1,721,107 research outputs found
Effects of late visual impairment on mental representations activated by visual and tactile stimuli.
No full textSimilarly to sighted people, individuals congenitally affected by a severe visual impairment can maintain and mentally manipulate spatial information about tactile stimuli [Vecchi, T., Cattaneo, Z., Monegato, M., Pece, A., Cornoldi, C., Pietrini, P., 2006. Why Cyclops could not compete with Ulysses: monocular vision and mental images. NeuroReport 17, 723-726]. The aim of the present study was to assess whether the onset timing of a severe (but not total) sight loss may influence spatial imagery abilities based on haptic input. To this purpose, a group of late severe visually impaired people and a matched group of normally sighted participants (all blindfolded) were presented with an imagery task requiring to memorize and retrieve a number of locations presented on tactile matrices. Results indicate that a severe visual deficit occurring later in life significantly impairs spatial imagery abilities to a greater extent than in the case of congenital blindness, probably as a consequence of a modest development of specific compensatory mechanisms associated with congenital deficits
Choroidal ischemia after photodynamic therapy with verteporfin for choroidal neovascularization
No full textPURPOSE: To report delay in choroidal perfusion suggestive of ischemia after photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV).DESIGN: Observational case series.METHODS: Retrospective review of all patients who developed choroidal ischemia after PDT.RESULTS: This vascular change was found in eight (2.1%) of 373 eyes of patients treated for CNV as a result of age-related macular degeneration (AMD) and in one (0.9%) of 114 eyes treated for pathologic myopia. A decrease of 3 lines of vision was reported to occur one week after treatment in patients with AMD. At the 12-month examination, patients did not exhibit any marked changes in visual acuity.CONCLUSIONS: Choroidal ischemia was an uncommon manifestation owing to the selectivity of verteporfin therapy and the existence of abundant anastomotic vascular connections in the choroid. The low incidence of this vascular event should not preclude counseling PDT in eyes that could benefit greatly from this therapy
Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization secondary to pathologic myopia: long-term study.
No full textPurpose: To assess the safety and effectiveness of photodynamic therapy (PDT) with
verteporfin for subfoveal choroidal neovascularization (CNV) secondary to pathologic
myopia (PM).
Methods: Sixty-two patients (62 eyes) with PM underwent PDT according to the
guidelines of the Verteporfin in Photodynamic Therapy Study. Clinical evaluations performed
at all study visits included measurement of best-corrected Snellen visual acuity,
slit-lamp biomicroscopy, and fundus fluorescein angiography. Patients were followed up at
1 month and 3 months after treatment and thereafter at 3-month intervals.
Results: The final visual acuity of the study patients, after a median follow-up of 31
months, improved by 1 Snellen lines in 8 patients (13%), deteriorated in 20 (32%), and
remained stable in 34 (55%). The baseline visual acuity was similar in the various study
groups. The final mean visual acuity in group A (55 years of age or younger) was 20/80 and
significantly (P 0.006) better than that (20/138) in group B (older than 55 years of age).
The mean final visual acuity in eyes with higher refractive error at baseline (greater than
17 diopters) was significantly better (P 0.014) than that in eyes with lower refractive
error ( 6 to 10 diopters). CNV size did not affect visual outcomes.
Conclusion: PDT preserves vision in patients with CNV associated with PM. Younger
patients and eyes with higher refractive error appear more likely to benefit from PDT with
verteporfin
Back pain after photodynamic therapy with verteporfin.
No full textPURPOSE:
To report the incidence of back pain after photodynamic therapy, which suggests methods for prevention that are related to its pathogenesis.
DESIGN:
Retrospective case series.
METHODS:
We retrospectively observed 548 patients who had undergone photodynamic therapy with verteporfin.
RESULTS:
Of 548 patients at the first treatment, 14 patients (2.6%) experienced pain during the infusion. Eleven patients were being treated for age-related macular degeneration; their mean age was 81 years, which significantly differed from the mean age of the overall age-related macular degeneration group (P = .003). The pain was mild in eight patients, moderate in four patients, and severe in two patients, with dyspnea and precordial pain. Five of the 14 patients had further courses of photodynamic therapy. After being treated prophylactically 60 minutes before photodynamic therapy, only one patient reported further mild pain.
CONCLUSIONS:
The biologic mechanisms of back pain may involve a high level of circulating thromboxanes that are induced by the liposomal composition of verteporfin. Prevention may include hydration, nonsteroidal anti-inflammatory drugs, and halving the infusion rate
Intravitreal Ranibizumab Injection for Nonarteritic Ischemic Optic Neuropathy
No full textPurpose: The aim of this study was to evaluate the functional and morphological outcomes of intravitreal ranibizumab injection (IVR) in the treatment of nonarteritic ischemic optic neuropathy (NAION). Methods: Three patients with NAION of 1-2 days onset underwent IVR. A complete ophthalmologic examination was performed at baseline (before IVR) and at 1 day, 1 week, 1 month, 6 months, and 1 year following IVR. Results: In all patients, we found an early resolution of optic disk swelling, as soon as 1 week after IVR; however, such a morphological improvement was not accompanied by a corresponding functional (visual acuity and perimetric) improvement. The first treated patient presented a good visual acuity and a relative central visual field defect at baseline, and at the 12-month follow-up, we found an overall functional stabilization, with no further visual acuity and visual field deterioration. The second and third treated patients presented a lower visual acuity and an absolute center-involving visual field defect at baseline. In these patients, despite early papillary edema resolution, late optic nerve atrophy occurred, and visual acuity and visual field did not improve at the 12-month follow-up. Conclusion: The results from our study suggest that even if IVR is effective in reducing optic nerve swelling in NAION patients, no functional improvement may be observed. Further studies are necessary to definitively establish the efficacy and safety of IVR in the treatment of NAION
Photodynamic Therapy With Verteporfin for Juxtafoveal Choroidal Neovascularization in Pathologic Myopia: A Long-term Follow-up Study.
No full textPurpose
To assess the effect of verteporfin photodynamic therapy (PDT) in juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia (PM).
Design
Prospective, open-label, consecutive, interventional case series.
Methods
We prospectively followed a series of 48 consecutive patients (49 eyes) with pathologic myopia (≥ 6 diopters) who received verteporfin PDT for juxtafoveal CNV. This population was divided into two groups based on age (group A ≤ 55 years old, group B >55 years old), in three subgroups based on CNV lesion size, and in three categories based on refractive error at baseline.
Results
The median follow-up was 32 months (range, 12 to 56 months). Visual acuity (VA) improved by 1 or more Snellen lines in 18 eyes (37%), decreased in 12 eyes (24%), and remained stable in 19 eyes (39%). The median number of lines gained was 2.15, while the median number of lines lost was 2.4. The final mean VA in group A (mean age, 43.9 years) was 20/50 (logMAR 0.41, standard deviation [SD] 0.3) and significantly better (P = .01) than the 20/105 (logMAR 0.72, SD 0.5) in group B (mean age, 67.8 years). Neither CNV size nor refractive error magnitude influenced visual outcomes.
Conclusion
Verteporfin PDT is a promising treatment modality resulting in stable or improved vision in 76% of the myopic eyes with juxtafoveal CNV. Younger patients appear to respond more favorably to treatment
Comparing the effects of congenital and late visual impairments on visuospatial mental abilities
No full textIntravitreal ranibizumab for choroidal neovascularization in a patient with angioid streaks and multiple evanescent white dots
No full textBackground: To report a patient with angioid streaks (ASs) and coincident multiple evanescent white dot syndrome (MEWDS) who developed choroidal neovascularization (CNV). Case presentation: A 20-year-old woman presented with reduced vision (20/100) in her left eye (LE). Based on a complete ophthalmologic examination the patient was diagnosed with ASs and coincident MEWDS. Two weeks later best-corrected visual acuity (BCVA) improved up to 20/25 and the MEWDS findings almost disappeared. Two months later BCVA dropped again (20/100) due to the development of CNV which was treated by a single intravitreal injection of ranibizumab (0.5 mg/0.05 mL). One month after this BCVA improved up to 20/40, and there was regression of the CNV. There was no need for retreatment at the last follow-up visit, 1 year after the ranibizumab injection, when the patient showed further recovery of BCVA up to 20/25. Conclusions: In this case of ASs, MEWDS completely resolved after 2 weeks, but 2 months later CNV developed. A single intravitreal injection of ranibizumab had a long-lasting effect. Larger series are necessary to clarify the pathogenesis of CNV in such cases and the role of intravitreal ranibizumab
Photodynamic therapy with verteporfin for choroidal neovascularization associated with retinal pigment epithelial detachment in age-related macular degeneration.
No full textAbstract
PURPOSE: To assess the effectiveness of photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV) associated with retinal pigment epithelium detachment (PED) in age-related macular degeneration.
METHODS: Thirty eyes of 26 patients with CNV and PED were treated with PDT. The eyes were divided in two groups based on CNV location in relation to PED; group 1 included 13 eyes with CNV within PED, and group 2 included 17 eyes with CNV at the edge of PED. The median follow-up was 16 months.
RESULTS: Patients received a mean +/- SD of 2.83 +/- 1.26 treatments (range, 1-6 treatments). In the whole cohort, the mean preoperative visual acuity changed from 20/144 (0.86 +/- 0.42 logarithm of minimal angle of resolution [logMAR]) to 20/182 (0.96 +/- 0.51 logMAR; P = 0.39) at month 18. Five eyes (16%) gained a mean of 1.5 Snellen lines from baseline. Twelve eyes (40%) lost a mean of 1.7 Snellen lines of visual acuity. Vision in 13 eyes (44%) remained stable. In group 1, the mean visual acuity at month 12 was 20/303 (1.18 +/- 0.51 logMAR) and significantly (P = 0.015) worse than that, 20/110 (0.74 +/- 0.42 logMAR), in group 2.
CONCLUSION: PDT can improve or stabilize visual function in 60% of eyes with vascularized PED. CNV at the edge of PED appears to respond more favorably to PDT. Appropriate patient selection and prompt treatment are essential to obtain the best outcomes after verteporfin therapy
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