11/49. diabetic retinopathy in two patients with congenital IGF-I deficiency (laron syndrome).OBJECTIVE: Animal and clinical studies have shown that excessive amounts of growth hormone or insulin-like growth factor-I (IGF-I) promote the development of diabetes and diabetic retinopathy. Forthwith, we present two patients with congenital IGF-I deficiency who developed type II diabetes and subsequently retinopathy. methods: Eighteen adult patients with classical laron syndrome (8 males, 10 females, aged 20-62 years) were followed by us since childhood or underwent fundus photography with a Nikon NF 505 instrument. Three had been treated in childhood with IGF-I, the rest were never treated, including the two patients reported. RESULTS: Two never-treated patients were diagnosed with type II diabetes (DM) at ages 39 and 41 respectively. There was no diabetes in the families. Oral treatment was followed by insulin injections. Metabolic control was not optimal and one patient developed proliferative diabetic retinopathy, necessitating laser surgery. He also has nephropathy and severe neuropathy. The other patient has background diabetic retinopathy and has developed, progressively, exudates, microaneurisms, hemorrhages and clinically significant macular edema. He also has subacute ischemic heart disease. CONCLUSIONS: Our findings show that congenital IGF-I deficiency, similar to excess, causes vascular complications of DM, denoting also that vascular endothelial growth factor can induce neovascularization in the presence of congenital IGF-I deficiency.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
12/49. Spontaneous regression of neovascularization at the disc in diabetic retinopathy.Neovascularization at the disc (NVD) is the most serious complication in diabetic retinopathy, and leads to vitreous hemorrhage and tractional retinal detachment. We report two cases of spontaneous regression of NVD in proliferative diabetic retinopathy. Two men (31 and 46 years old) with diabetes had NVD in both eyes. They were treated with panretinal photocoagulation on the left eye first, but their right eyes went untreated, because they did not revisit our clinic for several months. Fortunately, on revisit, their neovascularization had disappeared a few months later in both eyes, including their untreated right eyes. We could not find any specific causes for the spontaneous regression of the new vessels.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
13/49. Regression of optic nerve head neovascularization in proliferative diabetic retinopathy after intravitreal triamcinolone. Regression of diabetic optic disc neovascularization after intravitreal triamcinolone.The aim of this study is to report the clinical outcome of a diabetic patient with optic nerve head neovascularization treated with an intravitreal injection of triamcinolone acetonide. A 52-year-old patient presented with clinically significant diffuse macular edema and optic nerve head neovascularization due to proliferative diabetic retinopathy in her right eye. Despite grid laser photocoagulation in the macular region macular edema progressed and visual acuity declined. The patient received a single intravitreal injection of 4 mg triamcinolone acetonide with topical anesthesia. After injection of triamcinolone acetonide visual acuity increased and macular edema decreased. Furthermore optic nerve head neovascularization had markedly regressed. No complication was observed during follow-up period. Intravitreal injection of triamcinolone acetonide may be useful for treatment of optic nerve head neovascularization in patients with proliferative diabetic retinopathy.- - - - - - - - - - ranking = 12keywords = neovascularization (Clic here for more details about this article) |
14/49. Abortive foveal retinal neovascularization in diabetic retinopathy.We report six eyes with foveal white lesions and associated "abortive" retinal neovascularization. Over a two- to six-year follow-up period the clinical course was benign and the eyes maintained visual acuities of 20/20 to 20/30.- - - - - - - - - - ranking = 10.338747971577keywords = retinal neovascularization, neovascularization (Clic here for more details about this article) |
15/49. retinal neovascularization during treatment with IGF-1 for insulin resistance syndrome.BACKGROUND: Leprechaunism is a rare congenital syndrome and the most severe form of insulin resistance syndrome, with mutations in the insulin receptor gene. Recombinant human insulin-like growth factor-1 (rhIGF-1) is currently applicable to the treatment for insulin resistance syndrome by its insulin-like effect. Although IGF-1 is thought to promote tissue proliferation and neovascularization, it is uncertain how it acts on the development of diabetic retinopathy. methods: Interventional case report. RESULTS: A 12-year-old girl with leprechaunism has been treated with IGF-1 since she was 6 months old. She presented with neovascular glaucoma in the left eye, but with no serious changes in the right fundus except for tortuosity and dilatation of retinal veins. Thereafter, retinal neovascularization in the right eye developed in 6 months to form a loop-shaped vascular network in the vitreous cavity despite panretinal photocoagulation. CONCLUSIONS: Characteristics of retinal neovascularization and clinical course suggest that IGF-1 treatment was closely associated with the development of diabetic retinopathy in this case.- - - - - - - - - - ranking = 9.1354991886309keywords = retinal neovascularization, neovascularization (Clic here for more details about this article) |
16/49. Submacular fibrosis after photocoagulation for diabetic macular edema.Ten eyes of nine patients developed submacular fibrotic scars without fluorescein angiographic evidence of choroidal neovascularization between two and 11 months (mean, 6.1 months) after argon laser treatment for diabetic macular edema. In four eyes, development of the subretinal scar was associated with visual acuity loss of two, two, four, and eight lines of Snellen visual acuity, respectively, within five to 11 months of laser treatment. At the final follow-up visit, the visual acuity of the eyes with two lines of visual acuity loss had returned to within one line of the initial value, but the visual acuity of the eyes with more severe initial visual acuity loss did not recover notably. In four eyes, fibrous submacular strands extended from macular laser scars, suggesting an iatrogenic role of the laser in inducing this complication.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
17/49. Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage.PURPOSE: To report the short-term anatomic and visual acuity response after intravitreal injection of bevacizumab (Avastin, Genentech) in patients with proliferative diabetic retinopathy complicated by vitreous hemorrhage. methods: Two patients with vitreous hemorrhage due to proliferative diabetic retinopathy were treated with at least one intravitreal injection of bevacizumab 1.25 mg in 0.05 mL. The patients underwent Snellen visual acuity testing, ophthalmoscopic examination, and fluorescein angiography at baseline and follow-up visits. RESULTS: Both patients had proliferative diabetic retinopathy with vitreous hemorrhage extensive enough to preclude panretinal photocoagulation. Following intravitreal injection of bevacizumab both patients experienced improvement in visual acuity starting within the first week. At 1 month of follow-up one patient had 2 lines of improvement in visual acuity and the other 5 lines. Each patient had regression of retinal neovascularization at 1 month of follow-up. Repeat injection was given to one patient at the 1-month follow-up because of slight leakage from neovascularization on the nerve, and to the other patient at 3 months because the retinal neovascularization showed early signs of reperfusion. The vitreous hemorrhage in each patient showed partial resolution at 1 week and nearly complete regression at 1 month. No adverse events were observed in either patient. CONCLUSIONS: Initial treatment results of patients with vitreous hemorrhage and proliferative diabetic retinopathy did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in marked regression of neovascularization and rapid resolution of vitreous hemorrhage. The favorable short-term results suggest further study is needed in a larger group of patients.- - - - - - - - - - ranking = 6.1354991886309keywords = retinal neovascularization, neovascularization (Clic here for more details about this article) |
18/49. Clinicopathological features of severe corneal blood staining associated with proliferative diabetic retinopathy.A 54-year-old man with a history of severe proliferative diabetic retinopathy in both eyes and profound visual impairment presented with severe corneal blood staining in the left eye secondary to a "spontaneous" total hyphaema and raised intraocular pressure in an eye with iris neovascularization. Despite anterior chamber washout, the cornea remained virtually opaque and thickened. The subject subsequently underwent pars plana vitrectomy with endolaser using a temporary keratoprosthesis, insertion of a Morcher iris-surround intraocular lens and penetrating keratoplasty. Histopathology of the excised corneal button revealed fine eosinophilic granules composed of aggregations of haemoglobin and its breakdown products dispersed throughout the stroma, with occasional foci of weakly positive Perl staining for intracellular haemosiderin. fluorescence confocal microscopy revealed a marked increase in fluorescence throughout the corneal stroma and the basal epithelial layer. This case highlights the microstructural features and aspects of the surgical management of severe corneal blood staining.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
19/49. Severe ischemic maculopathy in a patient with west nile virus infection.A 60-year-old man with diabetes mellitus had a sudden decrease in vision in his right eye 3 weeks after confirmed west nile virus infection. visual acuity in the right eye was 20/400. Fundus examination showed bilateral multifocal chorioretinitis, which was associated with proliferative diabetic retinopathy in the right eye and severe nonproliferative diabetic retinopathy in the left eye. There were deep, dense retinal hemorrhages, retinal opacification, and retinal arterial sheathing in the macula of the right eye. fluorescein angiography revealed extensive capillary nonperfusion in the macular area of the right eye. Six months later, vision remained unchanged and a choroidal neovascularization developed over a chorioretinal scar in the same eye.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
20/49. iris neovascularization after central retinal artery obstruction despite previous panretinal photocoagulation for diabetic retinopathy.Five consecutive patients with proliferative diabetic retinopathy who were treated successfully with panretinal photocoagulation subsequently developed a central retinal artery obstruction. iris neovascularization developed in the affected eye within one to three months after the obstruction in four of the five patients despite the previous laser treatment. Additional retinal ischemia, as occurs in central retinal artery obstruction, appears to promote marked iris neovascularization in a large percentage of patients, even when successful photocoagulation for proliferative retinopathy has been previously administered.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
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