1/9. Dark spots in late-phase indocyanine green angiographic studies in a patient with presumed ocular histoplasmosis syndrome.PURPOSE: We analyzed indocyanine green (ICG) angiograms in a patient with presumed ocular histoplasmosis syndrome (POHS) complaining about "seeing spots" and decreased visual acuity in order to identify the pathologic process. patients AND methods: A 30-year-old caucasian man with clinical signs of POHS who had previously undergone laser photocoagulation for secondary choroidal neovascularization developed visual disturbances primarily in his temporal visual field. We performed fundus photography, fluorescein angiography and ICG angiography before, during and after the episode of visual disturbance. ICG angiographic findings were correlated to fundus photographs and fluorescein angiograms. RESULTS: Fundus examination, fluorescein angiograms and early-phase ICG angiograms were unremarkable at all time points. However, during the phase of visual disturbance, late-phase ICG angiographic study revealed hypofluorescent lesions in the area representing the visual disturbances. At 1 week follow-up, these hypofluorescent lesions were reduced in size and number; at 6 months follow-up they had completely resolved. CONCLUSIONS: Late-phase ICG angiographic study can provide additional information in inflammatory retinal disease by virtue of identifying areas of choroidal alterations while standard diagnostic examination remain unremarkable.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/9. Surgical removal of subfoveal choroidal neovascular membranes in high myopia.BACKGROUND: A study was carried out to elucidate the anatomical and functional outcome after surgical excision of subfoveal choroidal neovascular membranes in high myopia. methods: Sixty-five patients with high myopia (> or =6 diopters), well-defined subfoveal neovascular membranes on fluorescein angiography and preoperative visual acuity < or =20/100 were selected for surgery. A standardized surgical technique was used in all cases, by a single surgeon. The main outcomes assessed were Snellen visual acuity, surgical retinal pigment epithelium defect and postoperative perfusion of the choriocapillaris. Multifactor analysis of variance and chi-square/Fisher's exact test statistics were used to assess the association between patients' pre- and postoperative characteristics and outcome measures. RESULTS: Follow-up ranged from 6 to 48 months (mean 16 months). Mean postoperative visual acuity (0.18) was significantly better than mean preoperative visual acuity (0.09). visual acuity improved by at least two lines in 29 eyes (45%) and was unchanged in 24 (37%). overall, 43 eyes (66%) had visual acuity of 20/200 or better and 15 (23%), 20/60 or better. Predictive factors with a significant effect on final visual acuity were mean visual acuity, preoperative status of retinal pigment epithelium and postoperative perfusion of the choriocapillaris. Postoperative perfusion was detected in 31 (48%) of the total 65 eyes and in 12 (67%) of the 18 eyes with normal retinal pigment epithelium at baseline. The mean postoperative retinal pigment epithelium defect was 4.6 times larger than the original neovascular membrane. In selected patients, SLO macular scotometry showed areas of retained retinal sensitivity within the atrophic scar. CONCLUSION: The natural history of subfoveal neovascularization in high myopia is rarely visually restorative. By contrast, surgical excision of the membranes is feasible and may restore visual acuity in selected patients. This therapeutic approach merits a formal multicenter clinical trial.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
3/9. Retinal ischemia in diabetic retinopathy.Eight patients with proliferative diabetic retinopathy developed extensive retinal arteriolar and capillary obstruction. ophthalmoscopy showed many white, thread-like retinal arterioles associated with capillary and venous dilatation. Widespread retinal arteriolar and capillary nonperfusion was demonstrated by fluorescein angiography. Ischemic maculopathy resulted in severe loss of visual acuity in some eyes. The severe degree of retinal ischemia was accompanied by optic disc pallor and neovascularization and a high incidence of rubeosis iridis with neovascular glaucoma. patients with this variety of diabetic retinopathy have a poor prognosis of retaining useful vision.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
4/9. choroidal neovascularization after accidental macular damage by laser.A 30-year-old male physics professor was examined 2 months after being accidentally hit by a laser beam in his left eye. He complained of abrupt vision loss and central scotoma after the laser accident,with stabilization of the vision thereafter. At presentation, he presented best-corrected visual acuity of 6/18 in the left eye. Fundoscopy disclosed a slightly elevated foveal brownish lesion,surrounded by a subtle subretinal haemorrhage. fluorescein angiography demonstrated a hyperfluorescent foveal lesion with staining and a slight leakage in the late phase, characterizing a fibrovascular choroidal neovascularization (CNV). Optical coherence tomography showed a discrete increase in retinal thickness and a subretinal fibrotic CNV. visual acuity remained stable during the follow up(4 months). CNV after laser injury is rare. The evolution of this case suggests that CNV, after an accidental laser injury,in a healthy macula of a young patient might have a self-limited course and a relatively good prognosis.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
5/9. Photofield mapping in the evaluation and management of subretinal neovascularization.Photofield mapping is a useful method for classifying subretinal neovascularization based on its area and location. Careful central field mapping is performed to delineate scotomata during evaluation of patients with subretinal new vessels. A photofield map is then constructed by projecting 35 mm fundus photographs and angiograms onto an appropriately-oriented central visual field map. The composite map (photofield) documents the location and relationship of scotomata, subretinal neovascularization, foveal avascular zone, and retinal blood vessels. The areas of subretinal neovascularization and scotomata are measured in square millimeters with a planimeter. The distance between their closest edge and the center of the foveal avascular zone is measured in millimeters. This method permits quantitative comparison of results with different photocoagulation protocols and instrumentation. Such comparative analysis may help improve the technique and instrumentation used in laser photocoagulation of subretinal neovascularization.- - - - - - - - - - ranking = 8keywords = neovascularization (Clic here for more details about this article) |
6/9. The simultaneous presentation of retinopathy of prematurity and central serous chorioretinopathy.A case report of central serous chorioretinopathy (CSC) and retinopathy of prematurity (ROP) in the same patient is presented. CSC is a disease of the outer retinal layers, specifically the retinal pigment epithelium, which results in serous detachment of the neurosensory retina. ROP is a disease of the anterior retinal layers, affecting the retinal vasculature. Ocular manifestations may range from the peripheral neovascularization observed in the milder states to retinal detachment and secondary angle closure glaucoma that is often found in the later stages. Therefore it would appear that there is no direct relationship between the presence of ROP and the presence of CSC in a patient who presented with complaints of a unilateral relative central scotoma. To our knowledge this represents a heretofore unreported association.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
7/9. Diabetic papillopathy.A 13-year-old girl and a 20-year-old man with juvenile-onset diabetes mellitus developed transient bilateral optic disk edema with minimal impairment of optic nerve function and with minimal diabetic retinopathy. This conditions, termed diabetic papillopathy appears to be a local optic disk vasculopathy, and generally resolves without treatment. Diabetic papillopathy should not be mistaken for papilledema or for the optic disk neovascularization of diabetic retinopathy.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
8/9. Scanning laser ophthalmoscope macular perimetry in the evaluation of submacular surgery.PURPOSE: Submacular surgery for choroidal neovascularization (CNV) is under investigation in the treatment of age-related macular degeneration (AMD) and the presumed ocular histoplasmosis syndrome. Four case studies are presented to demonstrate scanning laser ophthalmoscope (SLO) testing in the pre- and postsurgical evaluation of visual function in patients with subfoveal CNV secondary to AMD, presumed ocular histoplasmosis syndrome, and submacular hemorrhage secondary to AMD. methods: patients underwent a visual assessment pre- and 6 months postoperatively, consisting of low vision visual acuity measurement, SLO macular perimetry of dense and relative scotomas, and analysis of the preferred retinal locus for fixation (PRL) location and ability. RESULTS: Visual acuity, dense and relative scotoma size and location, and PRL location were compared; and relationships between anatomic and functional changes were observed. Decreases in scotoma size and improvement in PRL location and ability usually corresponded with improved visual acuity. Preoperative scotoma and PRL location guided retinotomy site selection. CONCLUSION: Scanning laser ophthalmoscope macular perimetry and PRL testing may be useful adjuncts in the visual assessment of submacular surgery and may advance under-standing of the effects of submacular surgery on visual function. In addition, this testing may be used to plan location of surgical interventions for macular diseases.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
9/9. Scanning laser ophthalmoscope microperimetric assessment in patients with successful laser treatment for juxtafoveal choroidal neovascularization.PURPOSE: To evaluate fixation stability and changes in retinal function in patients with laser scar expansion after successful macular photocoagulation for juxtafoveal choroidal neovascularization (CNV). methods: A consecutive series of 35 patients was examined in this prospective study. Only patients who had been successfully treated with laser photocoagulation for juxtafoveal CNV and who could be followed over a period of at least 6 months were enrolled. Fixation stability and localized light sensitivity were examined by microperimetry using a scanning laser ophthalmoscope. visual acuity was measured 2 weeks and 3 and 6 months after the laser treatment. The correlation between changes in the logarithm of the minimum angle of resolution (LogMAR) visual acuity and the distance between fixation and the center of the fovea was evaluated. RESULTS: Of 22 eyes of 20 patients that underwent data analysis, laser scar expansion was observed in 16 (72.7%). Ten (62.5%) of the 16 eyes had relative scotomas corresponding to the expanded laser scars. Mean laser scar expansion ratio was 28.7% in the ARMD group and 109.2% in the myopia group, a statistically significant difference (P < 0.01). The change in LogMAR visual acuity was significantly correlated with the distance of fixation locus from the center of the fovea (r = 0.76). CONCLUSIONS: Laser scars produced by photocoagulation for juxtafoveal CNV may expand and extend into the fovea, causing secondary retinal dysfunction. Scanning laser ophthalmoscopic assessment may be useful in evaluating fixation stability and subclinical changes in retinal function surrounding the laser scars before visual disturbance appears.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |