1/21. choroidal neovascularization following macular hole surgery.BACKGROUND: Retinal pigment epitheliopathy, a recognized finding in eyes that have undergone macular hole surgery, may limit visual outcome and predispose to the development of choroidal neovascularization (CNV). This study reports on the features and outcomes of CNV following otherwise successful surgery for idiopathic macular holes. methods: Case series including three eyes of two patients who developed CNV following macular hole surgery. RESULTS: choroidal neovascularization developed 3 to 30 months after macular hole surgery. The CNV was crescent-shaped, surrounding a central area of retinal pigment epithelial mottling that corresponded to the site of the macular hole in all three cases. All neovascular membranes were adjacent to the fovea and were associated with substantial leakage of fluorescein. The macular hole remained closed in all cases. CONCLUSION: choroidal neovascularization is a rare complication following macular hole surgery. Retinal pigment epitheliopathy and defects in the Bruch's membrane, pre-existing or secondary to surgery, may be predisposing factors.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/21. Retinal pigment epithelial tear with vitreomacular attachment: a novel pathogenic feature.BACKGROUND: The development of tears of the retinal pigment epithelium (RPE) has classically been described with or without choroidal neovascularization (CNV) or after laser treatment. Tangential shear forces within the RPE or CNV are usually considered to cause the dehiscence. methods: Three patients with CNV and spontaneous RPE tear and additional vitreomacular traction were examined by fluorescein angiography (FA), optical coherence tomography (OCT) and kinetic ultrasound. RESULTS: From the pre-tear to the tear stage a sudden decrease in vision was observed. Fluorescein angiographic images demonstrated RPE-tear formation with blocked filling in the area of the contracted RPE and a well-demarcated hyperfluorescence in the bed of the torn RPE. OCT-scans demonstrated vitreomacular traction at the foveal area in all three cases. Kinetic ultrasound revealed vitreous attachments at the optic disc and fovea. CONCLUSION: Magnitude, variation of mechanical forces, and the continuous shear stress of the aged vitreous gel transmitted across vitreoretinal attachments may cause a chronic stimulus to retina and RPE. Vitreomacular traction may contribute to the subsequent formation of RPE tears via mechanical or cell mediator pathways.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
3/21. Management of eyes with both idiopathic macular hole and choroidal neovascularization.PURPOSE: To describe the characteristics, treatment, and outcome of five eyes with both choroidal neovascularization (CNV) and macular hole. methods: medical records of five patients with both macular hole and CNV were reviewed. RESULTS: All eyes had full-thickness macular holes. Most eyes had atypical-appearing macular holes (subretinal hemorrhage, prominent subretinal fluid, or discoloration at the hole margin) at presentation or subsequently when CNV developed. fluorescein angiography (FA) confirmed the presence of CNV in each eye. Three eyes underwent combined macular hole repair and CNV removal, and sustained closure of these macular holes was achieved. A fourth eye underwent successful argon laser photocoagulation of extrafoveal CNV, and macular hole surgery was declined. The final eye underwent two macular hole repairs before sustained closure was achieved. Final visual acuity, ranging from 20/100 to hand motions, was limited by macular pathology and/or cataract. CONCLUSIONS: choroidal neovascularization can occur in association with a macular hole. In eyes with an atypical-appearing macular hole, FA should be obtained to detect CNV. Excision of the CNV can be done safely in conjunction with macular hole surgery. Final visual acuity may be limited by cumulative retinal and retinal pigment epithelium damage, especially in eyes with underlying macular disease.- - - - - - - - - - ranking = 0.85714285714286keywords = neovascularization (Clic here for more details about this article) |
4/21. 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 = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
5/21. Macular hole following photodynamic therapy.A 66-year-old woman with prior posterior vitreous detachment underwent photodynamic therapy with verteporfin for a juxtafoveolar choroidal neovascularization. Twenty days after the photodynamic therapy, fluorescein angiography showed regression of the membrane and the new onset of a macular hole. Macular hole formation following photodynamic therapy could be related to choroidal swelling leading to dehiscence of the foveal pit, or to exacerbation of either tangential traction or cystoid spaces by the laser administered over the fovea.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
6/21. Subfoveal choroidal neovascularization in a patient with pre-existing pseudomacular hole.PURPOSE: To report concomitant use of fluorescein angiography (FA) and optical coherence tomography (OCT) in a case of pre-existing pseudomacular hole (PMH) and macular choroidal neovascularization (CNV) treated with photodynamic therapy (PDT). methods: Case report. RESULTS: A 63-year-old man who received laser treatment for branch retinal vein occlusion in 1993 developed an asymptomatic macular epiretinal membrane 2 years later. In 2001, the patient complained of metamorphopsia. Biomicroscopy showed a PMH, confirmed by OCT. One year later, metamorphopsia suddenly increased and visual acuity dropped from 20/20 to 20/70. FA and OCT revealed subfoveal occult CNV PDT was successfully performed. FA and OCT were essential diagnostic tools during the follow-up. CONCLUSIONS: The case presented stresses the importance of different tools for accurate diagnosis and proper follow-up of macular diseases.- - - - - - - - - - ranking = 0.71428571428571keywords = neovascularization (Clic here for more details about this article) |
7/21. lacquer crack formation after photodynamic therapy.PURPOSE: To report the occurrence of a lacquer crack after photodynamic therapy (PDT) of choroidal neovascularization (CNV) in a patient with pathologic myopia. methods: PDT was performed with verteporfin, which was activated by a diode laser light at 690 nm. RESULTS: The left eye of a 42-year-old woman was treated with PDT because of juxtafoveal CNV caused by pathologic myopia. No lacquer crack was present in the macula on either fluorescein or indocyanine green angiography before treatment. The CNV subsided after treatment. However, a large lacquer crack underlying a subretinal hemorrhage was formatted in the macula of the treated eye soon after PDT. CONCLUSIONS: Although the chorioretinal damage produced by PDT is minimal, it is enough to create, directly or indirectly, the basis for the formation of a lacquer crack in an eye with pathologic myopia.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
8/21. Echographic evaluation of retinal tears in patients with spontaneous vitreous hemorrhage.We studied the ability of standardized echography to correctly diagnose a retinal tear in patients with opaque ocular media due to vitreous hemorrhage. Records were studied of 42 patients with spontaneous vitreous hemorrhage and no ophthalmoscopic view of fundus details. Of these 42 patients, 11 had an echographic diagnosis of probable retinal tear and no retinal detachment. In 10 (91%) of 11 cases, the presence and location of the tears that were diagnosed echographically were confirmed on clinical follow-up. In one patient, an area of peripheral neovascularization was mistaken for a tear. Echography failed to identify one retinal tear that was later detected on clinical examination. Therefore, we have found standardized echography to be a reliable tool in identifying retinal breaks.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
9/21. Retinal pigment epithelial tear following intravitreal pegaptanib sodium.PURPOSE: To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium. To our knowledge, this is the first report of this finding after intraocular antivascular endothelial growth factor therapy. DESIGN: Observational case reports. methods: Two patients presented with occult choroidal neovascularization and associated serous pigment epithelial detachment that was a result of age-related macular degeneration. Both patients were treated with an intravitreal injection of pegaptanib sodium. RESULTS: One patient developed a retinal pigment epithelium tear one week after the intravitreal injection. The second patient developed a retinal pigment epithelium tear eight weeks after treatment. CONCLUSIONS: Although these cases may represent natural history, there should be a high index of suspicion for retinal pigment epithelium tears in patients who report significant visual deterioration after intravitreal injection of pegaptanib sodium. Further studies are needed to determine whether angiographic subtypes of choroidal neovascular membranes are more susceptible to developing retinal pigment epithelium tears after treatment with antivascular endothelial growth factor agents.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
10/21. Retinal pigment epithelial tears after pegaptanib injection for exudative age-related macular degeneration.PURPOSE: To report two cases of retinal pigment epithelium (RPE) tears following intravitreal pegaptanib injections for occult choroidal neovascularization. DESIGN: Noncomparative case series. methods: The charts of two patients with pigment epithelial tears after receiving intravitreal pegaptanib were reviewed. Approval from the institutional review board and informed consent were obtained before chart review. Fundus photos, intravenous fluorescein angiograms, and optical coherence tomography (OCT) were obtained before and after therapy confirmed the diagnosis. RESULTS: Two patients had turbid pigment epithelial detachments (PEDs) and occult choroidal neovascular membranes (CNVMs) treated with intravitreal pegaptanib. Both patients developed RPE tears weeks following one intravitreal pegaptanib injection. CONCLUSIONS: This report describes the development of RPE tears after intravitreal pegaptanib injection. Caution should be taken in cases of turbid pigment epithelial detachments in the monocular patient when treatment with intravitreal pegaptanib is entertained. Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this devastating visual complication.- - - - - - - - - - ranking = 0.14285714285714keywords = neovascularization (Clic here for more details about this article) |
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