11/34. Macular fold after limited macular translocation treated with scleral shortening release and intravitreal gas.PURPOSE: To describe a case developing a macular fold as a complication of limited macular translocation, which was successfully managed without repeat vitrectomy. methods: Interventional case report. A 34-year-old woman who underwent limited macular translocation for subfoveal choroidal neovascularization secondary to myopic degeneration developed a postoperative macular fold. Her visual acuity deteriorated from 20/100 to 20/200 postoperatively. RESULTS: She underwent scleral shortening release and intravitreal gas injection 4 days after the initial surgery and had a resolution of macular fold with adequate foveal displacement. Her visual acuity had improved to 20/40 3 months postoperatively. CONCLUSION: Scleral shortening release and intravitreal gas injection may be considered for the management of severe macular fold caused by limited macular translocation.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
12/34. Bilateral retinal hemorrhages following automated lamellar keratoplasty.We describe a case of bilateral multifocal retinal hemorrhages after receiving automated lamellar keratoplasty (ALK) surgery in a 32-year-old male with extremly myopic eyes. Before surgery, there was no retinal hemorrhage in routine fundus examination. This patient visited our clinic and complained of decreased vision in both eyes 2 weeks after the ALK surgery. Upon examination, his best-corrected visual acuity (BCVA) was 0.6 with -8.5-1.5 x 100(0) in the right eye and 0.9 with -4.0-2.50 x 90(0) in the left eye. Fundus examination revealed scattered multiple round focal retinal hemorrhages in both eyes. No evidence of choroidal neovascularization was noted. The retinal hemorrhages resolved 10 weeks later. The BCVA recovered to 1.0 in the right eye and 0.9 in the left eye. This case highlights the relationship between the postoperative bilateral posterior pole hemorrhages and the automated lamellar keratoplasty surgery, in which a microkeratome was used to create a corneal flap and keratectomy. patients should be informed of this rare complication before surgery.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
13/34. Optical coherence tomography of choroidal neovascularization in high myopia.AIM: To investigate morphologic changes in the eye with choroidal neovascularization (CNV) in high myopia using optical coherence tomography (OCT). methods: Optical coherence tomography was performed in 35 patients (42 eyes) with myopic CNV. Myopic CNV was divided into active, scar, or atrophic stages based on funduscopic and fluorescein angiographic findings. The characteristics of OCT findings in each stage were identified. RESULTS: In the active stage (11 eyes), OCT clearly displayed a neovascular membrane as a highly reflective dome-like elevation above the retinal pigment epithelium (RPE). No apparent subretinal fluid accumulation around the CNV was identified. In the scar stage (12 eyes), only the surface of the CNV showed high reflectivity, which was markedly attenuated below the surface. In the atrophic stage (19 eyes), the CNV had become totally flat and chorioretinal atrophy around the regressed CNV showed high reflectivity. CONCLUSIONS: Optical coherence tomography demonstrated characteristic features at each stage of myopic CNV. Optical coherence tomography appears to be useful in evaluating the stage and activity of myopic CNV.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
14/34. Long-term visual prognosis of choroidal neovascularization in high myopia: a comparison between age groups.OBJECTIVE: To analyze visual outcome in highly myopic patients of different age groups with choroidal neovascularization (CNV). DESIGN: Retrospective observational case series. PARTICIPANTS: We reviewed the medical records of 63 consecutive patients (73 eyes) with myopic CNV. The patient population was divided into two groups according to age at onset of CNV (< or =40 and >40 years old). INTERVENTION: Demographic and clinical data were obtained from the patients' medical records. MAIN OUTCOME MEASURES: visual acuity at least 3 years after CNV diagnosis. RESULTS: Group 1 (< or =40 years old) consisted of 22 patients (26 eyes), and group 2 (>40 years old) consisted of 41 patients (47 eyes). Throughout the follow-up period, group 1 retained better visual acuity than group 2. Almost half the patients in group 1 retained a final visual acuity better than 20/40. No significant change occurred in the logarithm of the minimum angle of resolution (logMAR) in group 1 during follow-up. Group 2 had worse visual acuity at the initial evaluation than did group 1, and a statistically significant worsening of logMAR was found during the follow-up period. More than half of the patients in group 2 had a final visual acuity less than 20/200. In addition, group 2 had a larger area of CNV, and chorioretinal atrophy was more frequently seen after the regression of CNV than in group 1. CONCLUSIONS: The visual prognosis of myopic CNV is influenced by age at onset. The results of this study indicate that patient age at the time of onset of myopic CNV should be considered when determining the therapeutic course.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
15/34. choroidal neovascularization occurring concurrently in myopic eyes of monozygotic twins.PURPOSE: To present young monozygotic twins both of whom developed choroidal neovascularization at the same time. CASE/OBSERVATIONS: Monozygotic twins, 22-year-old women, who lived in the same house, developed choroidal neovascularization in the left eye at the same time. The degree of myopia was higher in the left eye (-7.75 and -8.5 dpt in spherical equivalent) than in the right eye (-6.75 and -4.5 dpt) of both patients. The choroidal neovascularization regressed in a different time course and the visual acuity returned to normal in both patients. CONCLUSION: This pair of monozygotic twins suggests that both genetic and environmental factors underlie the development of choroidal neovascularization in myopic eyes.- - - - - - - - - - ranking = 8keywords = neovascularization (Clic here for more details about this article) |
16/34. Pathologic myopia: where are we now?.PURPOSE: To describe current concepts and available treatments for pathologic myopia. DESIGN: review of experimental and clinical studies. methods: The demography, natural history, medical and surgical treatments for choroidal neovascular membrane, vitreoretinal interface disorders and future strategies for pathologic myopia are reviewed. RESULTS: Several medical and surgical modalities are currently available to treat various complications of pathologic myopia. Macular translocation appears to stabilize or improve visual function in many eyes with choroidal neovascularization. CONCLUSION: Newer strategies are emerging to better ameliorate or prevent the complications of pathologic myopia.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
17/34. Peripapillary detachment in pathologic myopia.OBJECTIVE: To describe peripapillary detachment in pathologic myopia (PDPM), a newly recognized fundus lesion. DESIGN: Retrospective medical record review. methods: We evaluated a series of myopic eyes that had a yellow-orange elevation of the retina and retinal pigment epithelium at the inferior border of the myopic conus. RESULTS: Twenty eyes of 15 patients were identified during a 17-year period to have characteristic findings of PDPM. The mean age of the patients was 58 years. They were followed up for an average of 6 years. The mean spherical equivalent correction was -11.00 diopters (D) (range, -6.00 to -16.00 D). The mean axial length was 27.4 mm (range, 25.3-28.9 mm). In each case, ophthalmic coherence tomographic examination showed a localized detachment of the retinal pigment epithelium and retina corresponding to the PDPM lesion. During the follow-up period, the lesion remained stable in all cases except for 1. No apparent negative effect on visual function was noted. CONCLUSIONS: Peripapillary detachment in pathologic myopia is an asymptomatic, yellow-orange peripapillary detachment of the retinal pigment epithelium and retina in pathologic myopia. Recognition of this lesion is important to distinguish it from other fundus pathologic conditions, such as tumors or choroidal neovascularization, which require further investigation and treatment.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
18/34. Myopic choroidal neovascularization: a 10-year follow-up.PURPOSE: To clarify the long-term visual outcome of choroidal neovascularization (CNV) in eyes with high myopia in Asian patients. DESIGN: We reviewed the medical records of 25 consecutive patients (27 eyes) with myopic CNV who were followed up for at least 10 years after the onset of CNV. visual acuity was examined 10 years after CNV onset. INTERVENTION: Demographic and clinical data were obtained from the patients' medical records. MAIN OUTCOME MEASURES: visual acuity readings during the 10 years after CNV onset. RESULTS: At the onset of CNV, 19 eyes (70.4%) had a visual acuity better than 20/200, and six eyes (22.2%) had a visual acuity better than 20/40. Three years after the onset of CNV, 15 eyes (55.5%) retained a visual acuity of better than 20/200. At 5 and 10 years after the onset, however, visual acuity dropped to 20/200 or less in 24 eyes (88.9%) and in 26 eyes (96.3%), respectively. The logarithm of the minimum angle of resolution (logMAR) visual acuity was significantly worse at 5 and 10 years after onset as compared with that at CNV onset. Chorioretinal atrophy developed around the regressed CNV in 26 eyes (96.3%) at 5 and 10 years after the onset of CNV. CONCLUSIONS: Long-term visual outcome of myopic CNV is extremely poor. The visual acuity of almost all of the patients dropped to 20/200 or less within 5 to 10 years after the onset of CNV, secondary to the development of chorioretinal atrophy around the regressed CNV. These findings indicate that active treatments should be recommended to prevent long-term visual impairment in Asian patients with myopic CNV.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
19/34. Photodynamic therapy for juxtafoveal choroidal neovascularization in myopic eyes.PURPOSE: To report the results of photodynamic therapy in myopic patients with juxtafoveal choroidal neovascularization (CNV). DESIGN: Interventional case series. methods: Three consecutive myopic patients with juxtafoveal CNV were treated by photodynamic therapy with the same protocol as the one used to treat subfoveal CNV. visual acuity was measured on Early Treatment diabetic retinopathy Study (ETDRS) charts by an independent observer. fluorescein angiography was performed 6 and 12 weeks after photodynamic therapy and then every 12 weeks. RESULTS: In all three patients, one treatment of photodynamic therapy using verteporfin resulted in the involution of the CNV and improvement in best-corrected visual acuity from 20/50 or 20/40 to 20/25 or more. No retreatment was required during follow-up, which lasted for 12 to 24 months (mean = 17 months). CONCLUSION: Photodynamic therapy may be an effective treatment for juxtafoveal CNV in myopic eyes.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
20/34. The natural history of juxtafoveal and subfoveal choroidal neovascularization in high myopia.BACKGROUND: To assess the natural history of juxtafoveal and subfoveal choroidal neovascularization in eyes with high myopia. methods: We retrospectively reviewed the charts of 31 patients (31 eyes) with myopia > or = 6 diopters, well-defined juxtafoveal (1-200 microm from the foveal center) or subfoveal choroidal neovascularization (CNV) on fluorescein angiography at baseline, no prior laser treatment, age < or = 55 years and presenting visual acuity (VA) > or = 20/200. Initial and final VA were compared with the Wilcoxon signed rank test. Multifactor analysis of variance was used to assess the association between baseline characteristics of the lesion and final VA. RESULTS: Twenty-two patients were females and 9 males with a median age of 44 years (range 14-55). Median diopters spherical equivalent was -11.5 (range -6, -25). Follow-up ranged from 1 to 20 years (median, 3 years). Nine eyes had juxtafoveal CNV and 22 subfoveal involvement. Median final VA (20/100) was significantly worse than median initial VA (20/50)(p = 0.02). A decrease in VA > or = 2 lines occurred in 18 eyes, whereas 8 eyes remained stable and 5 improved (4 juxtafoveal membranes and 1 subfoveal membrane). Of the 9 juxtafoveal CNV, 7 had a final VA > or = 20/40 after a median follow-up of 4 years. By contrast, only 2 of the 22 subfoveal CNV had a final VA > or = 20/40 (median, 20/100) with a median follow-up of 2.5 years. The only factor associated with better final VA was the initial location of CNV (p = 0.0000). CONCLUSION: This study confirms the poor functional outcome of subfoveal CNV in degenerative myopia with more than 70% of patients having a final VA of 20/100 or less. Juxtafoveal CNV shows a better functional prognosis. These differences should be considered when planning treatment strategies.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
| <- Previous || Next -> |