1/7. A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.OBJECTIVE: To evaluate short-term safety and the effects on visual acuity and fluorescein angiography of single or multiple sessions of photodynamic therapy with verteporfin for choroidal neovascularization (CNV) not related to age-related macular degeneration (AMD), including pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes. DESIGN: A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial. SETTING: Four ophthalmic centers in europe and north america providing retinal care. PARTICIPANTS: Thirteen patients with subfoveal CNV due to pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, or idiopathic causes. methods: Standardized protocol refraction, visual acuity testing, ophthalmic examinations, color photographs, and fluorescein angiograms were used to evaluate the results of photodynamic therapy treatments with verteporfin. Follow-up ranged from 12 weeks for patients who were treated once to 43 weeks for patients who were treated up to 4 times. RESULTS: Verteporfin therapy was well tolerated in patients with CNV not related to AMD. No deterioration in visual acuity was observed; most patients gained at least 1 line of vision. Reduction in the size of leakage area from classic CNV was noted in all patients as early as 1 week after verteporfin therapy, with complete absence of leakage from classic CNV in almost half of the patients. Improvement in visual acuity after verteporfin therapy was greatest ( 6, 8, and 9 lines) in 3 patients with relatively poor initial visual acuity (between 20/200 and 20/800). Up to 4 treatments were found to have short-term safety even with retreatment intervals as short as 4 weeks. CONCLUSIONS: Treatment of CNV not related to AMD with verteporfin therapy achieves short-term cessation of fluorescein leakage from CNV in a small number of patients without loss of vision. Further randomized clinical trials including a larger number of patients are under way to confirm whether verteporfin therapy is beneficial for subfoveal CNV not related to AMD.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/7. Macular translocation for subfoveal choroidal neovascularization in angioid streaks.PURPOSE: To report a case of visual improvement after macular translocation performed for a subfoveal choroidal neovascular membrane in a patient with pseudoxanthoma elasticum and angioid streaks. methods: The fovea was translocated inferiorly by scleral imbrication, intentional retinal detachment with a small posterior retinotomy, and partial fluid-air exchange. The choroidal neovascular membrane was photocoagulated 1 week later. RESULTS: The visual acuity of the patient improved from 20/125 to 20/40. The center of the foveal avascular zone was moved inferiorly 844 microm. The choroidal neovascular membrane was extrafoveal after translocation and was treated with laser photocoagulation. CONCLUSION: Macular translocation may be considered in the management of subfoveal choroidal neovascular membrane in patients with pseudoxanthoma elasticum and angioid streaks.- - - - - - - - - - ranking = 0.8keywords = neovascularization (Clic here for more details about this article) |
3/7. angioid streaks associated with pseudoxanthoma elasticum in a 13-year-old patient.This report describes a 13-year-old girl who presented with angioid streaks associated with pseudoxanthoma elasticum (PXE). Extensive retinal pigment epithelial (RPE) mottling, known as peau d'orange, characteristic of PXE, was also noted. The potential complication of choroidal neovascularization is described. physicians should be aware that angioid streaks and their potentially sight-threatening complications can occur in this age group.- - - - - - - - - - ranking = 0.2keywords = neovascularization (Clic here for more details about this article) |
4/7. argon laser treatment in complications of angioid streaks.Five patients with subretinal neovascular complications of angioid streaks were treated with the argon laser. One patient, additionally had a central retinal vein occlusion with preretinal neovascularization. In four out of five cases we obliterated the subretinal neovascular membranes with ensuing improvement of visual acuity. In a follow-up period of 14 months on the average, the treatment appeared to be successful.- - - - - - - - - - ranking = 0.2keywords = neovascularization (Clic here for more details about this article) |
5/7. Laser treatment of choroidal neovascular membranes in angioid streaks.Eight patients with active extrafoveal choroidal neovascular membranes related to angioid streaks were studied. One eye of each of four patients was treated with argon laser. Two patients received bilateral treatment. Four patients received multiple treatments at different times for recurrence of neovascular membranes. Two patients were not treated. The visual acuity of the treated eyes remained the same or improved posttreatment, with one exception. The majority of untreated eyes lost vision. The vast majority of the treated eyes showed a marked improvement in central visual field posttreatment, whereas the untreated eyes remained the same or lost considerably more central visual field. In one to four years after treatment, recurrences of the neovascular membranes occurred in four of the treated eyes demonstrating that these cases must be followed indefinitely. Carefully selected cases appear to benefit from complete obliteration of choroidal neovascularization by argon laser photocoagulation.- - - - - - - - - - ranking = 0.2keywords = neovascularization (Clic here for more details about this article) |
6/7. Fluorescein angiographic features of neovascular maculopathy in angioid streaks.Among the 46 eyes of 23 patients diagnosed with angioid streaks, macular complications (subretinal neovascularization) were found in 20 eyes of 11 patients (43.5%): the 14 eyes of 7 males, and 6 eyes of 4 females. Of these patients, 81.8% were in their fifties to sixties. The patients with and without macular complications did not differ in the incidence of pseudoxanthoma elasticum and other ocular findings, including peau d'orange and salmon spots. In 17 eyes of 10 patients (85%) with macular complications, fluorescein angiography demonstrated multiple small, round, hypofluorescent dots in the area temporal to the macula and around the optic disc. The extent of this lesion varied from simple hypofluorescent dots to dots each surrounded by a hyperfluorescent area. These changes could be detected not by ophthalmoscopic fundus examination but only by fluorescein angiography.- - - - - - - - - - ranking = 0.2keywords = neovascularization (Clic here for more details about this article) |
7/7. indocyanine green angiography in angioid streaks.PURPOSE: To present the indocyanine green angiographic features of angioid streaks. methods: The angiographic findings of five typical cases, three cases of idiopathic angioid streaks and two pseudoxanthoma elasticum patients, are reported. RESULTS: In most cases angioid streaks are hyperfluorescent in the late venous and late phase of the indocyanine green angiogram. Within areas of chorioretinal atrophy they are not visualized. The 'peau d'orange' appearance is much better visualized by indocyanine green angiography than by fluorescein angiography. indocyanine green angiography further characterizes choroidal neovascularization, which is the major complication of angioid streaks. CONCLUSION: indocyanine green angiography contributes to the visualization of alterations in Bruch's membrane such as angioid streaks and the 'peau d'orange' appearance.- - - - - - - - - - ranking = 0.2keywords = neovascularization (Clic here for more details about this article) |