11/36. 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 = 1keywords = neovascularization (Clic here for more details about this article) |
12/36. Digital overlay of fluorescein angiograms and fundus images for treatment of subretinal neovascularization.A system for comparing sequential fundus photographs and angiograms has been developed using a personal computer and commercially available image processing software. This process provides rapid results and a high degree of accuracy in image correlation, even when images come from different cameras with different magnifications. Though no concentrated effort was made to compare the superiority of this method to the manual technique, the value of the manual results is fully acknowledged, and this technique is offered as another method of achieving the same end. This technique can be used to determine the adequacy of treatment of subretinal neovascularization, recurrence of subretinal neovascularization in subsequent angiograms, pigment epithelial creep, and changes in fundus lesions.- - - - - - - - - - ranking = 0.75keywords = neovascularization (Clic here for more details about this article) |
13/36. Digital fundus imaging of subretinal neovascularization.Digital fundus imaging was used for fluorescein angiography in patients with subretinal neovascularization. After laser treatment, digital red-free photographs were obtained and compared against pretreatment angiogram frames to determine the margins of treatment. This technique allowed instant review of images and confirmation of complete laser treatment of the lesions. Of 15 eyes treated and followed for at least one year, there were two eyes with early recurrences (13%). A total of five eyes had recurrences during the follow-up period (33%). Digital imaging is a useful tool for treating subretinal neovascularization.- - - - - - - - - - ranking = 0.75keywords = neovascularization (Clic here for more details about this article) |
14/36. Sequential combined therapy for treatment of choroidal neovascularization in age-related macular degeneration: photodynamic therapy and thermal laser photocoagulation.PURPOSE: To analyze the results achieved after treating extrafoveal choroidal neovascularization (CNV) recurrences with thermal laser photocoagulation (TLP) in patients who had previously undergone photodynamic therapy (PDT). patients AND methods: Seven eyes (seven patients: four women and three men) that had been initially treated by PDT for CNV associated with age-related macular degeneration (ARMD) and then developed extrafoveal recurrences were treated with green argon TLP. All patients underwent a complete ophthalmologic evaluation and fluorescein angiography. Mean age was 74.4 /- 4.4 years (range, 69 to 81 years). Five right eyes and two left eyes were treated. Mean follow-up after the beginning of the treatment with PDT was 18.0 /- 3.5 months (range, 11 to 22 months). Follow-up after TLP was 6.8 /- 1.0 months (range, 6 to 8 months). RESULTS: Mean best-corrected visual acuity (BCVA) before treatment was 20/150 (range 20/400 to 20/40). After PDT it was 20/281 (range, 20/400 to 20/80), with a mean of 3.1 /- 0.8 treatments (range, 2 to 4). After TLP, BCVA was 20/233 (range, 20/400 to 20/80), with no statistically significant difference from BCVA after PDT (p = 0.06, Student's t-test paired data). In all cases total closure of CNV was achieved after only one session of TLP. CONCLUSIONS: TLP could be helpful in association with multiple sessions of PDT in order to achieve a complete closure of subfoveal CNV secondary to ARMD. Further studies are required to confirm our findings.- - - - - - - - - - ranking = 0.625keywords = neovascularization (Clic here for more details about this article) |
15/36. Recurrent vitreous hemorrhage after sutured posterior chamber intraocular lenses.PURPOSE: To describe the clinical course and management of patients with late vitreous hemorrhage after scleral suturing of posterior chamber intraocular lenses (PCIOL). methods: The authors reviewed patient demographics, ocular findings, and clinical course of six patients with late (>3 weeks) vitreous hemorrhage after sclera-sutured PCIOL. Intraoperative endoscopy was performed on two patients to better assess the haptic sulcus interaction. RESULTS: Patient age ranged from 39 to 84 years (median 77 years). The interval between scleral suturing of the PCIOL and vitreous hemorrhage ranged from 3 weeks to 68 months (median 5 months). The number of hemorrhages ranged from one to four. The hemorrhage cleared spontaneously in three eyes. Three patients underwent surgery after the hemorrhages including sutured PCIOL removal with concurrent placement of an anterior chamber IOL (ACIOL) (two patients) and resuturing of a PCIOL in a different meridian (one patient). Follow-up ranged from 4 to 36 months, median 19.5 months, starting from the time of the initial postsuturing vitreous hemorrhage. Final vision ranged from 20/20 to hand motions, with four eyes having 20/40 or better vision. endoscopy revealed a haptic embedded into the pars plicata in one eye but no evidence of neovascularization. CONCLUSION: Recurrent vitreous hemorrhage may occur as a complication of scleral suturing of PCIOL. The etiology of these hemorrhages does not appear to be related to neovascular proliferation at the haptic suture site, but may be secondary to erosion of the haptic into uveal structures. Not all eyes require reoperation after these hemorrhages; however, good visual results may be achieved by replacing the sutured PCIOL with an ACIOL or by suturing the PCIOL in a different meridian.- - - - - - - - - - ranking = 0.125keywords = neovascularization (Clic here for more details about this article) |
16/36. Ocular conditions associated with peripapillary subretinal neovascularization, their relative frequencies, and associated outcomes.OBJECTIVE: To determine frequency and outcomes of conditions with peripapillary subretinal neovascular membranes (PSRNVMs). DESIGN: Retrospective observational case series. PARTICIPANTS: All patients from a private community-based retina practice diagnosed with a PSRNVM. methods: review of clinical charts, photographs, and fluorescein angiograms of 115 eyes of 96 patients, accrued over 18 years. MAIN OUTCOME MEASURES: Demographics, visual acuity (VA), laterality, neovascular membrane type and recurrence status over treatment course, and associated ocular conditions. RESULTS: Prevalences of reported associations were 52 (45.2%), age-related maculopathy (arm); 45 (39.1%), idiopathic; 5 (4.3%), multifocal choroiditis; 3 (2.6%), angioid streaks; 2 (1.7%), histoplasmosis; 2 (1.7%), choroidal osteoma; 1 (0.9%), optic disc drusen; and 1 (0.9%), congenital disc anomaly. Newly recognized associations include pattern dystrophy (3 [2.6%]) and peripapillary pseudopodal pigment epithelial and choroidal atrophy (1 [0.9%]). Second-eye involvement was observed in 19.8% of patients over a median follow-up of 2 years. Median initial VAs were 20/40 for arm-associated eyes and 20/30 for idiopathic eyes (P = 0.0230). Median final VAs were 20/70 for arm-associated eyes and 20/32 for idiopathic eyes (P = 0.0261). The VA changes in the arm-associated and idiopathic groups did not differ significantly (P = 0.1453). recurrence of PSRNVMs after laser ablation was seen in 14 of 73 eyes (19.2%). A case of a PSRNVM as a cause of pseudopapilledema leading to unnecessary neurological imaging is reported. CONCLUSIONS: Close inspection of fellow eyes at the time of first eye diagnosis and regular follow-up afterward are indicated, given the high rate of eventual bilateral involvement regardless of associated condition. Laser ablation of PSRNVMs with broad treatment margins reduces recurrence rates relative to earlier series. The differential diagnosis of disc edema should include PSRNVMs. Pattern dystrophy can be associated with PSRNVMs.- - - - - - - - - - ranking = 0.5keywords = neovascularization (Clic here for more details about this article) |
17/36. Intravenous pulse methylprednisolone therapy for acute treatment of serpiginous choroiditis.PURPOSE: To evaluate the safety and efficacy of high-dose intravenous steroid therapy (HDIST) for the acute treatment of vision-threatening serpiginous choroiditis. methods: Retrospective review of the records of five patients with serpiginous choroiditis who were treated with HDIST (1 g methylprednisolone for three days) in addition to their standard immunosuppressive treatment. The visual acuities and improvement of ocular signs after HDIST were evaluated. RESULTS: Twelve episodes of macula-threatening choroiditis in five patients with serpiginous choroiditis were treated during a seven-year period. All patients responded to HDIST with evidence of a decrease in intraocular inflammation immediately after and complete restoration of visual acuity within 10 days of commencing treatment. In one patient, medical intervention was required because of gastric distress. During the follow-up, three out of five patients experienced new attacks and two patients developed subretinal neovascularization. CONCLUSION: HDIST is effective in controlling severe vision-threatening serpiginous choroiditis and in improving visual function in a short period of time. However, the effect of this treatment in long-term disease control is uncertain.- - - - - - - - - - ranking = 0.125keywords = neovascularization (Clic here for more details about this article) |
18/36. Recurrent bleeding after photodynamic therapy in polypoidal choroidal vasculopathy.PURPOSE: To report a case of recurrent bleeding after photodynamic therapy (PDT) in an eye with polypoidal choroidal vasculopathy (PCV). DESIGN: Interventional case report. methods: A 73-year-old man was treated in the left eye for PCV with PDT. RESULTS: Two weeks after PDT, his left eye showed extensive subretinal hemorrhage, with a slight vision loss. Three months after PDT, subretinal hemorrhage was almost absorbed. He received a second session of PDT to the remaining choroidal neovascularization. Two weeks thereafter, his left eye showed massive suprachoroidal hemorrhage with further vision loss. One month after the second PDT, visual acuity was decreased to no light perception as a result of massive vitreous hemorrhage. Although the patient underwent pars plana vitrectomy, visual acuity in the left eye remained hand motion as a result of massive suprachoroidal hemorrhage. CONCLUSIONS: Ophthalmologists and patients should be aware of the risk of massive bleeding after PDT in eyes with PCV.- - - - - - - - - - ranking = 0.125keywords = neovascularization (Clic here for more details about this article) |
19/36. Profound central visual loss and ocular neovascularization in idiopathic recurrent branch retinal arterial occlusion.The authors report a 65-year-old healthy, white man who experienced a dramatic loss of central vision. iris neovascularization, rubeotic glaucoma, disc neovascularization and subhyaloid hemorrhage developed after multiple, recurrent, idiopathic branch retinal arterial occlusions. Vitreous and perivascular inflammation were prominent associated clinical features. Systemic steroids were useful in suppressing intraocular and perivascular inflammation, yet neither steroid nor anticoagulant therapy effectively prevented recurrent occlusive episodes. retinal neovascularization and rubeotic glaucoma were successfully managed with scatter panretinal photocoagulation. Episodic intraocular inflammation and ocular neovascularization have been noted in one-third of patients sustaining recurrent idiopathic branch retinal arterial occlusions.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
20/36. Clinicopathologic studies of treated choroidal neovascular membranes. A review and report of two cases.The previously reported and two additional clinicopathologic studies of treated choroidal neovascular membranes were reviewed. Laser photocoagulation can obliterate choroidal neovascular membranes, but persistent and recurrent neovascularization contiguous with the treated area or the development of a new area of neovascularization contiguous or not contiguous with the treated area was seen histopathologically in nine of 12 (75%) lesions of 10 eyes. The scar that ensues after photocoagulation resembles the naturally occurring scar associated with choroidal neovascularization. Portions of the scar are comprised of hyperplastic retinal pigment epithelium. The inner retinal layers are more likely to be preserved after krypton red photocoagulation. Full-thickness destruction of the retina occurs with argon blue-green and argon green photocoagulation at levels of energy in which the end point is a uniform, white lesion.- - - - - - - - - - ranking = 0.375keywords = neovascularization (Clic here for more details about this article) |
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