1,720,998 research outputs found
Choroidal neovascularization due to choroidal osteoma treated with anti–vascular endothelial growth factor therapy: An optical coherence tomography angiography study
No full textPurpose: To evaluate the response to anti–vascular endothelial growth factor therapy for choroidal neovascularization secondary to choroidal osteoma using optical coherence tomography angiography. Methods: This retrospective study included four eyes of four females with choroidal osteoma complicated by choroidal neovascularization, treated with ranibizumab. All patients underwent full ophthalmologic examination, including ocular ultrasound, retinography, fluorescein angiography, spectral-domain or swept-source optical coherence tomography, and optical coherence tomography angiography. These images were analyzed to measure choroidal osteoma and to study choroidal neovascularization changes after intravitreal anti–vascular endothelial growth factor. Results: In all cases, fluorescein angiography revealed the presence the choroidal neovascularization, as an early hyperfluorescence area increasing during the exam. Optical coherence tomography showed both the choroidal osteoma and choroidal neovascularization and intra- or subretinal fluid as activity sign. In optical coherence tomography angiography, choroidal osteoma vessels were valuable in outer retina and choroidal slabs, and were irregular and did not change after ranibizumab injection; neovascular network correlating with choroidal neovascularization showed a hyperflow tangled vessels in outer retina, decreasing in density after anti–vascular endothelial growth factor therapy. Conclusion: Optical coherence tomography angiography seems to be a useful tool in visualizing and distinguishing vascular networks of choroidal osteoma and of choroidal neovascularization secondary to choroidal osteoma better than fluorescein angiography
The Impact of Diabetic Retinopathy on the Choriocapillaris in Neovascular AMD
Full text linkPURPOSE. To investigate the impact of diabetic retinopathy (DR) on morphological choriocapillaris (CC) modifications in eyes with type 1 macular neovascularization (MNV) secondary to AMD using optical coherence tomography angiography (OCTA).METHODS. Eyes with AMD-related type 1 MNV with and without DR were prospectively included. We performed 3 x 3 mm OCTA scans at two visits: before the loading phase of intravitreal injections of aflibercept (T1) and 1 month after the last injection (T2). OCTA En face flow images of the CC were analyzed for flow deficit percentage (FD%), FD average area and FD number in a 500-mu m-wide ring surrounding the dark halo (DH) around type 1 MNV.RESULTS. A total of 65 eyes, out of which 30 eyes had mild DR, were included. In the group without diabetes, there was a gradual reduction in FD% in the CC ring around the DH after antiangiogenic therapy, indicating reperfusion of the CC (P = 0.003). However, in the DR group, there were no significant changes in CC parameters between the two study visits. Specifically, the FD% in the CC ring around the DH did not show a significant reduction at T2 compared with T1 values (P > 0.05). Furthermore, the comparison of the variation in FD% between the two groups was statistically significant. The nondiabetic group exhibited a gradual CC reperfusion after the loading phase of aflibercept, whereas the diabetic eyes did not show significant changes (P = 0.029).CONCLUSIONS. The CC surrounding the DH associated to type 1 MNV exhibited greater hypoperfusion in diabetic eyes compared with eyes without diabetes, both before starting therapy and after the loading phase. Hence, DR may be a potential risk factor in the development and progression of late-stage AMD and may also influence the response to antiangiogenic therapy
Retinal vessel analysis on OCTA immediately after intravitreal injection
No full textPurpose: to evaluate papillary, peripapillary and macular vascular change within 5 minutes from intravitreal injection (IVI) performed in ArcSterile setting.
Setting/Venue: Intravitreal Injection Centre of Eye Clinic, Policlinico in Bari, Italy. This diagnostic and surgical setting was a one-way track, from reception, examination, IVI under Arc Sterile and discharge. The presence of instrument in adjacent room allowed us to repeat examination in few minutes after the IVI, when iop spike occurred.
Methods: from January 2018 to May 2018, we prospectively selected participants from patients scheduled to perform an IVI. Inclusion criteria were: diagnosis of wet-Age related Macular Degeneration (wAMD) or active myopic Choroidal NeoVascularisation (mCNV). Exclusion criteria were: antiglaucoma treatment or intraocular pressure (IOP) > 21 mmHg, previous intraocular operation other than cataract, significant media opacity, best correct visual acuity (BCVA) < 20/200, poor compliance. All patients underwent to air-puff tonometry, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT Angiography (OCTA), before and immediately after IVI (no later than 5 minutes), because the instruments were placed just outside the room of ArcSterile cabin. Data collected were: age, systemic comorbidity (such as hypertension), use of anticoagulant or antiplatelet, central retinal thickness (CRT), retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, papillary, peripapillary and macular vessel density (VD) in 3x3 OCTA.
Results: 73 patients (78 eyes) were enrolled in the study, 39 male (53.4%) with an average age of 73 ±12 years. Indications for IVI were wAMD (92.3%) and mCNV (7.7%). The drugs administered were ranibizumab (55.1%) and aflibercept (44.9%). After IVI, IOP increased (17.9±2.2 vs 32.6±10.2 mmHg, p<0.01); the superficial vascular plexus vessel density reduced only in parafoveal area with a significantly difference (44.5±5.2 vs 40.8±5.8, p<0.01). Peripapillary fibre layer decreased (100.3±22.2 vs 99.1±21.3, p<0.05). Area and flow area of neovascular membrane unchanged.
Conclusions: after the IOP rise caused by IVI, vessel density in SCP and RNFL peripapillary thickness reduced, but neovascular membranes VD, despite their thin wall, did not statistically vary
One-year outcomes of 27-gauge versus 25-gauge pars plana vitrectomy for uncomplicated rhegmatogenous retinal detachment repair
No full text27-gauge (27G) and 25-gauge (25G) transconjunctival sutureless vitrectomy (TSV) were considered equal about safety, effectiveness and vitrectomy time for the treatment of rhegmatogenous retinal detachment (RRD), although larger and long-term comparative studies are needed to confirm previous knowledge. Furthermore, a combined comparison of time duration of surgery and vitreous removal was never performed. Our purpose was to compare the safety and efficacy of 27G versus 25G TSV for the treatment of uncomplicated RRD over a 1-year follow-up
Choriocapillaris Reperfusion in Resolved Chronic Central Serous Chorioretinopathy Treated with Eplerenone: Long-Term Effects on the Fellow Eye
No full textIntroduction: The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL). Methods: The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SSOCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy. CC OCT angiography was analyzed to determine the percentage of choriocapillaris flow deficits (FD%), the number of flow deficits (FDn), and the average area of flow deficits (FDa). Results: The results demonstrated significant changes in CC flow deficits from baseline to follow-up visits. Specifically, there was a significant decrease in FD% from 28.9 +/- 2.2% at baseline to 26.4 +/- 1.9% at 6 months (p = 0.023), and further to 24.9 +/- 1.7% at 12 months (p = 0.001). Additionally, the FD area gradually contracted over the follow-up period (p\ 0.05). Conversely, there was a significant increase in the number of flow deficits compared to baseline (p\ 0.05). No statistically significant changes were observed in best-corrected visual acuity (BCVA) at the follow-up visits (p[ 0.05). Conclusions: The findings of this study demonstrated long-term reperfusion of the choriocapillaris in unaffected fellow cCSC eyes during continuous oral eplerenone therapy. The beneficial effects of eplerenone therapy were observed after 6 months and maintained at 1 year. These results suggest that specific mineralocorticoid receptor (MR) antagonists may be effective in promoting choriocapillaris recovery in the unaffected eyes of patients with cCSC
Continuous Eplerenone Treatment in Chronic Central Serous Chorioretinopathy: Long-Term Results from a Pilot Study
No full textPurpose: To assess the long-term morpho-functional retinal and choroidal changes in chronic central serous chorioretinopathy (cCSC) pachychoroid eyes in response to continuous oral eplerenone (EPL) treatment. Methods: This pilot study was conducted on patients with unilateral exudative cCSC. We enrolled a total of 17 exudative cCSC and 17 non-exudative fellow eyes of 17 patients. Baseline best-corrected visual acuity (BCVA) and anatomical (structural optical coherence tomography [OCT] and OCT angiography) parameters in both eyes were collected at baseline. Follow-up data were collected at 6, 12, and 48 months after initiation of EPL treatment. Results: (i) Exudative cCSC eyes: Compared with baseline (0.34±0.13 LogMAR), BCVA significantly improved at follow-up examinations (6 months: 0.28±0.13 LogMAR, p=0.039; 12 months: 0.22±0.11 LogMAR, p=0.025; 48 months: 0.21±0.08 LogMAR, p=0.028). Furthermore, there was a significant reduction from baseline in all structural OCT parameters (subretinal fluid and subfoveal choroidal thickness [SFCT]; p<0.05). (ii) Non-exudative fellow eyes: There was no significant change in BCVA. There was a significant reduction from baseline in SFCT and choriocapillaris flow deficit percentage (p<0.05). Conclusion: In this pilot study, continuous oral EPL therapy in cCSC pachychoroid eyes resulted in long-term morpho-functional improvement. The beneficial effect of EPL occurred within the first year and was maintained after four years. Based on these preliminary observations, EPL may be effective in the exudative forms of CSC
Topographical Analysis of the Choriocapillaris Reperfusion After Loading Anti-VEGF Therapy in Neovascular AMD
Full text linkPURPOSE: The purpose of this study was to evaluate choriocapillaris vascular density changes around macular neovascularization (MNV) before and after anti-vascular endothelium growth factor (VEGF) injections by optical coherence tomography angiography (OCTA). METHODS: Treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV were included. En face optical coherence tomography angiograms were analyzed for percentage of choriocapillaris (CC) flow deficit percentage (FD%), the FD average area (FDa), and the FD number (FDn) in 5 progressive 200-µm-wide concentric rings (R1, R2, R3, R4, and R5) surrounding the dark halo around the MNV. The OCTA acquisition was performed at the following visits: (i) before the loading phase of intravitreal injection of aflibercept or ranibizumab (T1), and (ii) 1 month after the last intravitreal injection of loading phase comprising 3 monthly injections (T2). RESULTS: A total of 30 eyes of 30 Caucasian patients with treatment naïve neurovascular AMD (nAMD) were included in the study. All rings showed a progressive FD% reduction at T2 in comparison to T1 values indicating gradual CC reperfusion of the peripheral rings. Furthermore, we found a progressive contraction of the FD average area in all the rings considered (P < 0.05). On the other hand, at T2, a significant increase in the FD number of the 5 rings was displayed, as compared to T1 (P < 0.05). CONCLUSIONS: Our analysis showed topographical CC reperfusion after loading anti-VEGF therapy. CC flow deficits were greater around the associated dark halo before treatment, followed by a progressive recovery of CC flow after intravitreal therapy. TRANSLATIONAL RELEVANCE: OCTA may be used to assess the development and progression of MNV but also in assessing response to intravitreal injections of anti-VEGF
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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