1/6. Early neovascular bridging after photodynamic therapy of myopic choroidal neovascularization.BACKGROUND: Photodynamic therapy is a relatively new modality for the treatment of subfoveal choroidal neovascularization (CNV). An unusual response to verteporfin therapy of myopic CNVs is reported. methods: Out of 187 CNVs secondary to pathologic myopia treated with photodynamic therapy, three eyes manifested two separate foci of CNV before treatment. The three eyes were treated with verteporfin therapy according to the standard protocol, using a single spot of light that covered both neovascular fronds. RESULTS: All the three eyes showed neovascular bridging of the two separate neovascular complexes 1 month after treatment. CONCLUSIONS: Eyes with multiple foci of myopic CNV may show unexpected outcomes after verteporfin therapy. Several factors, such as changes of the retinal pigment epithelium and choroidal vasculature involved in the treatment and enhanced expression of vascular endothelial growth factor, may play a role.- - - - - - - - - - ranking = 1keywords = retinal pigment, pigment (Clic here for more details about this article) |
2/6. Peculiar arcuate scotoma in pathologic myopia--optical coherence tomography to detect peripapillary neural tissue loss over the disc crescent.BACKGROUND: Optical coherence tomography (OCT) was used to detect peripapillary neural tissue loss (PPNTL) over the disc crescent in pathologic myopia. The retinal neural tissue loss located inside the disc crescent in pathologic myopia is a newly recognized fundus lesion. methods: review of ten eyes of ten patients with peripapillary yellowish-white retinal lesions who underwent OCT for evaluation of the nature of PPNTL in pathologic myopia. OCT, fluorescein angiography, automated visual fields, axial length measurement with ultrasound A scan, and ultrasound B scan were performed. RESULTS: Ten eyes of ten patients were identified during a 14-year period to have findings characteristic of PPNTL. The mean age of the patients was 46 years. They were followed up for an average of 9 years. The mean spherical equivalent correction was -10.50 diopters (D) (range -6.0--16.0 D). The mean axial length was 28.6 mm (range 26.30-31.50 mm). In each case, OCT showed a complete retinal discontinuity in the PPNTL lesion. Automated visual field examination showed corresponding arcuate scotoma. During the follow-up period, the inner retina layer of the retinal defect margin was elevated by posterior hyaloid and partial retinal detachment developed in one eye. CONCLUSIONS: PPNTL in pathologic myopia is a relatively asymptomatic, yellowish-white peripapillary retinal discontinuity. Recognition of this lesion is important because the visual field defect may mimic glaucomatous changes owing to the loss of nerve fiber layer. Progressive partial retinal detachment may ensue as one of the complications of the peripapillary lesion.- - - - - - - - - - ranking = 10.311552440029keywords = detachment, retinal detachment (Clic here for more details about this article) |
3/6. Episcleral macular buckling by semirigid shaped-rod exoplant for recurrent retinal detachment with macular hole in highly myopic eyes.PURPOSE: To evaluate the effects of episcleral macular buckling in highly myopic eyes with postvitrectomy recurrent retinal detachment with macular hole. DESIGN: Interventional case study. methods: Episcleral macular buckling with a shaped-rod silicone plastic exoplant, facilitated by episcleral tissue removal and intraocular pressure reduction, was performed at tokyo Medical University Hospital for postvitrectomy recurrent retinal detachment due to macular hole in three highly myopic eyes with axial length of >27 mm. RESULTS: Optical coherence tomography showed successful retinal reattachment after the buckling procedure in all three eyes and closure of the macular hole in two of the three, and visual acuity improved to 20/200, 20/200, and 20/63 from preoperative values of 20/320, 20/250, and 20/320, respectively. CONCLUSIONS: The anatomic and functional results of the macular buckling procedure used in these three cases were favorable, suggesting that this procedure can provide an effective means of retinal reattachment particularly in cases of retinal detachment recurrence after vitrectomy and therefore warrants further study.- - - - - - - - - - ranking = 36.090433540102keywords = detachment, retinal detachment (Clic here for more details about this article) |
4/6. Peripapillary intrachoroidal cavitation in myopia.PURPOSE: To report optical coherence tomography (OCT) findings in disorders recently described as peripapillary detachment in pathologic myopia (PDPM). DESIGN: Observational case report. methods: OCT, fluorescein, and indocyanine green angiography. RESULTS: A 69-year-old woman presented with bilateral yellow-orange peripapillary area at the inferior border of the myopic conus, typical of PDPM. OCT showed this area as a large intrachoroidal hyporeflective space located below the normal plane of the retinal pigment epithelium. There was no detachment of the retinal pigment epithelium which appeared flat. CONCLUSIONS: OCT findings suggest calling this anomaly peripapillary intrachoroidal cavitation, instead of peripapillary detachment in pathologic myopia.- - - - - - - - - - ranking = 12.200827063207keywords = detachment, retinal pigment, pigment (Clic here for more details about this article) |
5/6. Characteristics of peripapillary detachment in pathologic myopia.OBJECTIVE: To evaluate the prevalence and clinical features of a newly recognized peripapillary lesion specific to high myopia, peripapillary detachment in pathologic myopia (PDPM), in a large series of patients with high myopia. methods: Three hundred twenty-four patients (632 eyes) with high myopia were enrolled in this study. We examined the prevalence, range, fluorescein and indocyanine green angiographic findings, and optical coherence tomography findings of PDPM for these patients. Visual field testing (Goldmann kinetic perimetry and the Humphrey 30-2 program) was also performed in the patients with PDPM. RESULTS: Peripapillary detachment in pathologic myopia was identified in 31 of 632 highly myopic eyes (4.9%). The optical coherence tomographic scan across the PDPM lesion revealed a localized detachment of retinal pigment epithelium adjacent to the optic nerve. Although PDPM was always situated adjacent to the inferior edge of the optic disc, in some patients it surrounded almost the entire optic disc. There was a steep excavation of the inferior myopic conus adjacent to the PDPM, and the inferotemporal retinal vein was markedly bent at the transition from the PDPM to the excavated myopic conus. Glaucomatous visual field defects were frequently detected in eyes with PDPM (71.0%). CONCLUSIONS: The findings of this study indicate that PDPM is not uncommon among highly myopic eyes. Although its pathogenesis and pathologic significance require further classification, PDPM might be another indicator of visual field defects in high myopia.- - - - - - - - - - ranking = 24.801929814149keywords = detachment, retinal pigment, pigment (Clic here for more details about this article) |
6/6. vitrectomy for myopic posterior retinoschisis or foveal detachment.PURPOSE: To evaluate the efficacy of vitrectomy for posterior retinoschisis (RS) or foveal detachment (FD) associated with posterior staphyloma in myopic eyes. methods: We reviewed the records of 14 consecutive patients (53-77 years of age; 16 eyes) with progressive visual impairment as a result of myopic RS or FD. Optical coherence tomography demonstrated the presence of a variety of RS and FD characteristics. Five eyes had RS alone, and 11 eyes had RS and FD. Two eyes with RS and severe FD developed retinal detachment in conjunction with a tiny macular hole. vitrectomy, including posterior vitreous separation in all eyes and internal limiting membrane (ILM) peeling in six eyes, had been performed. The patients were followed postoperatively for 6 to 66 months (mean, 24 months). The anatomical outcome and visual acuity were retrospectively analyzed in this study. RESULTS: Although the two eyes with RS and severe FD developed retinal detachment with a macular hole after an initial vitrectomy, final retinal reattachment was achieved in all 16 eyes. visual acuity improved in nine eyes and remained unchanged in seven eyes. CONCLUSIONS: vitrectomy with posterior vitreous separation is effective for reattaching the macula and preventing a deterioration of vision, although eyes with RS and severe FD may be at risk for the development of a macular hole after the initial vitrectomy.- - - - - - - - - - ranking = 27.312930878707keywords = detachment, retinal detachment (Clic here for more details about this article) |