1/10. Surgical removal of subfoveal choroidal neovascularization without removal of posterior hyaloid: a consecutive series in younger patients.PURPOSE: Subfoveal choroidal neovascularization (CNV) remains a common and important cause of visual loss. Previous studies have suggested that submacular surgery may improve or maintain visual acuity, particularly in younger patients. The majority of reported cases included removal of the posterior hyaloid during vitrectomy. The authors present a consecutive series of patients age 55 or younger with subfoveal CNV removal without posterior hyaloid removal. methods: Seventeen patients without age-related macular degeneration (ARMD), with subfoveal CNV from choroiditis, presumed ocular histoplasmosis syndrome, myopia, or idiopathic causes, underwent a small retinotomy technique to extract the membranes after vitrectomy without posterior hyaloid removal. RESULTS: Median improvement in visual acuity was from 20/320 to 20/50. Eleven patients (65%) experienced an improvement of three or more lines of Snellen acuity (average 7.5), 4 (23%) were within two lines of preoperative acuity, and 2 (12%) had decreased acuity, with an average follow-up of 12 months (range 3-31). Choroidal neovascularization recurred in six patients (35%). Postoperative retinal detachment, epiretinal proliferation, or macular hole did not occur. CONCLUSIONS: In this series of younger patients with subfoveal CNV not from ARMD, visual acuity was improved in the majority after submacular membrane removal. Omission of removal of the posterior hyaloid did not adversely affect outcome.- - - - - - - - - - ranking = 1keywords = choroiditis (Clic here for more details about this article) |
2/10. Multifocal choroiditis after allogenic bone marrow transplantation.PURPOSE: To describe the clinical manifestations of multifocal choroiditis presumed to be secondary to allogenic bone marrow transplantation after development of self-tolerance to chronic graft-versus-host disease (GVHD). methods: Case report. A 17-year-old male who received an allogenic bone marrow transplant (BMT) from his HLA-identical sister. RESULTS: One year after BMT, grade II chronic GVHD developed. Two years later, vision deteriorated to 20/50 R.E. and 20/400 L.E. Ophthalmoscopic examination showed multiple chorioretinal punched-out scars throughout the posterior pole and mid-periphery of both eyes. fluorescein angiography showed four choroidal neovascular membranes (CNVMs) in the right eye that were surgically removed, and a subfoveal disciform scar in the left eye. CONCLUSIONS: Multifocal choroiditis is a possible complication related to allogenic BMT. It should be included as a late cause of BMT-associated choroidopathy. Surgical removal of vision-threatening CNVMs is a reasonable approach.- - - - - - - - - - ranking = 6keywords = choroiditis (Clic here for more details about this article) |
3/10. Successful photodynamic therapy combined with laser photocoagulation in three eyes with classic subfoveal choroidal neovascularisation affecting two patients with multifocal choroiditis: case reports.Multifocal choroiditis (MC) is an idiopathic choroidal inflammatory disease affecting young subjects. Secondary choroidal--and often central--neovascularisation is a frequent complication leading to a poor visual prognosis. Photodynamic therapy (PDT) has now proven to be successful to treat classic subfoveal choroidal neovascularisation in age-related macular degeneration and in pathologic myopia. We describe the treatment applied to classic choroidal neovascularisation in two young women with MC, two eyes with subfoveal neovascular membrane and one eye in which new vessels encroach the foveal avascular zone. PDT has been useful in the three reported eyes, with stable or improved visual acuity. In two of them, it even made the membrane retract and become extrafoveal, allowing a secondary treatment using conventional laser.- - - - - - - - - - ranking = 5keywords = choroiditis (Clic here for more details about this article) |
4/10. Clinicopathologic study after submacular removal of choroidal neovascular membranes treated with verteporfin ocular photodynamic therapy.PURPOSE: To report the clinicopathologic findings after submacular removal of choroidal neovascular membranes (CNV) treated with verteporfin ocular photodynamic therapy. DESIGN: Interventional case series. methods: Retrospective review of eight eyes of eight patients who underwent submacular surgery for CNV after having previously received verteporfin ocular photodynamic therapy for presumed ocular histoplasmosis (one patient), age-related macular degeneration ([AMD] three patients) pathologic myopia (two patients), punctate inner choroiditis (one patient), and idiopathic CNV (one patient). All cases had undergone ocular photodynamic therapy with verteporfin using standard protocols. Six of eight patients suffered a submacular hemorrhage after ocular photodynamic therapy, and two of eight patients refused further ocular photodynamic therapy. All patients subsequently had submacular surgery with removal of the CNV. One membrane was routinely processed, sectioned, and stained with hematoxylin and eosin. Five membranes were stained with toluidine blue for light microscopic examination. Semithin (1.0 microm) sections were cut and stained with uranyl acetate-lead citrate for transmission electron microscopy. RESULTS: Choroidal neovascular membranes were removed at 3 days (presumed ocular histoplasmosis), 29 days (punctate inner choroiditis), 63 days (AMD, pathologic myopia), 66 days (AMD), 107 days (pathologic myopia), 116 days (AMD), and 152 days (idiopathic) after verteporfin ocular photodynamic therapy. Histopathologic and ultrastructural examination showed areas of vascular occlusion at 3 days that were not seen at later time points. All specimens had patent CNV. There were signs of vascular damage with extravasated erythrocytes and fibrin, pigment clumping in cells, and inflammatory cells in all but the 3-day specimen.CONCLUSIONS: This case series presents data only from patients who refused repeat treatment with ocular photodynamic therapy or who developed submacular hemorrhage after initial photodynamic therapy. Histopathologic evaluation of CNV 3 days after verteporfin ocular photodynamic therapy showed partial vascular occlusion that was not present in later specimens. These later specimens demonstrated evidence of vascular damage. Verteporfin ocular photodynamic therapy does not appear to lead to permanent and complete occlusion of the CNV. Thus, treatments that lead to permanent closure of CNV without damage to the retinal pigment epithelium and sensory retina are still needed.- - - - - - - - - - ranking = 2keywords = choroiditis (Clic here for more details about this article) |
5/10. Surgery for subfoveal choroidal neovascularization in toxoplasmic retinochoroiditis.PURPOSE: To report a case of subfoveal choroidal neovascularization in a patient with toxoplasmic retinochoroiditis who underwent surgical excision. DESIGN: Interventional case report. methods: A 36-year-old woman with toxoplasmic retinochoroiditis presented with sudden dimness of vision and metamorphopsia in the left eye. The patient was examined with ophthalmoscopy and fluorescein angiography. RESULTS: Fundus examination and fluorescein angiography of the left eye revealed a subfoveal choroidal neovascularization. Pars plana vitrectomy with submacular surgery was performed, with a postoperative improvement of visual acuity and resolution of the distortion. CONCLUSIONS: This case report describes a case of subfoveal choroidal neovascularization associated with toxoplasmic retinochoroiditis that responded remarkably well to vitrectomy surgery.- - - - - - - - - - ranking = 7keywords = choroiditis (Clic here for more details about this article) |
6/10. indocyanine green-mediated photothrombosis combined with intravitreal triamcinolone for the treatment of choroidal neovascularization in serpiginous choroiditis.PURPOSE: To report a case of peripapillary choroidal neovascularization (CNV) complicating serpiginous choroiditis that was treated by a single indocyanine green (ICG)-mediated photothrombosis session combined to intravitreous triamcinolone acetonide (TA) injection. methods: Interventional case report. A 48-year-old patient with peripapillary CNV was submitted to a laser-dye-mediated technique that uses ICG and low-intensity 810-nm light for continuous laser application; TA was then injected into the vitreous cavity 1 hour later, and prospective evaluation with fluorescein and ICG angiography as well as optical coherence tomography (OCT) was performed. RESULTS: At 2 weeks after treatment, best-corrected visual acuity improved from 20/200 to 20/50, with further improvement to 20/20-1 in the subsequent 10 weeks. Absence of fluorescein leakage from the CNV and OCT evidence of resolved retinal oedema was observed at that time. Clinical stabilization was maintained up to 1 year of follow-up. There was no significant complication related to the procedure. CONCLUSION: Combined ICG-mediated photothrombosis and intravitreous TA induced rapid and significant visual acuity recovery in this particular case of peripapillary CNV complicating serpiginous choroiditis. Accordingly, angiographic and OCT findings demonstrated neovascular lesion regression and restoration of the macular architecture.- - - - - - - - - - ranking = 6keywords = choroiditis (Clic here for more details about this article) |
7/10. Photodynamic therapy-treated choroidal neovascular membrane secondary to toxoplasmic retinochoroiditis.PURPOSE: To report the result of photodynamic therapy with Visudyne (PDT) on a child with choroidal neovascular membrane (CNV) secondary to toxoplasmic retinochoroiditis. methods: An 11-year-old child with a unilateral lowering of visual acuity secondary to an extrafoveal choroidal neovascular membrane was submitted to PDT. RESULTS: One week after PDT, the patient's vision had improved from 10/160 to 20/70, with marked improvement in the angiographic findings. The CNV evolved with decreasing of leakage until 45 days after operation, when it regressed to a chorioretinal scar formation, with final vision of 20/25. CONCLUSION: PDT promoted an early recovery of visual acuity in an eye with choroidal neovascularization secondary to toxoplasmic retinochoroiditis.- - - - - - - - - - ranking = 6keywords = choroiditis (Clic here for more details about this article) |
8/10. Photodynamic therapy for choroidal neovascularization in patients with multifocal choroiditis and panuveitis.PURPOSE: To evaluate the visual benefit of photodynamic therapy (PDT) with verteporfin in patients with choroidal neovascularization (CNV) secondary to multifocal choroiditis and panuveitis over a longer follow-up period. methods: A total of 14 eyes of 12 patients (mean age 34 years) with a classic subfoveal CNV (13/14) or juxtafoveal CNV (1/14) were treated with PDT. Visual outcome was assessed by best-corrected visual acuity (VA). Morphologic characteristics of CNVs such as localization, size, and activity were monitored by fluorescein angiography. RESULTS: patients were followed for 3 to 45 months (mean 23 months). During this period, one to six PDTs (mean 2.4) were performed. At the time of the first PDT no acute inflammation was seen in the affected eyes. Improved or stabilized visual function (VA loss < or = 2 lines in the Early Treatment diabetic retinopathy Study chart) was observed in 71.4% of the eyes. A total of 78% of the eyes showed an inactive scar in the area of CNV after PDT. treatment failure after PDT occurred due to uninfluenced CNV growth. No further complications were observed. CONCLUSIONS: PDT in subfoveal or juxtafoveal classic CNV secondary to multifocal choroiditis and panuveitis stabilized or improved VA in the majority of patients over a longer follow-up period. No risk factor for failed VA rehabilitation could be defined.- - - - - - - - - - ranking = 6keywords = choroiditis (Clic here for more details about this article) |
9/10. Photodynamic therapy for choroidal neovascularisation secondary to inflammatory chorioretinal disease.INTRODUCTION: To review the long-term outcome of photodynamic therapy (PDT) with verteporfin for inflammatory chorioretinal disease with subfoveal choroidal neovascularisation (CNV) over a 1-year period. MATERIALS AND methods: Retrospective review of eyes with subfoveal CNV for associated choroiditis that were treated with PDT using verteporfin over a 1-year period. MAIN OUTCOME MEASURE: visual acuity. RESULTS: Five eyes in 4 patients, with diagnoses including serpiginous choroiditis (2), ocular histoplasmosis syndrome (OHS, 1), and punctate inner choroidopathy (PIC, 2) underwent standard treatment procedure for PDT with verteporfin. visual acuity, fluorescein angiography and treatment parameters were reviewed. Follow-up ranged from 12 months to 36 months (median, 36 months). Pre-PDT visual acuities ranged from 20/60 to 20/400 (median, 20/200). Post-PDT visual acuities ranged from 20/30 to 20/400 at 1 year (median, 20/300). visual acuity was stabilised (within 1 line) or improved (greater than 1 line) in 3 eyes at 1 year and 4 of the 5 eyes at last follow-up. CONCLUSION: PDT for subfoveal CNV may stabilise, but rarely improves, visual acuity in eyes with choroidal neovascularisation secondary to inflammatory chorioretinal disease.- - - - - - - - - - ranking = 2keywords = choroiditis (Clic here for more details about this article) |
10/10. Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization in serpiginous choroiditis.The authors describe a patient who underwent successful photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization complicated by serpiginous choroiditis. A 41-year-old woman presented with decreased vision and metamorphopsia in her right eye, which was diagnosed as a recurrence of serpiginous choroiditis at the first visit. Within a month, visual acuity had diminished to 20/1000 despite immunosuppressive treatment. At that time, indocyanine green angiography and optical coherence tomography revealed choroidal neovascularization in the juxtafoveal area. Photodynamic therapy with verteporfin was administered twice, after which juxtafoveal choroidal neovascularization regressed and her visual acuity improved to 20/20.- - - - - - - - - - ranking = 6keywords = choroiditis (Clic here for more details about this article) |
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