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At least 1,207 records · Page 67Linked to original sources
PubMed1989

Cryotherapy for stage 3+ retinopathy of prematurity: visual and anatomic results.

Fifty eyes of 25 preterm infants with stage 3+ retinopathy of prematurity (ROP) and 180 degrees to 360 degrees of preretinal neovascularization were treated with cryotherapy to ablate the peripheral zone of avascular retina. All neovascularization regressed. Eleven eyes developed traction detachments, eight of which were successfully reattached with scleral buckling surgery. With follow-up of 6 to 70 months (mean, 29 months), visual acuity was 20/30 to 20/60 in 11 of 16 eyes (69%) of eight children old enough to be tested, and 20/100 to 20/200 in three of these eyes. Thus, vision was 20/200 or better in 14 of 16 eyes (87.5%). Visual behavior was normal for their age in 16 infants too young to test. One child developed bilateral inoperable detachments. We conclude that cryotherapy safely resolves stage 3+ ROP with excellent visual results.

Cryosurgery↗
PubMed1990

Rheological studies on patients with posterior subretinal neovascularization and exudative age-related macular degeneration.

To investigate the potential influence of a decreased perfusion rate of the choriocapillaris on the development of age-related macular degeneration (ARMD) with subretinal neovascularization (SRNV) apparently caused by disturbed flow properties of blood, we compared the hemorheological parameters of blood from 35 patients suffering from ARMD with SRNV with those from the 35 healthy patients of the same age. In both groups hematocrit, plasma viscosity, erythrocyte filtrability, aggregation, aggregating proteins, leukocyte and thrombocyte count, differentiation of leukocytes, thrombelastography, PTT, Quick test, and rheological profiles were comparable. The differences were not significant (P greater than 0.05). These results refute the hypothesis that changed flow properties of blood are the primary cause of the pathogenesis of ARMD with SRNV.

Aged↗
PubMed2000

The bst locus on mouse chromosome 16 is associated with age-related subretinal neovascularization.

Ocular neovascularization is the leading cause of blindness in developed countries and often causes rapid loss of vision in age-related macular degeneration. Acute visual loss is most often due to hemorrhage from new vessels that have extended from the choroid into the subretinal space. Growth of abnormal vessels beneath the retina in this condition is known as subretinal neovascularization (SRN). Age-related animal models of macular degeneration and SRN have not been described. Current animal models of SRN depend on chemical or physical stimuli to initiate growth of subretinal vessels. The genes responsible for age-related human macular degeneration with SRN have not been firmly identified. We report an angiogenic phenotype in Bst/+ mice that is age-related, clinically evident, and resembles human SRN. This represents a spontaneous, genetically determined model of SRN. Bst/+ mice offer the possibility of exploring the molecular mechanisms of SRN without the need for exogenous agents.

Aging↗
PubMed1991

Central serous choroidopathy in patients over 50 years of age.

Reviewing all records of patients with the diagnosis of central serous choroidopathy (CSC) at Retina Consultants, Ltd since 1975, we identified 47 patients with CSC who were older than 50 years at initial presentation. These patients were divided into three groups, based on type of management: observation; light "CSC-type" photocoagulation; and heavy "subretinal-neovascular-membrane (SRNVM)-type" photocoagulation. Although most of these patients retained excellent central visual acuity, overall final visual acuities were poorer than those in other reported series. Heavier photocoagulation, as compared with lighter treatment, was associated with a decreased incidence of posttreatment SRNVM formation and appeared to have no adverse effect on final visual outcome. Patients with multiple irregular leaks on fluorescein angiography had a greater tendency to develop SRNVMs, with or without treatment. Ophthalmologists diagnosing CSC in patients over age 50 should be aware that there is a greater risk of SRNVM developing in these patients.

Age Factors↗
PubMed2001

[Proton therapy of occult neovessels in age-related macular degeneration].

INTRODUCTION: The interest of radiation therapy in the management of age-related macular degeneration inaccessible to photocoagulation is still controversial. Our purpose was to demonstrate the feasibility and the possible efficacy of a single dose delivered to the macular region using a 65-MeV proton beam. MATERIAL AND METHODS: A phase II trial was set up using the cyclotron in Nice, France. Fifty-eight patients were included after signing an informed consent. All patients presented with occult subfoveal choroidal neovascularization. A single dose of 9.1 Gy (i.e., 10 Gy cobalt equivalent) was delivered to the macular region. RESULTS: The results were analyzed 3, 6, 12 and, 18 months after proton therapy. At 3 months, the visual acuity was stable or enhanced for 86% of patients, at 6 months for 82.3%, at 12 months for 80%, and at 18 months for 61%. For 22 patients at follow-up at 18 months, the reasons for a decrease in visual acuity were a macular hemorrhage for 4 patients and a progression of the neovascular membrane for 3 patients. No secondary effects related to the treatment have been observed. Regarding the lesions visible on the angiographies (i.e., hemorrhage, exudates, subretinal detachment), we observed a stabilization or a decrease in two-thirds of the cases. CONCLUSION: Preliminary results of single-dose proton therapy are at least comparable to those obtained by other teams. A second study is in progress comparing 3 dose levels, looking for a dose-effect relationship. Furthermore, a randomized study comparing a single proton dose to a placebo will be necessary to assess the long-term value of proton treatment.

Aged↗
PubMed1989

[Laser treatment of subretinal macular neovascularization in pathologic myopia].

The authors evaluated retrospectively 100 eyes with pathological myopia and a macular subretinal neovascular membranes (SRNV) which was treated with direct laser photocoagulation. Argon green, krypton red and orange dye (590 nm) laser were used to treat, respectively, 19, 63 and 18 eyes. The follow-up period was of 12 months. Mean initial visual acuity was 0.33 and mean final visual acuity was 0.31, with no statistically significative difference between them. One or more recurrence was observed in 44% of the eyes. Recurrences could be treated in 80% of cases. At the end of the follow-up period SRNV had disappeared in 83 eyes and extended into the foveola in the remaining 17.

Adult↗
PubMed2006

Subretinal membranes are associated with abnormal degrees of pupil "evasion": an index of clinical macular dysfunction.

AIM: To assess whether macular dysfunction caused by unilateral subretinal neovascular membranes (SRNs) is associated with pupil "evasion" (that is, increased initial rate of re-dilation following a brief light stimulus). METHODS: Comparative observational series. 20 eyes of 10 participants, all with unilateral SRNs and healthy fellow eyes. Dynamic infrared pupillography at seven stimulus intensities (duration 1100 ms, intensities over 2 log unit range). Pupil evasion ratio (PEVR; defined as the ratio of light response amplitude to amount of recovery at the mid-time point of re-dilation expressed as a percentage) was calculated for each stimulus intensity (mean of five recordings). RESULTS: Inter-eye PEVR is significantly reduced in eyes with SRN (that is, greater pupil evasion in SRN eyes: range p = 0.002 to p = 0.05 (paired t test)) and is most apparent at higher stimulus intensities. CONCLUSIONS: PEVR is a novel parameter that is analogous to the pupil escape ratio, but measured following a short rather than a sustained light stimulus. PEVR is significantly altered by macular disease. Clinically PEVR may be used to detect occult unilateral or asymmetric maculopathy in situations such as ocular media opacities like cataract, when pupil reactions are unaffected or augmented, while other tests of retinal function are diminished. PEVR represents altered neuronal firing in cones and macular ganglion cells.

Adult↗
PubMed1993

Subretinal neovascular membranes in Vogt-Koyanagi-Harada syndrome.

Subretinal neovascular membranes cause late visual loss and are important determinants of final visual acuity in patients with Vogt-Koyanagi-Harada syndrome. The purpose of this study was to determine the prevalence and risk factors associated with the development of subretinal neovascular membranes in Vogt-Koyanagi-Harada syndrome. We reviewed the charts of 58 patients (116 eyes) with Vogt-Koyanagi-Harada syndrome. We separated patients into two groups, one with and one without subretinal membranes. Demographic characteristics, namely age, gender, and race, initial and final visual acuities, duration and method of treatment, anterior chamber and vitreous cell, presence of fundus pigmentary disturbances, and phase of inflammation, were evaluated for each group. Overall, ten eyes (9%) of seven patients developed the subretinal neovascular membranes. Demographic characteristics among the two groups of patients were not markedly different (P > .10). Visual outcome of patients with subretinal membranes was significantly poorer than was that of patients without these membranes (P < .001). Eyes with subretinal membranes had a significantly greater degree of anterior chamber and vitreous inflammation (P < .02), greater incidence of fundus pigmentary disturbances (P < .02), and a greater frequency of chronic recurrent phase of inflammation, marked by recurrence of predominantly anterior chamber, and occasionally posterior segment, inflammation (P < .02). The membranes were located in the peripapillary (four eyes), subfoveal (three eyes), and macular extrafoveal (three eyes) regions.

Adult↗
PubMed1999

Cablin: a novel protein of the capillary basal lamina.

The microvascular wall is remarkably simple, consisting only of the endothelial lining, subjacent basal lamina, and underlying periendothelial cells. This study describes the characterization of a novel microvascular protein. This 80,000-molecular weight protein was predominantly associated with electron-lucent amorphous material in capillary basal laminae and therefore termed cablin (protein of the capillary basal lamina). Consistent with its immunolocalization to the microvasculature, cablin was synthesized and secreted by cultured endothelial cells and vascular smooth muscle cells. Furthermore, cablin expression was induced during neovascularization. The predicted amino acid sequence of cablin revealed a prevalence of polar amino acids. Accounting for the low yet significant homology to several alpha-helical proteins, these residues were best accommodated by secondary structure predictions that aligned the molecule into two large alpha-helical domains. The presence of the integrin-binding RGD tripeptide and a putative elastin-binding sequence suggest that this rodlike molecule is suited to cross-link cells and matrix constituents. In this capacity it could contribute to the mechanical strength or the angiogenic potential of the microvasculature.

Amino Acid Sequence↗
PubMedDate not supplied

[Results of photodynamic therapy of subretinal neovascular membranes according to the data of fluorescence angiography and optical coherence tomography].

We studied the possibilities of the method of photodynamic therapy (PDT) in the treatment of subretinal new-vascular membranes. The results of PDT in 28 patients (28 eyes) with subretinal new-vascular membranes of different etiologies were evaluated by using the techniques of fluorescent angiography and optic coherent tomography. A reduced membrane area was noted in 17 patients (17 eye), and an improved visual acuity was registered in 7 patients (7 eyes). The use of PDT makes it possible, in a number of cases, to prevent the reduction of visual functions and even to improve them in patients with subretinal new-vascular membranes. The use of diagnostic opportunities of fluorescent angiography and optic coherent tomography is an indispensable part belonging to the monitoring of the conducted treatment.

Aged↗
PubMedDate not supplied

Argon laser lesions of the retina; occurrence and origin of macrophages.

Macrophage infiltration is frequent in the early stages of various proliferative eye disorders, including subretinal neovascularization. In this study, we set out to establish the origin of macrophages found in an animal model of laser-induced subretinal neovascularization. One primate received several intravenous injections of a colloidal carbon suspension. We then applied standard argon laser lesions to the retina of both eyes, which were enucleated eight days later and sectioned serially for histological examination. A quantitative estimate of carbon-laden and non-laden leukocytes was made based on morphological criteria. Mononuclear leukocytes accumulated in the laser lesions and the percentage of carbon-laden mononuclear leukocytes in relation to the total leukocyte number was higher in the extravascular area of the laser sites than in the systemic circulation. These findings indicate that the majority of mononuclear leukocytes that accumulate at the sites of laser lesions are derived from the systemic circulation.

Animals↗
PubMed1995

[Neovascular glaucoma in the diabetic patient].

Neovascular glaucoma is the final complication of diabetic proliferative retinopathies. Its incidence had significantly reduced during these last ten years owing to the improvement of the management of diabetic patients and systematic panretinal photocoagulation for the treatment of these proliferative retinopathies. Contrary to the other causes of neovascular glaucomas, its evolution is usually capricious, bilateral and its delay of appearance may be quite variable. Vitrectomy--when non associated to peroperative endoretinal photocoagulation--and cataract extraction--mainly intracapsular cataract extraction--increase significantly the incidence of this complication. Fluorescein angiography of the anterior segment and fluorescein gonio-angiography may be contributive to the diagnosis of early rubeosis iridis and/or to evaluation of the efficacy of panretinal photocoagulation. Its management must remain as conservative as possible. It lies upon panretinal photocoagulation and/or cryoablation, both representing the preventive and the curative treatment of this secondary glaucoma. Secondarily a filtering procedure associated with antimetabolites or an anterior chamber drainage implant may be discussed individually if necessary and according to the residual visual function.

Cataract Extraction↗
PubMedDate not supplied

Bevacizumab for occult subfoveal neovascularization in age-related macular degeneration.

PURPOSE: To report on the treatment of exudative age-related macular degeneration by intravitreal bevacizumab (Avastin). METHODS: A 78-year-old patient experienced a progressive loss of visual acuity in her right eye due to an occult subfoveal neovascular membrane in age-related macular degeneration. She received an intravitreal injection of 1.5 mg bevacizumab. RESULTS: Within 4 weeks after the injection, visual acuity improved from 0.40 to 0.60 with complete resolution of subretinal and intraretinal leakage and edema as shown on optical coherence tomography. Pre-existing metamorphopsias disappeared. Intraocular pressure remained in the normal range. During the follow-up, there were no sings of intraocular inflammation or any other intraocular pathology induced by the intravitreal injection. CONCLUSIONS: Intravitreal bevacizumab may potentially be helpful in the treatment of exudative age-related macular degeneration and may deserve further evaluation.

Aged↗
PubMed1993

Use of digitized fluorescein angiogram system to evaluate laser treatment for subretinal neovascularization: technique.

In patients with subretinal neovascular membranes (SRNVM), persistence of the SRNVM after laser treatment is a major cause of decreased visual acuity. Persistence is associated with inadequate initial laser treatment. A technique using a digitized fluorescein angiogram (DFA) system is presented that allows immediate evaluation of the adequacy of laser treatment for SRNVM. This involves overlaying a red-free photograph taken after treatment on a fluorescein angiogram taken before treatment using a digital angiogram system that evaluates the adequacy of treatment. A protocol for augmentation of laser treatment has been developed that will aid in the reduction of persistence after laser treatment of SRNVM.

Aged↗
PubMed1994

Fluorescein angiographic features of neovascular maculopathy in angioid streaks.

Among the 46 eyes of 23 patients diagnosed with angioid streaks, macular complications (subretinal neovascularization) were found in 20 eyes of 11 patients (43.5%): the 14 eyes of 7 males, and 6 eyes of 4 females. Of these patients, 81.8% were in their fifties to sixties. The patients with and without macular complications did not differ in the incidence of pseudoxanthoma elasticum and other ocular findings, including peau d'orange and salmon spots. In 17 eyes of 10 patients (85%) with macular complications, fluorescein angiography demonstrated multiple small, round, hypofluorescent dots in the area temporal to the macula and around the optic disc. The extent of this lesion varied from simple hypofluorescent dots to dots each surrounded by a hyperfluorescent area. These changes could be detected not by ophthalmoscopic fundus examination but only by fluorescein angiography.

Adolescent↗
PubMed1989

[The dye laser: experimental and clinical results in subretinal macular neovascularization].

The tunable dye laser provides now a large assortment of monochromatic wavelengths that allow selective targeting on individual tissues in the retina, according to in vitro studies showing extinction coefficient of ocular pigments (xanthophyllic pigment, rhodopsin, melanin, lipofuschin, hemoglobin) for different laser wavelengths. Confluent heavy and juxtafoveolar laser burns in eyes of cynomolgus monkeys showed, after 38 days, similar lesions in all the wavelength studied (green, red, yellow, orange) at the level of the choriocapillaris, Bruch's membrane, pigment epithelium and photoreceptor's layers. However, the inner retina layers were discretely more damaged with yellow and orange than with green and red. In clinical approach, the effects of these different wavelength haven been compared in human eyes presenting with subfoveol new vessels and disciform age-related macular degeneration. After healing, the scar was similar biomicroscopically, and on fluorescein angiography with all wavelengths studied (green, red, yellow, orange). In conclusion, dye laser seems to be efficient and easily tunable for photocoagulation in macular area.

Aging↗
PubMed1993

[Do scars grow despite successful laser coagulation of subretinal neovascularization?].

After successful laser coagulation of subretinal neovascularization, we examined 9 patients to see if laser scar growth (which can be expected according to the literature) is accompanied by an increase in associated scotoma. We used a specially designed visual field program. Laser scars had grown by 23% 107 days after therapy and by 32% after 409 days. The changes in our patients were at the lower range of the data reported in the literature. The increase in the laser scar was statistically significant in just one patient. Mean sensitivity and two further parameters for describing visual fields, which we introduced, all hinted at an improvement in the central visual field, although the laser scars had grown. The mean sensitivity increased by 4.9% and 7.5% after 107 and 409 days, respectively.

Adult↗
PubMed1994

[Does indocyanine green angiography aid in deciding indications for laser therapy of exudative senile macular degeneration?].

BACKGROUND: Only a few patients with neovascularized age-related macular degeneration (AMD) have clinical and fluorescein angiographic manifestations that meet eligibility criteria for photocoagulation therapy. Angiography with indocyanine green (ICG) may expand those criteria. MATERIAL AND METHODS: Fifty-two patients with exudative AMD were studied by fluorescein and ICG angiography (using the Rodenstock scanning laser ophthalmoscope). The ICG-angiograms were studied in relation to the questions, how often subretinal neovascularizations (SNV) were visible and how often the results were helpful for laser treatment. RESULTS: In 18 cases (about one third) a SNV was detected by ICG-angiography and in 8 (15%) the result allowed a laser treatment. "Ideal" SNV presented as neovascular trees with a visible feeder-vessel. Other cases showed a circumscribed area of diffuse hyperfluorescence especially in the late phase. Macular edema often prevented the resolution of subretinal membranes. CONCLUSIONS: Only randomised studies will be able to show whether the combination of fluorescein and ICG angiography allows the possibility of treating more patients with SNV than fluorescein angiography alone. In the following circumstances this might be the case: 1. If in subfoveal SNV a feeder-vessel could be delineated with ICG-angiography that might be treated selectively. 2. If an occult SNV might be reclassified as manifest SNV due to findings provided by ICG-angiography. 3. Examination of patients with ICG-angiography immediately after laser photocoagulation might be a way of proving the completeness of the treatment.

Aged↗