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Results for “Retinal Neovascularization”

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PubMed1994

Transplantation of fetal retinal pigment epithelium in age-related macular degeneration with subfoveal neovascularization.

BACKGROUND: Age-related macular degeneration (ARMD) is caused by abnormal retinal pigment epithelium (RPE) and may be complicated by choroidal neovascularization. The object of treatment would be to replace the diseased RPE with normal human RPE. METHOD: Five patients with ARMD (preoperative visual acuity 0.08-0.2) underwent removal of subretinal fibrovascular membranes using pars plana vitrectomy techniques. Human fetal RPE (15-17 weeks gestational age) was cultured and transplanted as a monolayer patch into the subretinal space. Transplants were followed by funduscopy and fluorescein angiography. Macular function was assessed using scanning laser ophthalmoscopic (SLO) microperimetry. RESULTS: Three RPE transplants were placed in the fovea; two were placed parafoveally. All transplants have survived for 3 months. They have grown and increased in size covering part of the epithelial defect caused by removal of the fibrovascular membrane. SLO microperimetry indicated that visual function was present in four of the transplants at 1 month but in only two at 3 months after surgery. Function over the transplants, especially those in the fovea, was compromised by cystoidlike macular edema. CONCLUSIONS: Human fetal RPE transplants survive well in the macula for as long as 3 months. They are capable of growing to cover epithelial defects caused by removal of subretinal neovascular membranes. The causes for development of macular edema in transplants directly in the fovea warrant further evaluation.

Aged↗
PubMed1980

Experimental ocular angiogenesis.

In 29 experiments, vascular autologous retina from the contralateral rabbit eye was implanted into corneal pockets in New Zealand white rabbits. The implants induced a neovascular growth of limbal vessels that anastomosed with the vessels of the implant in 15 of the cases. Implantation of vascular autologous iris, choroid, optic nerve extraocular muscle, and conjunctiva also induced neovascularization. Avascular peripheral retina, cornea, and scleral implants did not cause a neovascular response, nor did boiled vascular retina, boiled iris, and boiled choroid. Neovascularization from the retinal and iris intracorneal implants was induced by V2 carcinoma.

Animals↗
PubMed2003

[Optical coherence tomography features of central exudative chorioretinopathy].

OBJECTIVE: To study the morphological features of submacular choroidal neovascularization in central exudative chorioretinopathy (CEC) using optical coherence tomography (OCT). METHODS: Using OCT, we examined 21 consecutive eyes (20 patients; 8 men, 12 women; mean age 38 years) with central exudative chorioretinopathy. Results of OCT were compared with fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). RESULTS: Choroidal neovascularization appeared in subsensory retinal space anterior to the retinal pigment epithelium as a highly or moderately reflective mass, which protruded from the retinal pigment epithelium in 16 of 21 eyes. In five eyes, choroidal neovascularization appeared as a highly reflective fusiform or irregular mass at the level of retinal pigment epithelium and choriocapillaris. Nine of 21 eyes were associated with serous neurosensory retina detachment, 6 eyes with hemorrhagic pigment epithelium detachment (PED) and 14 eyes with edema and thickening of sensory retina. In 3-12 months (mean 6 months), choroidal neovascularization of 17 eyes with PDT regressed and its morphological features changed. The results obtained from OCT, FFA and ICGA could be supplemented with each other. CONCLUSIONS: OCT can be used to confirm the morphological features, location and size of submacular choroidal neovascularization. Choroidal neovascularization appears as a highly or moderately reflective round mass which protrudes from the retinal pigment epithelium in most cases. The morphology and the size of this mass may change after treatment and during follow-up.

Adult↗
PubMed1982

Scatter retinal photocoagulation for proliferative sickle cell retinopathy.

We treated sea-fan neovascularization in 19 patients (21 eyes) who had proliferative sickle cell retinopathy with localized scatter photocoagulation. We placed burns of light to moderate intensity adjacent to 45 sea fans in a scatter fashion. In general, treatment extended from 1.5 mm posterior to 1.5 mm anterior to the sea fan and one clock hour to each side of each lesion. Flat sea fans responded dramatically to treatment, with complete regression in 24 of 28 lesions. Elevated sea fans (especially large ones) responded less rapidly, with complete regression in only four of 17 lesions. Localized scatter photocoagulation is valuable in treating patients with early proliferative sickle cell retinopathy.

Adolescent↗
PubMed2002

Indocyanine green angiography in the presence of subretinal or intraretinal haemorrhages: clinical and experimental investigations.

PURPOSE: The absorption and emission characteristics of indocyanine green are associated with better penetration through ocular pigments, including melanin and blood, in comparison with fluorescein. Therefore, it has been assumed that indocyanine green angiography (ICG-A) allows better delineation of fluorescent structures including choroidal neovascularization in the presence of haemorrhages. The degree and frequency of blockage by haemorrhages during ICG-A and fluorescein angiography (Fl-A) were compared and absorption characteristics by blood were experimentally determined. METHODS: Simultaneous confocal scanning laser ophthalmoscopy was performed in patients with intraretinal or sub-retinal haemorrhages associated with various retinal diseases including neovascular age-related macular degeneration. Areas of blocked choroidal fluorescence were compared in Fl-A and ICG-A using a standardized classification system by two independent readers. Experimental absorption measurements were performed using blood-filled quartz cuvettes and laser light with 488 and 790 nm, respectively. RESULTS: Sixty eyes of 59 patients were analysed. Twelve eyes (20%) showed blockage in Fl-A only corresponding with funduscopically visible blood. In 35 eyes (58%) the extent of absorption was greater in Fl-A compared with ICG-A. An identical area of blockage in both Fl-A and ICG-A was noted in 13 eyes (22%). The coefficient of absorption was 18.4 mm(-1) for Fl-A (488 nm) and 5.4 mm(-1) for ICG-A (790 nm). CONCLUSIONS: In contrast to previous assumptions, the findings indicate that clinically intraretinal or subretinal haemorrhages are frequently associated with blockage not only in Fl-A but also in ICG-A. This is in accordance with the experimentally determined coefficient of absorption. Apparently, haemorrhages occurring in association with retinal and choroidal diseases commonly have a thickness sufficient enough to induce relevant absorption during ICG-A, and thus impair delineation of fluorescent structures in planes posterior to the haemorrhage. Therefore, the diagnostic value of ICG-A in presence of subretinal or intra-retinal bleedings is limited.

Aged↗
PubMed1991

Electroretinography as a prognostic indicator or neovascularisation in CRVO.

A prospective study was carried out to compare the efficacy of electroretinography, fundus fluorescein angiography and clinical examination in identifying those at risk of rubeotic glaucoma following central retinal vein occlusion (CRVO). Our preliminary observations are described. The findings suggest a complementary role for electroretinography in the management of CRVO. Particularly significant were interocular differences in 30 Hz flicker latency, the ability to elicit pattern ERGs and the ratio of scotopic and photopic a:b wave amplitudes. Of the clinical measures the depth of the relative afferent pupil defect was a sensitive indicator of rubeosis. Factors of lesser statistical prognostic value included poor visual acuity and the extent of deep retinal haemorrhages. Fundus fluorescein angiography in this study had limited value in predicting those patients at risk of rubeosis.

Electroretinography↗
PubMed1985

Hemorrhagic detachment of the peripheral retinal pigment epithelium.

Peripheral hemorrhagic detachments of the retinal pigment epithelium after choroidal neovascularization in age-related macular degeneration in the fellow eye have been reported only rarely. We report a case of a 75-year-old male with such involvement who presented with the acute onset of a shower of floaters in the right eye 9 months after argon laser photocoagulation of juxtafoveal choroidal neovascularization in his left eye. The peripheral hemorrhagic detachment resolved within one month.

Aged↗
PubMed1996

[Role of the vitreous in central retinal vein occlusion].

To investigate the role of the vitreous in eyes with central retinal vein occlusion, especially in relation to neovascularization and macular edema, we conducted a retrospective chart review of the vitreous condition of 150 patients (150 eyes) with central retinal vein occlusion. Based on fluorescein angiography findings and color photographs, eyes with central retinal vein occlusion were classified as ischemic or nonischemic. In ischemic cases, retinal or optic disc neovascularization, or both, developed in eight (57%) of 14 eyes without complete posterior vitreous detachment at the final examination. The prevalence of neovascularization was significantly higher than in eyes with complete posterior vitreous detachment (0%, 0/43) at the final examination (p < 0.01). In nonischemic cases, the prevalence of no posterior vitreous detachment or partial posterior vitreous detachment with vitreomacular adhesion was significantly higher in eyes with macular edema (76%, 28/37) than in eyes without it (23%, 13/56) at the final examination (p < 0.01). Complete posterior vitreous detachment may protect against retinal or optic disc neovascularization in eyes with severe central retinal vein occlusion. Vitreomacular adhesion may cause persistent macular edema in eyes with mild central retinal vein occlusion.

Adult↗
PubMed1984

[Neovascular glaucoma caused by branch vein occlusion and deficiency of carotid-encephalic circulation: pathogenetic correlation].

The authors present two cases of neovascular glaucoma following branch retinal vein occlusion. The first case presented bilateral ischaemic branch retinal vein occlusions. In this case there was bilateral impairment of blood flow in the carotido-cerebrovascular system, more marked on the side where the neovascular glaucoma was present. The second case developed neovascular glaucoma following an ischaemic branch retinal vein occlusion of the right eye and had bilateral carotid stenosis that was more complete on the right: where the neovascular glaucoma occurred. The authors analyse the main pathogenic hypothesis of neovascular glaucoma, and suggest that it could be the result of the concurrent action of posterior ocular alterations (like retinal ischaemia following a branch retinal vein occlusion) and of cerebrovascular insufficiency. This second factor could contribute to global ocular ischaemia, thus, involving the anterior vascular structures of the eye as well.

Aged↗
PubMedDate not supplied

Goniophotocoagulation for neovascular glaucoma.

A new treatment, goniophotocoagulation, for neovascularization of the anterior chamber angle has been applied with the argon laser to 21 eyes of 20 patients. Three of the eyes had neovascularization related to central retinal vein occlusion. In the other 18 eyes the neovascularization was related to diabetic retinopathy. A specific protocol has been followed since January 1973. The results so far indicate that closure of the angle and progression of the usual chain of pathologic events in neovascular glaucoma were prevented in 10 (77%) of the 13 eyes having an average follow-up of 22 months. We believe that goniophotocoagulation of the angle deserves more extensive, judicious, and carefully monitored clinical use. Our results suggest that this new technique is safe and reasonably effective in preventing progressive neovascularization of the angle, synechial closure, and severe nonvascular glaucoma.

Anterior Chamber↗
PubMedDate not supplied

Postoperative assessment of retinal function using a multifocal electroretinogram after the removal of subfoveal choroidal neovascularization secondary to age-related macular degeneration.

PURPOSE: To assess retinal function in a macular lesion with multifocal electroretinography (mfERG) after successful surgical removal of choroidal neovascularization (CNV). METHODS: We prospectively studied 15 patients (15 eyes) who underwent surgical removal of subfoveal CNV secondary to age-related macular degeneration. Three and 6 months after surgery, retinal thickness in the parafoveal lesion and the size of the serous retinal detachment (SRD) were measured. The mfERG was also recorded, and the data from each of six concentric ring annuli were averaged. RESULTS: After surgery, the parafoveal retinal thickness significantly decreased compared with the preoperative value, and SRD was not recognized in any patient. The change in the amplitude of the P1-wave within 2 degrees to 15 degrees in diameter positively correlated with the decrease in the parafoveal retinal thickness. Additionally, amplitude within 8 degrees to 24 degrees in diameter positively correlated with the size of the preoperative SRD. CONCLUSION: mfERG is helpful to quantitatively and objectively assess the effect of the surgical removal of CNV on retinal function, not only in the fovea but also in the entire macular area.

Aged↗
PubMed2002

[Nocardia farcinica: life-threatening chorioiditis under systemic immunosuppression].

BACKGROUND: Immunosuppressed patients occasionally suffer from a multifocal infection with Nocardia. It is important to distinguish Nocardia farcinica from Nocardia asteroides, because of different sensitivity against antibiotics. PATIENT AND METHODS: A 40-year-old patient with polycystic renal disease successfully underwent a kidney transplantation without complications. Immunosuppression consisted of: corticosteroids, azathioprin and ciclosporin A. Ten weeks later he developed acute choroiditis with consecutive retinal detachment and neovascular glaucoma in one eye. In addition, 14 weeks after transplantation CT scans revealed multiple cerebral abscesses. RESULTS: In the course of the disease Nocardia farcinica (N. f.) was identified by cerebral stereotactic biopsy of a cerebral lesion, histological examination of the enucleated globe and sputum culture. Histologically filamentous, eosinophilic organisms were found. Microbiology identified aerobic actinomycetes in cultures and Nocardia farcinica by PCR. Therapeutically the combination of vancomycin, ampicillin, and sulbactam was successful. CONCLUSION: In immunosuppressed patients Nocardia farcinica can become life-threatening. One of the first manifestations may be a choroiditis. Infection of the respiratory tract followed by hematogenous spread is the common way of systemic nocardiosis. Biopsy followed by identification of species by PCR is recommended because of the specific therapeutic strategies associated with each species.

Adult↗
PubMed1997

[Vitrectomy and proliferative diabetic retinopathy. Apropos of 66 eyes].

PURPOSE: We report a retrospective study about vitrectomy in diabetic patients and the analysis of anatomical and functional results after surgery. METHODS: We studied 66 eyes of 52 diabetic patients who underwent pars plana vitrectomy. Vitrectomy was performed for nonclearing intravitreous hemorrhage in 75% of eyes and for tractional macular retinal detachment in 14% of eyes. RESULTS: After vitrectomy for intravitreous hemorrhage, visual acuity increased in 84% of eyes with more than 5/10 in half the cases. After vitrectomy for tractional retinal detachment, visual acuity increased or became stable in only 55% of eyes. The major complication of surgery was recurrence of intravitreous hemorrhage. A new surgery was not necessary in most cases. Neovascular glaucoma, phtysis, retinal detachment and cataract were the other complications of surgery. CONCLUSION: Visual prognosis after vitrectomy performed in complicated diabetic retinopathy depends on the final macular function. Surgery for intravitreous hemorrhage without macular detachment produced in most of cases a good visual acuity. On the other hand, vitrectomy for tractional macular retinal detachment was followed by poor visual prognosis. After recurrent intravitreous hemorrhage, a new surgical procedure is possible with good visual results in most cases, even if several procedures are necessary.

Adult↗
PubMedDate not supplied

Two cases of frosted branch angiitis with central retinal vein occlusion.

BACKGROUND: Frosted branch angiitis usually occurs in children, and has a good prognosis. We report two cases of unilateral frosted branch angiitis in adults. Both had poor visual outcomes because of associated central retinal vein occlusion and neovascular glaucoma. CASES: Case 1 was a 36-year-old woman. Almost all retinal veins and some retinal arteries showed vasculitis in her right eye, and veins were slightly dilated and sheathed. Case 2 was a 23-year-old woman. Angle hypopyon was observed in her left eye. Retinal veins were dilated, meandering, and sheathed. Retinal hemorrhages were also observed. In both cases, after systemic steroid therapy the retinal vasculitis gradually decreased, but central retinal vein occlusions gradually developed. Despite systemic administration of urokinase and panretinal photocoagulation, neovascular glaucoma developed, and visual acuity diminished in both cases. CONCLUSIONS: Two cases of frosted branch angiitis complicated by retinal vein occlusion are reported. Careful observation of retinal blood flow is necessary in frosted branch angiitis in adults.

Adult↗
PubMed1997

Histopathologic features of neovascularization in sickle cell retinopathy.

PURPOSE: To examine the histopathologic and morphometric features of neovascular lesions in human proliferative sickle cell retinopathy. METHODS: Postmortem ocular tissue was obtained from three subjects (aged 20, 28, and 40 years) with SS hemoglobinopathy and prepared for adenosine diphosphatase flat-embedding. Morphometric analysis was performed before serial sectioning. RESULTS: Numerous active and autoinfarcted lesions were found that represented virtually all stages in the life cycle of preretinal neovascularization. These formations ranged from single small loops extending from arteries and veins along the retinal surface to the typical complex, elevated sea fan formations. Sea fans developed at hairpin loops and at arteriovenous crossings. There was an average of 5.6 connections between sea fans and retinal vessels; of these, 45% were arteriolar, 52.5% were venular, and 2.6% were at the capillary level. Six of eight sea fans were located at arteriovenous crossings. Autoinfarction appeared to occur initially within the sea fan capillaries. The average height of sea fans was 123 microns above the retinal surface. CONCLUSIONS: Preretinal neovascularization in sickle cell retinopathy can arise from both the arterial and venous sides of the retinal vasculature and can assume a variety of morphologic configurations. Multiple feeding arterioles and draining venules are common, and autoinfarction appears to occur initially at the preretinal capillary level rather than at feeding arterioles. Arteriovenous crossings may be a preferential site for sea fan development.

Adult↗
PubMed1993

Intraoperative fluorescein angiography.

BACKGROUND: Fluorescein angiography is often beneficial in the evaluation and management of many retinal vascular diseases. However, vitreous blood or opacities may prevent fluorescein studies before pars plana vitrectomy. After vitrectomy, fluorescein angiography may be delayed, creating uncertainty over differentiation of preoperative, intraoperative, and postoperative findings. METHODS: The authors have modified an intraocular light source and operating microscope to perform intraoperative fluorescein angiography easily. Twenty-five patients underwent fluorescein angiography during pars plana vitrectomy. All studies were recorded using a microscope-mounted video camera for intraoperative and postoperative evaluation. RESULTS: In all cases, intraoperative angiography was performed without complication. Indications for intraoperative studies included confirmation of macular edema, delineation of avascular retina, and localization of retinal and choroidal neovascularization. All videotape recordings of procedures were of high quality, allowing easy review and interpretation. CONCLUSION: Intraoperative fluorescein angiography is an easily performed adjunctive diagnostic procedure that can aid intraoperative evaluation and treatment of selected retinal vascular disorders.

Adult↗
PubMed1982

Talc retinopathy in primates: a model of ischemic retinopathy. II. A histopathologic study.

Experiment talc retinopathy was produced in four adult rhesus monkeys by biweekly intravenous injections of talc for 31/2 to ten months and was studied by retinal vascular flat preparations and by light microscopy. Talc particles were lodged in the walls of the precapillary arterioles and capillaries, producing focal occlusion of retinal and choroidal capillaries. The pericyte-endothelial cell ratio was 1:0.77 in the posterior pole and 1:0.53 in the retinal periphery. The horseradish peroxidase study showed leakage of tracer from the retinal vasculature into the extracellular interstitial space, but the barrier of the retinal pigment epithelium was intact. Microinfarcts produced small cystoid spaces in the outer plexiform layer, inner nuclear layer, and ganglion cell layer of the macula. Cytoid bodies and macrophages were scattered in the retina. No retinal or vitreal neovascularization was observed.

Animals↗