1/49. Peripheral choriovitreal neovascularization in proliferative diabetic retinopathy: histopathologic and ultrastructural study.We describe the histopathologic and ultrastructural evidence of choriovitreal neovascularization in the peripheral fundus of a non-vitrectomized eye with proliferative diabetic retinopathy (PDR). One eye with PDR was surgically enucleated because of neovascular glaucoma and studied with light and electron microscopy. The eye had neovascular membranes at the ora serrata of the peripheral fundus. The newly formed vessels originated from the choroid, passed through Bruch's membrane and the retina, and extended into the vitreous. These vessels had either developing or mature characteristics. The endothelial cells of the developing vessels contained a bulky cytoplasm with many intracytoplasmic filaments, ribosomes and rough endoplasmic reticulum. Budding endothelial cells were frequently found in the developing vessels. The endothelial cells of the mature vessels had attenuated cytoplasm and fenestrations with diaphragms. These observations suggest that choriovitreal neovascularization in the peripheral fundus is one of the features of PDR.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/49. Endoscopic vitreoretinal surgery for complicated proliferative diabetic retinopathy.PURPOSE: To evaluate the indication for endoscopic vitreoretinal surgery in proliferative diabetic retinopathy (PDR). methods: Chart review of consecutive cases of vitreoretinal surgery for PDR performed by one of the authors (Y.L.F.) over a 2-year period. RESULTS: Endoscopic vitreoretinal surgery was performed in 8 of 41 (19.5%) eyes. The surgical indications were small pupil (3), hyphema (3), pseudophakia with fibrotic posterior capsule (1), and pars plana neovascularization with anterior tractional retinal detachment (6). CONCLUSION: Endoscopic vitreoretinal surgery, by enhancing the visualization of the retroirideal space, is a useful technique in PDR with opaque ocular media and/or neovascularization of the pars plana and ciliary body.- - - - - - - - - - ranking = 0.33333333333333keywords = neovascularization (Clic here for more details about this article) |
3/49. Photodynamic therapy with verteporfin for choroidal neovascularization in patients with diabetic retinopathy.PURPOSE: To report the use of photodynamic therapy (PDT) with verteporfin in three patients with choroidal neovascularization (CNV) from age-related macular degeneration and underlying diabetic retinopathy. The level of diabetic retinopathy would have excluded these patients from participation in previously reported randomized clinical trials evaluating PDT with verteporfin due to a theoretic concern of damage to the overlying retinal vasculature. DESIGN: Retrospective interventional case series. methods: Three patients from a referral practice with at least severe nonproliferative diabetic retinopathy and a history of clinically significant macular edema developed loss of vision from concurrent choroidal neovascularization evaluated with fundus photography and fluorescein angiography before and after PDT with verteporfin to identify adverse retinal vascular events. RESULTS: Four eyes in three patients had PDT using verteporfin. Three eyes received two treatments. With short follow-up, visual acuity remained stable in two eyes, improved from 20/400 to 20/320 in one eye, and decreased from 20/200 to 20/400 in one eye. Fluorescein angiograms at intervals from 2 weeks to 3 months after PDT showed no damage to the retinal vasculature or progression of the diabetic retinopathy, but did show a decreased area of fluorescein leakage from CNV. One eye that had new subretinal hemorrhage following treatment appeared to show new vasculopathy on initial evaluation of the post-treatment angiogram. Retrospective review suggested that the subretinal hemorrhage provided increased contrast to more easily visualize vasculopathy that was present before the PDT. CONCLUSIONS: Three patients with diabetic retinopathy undergoing a total of seven PDT treatments with verteporfin in four eyes had no new retinal vascular abnormalities develop. No other atypical responses of CNV to PDT were noted except new subretinal hemorrhage, providing increased contrast of the overlying vasculature, which gave the false impression of the development of new vasculopathy in one eye. patients with diabetic retinopathy who have concurrent CNV for which PDT with verteporfin is recommended should be cautioned regarding the theoretical concerns of harming the retinal vasculature. Periodic surveillance for such concerns seems warranted until more experience is obtained.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
4/49. Retinal ischemia in diabetic retinopathy.Eight patients with proliferative diabetic retinopathy developed extensive retinal arteriolar and capillary obstruction. ophthalmoscopy showed many white, thread-like retinal arterioles associated with capillary and venous dilatation. Widespread retinal arteriolar and capillary nonperfusion was demonstrated by fluorescein angiography. Ischemic maculopathy resulted in severe loss of visual acuity in some eyes. The severe degree of retinal ischemia was accompanied by optic disc pallor and neovascularization and a high incidence of rubeosis iridis with neovascular glaucoma. patients with this variety of diabetic retinopathy have a poor prognosis of retaining useful vision.- - - - - - - - - - ranking = 0.16666666666667keywords = neovascularization (Clic here for more details about this article) |
5/49. Photodynamic therapy for choroidal neovascularization after thermal laser photocoagulation for diabetic macular edema.PURPOSE: To report the use of photodynamic therapy for treating a choroidal neovascular membrane secondary to thermal laser photocoagulation. DESIGN: Interventional case report. methods: A 61-year-old man with a choroidal neovascular membrane secondary to thermal laser photocoagulation for diabetic macular edema was treated with photodynamic therapy. RESULTS: Subjective and objective improvement in visual acuity and improvement of fluorescein angiogram have been demonstrated for more than a year after treatment. CONCLUSIONS: Photodynamic therapy may be useful for treating patients with choroidal neovascularization secondary to thermal laser photocoagulation.- - - - - - - - - - ranking = 0.83333333333333keywords = neovascularization (Clic here for more details about this article) |
6/49. Subthreshold infrared footprinting with indocyanine green for localizing low-intensity infrared photocoagulation.A novel technique for localizing subthreshold infrared (810 nm) laser treatment and its use in three patients is described. Two patients were treated for choroidal neovascularization with transpupillary thermotherapy or focal subthreshold photocoagulation, and the third patient was treated with grid laser photocoagulation for diabetic macular edema using the 810-nm laser after undergoing indocyanine green angiography for diagnostic purposes. Postoperative indocyanine green images, obtained without reinjection of indocyanine green, revealed areas of hypofluorescence that corresponded to the laser treatment spots. This technique, named subthreshold infrared footprinting, can precisely localize subthreshold infrared laser photocoagulation sites and is potentially useful for evaluating treatment postoperatively and planning additional therapy if necessary.- - - - - - - - - - ranking = 0.16666666666667keywords = neovascularization (Clic here for more details about this article) |
7/49. Increased diode laser uptake in inner retinal layers after indocyanine green staining of the internal limiting membrane.Intraoperative use of indocyanine green to stain the internal limiting membrane assists in its visualization and removal. This article describes increased uptake of diode laser energy by the superficial layers of the retina after indocyanine green staining of the internal limiting membrane in a patient with diabetic macular edema and a taut, attached posterior hyaloid. The patient was undergoing pars plana vitrectomy, removal of the posterior hyaloid, and indocyanine green-assisted peeling of the internal limiting membrane. In addition, panretinal diode laser endophotocoagulation was performed after discovering retinal neovascularization. In areas that were more intensely stained with indocyanine green, the clinical appearance and optical coherence tomography scans demonstrated markedly increased laser energy uptake in the superficial layers of the retina. This case indicates near-infrared or infrared laser procedures performed in areas of indocyanine green-stained internal limiting membrane may necessitate adjustment of laser power and technique.- - - - - - - - - - ranking = 0.34462493238591keywords = retinal neovascularization, neovascularization (Clic here for more details about this article) |
8/49. Preretinal neovascularization in diabetic retinopathy: a preliminary investigation using contrast-enhanced magnetic resonance imaging.Preretinal neovascularization is a well-described feature of advanced diabetic retinopathy. In this study, contrast-enhanced magnetic resonance imaging was used to examine blood-retinal barrier breakdown associated with preretinal neovascularization in three subjects with proliferative diabetic retinopathy. Using a standard imaging protocol, a varying degree of vitreous enhancement was observed in these eyes. The location and severity of enhancement, judged by visual inspection of the images, corresponded to the fluorescein angiographic and/or clinical appearance of preretinal neovascularization. This result suggests that contrast-enhanced magnetic resonance imaging may prove a reasonable approach to the identification of preretinal neovascularization in eyes with significant media opacities.- - - - - - - - - - ranking = 2.7569994590873keywords = retinal neovascularization, neovascularization (Clic here for more details about this article) |
9/49. Acute onset of rubeosis iridis after diabetic vitrectomy can indicate peripheral traction retinal detachment.Acute onset or exacerbation of rubeosis iridis associated with peripheral retinal detachment after vitrectomy represents a rare but serious complication of advanced diabetic retinopathy that indicates a poor prognosis. The clinical features, surgical procedures, and anatomical and functional results for a series of 13 eyes presenting with this complication are reported. In addition to rubeosis iridis and peripheral retinal detachment, anterior hyaloidal fibrovascular proliferation (APH) was also present in 10 eyes. All eyes had undergone one or more previous vitrectomies for diabetic complications such as nonclearing vitreous hemorrhage and traction retinal detachment. Treatment modalities for iris neovascularization and peripheral retinal detachment included reattachment procedures with an encircling band, peripheral membrane peeling, and, if necessary, peripheral retinectomy. Peripheral coagulation therapy was performed in all eyes. Eight eyes received an intraocular silicone-oil tamponade. Early results (4 weeks post-surgery) showed regression or stabilization of rubeosis iridis in all eyes. Later results (mean, 9 months post-surgery) revealed nine eyes with stabilized anterior ocular neovascularization and reattachment of the retina. Four eyes were anatomic failures due to recurrent rubeosis iridis/AHP or traction retinal detachment, and three of them also developed ocular hypotony. None of the eyes has thus far been lost as a result of neovascular glaucoma or painful phthisis. Ambulatory vision was retained in ten eyes, but function was limited to a low level as a result of the underlying ischemic disease. Immediate reattachment surgery in combination with anterior/peripheral coagulation therapy was shown to be an effective measure for controlling iris neovascular activity in eyes afflicted with acute anterior ocular neovascularization.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
10/49. Management of post-vitrectomy persistent vitreous hemorrhage in pseudophakic eyes.PURPOSE: To prospectively assess the effect of neodymium:yttrium-aluminum-garnet peripheral capsulotomy on postvitrectomy hemorrhage in diabetic patients with a posterior chamber intraocular lens (IOL) implant and an intact posterior capsule. DESIGN: Interventional case series. methods: This is a prospective case series, clinical practice. patients: Five vitrectomized, diabetic, pseudophakic patients with persistent vitreous cavity hemorrhage remaining after vitrectomy were selected. They all had a posterior chamber IOL implant with an intact posterior capsule. Additionally, they had all undergone laser panretinal photocoagulation in the involved eye in the past for diabetic retinopathy. neodymium:yttrium-aluminum-garnet laser capsulotomy outside the optic of the IOL was performed in victrectomized diabetic patients to treat the remaining vitreous cavity hemorrhage. visual acuity, intraocular pressure (IOP), and fundus examination were measured and done immediately after the laser procedure, in 7 days and in approximately 3 months. RESULTS: The visual acuity was improved at the time of the first follow-up. However, a mild elevation of IOP was noticed in some patients, which was treated with topical dorzolamide. The final visual acuity was dramatically improved, to 20/30 or better, and the IOP was normalized without medication within a few weeks in all five cases. No neovascularization of the iris or elsewhere was noticed in any case. CONCLUSIONS: neodymium:yttrium-aluminum-garnet laser peripheral capsulotomy appears to be a safe and effective management procedure in treating postvitrectomy hemorrhage in diabetic patients who have previously undergone cataract surgery with posterior chamber lens implant, intact posterior capsule, and extensive panretinal photocoagulation. The vitreous hemorrhage cleared completely in all five cases.- - - - - - - - - - ranking = 0.16666666666667keywords = neovascularization (Clic here for more details about this article) |
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