1,721,089 research outputs found
Vascularized Drusen Slowly Progressive Type 1 Neovascularization Mimicking Drusenoid Retinal Pigment Epithelium Elevation
No full textMULTIMODAL IMAGING OF EARLY STAGE 1 TYPE 3 NEOVASCULARIZATION WITH SIMULTANEOUS EYE-TRACKED SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND HIGH-SPEED REAL-TIME ANGIOGRAPHY
No full textPurpose: To analyze the multimodal imaging features of eyes with early Type 3 neovascularization showing primarily intraretinal proliferation without evidence of choroidal involvement. Methods: The multimodal imaging data for a consecutive series of patients with new onset stage 1 Type 3 neovascularization were reviewed and the changes at the site of early lesion development were analyzed. Results: Nineteen eyes of 19 patients (12 women, mean age 79.9 +/- 6.3 years) were included for analysis. Both fluorescein angiography and indocyanine green angiography showed a focal hyperfluorescence corresponding to the intraretinal vascular complex (early Type 3 neovascularization) and disclosed a single retinal arteriole feeding this lesion. There was no angiographic evidence of a retinal-choroidal anastomosis or underlying Type 1 or Type 2 neovascularization. In all study eyes, eye-tracked spectral-domain optical coherence tomography showed the intraretinal neovascular complex as a hyperreflective lesion located in the outer retina, which appeared adherent to the underlying retinal pigment epithelium. In all eyes, there seemed to be a focal discontinuity of the retinal pigment epithelium band through which the hyperreflective intraretinal lesions communicated with the underlying material of medium reflectivity within drusen or drusenoid pigment epithelium detachment. With spectral-domain optical coherence tomography, clear evidence of a communication with the choroid was not detected. Conclusion: Multimodal imaging seems to support available clinicopathologic findings showing primarily intraretinal proliferation and anastomoses between retinal vessels and evolving Type 1 (subretinal pigment epithelium) neovascular tissue within underlying drusen or drusenoid pigment epithelium detachments without evidence of anastomoses with the choroidal circulation
Resolution of vitreomacular traction and pigment epithelium detachment
No full textPurpose: To report a case of spontaneous combined resolution of vitreomacular traction (VMT) and pigment epithelial detachment (PED). Methods: A 70-year-old woman presented with a 10-day history of metamorphopsia in her right eye. Medical history was unremarkable. The patient underwent a complete ophthalmic examination. Best-corrected visual acuity (BCVA) was 20/50 in the right eye. Fundus examination, fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT) revealed a shallow elevated area with irregular edges suggestive of drusenoid avascular PED associated with VMT. Results: During the follow-up, OCT showed combined resolution of VMT and PED with almost complete normalization of the outer retinal layers; BCVA increased to 20/40. Conclusions: The temporal sequence of events in our case strongly suggests that the spontaneous resolution of PED could be the consequence of or could be favorably influenced by the VMT resolution
Natural Course of Adult-Onset Foveomacular Vitelliform Dystrophy: A Spectral-Domain Optical Coherence Tomography Analysis REPLY
No full textType 3 Choroidal Neovascularization Associated with Fundus Flavimaculatus
No full textAim: To describe a patient with type 3 choroidal neovascularization (CNV) associated with fundus flavimaculatus (FFM), who underwent treatment with intravitreal ranibizumab. Methods: A 78-year-old woman diagnosed with FFM presented at our department complaining of decreased vision and metamorphopsia in her left eye. Upon a complete ophthalmologic examination, including best corrected visual acuity (BCVA), fundus autofluorescence, fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT), the patient was diagnosed with type 3 CNV associated with FFM, and was submitted to intravitreal ranibizumab injections at monthly intervals. Results: Six months after 3 monthly injections of ranibizumab, the patient's BCVA improved from 20/64 to 20/32. FA and ICGA revealed a type 3 CNV closure, and the SD-OCT scan showed a fibrous scar replacing the type 3 CNV, with resolution of serous retinal detachment. Conclusion: This case represents the first demonstration of type 3 CNV associated with FFM. Based on our findings, intravitreal ranibizumab may be considered as a therapeutic option for this rare association. Copyright (C) 2009 S. Karger AG, Base
Microperimetric Correlations of Autofluorescence and Optical Coherence Tomography Imaging in Dry Age-Related Macular Degeneration.
No full textAbstract
PURPOSE:
To investigate the microperimetric correlations of autofluorescence imaging and optical coherence tomography (OCT) in dry age-related macular degeneration (AMD).
DESIGN:
Retrospective, observational, cross-sectional study.
METHODS:
Consecutive patients with dry AMD underwent a complete ophthalmologic examination, including best-corrected visual acuity (BCVA), blue fundus autofluorescence (FAF), near-infrared autofluorescence, and spectral-domain (SD)-OCT with integrated microperimetry.
RESULTS:
A total of 58 eyes of 29 patients (21 women; mean age 73 ± 9 years) were included. Mean BCVA was 0.28 ± 0.3 logarithm of the minimal angle of resolution (logMAR). Overall, 2842 points were analyzed as regards FAF and near-infrared autofluorescence patterns, the status of inner segment/outer segment (IS/OS) interface, and retinal sensitivity. We observed a good correlation between the FAF and near-infrared autofluorescence patterns for all the points graded (increased FAF/near-infrared autofluorescence, Pearson rho = 0.6, P = .02; decreased FAF/near-infrared autofluorescence, Pearson rho = 0.7, P = .01; normal FAF/near-infrared autofluorescence, Pearson rho = 0.7, P = .01). Mean retinal sensitivity was significantly reduced in cases of decreased FAF (4.73 ± 2.23 dB) or increased FAF (4.75 ± 2.39 dB) compared with normal FAF (7.44 ± 2.34 dB) (P = .001). Mean retinal sensitivity was significantly reduced in case of decreased near-infrared autofluorescence (3.87 ± 2.28 dB), compared with increased near-infrared autofluorescence (5.76 ± 2.44 dB) (P = .02); mean retinal sensitivity in case of increased near-infrared autofluorescence was significantly reduced compared with normal near-infrared autofluorescence (7.15 ± 2.38 dB) (P = .002). On SD-OCT, there was a high inverse correlation between retinal sensitivity and rate of disruptions in IS/OS interface (Pearson rho = -0.72, P = .001).
CONCLUSION:
A reduced retinal sensitivity consistently correlates with decreased FAF/near-infrared autofluorescence and a disrupted IS/OS interface. Increased near-infrared autofluorescence may represent a useful method for detection of retinal abnormalities early in dry AMD development
Intravitreal ranibizumab (Lucentis) for choroidal neovascularization associated with Stargardt's disease
No full textPurpose To describe a young patient with choroidal neovascularization, associated with Stargardt's disease, who underwent treatment with intravitreal ranibizumab. Methods A 26-year-old man with a diagnosis of Stargard's disease presented at our department for sudden decreased vison in his right eye (20/800). Upon a complete oplthamologic examination, including fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT), the patient was diagnosed with subfoveal CNV of the right eye. Owing to the subfoveal localization of the CNV, intravitreal ranibizumab injection was performed on this young patient. Results Three months after the last intravitreal injection of ranibizumab, fundus biomicroscopy, FA, ICGA and OCT revealed the CNV closure and total resolution of the associated cistoid macular edema and serous retinal detachment, with no recurrence and no complication from the intravitreal injection of ranibizumab. Visual acuity improved only to 20/400. Conclusions Intravitreal ranibizumab injection seems to induce total regression of CNV complicating Stargardt's disease. Further investigations are required to confirm our results
High-resolution Spectral Domain Optical Coherence Tomography Findings in Multifocal Vitelliform Macular Dystrophy
No full textWe describe the abnornialities seen in the mid periphery and posterior pole of two patients with multifocal vitelliform macular distrophy as evaluated by high-definition spectral domain optical coherence tomography (HD-OCT). In patient 1, HD-OCTscans revealed, in the central area, a thicker and more reflective layer compared with the normal macula, located between the retinal pigment epitelium and the interface of the inner segment /outer segment, correspon cling to the Verhoeff's membrane. Moreover, HD-OCT macular scans, as well as C-scans, revealed a slight hy, per-reflective lesion just above an area of reduced reflectivity between the photoreceptor layer (interface of the inner segment and outer segment) and the Verhoeff's membrane. In patient 2, on HD-OCT macular scans, the layer corresponding to the interface of inner segment and Outer segment,of the photoreceptor, and the Verhoeff's membrane, appeared disrupted, whereas the retinal pigment epithelium layer appeared preserved. On the other hand, in both patient I and 2, the clinically evident vitelliform lesions outside the macular area appeared on HD-OCT scans either as small focal hyper-reflective lesions at the level of the retinal pigment epithelium/photoreceptor complex, either as a more pronounced diffuse thickening of the retinal pigment epithelium/photoreceptor complex, facing the deposition of lipofuscin reported on the histopathologic examination. These new findings Would help in a further understanding of multifocal vitelliform macular distrophy (Surv Ophthalmol 54:311-316, 2009. (C) 2009 Elsevier Inc. All rights reserved.
Natural Course of Adult-Onset Foveomacular Vitelliform Dystrophy: A Spectral-Domain Optical Coherence Tomography Analysis
No full textPURPOSE: To describe the natural course of adult-onset foveomacular vitelliform dystrophy using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Retrospective study. METHODS: We reviewed the charts of all consecutive patients with adult-onset foveomacular vitelliform dystrophy who underwent SD-OCT at baseline and at least 12 months later (last visit). Main outcome measures were changes of clinical and SD-OCT features over time. RESULTS: Forty-six eyes (31 patients, 15 male and 16 female; mean age 74.6 +/- 8.2 years) were included. Follow-up was 16.2 +/- 6 (range, 12-30) months. Visual acuity (VA) reduced from 0.32 +/- 0.22 logMAR at baseline to 0.39 +/- 0.28 logMAR at last visit (P = .03). The stage of the disease was vitelliform in 28 eyes (60.8%), pseudohypopyon in 7 eyes (15.2%), vitelliruptive in 11 eyes (23.9%) at baseline; vitelliform in 23 eyes (50%), pseudohypopyon in 5 eyes (10.9%), vitelliruptive in 13 eyes (28.2%), and atrophic in 5 eyes (10.9%) at last visit. Stabilization of the disease stage, inner segment/outer segment (IS/OS) interface status, and lesion reflectivity on SD-OCT determined no VA changes (P > .05), while their worsening determined a reduction of VA (P = .03). In eyes that presented a progression of the disease stage, mean central macular thickness, maximal thickness of the lesion, and maximal width of the lesion showed a significant change (from 404.1 +/- 107.6 mu m to 246.1 +/- 74.0 mu m, P = .004; from 277.0 +/- 80.8 mu m to 105.3 +/- 92.3 mu m, P = .001; from 2324.2 +/- 1250.3 mu m to 1751.0 +/- 858.3 mu m, P = .04, respectively). CONCLUSIONS: In adult-onset foveomacular vitelliform dystrophy, progression of the lesion stage (partial/complete resorption of the material) is generally accompanied by IS/OS interface disruption/loss and visual impairment. (Am J Ophthalmol 2011;152:304-313. (C) 2011 by Elsevier Inc. All rights reserved.
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