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At least 1,045 records · Page 58Linked to original sources
PubMed1986

Silicone oil for retinal detachment with advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy.

We used sophisticated vitreous surgical techniques in conjunction with silicone oil injection in ten eyes of ten patients with rhegmatogenous retinal detachment complicated by advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy. After a minimum follow-up of one year, three patients achieved total retinal reattachment and two patients regained ambulatory vision (5/200 or better). Maintenance of low to normal intraocular pressure was observed in nine of the ten eyes despite some cases of progressive anterior segment neovascularization and retinal detachment. Although treatment was more difficult and less successful than in either retinal detachment with proliferative diabetic retinopathy or proliferative vitreoretinopathy alone, these techniques allowed some success in eyes that otherwise would have a poor prognosis.

Adult↗
PubMed2003

[Chorioretinal anastomosis as unfavourable prognostic factor during photodynamic therapy].

BACKGROUND: The aim of this study was the documentation of chorioretinal anastomosis in neovascular age-related macular degeneration (AMD) and correlation with functional and angiographic results following photodynamic therapy (PDT). METHOD: A total of 100 patients presenting with neovascular AMD and indication for PDT based on the presence of predominantly classic choroidal neovascularization (CNV), underwent ophthalmoscopic and angiographic screening for chorioretinal anastomosis. Conventional PDT using verteporfin was performed according to the recommended standard procedure. The pre- and post-treatment status at 3 and 6 months post-PDT in all patients and at 1 week in selected patients was documented with respect to the central visual acuity test (ETDRS), ophthalmoscopy as well as fluorescein (FA) and indocyanine green angiography (ICGA). RESULTS: A primary chorioretinal anastomosis was found in 6% ( n=12) of all eyes with CNV and classic PDT indication. Mean visual loss within the first 6 months after therapy was 3 lines indicating lack of visual stabilization according to the PDT study criteria.Furthermore, an increase in visual acuity could not be documented in any case. Angiography demonstrated continuous progression of CNV size although PDT had been uneventful. The characteristic initial occlusion of the CNV with homogeneous hypofluorescence was absent angiographically at 1 week post-PDT. The anastomosis was detected by ICGA in all eyes and by ophthalmoscopy or optical coherence tomography (OCT) in most eyes. DISCUSSION: Chorioretinal anastomosis is not a rare finding associated with predominantly classic CNV. The presence of anastomosis appears to be an unfavourable prognostic factor during PDT. If a chorioretinal shunt is suspected evaluation by ICGA and/or OCT should be performed and the indication for PDT should be rediscussed.

Aged↗
PubMed2002

Transpupillary thermotherapy for occult subfoveal neovessels in age-related macular degeneration: importance of patient pigmentation for the determination of laser settings.

BACKGROUND: Presently the indication for transpupillary thermotherapy (TTT) is the treatment of retrofoveal occult subretinal neovascular membranes (OSRNM) for which PDT (photodynamic therapy) has a limited effect. The diode laser power settings given by the manufacturer (Iridex Co, Mountain View, California) have to be modulated according to several criteria including patient pigmentation. The purpose here was to report on a group of patients that presented chorioretinal atrophy after TTT. METHODS: Thirty-eight eyes of 37 patients with OSRNM due to age-related macular degeneration underwent TTT. Indications to treat were diffuse exudative membranes, limited subfoveal OSRNM with a visual acuity of less than 0.4, or a drop of visual acuity of 3 Snellen lines or more since the previous examination. Dual fluorescein and indocyanine green angiography were used for angiographic follow-up. Treatment was performed according to the manufacturer's parameters. The group of patients that presented chorioretinal atrophy after TTT was analysed in this study RESULTS: Five patients presented a limited or spot-size related post-TTT chorioretinal atrophy. Pre-laser visual acuity was 0.34 +/- 0.13 and post-TTT visual acuity was 0.25 +/- 0.15. The OSRNM had disappeared in all cases. The common denominator in these patients was that they were white haired but upon questioning all happened to be dark-haired in their youth. CONCLUSIONS: Evolution towards atrophy can occur after TTT and probably depends on several factors. We showed that pigmentation is a parameter to be evaluated carefully before TTT and that laser power settings should progressively be diminished with increasing patient pigmentation. In white haired persons the original pigmentary status should be part of the patient history.

Aged↗
PubMedDate not supplied

[Experimental (in vivo) study of the capacities of use of radachlorine (chlorine E-6) for photodynamic therapy in ophthalmology].

To study the capacities of ophthalmological application of the photosensitizer Radachlorine (0.35% solution for intravenous injection), the authors carried out a series of in vivo experiments on rabbits. They studied the time parameters of distribution of the agent in the chorioretinal complex and the reaction of newly formed vessels to photodynamic therapy. Radiation of a diode laser at a wavelength of 0.662 microm was used to stimulate the photosensitizer. A video micro-camera adapted to the ocular of a split lamp was applied to fluorescence fixation. Superficial corneal vascularization was used as a model of the neovascular membrane in response to the application of a non-penetrating silk suture. The findings suggest that photodynamic therapy using Radachlorine is safe and effective in treating ocular tissue neovascularization.

Animals↗
PubMed2000

[Neovascular maculopathy associated with rubella retinopathy].

BACKGROUND: We report three eyes of two patients with rubella retinopathy which were associated with choroidal neovascularization in the macula. CASES: A 7-year-old girl (case 1) and a 12-year-old girl (case 2) whose mothers had suffered rubella during their pregnancy revealed typical rubella retinopathy in both eyes and neovascular maculopathy in one eye at their initial visit to our clinic. Neovascular maculopathy developed in another eye of case 1 after a follow-up of 10 months. RESULTS: The clinical characteristics indicated that 1. sudden visual loss occurs in children, 2. there is no external trigger such as eye injury, and 3. the visual prognosis appears relatively good. CONCLUSION: Although neovascular maculopathy is rare in pediatric disease, the rubella retinopathy may have the potential to cause neovascular maculopathy.

Child↗
PubMed1992

Peripapillary subretinal neovascularization. A review.

Peripapillary choroidal neovascularization is an important feature in the pathogenesis and treatment of a number of disorders affecting the optic nervehead and adjacent chorioretinal areas. Although less well understood than its macular counterpart, peripapillary subretinal neovascularization possesses characteristic clinical and histopathologic features that directly affect its prognosis and management. This review provides a summary of the diseases in which peripapillary subretinal neovascularization occurs and an overview of studies on the natural history, clinicopathologic findings, and therapy. In addition, a pathogenetic model of peripapillary subretinal neovascularization is discussed based on these findings.

Choroid Neoplasms↗
PubMed2005

Differences between rat strains in models of retinopathy of prematurity.

PURPOSE: Genetic factors appear to modulate the incidence and severity of retinopathy of prematurity (ROP). Different rat strains may be analogous to genetic differences across human ethnic groups. We investigated the incidence and severity of neovascularization (NV) in Brown Norway (BN) and Sprague Dawley (SD) rats in oxygen-induced retinopathy (OIR) and acidosis-induced retinopathy (AIR) models for ROP. We also studied whether there was a difference in retinal vascular endothelial growth factor (VEGF) mRNA levels in OIR animals. METHODS: Newborn SD and BN rats (110 in both groups) were raised in standardized litters of ten (four OIR, twelve AIR, six non-gavaged room air controls). Beginning on day 1 of life, OIR litters were exposed to seven cycles of hyperoxia (80% O2, 20.5 h) and hypoxia (10% O2, 0.5 h) with a gradual return to 80% O2 over 3 h. This was followed by room air recovery for five days. OIR and OIR control rats were sacrificed on day 13 of life. AIR rats were gavaged twice daily with NH4Cl (10 mmol/kg) from day 2 to day 7 of life, or 15 mmol/kg twice daily on day 2 and then 10 mmol/kg twice daily from day 3 to day 7. AIR and AIR control rats were sacrificed on day 10 or day 13. Retinas from left eyes were dissected, ADPase stained and flatmounted. Presence and severity of NV (clock hours, 0 to 12) was scored by a masked observer. Right retinas from OIR and room air controls were processed for VEGF mRNA analysis. RESULTS: In OIR rats, the incidence of NV was higher in BN than SD rats (100% compared to 5%, p<0.0001). NV was more severe in BN rats (1 to 10 clock hours, median 7 clock hours compared to 0 to 1 clock hours, p=0.0001). In contrast, the incidence of NV in AIR rats was similar in BN and SD rats (4% compared to 0%, p=1.0) in the 10 mmol/kg study, and 18% compared to 0%, (p= 0.15) in the 15 mmol/kg study. Increased levels of retinal VEGF mRNA were found in BN OIR animals when compared to BN room air controls (1.4 fold increase) whereas retinal VEGF mRNA levels were similar between SD OIR and SD room air control animals. CONCLUSIONS: BN rats differ from SD rats in incidence and severity of NV in OIR. The findings in AIR were limited by the low incidence of NV and intolerance to higher multiple doses of NH4Cl. In OIR, the higher severity of NV was associated with higher retinal VEGF mRNA in BN OIR rats. Studies are warranted to investigate the genetic differences between Brown Norway and Sprague Dawley rats in models of ROP. These genetic studies may yield further clues into the pathogenesis of clinical ROP.

Acid-Base Equilibrium↗
PubMed1993

[Surgical treatment of subretinal neovascular membranes. Initial experience].

Since june 1992 to march 1993 we removed the subretinal neovascular membranes in 4 patients. In three of them, aged 72-75 years, the membrane was diagnosed by age-related macular degeneration. In 57-y. old woman the membrane originated presumable in an ethiologically uncleared choroiditis. In the last two patients we used technique after Thomas and Kaplan with special instruments from DORC. In one patients the visual acuity improved and in three patients remained same, or a little worse than before. The chirurgical removal of the subretinal neovascular membrane is an alternative mode in the treatment of these membranes.

Aged↗
PubMed1995

[Idiopathic juxtafoveolar telangiectasis. Long-term follow-up of visual acuity].

The beneficial effect of laser therapy on idiopathic juxtafoveolar telangiectasis is questionable. We therefore studied retrospectively the spontaneous course of the disease and tried to show a correlation between the initial angiographic findings and visual outcome. In addition, the results after laser therapy were compared with untreated patients. Thirteen patients (24 eyes) with idiopathic juxtafoveolar telangiectasis diagnosed by fluorescein angiography were reexamined after a mean time interval of 38 months. Argon laser coagulation had been performed in 6 patients. The initial extension of fluorescein leakage was divided angiographically into three different stages. The existence of secondary macular changes and peripheral involvement was noted. The mean visual acuity decreased from 0.71 to 0.62 over the follow-up period. No correlation could be found between the final visual outcome and initial extension of telangiectasis or existence of secondary changes. After laser coagulation the patients did not show a better visual outcome. Due to the relatively benign spontaneous course of idiopathic juxtafoveolar telangiectasis laser coagulation cannot be recommended in general. Only in exceptional cases (e.g., development of subretinal neovascularization) can laser coagulation be of benefit.

Aged↗
PubMed1998

Neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery.

PURPOSE: To report clinical features and surgical management of neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery in nondiabetic patients. METHODS: Seven consecutive eyes of seven nondiabetic patients who developed neovascular complications associated with rubeosis iridis and peripheral retinal detachment after scleral buckling and vitrectomy procedures were retrospectively reviewed. None of the eyes had clinical evidence of anterior segment ischemia or retinal vascular disease, but each eye developed rubeosis iridis and neovascular complications. RESULTS: Of the seven eyes with rubeosis iridis and peripheral retinal detachment, six developed recurrent or progressive vitreous hemorrhage, and three developed progressive neovascular glaucoma. Four eyes underwent a revision procedure to repair the peripheral retinal detachment, and anterior proliferative vitreoretinopathy was found in each of these cases. Rubeosis iridis regressed in all three eyes in which surgery resulted in complete reattachment of the retina. In one eye with persistent peripheral retinal detachment and in the three remaining eyes that did not undergo revision surgery, rubeosis iridis persisted and was associated with long-term neovascular complications. Final corrected visual acuity was 20/70 to 20/400 in three eyes with total retinal reattachment and no light perception to hand motions in four eyes with persistent peripheral retinal detachment and rubeosis iridis. CONCLUSION: Visually significant neovascular complications may occur in eyes that develop rubeosis iridis associated with peripheral retinal detachment after retinal detachment surgery in nondiabetic patients. Successful repair of the peripheral retinal detachment may induce regression of rubeosis iridis, reduce associated complications, and improve the long-term prognosis of these eyes.

Adult↗
PubMed2001

Adenoma of the retinal pigment epithelium simulating a juxtapapillary choroidal neovascular membrane.

We report a case of an adenoma of the retinal pigment epithelium that clinically simulated a juxtapapillary choroidal neovascular membrane in a 60-year-old man. Fluorescein angiography supported the diagnosis of a juxtapapillary choroidal neovascular membrane in his left eye. After 13 years the lesion become slightly pigmented and the optic disc became swollen. The possibility of choroidal melanoma with optic disc invasion was considered, and the eye was enucleated. The lesion proved histopathologically to be an adenoma of the retinal pigment epithelium.

Adenoma↗
PubMedDate not supplied

[Posterior hyaloid membrane as structural base of growth of neovascular tissue in proliferative diabetic retinopathy].

Morphologic study of 38 specimens of epiretinal membranes obtained during transciliary vitrectomy in 26 patients with type I diabetes mellitus and 12 with type II diabetes with proliferative diabetic retinopathy of different stages was carried out. In proliferative diabetic retinopathy, new vessels grow mainly along the posterior (retinal) surface of the posterior hyaloid membrane. Sometimes, if there are defects in the posterior hyaloid membrane, proliferative tissue stratifies it and appears on the anterior (hyaloid) surface. We observed no growth of new vessels outside the posterior hyaloid membrane. The impossibility of clinical and mechanical separation of the posterior hyaloid membrane and tumor tissue permits us to regard the stages of proliferative process in diabetic retinopathy as stages in the alteration of the posterior hyaloid membrane proper. Five variants in the structure of proliferative tissue can be distinguished in diabetic retinopathy; we consider that these variants are stages in its development: 1) glial--with predominance of cell-free or hypocellular glial tissue; 2) glial vascular--with growth of thin-wall vessels into glial tissue; 3) glial vascular fibrous--with growth of porous fibrovascular membrane in glial tissue; 4) fibrovascular--with predominance of fibrovascular tissue; and 5) fibrous (cicatricial) hypocellular compact connective tissue with just few vessels or none at all. Reduction of new vessels, involution of proliferative tissue, and development of traction detachment of the retina are associated with the beginning of fibrous proliferation.

Diabetes Mellitus, Type 1↗