor 2, inhibits VEGF-mediated angiogenesis and suppresses experimental corneal neovascularization. Water-insoluble apatinib was encapsulated in nanoparticles composed of human serum albumin (HSA)-conjugated polyethylene glycol (PEG). In vitro angiogenesis assays showed that apatinib-loaded HSA-PEG (Apa-HSA-PEG) nanoparticles potently inhibited VEGF-induced tube formation, scratch wounding migration, and proliferation of human endothelial cells. In a rat model of alkali burn injury-induced corneal neovascularization, a subconjunctival injection of Apa-HSA-PEG nanoparticles induced a significant decrease in neovascularization compared to that observed with an injection of free apatinib solution or phosphate-buffered saline. An in vivo distribution study using HSA-PEG nanoparticles loaded with fluorescent hydrophobic model drugs revealed the presence of a substantial number of nanoparticles in the corneal stroma within 24 h after injection. These in vitro and in vivo results demonstrate that apatinib-loaded nanoparticles may be promising for the prevention and treatment of corneal neovascularization-related ocular disorders.

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

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi

    2013-01-01

    The pathogenesis of AMD is associated with age changes plus pathological changes involving oxidative stress and an altered inflammatory response leading to injury of retinal pigment epithelial cells and the adjacent choroidea and photoreceptor cells. AMD is divided into early, intermediate...... the growth of subfoveal fibrous tissue or neuroretinal atrophy, it is important to define subgroups of eyes at risk of these pathological changes. The second PhD study has contributed to identify this subgroup of eyes. The third study included in this PhD thesis revealed that the annual incidence rate of AMD-related...

  8. Intravitreal ranibizumab for peripapillary neovascular membrane associated to papiledema due to idiopathic intracranial hypertension: a case report

    Directory of Open Access Journals (Sweden)

    Muñoz Cardona, Marta Lucia

    2014-01-01

    Full Text Available Peripapillary neovascular membrane is a rare complication of chronic papiledema. When the latter is due to idiopathic intracranial hypertension, neovascularization is even rarer. Because of this low occurrence, it is difficult to design studies to define the most appropriate treatment. We report the case of a woman who developed papiledema by idiopathic intracranial hypertension with peripapillary neovascular membrane, and who was successfully treated with intravitreal ranibizumab.

  9. Role of echography in diagnostic dilemma in choroidal masses

    Directory of Open Access Journals (Sweden)

    Kopal N Mithal

    2014-01-01

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

  10. Papiloma de los plexos coroideos Papilloma of choroid plexuses

    Directory of Open Access Journals (Sweden)

    Ivón Aimé Sánchez Monterrey

    2012-03-01

    Full Text Available Los papilomas de los plexos coroideos son tumores infrecuentes de origen neuroectodérmico, que representan menos del 5 % del total de los tumores del sistema nervioso central en pediatría. La clínica suele estar provocada por el aumento de presión intracraneal debido a la hidrocefalia, con la que habitualmente cursan. La cirugía es curativa, con un porcentaje de supervivencia de casi el 100 % a los 5 años y ocasionales recurrencias. Se presenta el caso de un recién nacido con diagnóstico de papiloma de los plexos coroideos y evolución favorable.The papillomas of choroid plexuses are non-frequent tumors of neuroectoderm origin accounting for the less of the 5 % of total of tumors of the central nervous system (CNS in children. The clinic may be caused by the increase of the intracranial pressure due to the usually present hydrocephalus. The surgery is curative with a survival percentage of almost the 100 % at 5 years and occasional recurrences. This is the case of a newborn diagnosed with papilloma of choroid plexuses and a favorable evolution.

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

    Directory of Open Access Journals (Sweden)

    Xiong Y

    2014-11-01

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

  12. Aflibercept treatment for neovascular AMD beyond the first year: consensus recommendations by a UK expert roundtable panel, 2017 update

    Directory of Open Access Journals (Sweden)

    Patel PJ

    2017-11-01

    vision, recurrent fluid, decrease in vision in the presence of fluid, macular hemorrhage,