1/40. optic disk neovascularization in a patient with cytomegalovirus retinitis associated with renal transplantation.PURPOSE: To report the development of optic nerve head neovascularization during the recovery phase of cytomegalovirus (CMV) retinitis in a renal allograft recipient. CASE REPORT: A 46-year-old male renal allograft recipient developed CMV retinitis seven months after transplantation. At the time of the diagnosis, the patient was being immunosuppressed with prednisone, cyclosporine, and azathioprine, and was treated with repeated intravitreal and intravenous ganciclovir. Six weeks after the initiation of therapy, optic disk neovascularization developed. This was confirmed by fluorescein angiography, which showed no areas of retinal capillary nonperfusion. At this stage, active retinal lesions were partially resolved. Apart from intraocular inflammation, no other cause of neovascularization was detected. Over the following six months, optic disk neovascularization regressed spontaneously without causing vitreous hemorrhage or visual loss. There was no recurrence of CMV retinitis during follow-up. CONCLUSION: optic disk neovascularization may develop in the healing phase of CMV retinitis in renal transplant recipients.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/40. Salvage of ischemic digits using a lateral arm fascial flap.Four patients underwent microvascular transfer of a lateral arm fascial flap to salvage severely ischemic digits by means of induction of neovascularization. The cause of the digital ischemia was direct trauma (crush injury) in one patient and chronic embolic phenomena (proximal arterial occlusion) in three patients. None of the patients had responded to traditional therapy, including treatment with one or more of the following: anticoagulation, lytic therapy, oral vasodilators, digital sympathectomy, and vein bypass grafting. Each patient underwent noninvasive (Doppler ultrasound, digital pressures, digital temperatures, vascular refill) and invasive (angiogram) vascular assessment preoperatively. After microvascular transfer of the lateral arm fascial flap, all patients reported symptomatic relief, and objective improvements were documented by both noninvasive and invasive assessment criteria. One patient developed a seroma at the donor site; another experienced a late complication of thrombosis of the flap after his wound dehisced. A 6-month follow-up evaluation demonstrated neovascular collateralization and stable improvement without regression in the remaining patients. The authors present their clinical experience and propose a treatment algorithm for patients with chronic digital ischemia.- - - - - - - - - - ranking = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
3/40. Limited macular translocation for the management of subfoveal retinal pigment epithelial loss after submacular surgery.PURPOSE: To report a case of subfoveal retinal pigment epithelial (retinal pigment epithelium) loss after submacular surgery managed successfully by limited macular translocation. methods: Case report. RESULTS: A 28-year-old woman presented with a visual acuity of 20/100 caused by subfoveal choroidal neovas-cularization secondary to ocular histoplasmosis syndrome. Submacular resection of the choroidal neovascularization was complicated by inadvertent retinal pigment epithelium loss from beneath the foveal center. She underwent limited macular translocation 5 days after the initial surgery and had successful displacement of the fovea to an area inferior to the retinal pigment epithelium defect. Her visual acuity was 20/60 4 months postoperatively. CONCLUSION: This report demonstrates the feasibility of using limited macular translocation for the management of eyes with central retinal pigment epithelium defect after submacular surgery and extends the clinical indications for limited macular translocation.- - - - - - - - - - ranking = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
4/40. Foveal translocation with scleral imbrication in patients with myopic neovascular maculopathy.PURPOSE: To report our surgical results of foveal translocation with scleral imbrication in patients with myopic neovascular maculopathy. DESIGN: Noncomparative, interventional, consecutive case series. methods: Ten eyes of 10 myopic patients with subfoveal neovascular membranes that had undergone foveal translocation with scleral imbrication were recruited for this retrospective study. Inclusion criteria were myopia 6.0 diopters or greater in refractive error (or axial length 26.5 mm or longer), subfoveal choroidal neovascularization, and preoperative best-corrected visual acuity of 20/100 or worse. None of these eyes had undergone prior laser photocoagulation or submacular surgery. The main outcome measures were surgical complications and postoperative visual function. RESULTS: Postoperatively, visual acuity had improved more than 3 lines in the logarithm of minimum angle of resolution (logMAR) measurement in all eyes. The mean preoperative, postoperative best, and final visual acuity were 0.12, 0.59, and 0.51, respectively. Of the 10 eyes, six achieved a postoperative final visual acuity of 20/40 or better. The mean postoperative foveal displacement was 0.78 disk diameter (range, 0.3--1.3 disk diameter). Two patients underwent a reoperation because of insufficient foveal displacement. Furthermore, one of these two patients required a third operation to reduce an excessive retinal fold involving the fovea induced by the second surgery. Of the 10 patients, two noted transient diplopia. This complaint, however, resolved over time as suppression developed. Although unintentional iatrogenic retinal tears formed intraoperatively in two eyes, these were successfully treated without serious complications. Postoperatively, mild retinal pigment epithelial changes were observed in all cases, but none led to significant deterioration of visual acuity during the follow-up period. All patients but one were followed for a minimum of 6 months. CONCLUSIONS: In eyes with myopic neovascular maculopathy, foveal translocation with scleral imbrication may be useful in improving visual acuity. Further refinements in surgical technique and assessment of the long-term complications will be needed to make this procedure safer and more useful.- - - - - - - - - - ranking = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
5/40. Surgical removal of submacular choroidal neovascularization: a clinicopathologic study and factors influencing visual outcomes.BACKGROUND AND OBJECTIVE: Clinical and histopathologic characteristics of submacular choroidal neovascular membranes (CNV) are investigated and features predictive of postoperative complications or poorer visual outcome following CNV removal are identified. MATERIALS AND methods: Records of patients who underwent submacular CNV removal at Bascom Palmer eye Institute between 1991 and 1998 are reviewed. RESULTS: At 6 months postoperatively, vision was stable or improved in 19/26 (73%) eyes, with 15/26 (58%) having 20/200 to 20/400 vision. Postoperative retinal detachment occurred more commonly in age-related macular degeneration eyes (AMD) (P <0.05), and CNV recurrence occurred most frequently in presumed ocular histoplasmosis (POHS) eyes (P <0.05). The one eye with an extrafoveal CNV in-growth site had the largest improvement in vision postoperatively. Choroid in the specimen was associated with worse postoperative vision (P = 0.05). CONCLUSION: Submacular CNV removal achieves visual stabilization at the 20/200 to 20/400 level in most eyes. Potential risk factors for postoperative complications or poorer visual outcome include the underlying disease process, subfoveal in-growth site of CNV, and presence of choroid in the specimen.- - - - - - - - - - ranking = 0.44444444444444keywords = neovascularization (Clic here for more details about this article) |
6/40. 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 = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
7/40. Comparison of xenon arc and argon laser photocoagulation in ocular histoplasmosis.argon laser and xenon arc photocoagulation can be utilized to obliterate choroidal neovascularization in selected cases of macular histoplasmosis. Central vision can be preserved in many instances if criteria for patient selection, treatment techniques, and method of follow-up, as described in this chapter, are adhered to rigidly. Of 40 patients treated with argon laser photocoagulation, 75 percent maintained or improved central vision an average of one year following treatment. Nonetheless, there is a definite need for a prospective controlled study to document the efficacy of this mode of treatment on a long-term basis.- - - - - - - - - - ranking = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
8/40. Scatter macular photocoagulation for subfoveal neovascular membranes in age-related macular degeneration. A pilot study.Forty eyes with age-related macular degeneration and a choroidal neovascular membrane involving the entire foveal avascular zone were enrolled in a pilot study to evaluate an unconventional photocoagulation technique that was postulated to stimulate inhibitors of neovascularization. Eighteen (45%) eyes were treated with extrafoveal scatter macular photocoagulation, and 22 (55%) eyes were treated with this type of photocoagulation and focal extrafoveal ablation of the choroidal neovascular membrane. The eyes were followed for at least 1 year and up to 4 years (average, 2.4 years). One to 7 months after treatment, approximately 45% of the membranes treated with each technique did not leak fluorescein during angiography. The absence of leakage was associated with better visual acuity, but this difference was not statistically significant. At the beginning of the study, the visual acuity was 20/200 or better in 32 eyes (80%) and 20/80 or better in 11 (28%). At the conclusion of the study, the visual acuity was 20/200 or better in 21 eyes (53%) and 20/80 or better in 7 (18%). After treatment, 24 eyes (60%) had the same or better (plus or minus two lines) visual acuities. Compared with eyes in natural history studies, those treated with scatter macular photocoagulation had less visual loss from baseline but did not recover acuity of 20/100 or better more frequently. There was no difference in results between these two methods of treatment.- - - - - - - - - - ranking = 0.11111111111111keywords = neovascularization (Clic here for more details about this article) |
9/40. Successful photodynamic therapy with verteporfin for recurrent choroidal neovascularization beneath the new fovea after macular translocation surgery with 360-degree retinotomy.PURPOSE: To report a case of successfully treated recurrent choroidal neovascularization after macular translocation surgery with 360-degree retinotomy by photodynamic therapy with verteporfin. DESIGN: Interventional case report. methods: A 76-year-old man developed recurrent choroidal neovascularization at the new fovea after macular translocation surgery with 360-degree retinotomy. RESULTS: Two sessions of photodynamic therapy were applied, which resolved the choroidal neovascularization. Best-corrected visual acuity improved to 20/50 at the 6 and 12 months follow-up. CONCLUSION: Photodynamic therapy may be an option for treatment of recurrent choroidal neovascularization in the new subfoveal region after macular translocation surgery with 360-degree retinotomy.- - - - - - - - - - ranking = 0.88888888888889keywords = neovascularization (Clic here for more details about this article) |
10/40. choroidal neovascularization associated with choroidal hemangiomas.Two patients with choroidal hemangiomas developed choroidal neovascularization. One patient with sturge-weber syndrome, a unilateral diffuse choroidal hemangioma, and a serous detachment of the macula was treated with yellow dye laser photocoagulation in a grid pattern to the tumor before glaucoma filtration surgery. Four years after successful laser treatment, the patient developed subfoveal choroidal neovascularization in an area of treatment. A second patient with a circumscribed choroidal hemangioma developed spontaneous subfoveal choroidal neovascularization 12 years after initial diagnosis of the hemangioma. The development of choroidal neovascularization associated with choroidal hemangiomas represents a potential cause of poor visual outcome in these patients.- - - - - - - - - - ranking = 0.88888888888889keywords = neovascularization (Clic here for more details about this article) |
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