1/30. Multifocal choroiditis with panuveitis and punctate inner choroidopathy: a mini review.Multifocal choroiditis and punctate inner choroidopathy cause scattered acute chorioretinal lesions in the fundus. Secondary choroidal neovascularization and, more rarely, diffuse subretinal fibrosis without obvious neovascularization are associated with both syndromes and cause severe visual loss. Both disorders are of unknown etiology and have many similarities. It is our purpose to present four such cases with emphasis on their fluorescein and indocyanine green angiographic appearance. We review shortly the literature on the subject.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/30. Polypoidal choroidal vasculopathy masquerading as central serous chorioretinopathy.OBJECTIVE: To differentiate polypoidal choroidal vasculopathy (PCV) from central serous chorioretinopathy (CSC). DESIGN: A retrospective, observational case series. PARTICIPANTS: Thirteen patients originally diagnosed with CSC proved to have PCV after more extensive evaluation and follow-up. methods: A clinical and angiographic review of patients with manifestations of CSC, including macular detachment. MAIN OUTCOME MEASURES: Demographic data, funduscopic examination, and fluorescein and indocyanine green (ICG) angiographic findings. RESULTS: Thirteen patients initially suspected of having CSC were ultimately diagnosed as having PCV. These eyes had exudative macular detachments secondary to a small caliber, polypoidal choroidal vascular abnormality or so-called polypoidal choroidal neovascularization. The clinical manifestations in the fundus varied. They included multiple, variably sized serous pigment epithelial detachments, neurosensory retinal detachment, lipid deposition, patchy atrophy of the pigment epithelium and indistinct staining from decompensation of the posterior blood-retinal barrier on fluorescein angiography. In reality, the suspected PEDs proved to be polypoidal lesions of PCV when imaged with ICG angiography. CONCLUSIONS: The clinical diagnosis of CSC or PCV generally poses little challenge to the experienced retinal specialist. However, in CSC with persistent and/or recurrent exudation, a myriad of retinal pigment epithelial changes may evolve that make it difficult to differentiate these two entities. In such patients, ICG angiography is useful in differentiating CSC from PCV. An accurate clinical diagnosis is important since each of these entities, CSC and PCV, may differ in terms of their risk factors, natural course, and visual prognosis.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
3/30. Optical coherence tomographic findings of idiopathic polypoidal choroidal vasculopathy.BACKGROUND AND OBJECTIVE: To identify the histological level of abnormal vessels associated with idiopathic polypoidal choroidal vasculopathy (IPCV), we examined IPCV with Optical Coherence tomography (OCT). patients AND methods: Fourteen patients diagnosed with IPCV were examined with indocyanine green (ICG) angiography and OCT. RESULTS: ICG angiography demonstrated branching vascular networks with polypoidal dilatations at the terminals beneath the retinal pigment epithelium (RPE). OCT showed dome-like elevation of the RPE, and moderate reflex or nodular appearance were seen beneath the RPE. CONCLUSION: The abnormal vessel associated with IPCV is supposed to be choroidal neovascularization with polypoidal dilatations at the terminals between Bruch's membrane and RPE. We consider that this disease is a peculiar form of age-related macular degeneration.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
4/30. indocyanine green videoangiography in macular variant of idiopathic polypoidal choroidal vasculopathy.BACKGROUND: Fifty patients diagnosed with choroidal neovascularization in age-related macular degeneration were examined by indocyanine green videoangiography. Results were correlated with fundus photographs and fluorescein angiograms. Two patients were diagnosed with the macular variant of idiopathic polypoidal choroidal vasculopathy. CASES: Two middle-aged hypertensive women were diagnosed with macular idiopathic polypoidal choroidal vasculopathy. Throughout the follow-up period, both cases showed improved signs and symptoms without worsening of visual acuity, and despite the absence of definitive therapy. OBSERVATIONS: indocyanine green videoangiography demonstrated the characteristic polypoidal lesions in idiopathic polypoidal choroidal vasculopathy better than fluorescein angiography, particularly when blood, exudates, or pigment epithelial detachments blocked visualization of the lesions. CONCLUSIONS: incidence of idiopathic polypoidal choroidal vasculopathy may not be as low as reported, as its presentation mimics choroidal neovascularization in age-related macular degeneration. Differentiation can be made only through indocyanine green videoangiography. Conservative management may be beneficial, as visual prognosis is good.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
5/30. Submacular surgery to remove choroidal neovascularization associated with central serous chorioretinopathy.PURPOSE: To report the results of submacular surgery for removal of choroidal neovascularization associated with central serous chorioretinopathy. methods: Ten eyes of nine consecutive patients with central serous chorioretinopathy and subfoveal or juxtafoveal choroidal neovascularization underwent pars plana vitrectomy with removal of the choroidal neovascular membrane between January 1994 and January 1999.RESULTS: All 10 eyes (nine patients) were followed postoperatively for at least 6 months. The mean postoperative follow-up was 23 months (range, 6 to 56.5 months). The patients were followed for an average of 6.2 months from the time of symptoms to the removal of the choroidal neovascularization. Preoperative mean best-corrected visual acuity was 20/100 (range, 20/25 to 20/400), and postoperative best-corrected mean visual acuity was 20/60 2 (range, 20/20 to 20/400). Seven eyes had improved postoperative visual acuity, with an average of 3.4 lines gained. Of the three eyes that had worse acuity, an average of 1.3 lines of visual acuity was lost; final mean postoperative visual acuity was 20/80 1 (range, 20/25 to 20/400). Of the six eyes with symptoms of less than 3 months' duration, four had a final visual acuity of 20/50 or better. All three eyes with 20/300 or worse final visual acuity had loss of foveal retinal pigment epithelium after surgery; the remaining eyes had preserved retinal pigment epithelium with a visual acuity of 20/70 or better. Two eyes had intraoperative peripheral retinal tears, and two eyes had recurrence of the choroidal neovascular complex. CONCLUSIONS: The anatomic and visual results in eyes with choroidal neovascularization associated with central serous chorioretinopathy are modestly encouraging and suggest that submacular surgery for choroidal neovascularization in patients with central serous chorioretinopathy is a treatment option that may salvage good macular function in some eyes.- - - - - - - - - - ranking = 4.5keywords = neovascularization (Clic here for more details about this article) |
6/30. Polypoidal choroidal vasculopathy: natural history.PURPOSE: The present study was performed to clarify the long-term natural history of polypoidal choroidal vasculopathy (PCV). DESIGN: Prospective, consecutive observational case series. methods: Fourteen eyes of 12 consecutive patients with PCV were prospectively followed in our clinic for at least 2 years without any treatment after a first visit to the clinic between February 1996 and November 1998. All patients underwent complete ophthalmologic examination, color fundus photography, and fluorescein and indocyanine green (ICG) angiography at regular intervals. Inclusion criteria were as follows: eyes had serous and/or hemorrhagic pigment epithelium detachment (PED) and retinal detachment in the posterior pole, and ICG angiography revealed a branching vascular network with polypoidal dilations at the terminals of the network. Exclusion criteria were as follows: other diseases such as exudative age-related macular degeneration, high myopia, angioid streaks, and presumed ocular histoplasmosis syndrome, and patients who previously underwent any ocular surgery. RESULTS: patients were followed for mean of 39.9 months (range, 24-54 months). PCV was present in 10 (83%) men and two women and in the elderly (mean age 68.1 years), usually unilateral (83%) with vascular lesions located at the macula (93%). The PCV manifested in two patterns, exudative and hemorrhagic. In the exudative pattern, serous PED and retinal detachment were predominant at the macula. The hemorrhagic pattern was characterized by hemorrhagic PED and subretinal hemorrhage at the macula. ICG angiography revealed polypoidal choroidal neovascularization that was changeable in appearance and repeatedly grew and spontaneously regressed, but the vascular network persisted. In some eyes, a collection of small aneurysmal dilations of vessels resembling a cluster of grapes appeared and all of them had marked bleeding and leakage and worse outcome. CONCLUSION: Polypoidal choroidal vasculopathy is a long persistent chronic disease and the patients had a variable course. Fifty percent of the patients had a favorable course. In the remaining half of the patients, the disorder persisted for a long time with occasional repeated bleeding and leakage, resulting in macular degeneration and visual loss. Eyes with a cluster of grapes-like polypoidal dilatations of the vessels had a high risk for severe visual loss.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
7/30. Long-term follow-up of central serous chorioretinopathy (CSCR).We studied retrospectively the clinical files of 6 patients (11 eyes), who were diagnosed as CSCR between 1968 and 1986. They were all males, aged from 28 tot 46. The initial diagnosis of CSCR was based on the clinical symptoms and ophthalmic findings. It was supported by fluorescein angiography and later also by ICG angiography. Eight eyes have been treated by laser. After a follow-up of at least 15 years: 2 of the treated eyes and one untreated eye developed subretinal neovascularization; 6 of the treated eyes and one untreated eye progressed to diffuse pigment epitheliopathy; Final visual acuity was less than 2/10 in 6 eyes.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
8/30. Retinal angiopathy and polypoidal choroidal vasculopathy.PURPOSE: To describe the clinical and angiographic features of patients with polypoidal choroidal vasculopathy, exudative detachment of the macula, and an associated retinal microangiopathy. methods: Case series. RESULTS: Four patients with chronic exudative detachment of the macula with a variable degree of lipid deposition are described. The retina in the detached area, but not beyond, was noted to have a microangiopathy. There was capillary telangiectasia, microaneurysm formation, patchy nonperfusion, and intraretinal leakage. In each patient, there were no other retinal vascular changes in the fundus of either eye. The fluorescein angiogram showed subretinal leakage suspicious for occult choroidal neovascularization. The indocyanine green angiogram showed the presence of underlying polypoidal choroidal neovascularization, accounting for the exudative detachment. After photocoagulation, the retinal angiopathy improved, but not completely. CONCLUSION: Retinal microangiopathy may occur in a chronic macular detachment secondary to polypoidal choroidal neovascularization. The development of these secondary retinal changes is not clearly understood; however, hypoxia from the chronic detachment, a neurotoxic effect from the lipid deposition, or a biochemically induced microvascular abnormality from secretion of vasogenic mediators are possible mechanisms. indocyanine green angiography is helpful in making a definitive diagnosis. Clinicians should be aware that a retinal microangiopathy may occur in such eyes so that the proper diagnosis can be made and appropriate treatment administered.- - - - - - - - - - ranking = 1.5keywords = neovascularization (Clic here for more details about this article) |
9/30. Management of choroidal neovascularization following laser photocoagulation for central serous chorioretinopathy.Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.- - - - - - - - - - ranking = 2.5keywords = neovascularization (Clic here for more details about this article) |
10/30. Ill-defined choroidal neovascularization within ocular histoplasmosis scars.Seven patients with scars typical of ocular histoplasmosis syndrome presented with new symptoms of decreased vision or metamorphopsia. In each patient the symptoms corresponded to an atrophic or "punched-out" histoplasmosis scar in the macula. Clinically, a small amount of subretinal fluid overlying the scars and slight hyperfluorescence were seen on fluorescein angiography. These findings were due to a choroidal neovascular membrane growing within the margins of the atrophic scar. The membranes were difficult to diagnose because of the absence of hemorrhage, pigmentation, or growth of vessels beyond the margins of the scar. Clinicians should be aware that these patients may have early and growing choroidal neovascularization and may need to undergo photocoagulation or to be followed closely.- - - - - - - - - - ranking = 2.5keywords = neovascularization (Clic here for more details about this article) |
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