11/27. Clear cell renal cell carcinoma associated with bilateral atypical acute posterior multifocal placoid pigment epitheliopathy.BACKGROUND/OBJECTIVE: Clear cell renal cell carcinoma (CCRCC) is a malignant neoplasm frequently associated with an increase in circulating immune complexes (CIC). Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a disease involving the chorioretinal structures of the eye, and it is commonly observed in association with several immunogenic disorders. We report here the clinical association between humoral immunologic modifications during tumoral diseases (long-standing CIC increase) and chorioretinal changes resembling atypical APMPPE. CASE REPORT: A 52-year-old white male affected by metastatic CCRCC is described. Histopathologic review of his surgically removed organs (kidney and lung), periodical laboratory immunologic tests and ophthalmologic examinations, including fluorescein and indocyanine green angiographies, were performed. RESULTS: The patient underwent total left nephrectomy (May 1997) and total left pneumonectomy (March 2001) for the presence of stage III CCRCC and CCRCC lung metastasis, respectively. On both occasions, postoperative immunotherapy was started. From June 1997 to February 2003, laboratory analyses demonstrated the presence of marked CIC peaks. During the follow-up period, an atypical APMPPE pattern, complicated by asynchronous choroidal neovascularization, occurred in both eyes. CONCLUSIONS: Long-standing tumorous disease, through a pathogenic mechanism triggered by CIC spreading, can be responsible, over time, for a progressive choroidal occlusive microangiopathy (atypical APMPPE pattern), associated with a high risk of poor visual outcome. Therefore, bilateral APMPPE could be related to a systemic disease able to increase CIC levels.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
12/27. Longterm follow-up of patients with multifocal choroiditis and panuveitis.PURPOSE: To report the visual prognosis and longterm complications in patients with multifocal choroiditis and panuveitis (MCP). methods: A retrospective study was performed with patients who met inclusion criteria for MCP at the Uveitis Clinic, Royal victoria Hospital, McGill University, Montreal, canada. Information collected included duration of follow-up, visual acuity (VA) measured at each clinical visit, ocular and systemic treatment and ocular complications observed during follow-up. RESULTS: Nineteen patients (37 eyes) with MCP with a mean follow-up of 76.9 months were studied. Kaplan-Meier survival analysis showed a decrease in the proportion of patients with a final VA > or = 20/40 over time. Cystoid macular oedema was seen in 29.7% of the eyes and was the most frequent macular abnormality observed in our group. On the other hand, choroidal neovascularization was detected in only six (16.2%) of the eyes, but was related to VA < 20/200 in four of these eyes. glaucoma was detected in 10.8% of the eyes. cataract (posterior subcapsular and/or nuclear) was the most common longterm complication, occurring in 40% of affected eyes. cataract surgery improved the VA in 83.3% of these eyes. CONCLUSION: The visual acuity of patients with MCP decreases with time. Visual loss can occur from complications following the inflammation itself and/or iatrogenic induced by the chronic use of corticosteroids.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
13/27. Cultivated corneal epithelial transplantation for severe ocular surface disease in vernal keratoconjunctivitis.PURPOSE: To report cultivated epithelial transplantation in 2 patients with vernal keratoconjunctivitis (VKC) with severe ocular surface disease. methods: Two patients initially diagnosed with burnt-out VKC presented with bilateral photophobia, decreased vision, and corneal neovascularization. The first patient underwent living-related conjunctival-limbal allograft in the left eye and cultivated limbal epithelial cell allotransplant in the right. The second patient underwent unsuccessful amniotic membrane transplantation (AMT) followed by autologous cultivated limbal epithelial cell transplantation in the worse eye. RESULTS: Both patients had onset of VKC in the first decade. Surgical intervention in both led to marked amelioration in symptoms and improvement in vision. In patient 1, vision improved from 20/800 (both eyes) to 20/30 in the right and 20/100 in the left eye at a follow-up of 34 months. In patient 2, it improved from 20/400 to 20/50 after the second procedure, 25 months postoperatively. Histopathology of the excised pannus revealed fibrosis and mononuclear cell infiltrates in all 3 eyes. CONCLUSIONS: Severe ocular surface disease may occur in persistent VKC, leading to marked visual loss. AMT alone may be insufficient to restore the ocular surface, and limbal epithelial cell transplantation is warranted.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
14/27. Late-onset visual decline following successful treatment of subfoveal choroidal neovascularisation with photodynamic therapy.Photodynamic therapy (PDT) has been shown in large studies to be capable of achieving closure of choroidal neovascularization (CNV), thereby resulting in stabilization of visual acuity. We report a series of four patients with classic CNV treated with PDT with good initial result but subsequent severe visual loss that may be related to a change in the morphology of the subretinal scar.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
15/27. Subretinal neovascularization associated with retinochoroidal coloboma.PURPOSE: To report a case of subretinal neovascularization associated with retinochoroidal coloboma. methods AND RESULTS: A 44-year-old female presented with metamorphopsia in her right eye for 4 weeks. Funduscopic examination revealed bilateral inferior retinochoroidal coloboma. fluorescein angiography disclosed foci of subretinal neovascularization at the margin between the colobomatous defect and the normal-appearing retina. Five month later, multiple small areas of subretinal hemorrhages were noted. The hemorrhage was gradually absorbed. Six years after initial presentation, subretinal hemorrhage did not recur and her right VA was 0.2. CONCLUSIONS: Ophthalmologists should be aware of this rare but important complication of retinochoroidal coloboma.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
16/27. Severe ischemic maculopathy in a patient with west nile virus infection.A 60-year-old man with diabetes mellitus had a sudden decrease in vision in his right eye 3 weeks after confirmed west nile virus infection. visual acuity in the right eye was 20/400. Fundus examination showed bilateral multifocal chorioretinitis, which was associated with proliferative diabetic retinopathy in the right eye and severe nonproliferative diabetic retinopathy in the left eye. There were deep, dense retinal hemorrhages, retinal opacification, and retinal arterial sheathing in the macula of the right eye. fluorescein angiography revealed extensive capillary nonperfusion in the macular area of the right eye. Six months later, vision remained unchanged and a choroidal neovascularization developed over a chorioretinal scar in the same eye.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
17/27. Inherited retinal venous beading.Four affected family members in two generations demonstrated an unusual, probably autosomal dominant, retinal vascular disorder called inherited retinal venous beading. The proband had retinal neovascularization, exudation, and vitreous hemorrhage. The other three affected family members had significant venous beading and varying degrees of arteriolar tortuosity. family members with venous beading had low to normal leukocyte and neutrophil counts, which differed significantly from unaffected family members.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
18/27. Reticular-like pigmentary patterns in pseudoxanthoma elasticum.Of 14 consecutive patients with pseudoxanthoma elasticum (PXE), 9 (64%) had a spectrum of peculiar, sometimes reticular, pigmentary changes in the retina. Ten of 18 (56%) eyes had a random scattering of small, round pigment dots throughout the macula and around the optic nerve, sometimes extending to the equator. In four of 18 (22%) eyes, the pigment clumps appeared in lines, resembling a string of pearls. These strings occasionally radiated from the macula in a spoke-like fashion. In 4 of the 18 (22%) eyes, the pigment clumping occurred in a fishnet, or truly reticular, pattern. Of the 18 eyes in these 9 patients, 12 (67%) had subretinal neovascularization. Of the ten eyes in the five patients who did not show this pigmentary change, two (20%) had subretinal neovascularization.- - - - - - - - - - ranking = 2keywords = neovascularization (Clic here for more details about this article) |
19/27. Multifocal choroiditis associated with progressive subretinal fibrosis.Five patients (all female, 14 to 34 years old) had an unusual form of multifocal choroiditis resulting in progressive subretinal fibrosis. This condition differed from other multifocal choroidal diseases such as acute multifocal placoid pigment epitheliopathy, birdshot retinochoroidopathy, and punctate inner choroiditis. Instead of forming atrophic or pigmented chorioretinal scars, the acute lesion healed with the formation of discrete, sharply angulated subretinal scars. In the macula the lesions coalesced, forming broad zones of subretinal fibrosis. Serous and hemorrhagic macular detachment may occur during the course of the disease with fluorescein angiographic features suggesting subretinal neovascularization. Subretinal neovascularization could not, however, explain the widespread scarring. Although progressive subretinal fibrosis may be considered an unusual outcome for a variety of other diseases, we believe that it is a distinct clinical entity distinguishable from other multifocal choroidal diseases. Retinal pigment epithelial hyperplasia may cause the condition.- - - - - - - - - - ranking = 2keywords = neovascularization (Clic here for more details about this article) |
20/27. Optic disc neovascularization associated with ocular involvement in acute lymphocytic leukemia.A case of vitreous involvement in acute lymphoblastic leukemia associated with neovascularization of the optic nerve head is presented. The diagnosis was made from a vitreous biopsy specimen obtained by pars plana vitrectomy and prepared by a membrane filter and modified Papanicolaou stain technique. Fibrovascular membranes and leukemic cells were seen on microscopic examination of the vitreous biopsy specimen. retinal neovascularization associated with acute lymphoblastic leukemia is discussed.- - - - - - - - - - ranking = 6keywords = neovascularization (Clic here for more details about this article) |
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