1,721,080 research outputs found
High-definition optical coherence tomography features in simultaneous double cilioretinal artery occlusion
No full textChoroidal neovascularization associated with cancer-associated retinopathy
No full textPurpose: To report an unusual association between cancer-associated retinopathy (CAR) associated with invasive thymoma and choriodal neovascularization (CNV), treated by photodynamic theraphy (PDT). Methods: A 39-year-old man affected with thymoma and paraneoplastic syndrome (myasthenia gravis and diarrhoea) was observed between October 1997 and September 2007. The patient developed progressive visual dysfunction including bilateral visual acuity loss and concentric constriction of visual fields. Ophthalmological, immunological and systemic examinations were performed. Immunological evaluations included an assessment of antibody activity by indirect immunohistochemistry on sectioned rhesus monkey eye, and Western blot reactions upon an extract of pig retina. Results: Fundus ophthalmoscopy and fluorescein angiography revealed retinal vessel attenuation and retinal pigment epithelium degeneration. Electroretinogram suggested both rod and cone dysfunction. Indirect immunohistochemistry identified antibody activity within the photoreceptor outer segments. Western blots on the retina revealed that most of the patient's antibody activity was focused upon a retinal protein antigen approximating 145 kD. These findings share the commonalities of size and retinal distribution of the interphotoreceptor retinoid-binding protein (IRBP), a recognized autoantigen. The surgically resected mediastinal tumour was diagnosed as invasive thymoma. No other malignancy has since been found throughout nearly 10 years of follow-up. In March 2006, the patient developed a subfoveal CNV in his left eye, which was treated by PDT. Conclusion: We describe the third case of paraneoplastic retinopathy associated with invasive thymoma. This is the first example of CAR involving autoantibodies reactive with a retinal protein having the characteristics of the IRBP, and is also the first complicated by CNV treated by PDT
Type 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
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
Type II idiopathic macular telangiectasia and soft confluent drusen
No full textPURPOSE. To describe the simultaneous presentation of soft confluent drusen and type 2 idiopathic macular telangiectasia (IMT) in both eyes of one patient. METHODS. A 79-year-old man with bilateral metamorphopsia and gradual reduction of central vision underwent a complete ophthalmologic examination. RESULTS. In this patient, fundus biomicroscopy revealed soft confluent drusen and a cystic appearance within the fovea, and fluorescein angiography (FA) showed late dye leakage. Interestingly, indocyanine green angiography (ICGA) showed absence of late hypercyanescence, and spectral domain optical coherence tomography (Spectralis SD-OCT) clearly revealed the presence of bilateral foveal cysts with thinning and loss of the normal architecture of the outer retina, as well as absence of retinal thickening within the parafoveolar area showing discrete late dye leakage on FA. Based on these findings, the patient was diagnosed with nonexudative age-related macular degeneration with foveal soft confluent drusen, and coincident nonproliferative type 2 IMT. CONCLUSIONS. To our knowledge, there is no previously reported case of simultaneous presentation of soft confluent drusen and type 2 IMT. This report highlights the importance of ICGA and OCT in the correct diagnosis of such cases. (Eur J Ophthalmol 2010; 20: 466-8
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.
Intravitreal ranibizumab (Lucentis) for choroidal neovascularization associated with vitelliform macular dystrophy
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