scholarly journals Characteristics of pachychoroid neovasculopathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Miho Tagawa ◽  
Sotaro Ooto ◽  
Kenji Yamashiro ◽  
Hiroshi Tamura ◽  
Akio Oishi ◽  
...  
Keyword(s):  
Risk Allele ◽  
Lesion Size ◽  
Lesion Group ◽  
Genetic Characteristics ◽  
Polypoidal Lesion ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Treatment Naïve ◽  
Pachychoroid Neovasculopathy

Abstract Recently, several research groups have reported a newly recognized clinical entity of choroidal neovascularization, termed pachychoroid neovasculopathy. However, its characteristics have yet to be well described. The purpose of this study was to investigate the clinical and genetic characteristics of pachychoroid neovasculopathy regardless of treatment modality. This study included 99 eyes of 99 patients with treatment-naïve pachychoroid neovasculopathy. Mean initial best-corrected visual acuity (BCVA) was 0.20 ± 0.32 logMAR, and did not change (P = 0.725) during follow-up period (mean ± SD, 37.0 ± 17.6 months). Subretinal hemorrhage (SRH) (≥ 4 disc areas in size) occurred in 20 eyes (20.2%) during follow-up. Age, initial BCVA, central retinal thickness, SRH (≥ 4 disc areas in size) and treatment (aflibercept monotherapy) were significantly associated with the final BCVA (P = 0.024, < 0.001, 0.031, < 0.001, and 0.029, respectively). Multiple regression analysis showed initial BCVA and presence of SRH to be significant predictors of final BCVA (both P < 0.001). Polypoidal lesions were more common in the SRH group than in the non-SRH group (85.0% vs 48.1%, P = 0.004). There was no significant difference in the frequency of the risk allele in ARMS2 A69S, CFH I62V, CFH Y402H between these groups (P = 0.42, 0.77, and 0.85, respectively). SRH (29.1% vs 9.1%, P = 0.014) and choroidal vascular hyperpermiability (65.5% vs 43.2%, P = 0.027) were seen more frequently in the polypoidal lesion (+) group than in the polypoidal lesion (−) group. There was considerable variation in lesion size and visual function in patients with pachychoroid neovasculopathy, and initial BCVA and presence of SRH at the initial visit or during the follow-up period were significant predictors of final BCVA.

No Difference in Outcomes Following Osteochondral Allograft with Fresh Precut Cores Compared to Hemi-Condylar Allografts

Cartilage ◽  
2021 ◽  
pp. 194760352110219
Author(s):  
Danielle H. Markus ◽  
Anna M. Blaeser ◽  
Eoghan T. Hurley ◽  
Brian J. Mannino ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Lesion Size ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Objective The purpose of the current study is to evaluate the clinical and radiographic outcomes at early to midterm follow-up between fresh precut cores versus hemi-condylar osteochondral allograft (OCAs) in the treatment of symptomatic osteochondral lesions. Design A retrospective review of patients who underwent an OCA was performed. Patient matching between those with OCA harvested from an allograft condyle/patella or a fresh precut allograft core was performed to generate 2 comparable groups. The cartilage at the graft site was assessed with use of a modified Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system and patient-reported outcomes were collected. Results Overall, 52 total patients who underwent OCA with either fresh precut OCA cores ( n = 26) and hemi-condylar OCA ( n = 26) were pair matched at a mean follow-up of 34.0 months (range 12 months to 99 months). The mean ages were 31.5 ± 10.7 for fresh precut cores and 30.9 ± 9.8 for hemi-condylar ( P = 0.673). Males accounted for 36.4% of the overall cohort, and the mean lesion size for fresh precut OCA core was 19.6 mm2 compared to 21.2 mm2 for whole condyle ( P = 0.178). There was no significant difference in patient-reported outcomes including Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and Tegner ( P > 0.5 for each), or in MOCART score (69.2 vs. 68.3, P = 0.93). Conclusions This study found that there was no difference in patient-reported clinical outcomes or MOCART scores following OCA implantation using fresh precut OCA cores or size matched condylar grafts at early to midterm follow-up.

scholarly journals Comparative Analysis of the Clinical Features and Long-Term Outcomes of Pachychoroid Neovasculopathy and Type 1 Neovascular Age-Related Macular Degeneration

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jong In You ◽  
Kiyoung Kim
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Long Term Outcomes ◽  
Age Related ◽  
Treatment Naïve ◽  
History Of ◽  
Pachychoroid Neovasculopathy

Purpose. To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Methods. We retrospectively analyzed 30 and 60 patients whose eyes were diagnosed as treatment-naïve PCN or type 1 nAMD, respectively. All subjects were followed up for 5 years. Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. Results. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all p  < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. A progressive decrease in the subfoveal choroidal thickness was observed in the type 1 nAMD group, while the thick choroid was maintained in the PCN group during the 5-year follow-up period. Conclusions. PCN developed in younger patients with a higher propensity of forming polypoidal lesions and a history of CSC. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD.

scholarly journals Real-World Results of Aflibercept versus Ranibizumab for the Treatment of Exudative AMD Using a Fixed Regimen

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Joana Providência ◽  
Tiago M. Rodrigues ◽  
Mariana Oliveira ◽  
João Bernardes ◽  
João Pedro Marques ◽  
...  
Keyword(s):  
Real World ◽  
Age Related Macular Degeneration ◽  
Treatment Protocols ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Clinical Practice Setting ◽  
The Mean ◽  
Endothelial Growth Factors

Intravitreal injections of antivascular endothelial growth factors have been considered a milestone in the treatment of neovascular age-related macular degeneration (nAMD). However, the increasing incidence of AMD and the burden of visits and injections overcharge both the patient and the healthcare systems. Real-world solutions depend on treatment protocols aimed at optimizing the number of clinical visits while guaranteeing good functional outcomes. We performed a retrospective analysis of 72 eyes from 63 naïve patients diagnosed with nAMD that underwent a fixed intravitreal protocol consisting of bimonthly injections after a three-month loading dose, with either Aflibercept or Ranibizumab (no predefined criteria for treatment selection). Best corrected visual acuity (BCVA) and optical coherence tomography were analyzed at baseline and during follow-up clinical visits (months 3, 6, 12, and 18). From the included participants, 42 followed a fixed regimen with Aflibercept and 30 with Ranibizumab. At the 12-month visit, there was not a statistically significant difference in the mean change of BCVA between the two groups (p=0.121); however, the mean difference in the central retinal thickness was significantly superior in the Aflibercept group (-142.2 versus -51.5, p=0.011). The described fixed regimen seems to be efficient in the treatment of nAMD in a clinical practice setting.

scholarly journals The role of bone marrow edema on autologous matrix induced chondrogenesis for the treatment of osteochondral lesions of the talus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Marrow ◽  
Repeated Measures ◽  
Bone Marrow Edema ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Significant Difference ◽  
T1 And T2 ◽  
Marrow Edema

Category: Ankle, Arthroscopy, Basic Sciences/Biologics Introduction/Purpose: to assess the functional and radiological outcomes after AT-AMIC® (arthroscopic talus autologous matrix induced chondrogenesis) in 2 groups: patients with and without bone marrow edema (BME). Methods: Thirty-seven patients of which 24 without edema (GNE) and 13 with edema (GE) were evaluated. All patients were treated with AT-AMIC® repair for osteochondral talar lesion. MRI and CT-scan evaluations, as well as clinical evaluations measured by the VAS score for pain, AOFAS and SF-12 were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results: GNE consisted of 24 patients while GE consisted of 13 patients. In both groups we found a significant difference for clinical and radiological parameters with ANOVA for repeated measures through four time points(p<0.001). In GNE, AOFAS improved significantly at each follow-up(p<0.05); while CT and MRI showed a significant decrease between T1 and T2 and T2 and T3(p<0.05). In GE, AOFAS improved significantly between T0 and T1 and T2 and T3(p<0.05); CT decreased between T1 and T2(p<0.05), while MRI showed a reduction at each follow-up(p<0.05). Lesion size was significantly higher both in MRI and CT in GE in respect to GNE(p<0.05). In the GNE no patients presented edema at T3, while in GE only 23.08% of the patients presented edema at T3. Conclusion: The study revealed that osteochondral lesions of the talus were characterized by bigger size both in MRI and CT in patients with edema. We conclude that AT-AMIC® can be considered a safe and reliable procedure that allows effective healing, regardless of edema and more than half of patients did not present edema six months after surgery.

scholarly journals Arthroscopic autologous-matrix induced chondrogenesis in association with microfractures and autologous bone graft for the treatment of osteochondral talar lesions in young patients

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Federico Giuseppe Usuelli ◽  
Camilla Maccario ◽  
Riccardo D’Ambrosi
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Multivariate Statistical ◽  
Significant Difference ◽  
Autologous Bone

Category: Ankle, Ankle Arthritis, Arthroscopy, Basic Sciences/Biologics Introduction/Purpose: The purpose is to evaluate the clinical and radiological outcomes of patients younger than 20 years, treated with the arthroscopic-talus autogolous matrix-induced chondrogenesis (AT-AMIC®) technique and autologous bone graft for osteochondral lesion of the talus (OLT) at a follow-up of 24 months. Methods: 13 patients under 20 years (range 13.2 – 19.85) underwent the AT-AMIC® procedure and autologous bone graft for OLTs. Patients were evaluated pre-operatively (T0) and at 6 (T1), 12 (T2) and 24 (T3) months postoperatively, using the AOFAS score, the VAS and the SF-12 respectively in its Mental (MCS) and Physical component (PCS). Radiological assessment included CT-scan, MRI and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean size lesion measured during surgery was 1.1102 cm3 ± 0.518 cm3. We found a significant difference in clinical and radiological parameters with ANOVA for repeated measures (p<0.001). All clinical scores significantly improved (p<0.05) from T0 to T3. Lesion area significantly reduced from 120.12 ± 29.58 mm2 pre-operatively to 75.78 ± 15.00 mm2 (p<0.05) at final follow- up as assessed by CT, and from 133.32 ± 32.42 mm2 to 83.45 ± 15.54 mm2 (p<0.05) as assessed by MRI. Moreover we noted an important correlation between intra-operative size measurement of the lesion and BMI (p=0.0114). Conclusion: The technique can be considered safe and effective, reporting early good results in young patients. Moreover we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life.

Phacoemulsification in Eyes with Neovascular AMD Treated with Anti-VEGF Injections

2011 ◽  
Vol 21 (6) ◽  
pp. 766-770 ◽  
Author(s):  
Maria Muzyka-Woźniak
Keyword(s):  
Visual Acuity ◽  
Median Time ◽  
Time Interval ◽  
Neovascular Amd ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Case Series Study ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Purpose. To evaluate visual results of phacoemulsification in eyes with neovascular age-related macular degeneration (AMD) treated with anti–vascular endothelial growth factor (VEGF) intravitreal injections. Methods. This retrospective noncomparative interventional case-series study assessed best-corrected visual acuity (BCVA) at 4 timepoints: 1) baseline, immediately before first anti-VEGF injection; 2) preoperative, immediately before phacoemulsification; 3) postoperative, 1 month after phacoemulsification; 4) endpoint, at the last visit. Anti-VEGF retreatment regimen was based only on optical coherence tomography. The median time between anti-VEGF injections was evaluated for the time period before and after phacoemulsification. Results. Sixteen eyes of 16 patients were included. The median (range) baseline, preoperative, post-operative, and endpoint BCVA was 0.7 (0.3–1.3), 0.72 (0.4–1.3), 0.5 (0.05–1.0), and 0.36 (0.0–1.0) logMAR, respectively. Best-corrected visual acuity significantly improved after phacoemulsification (mean 3 logMAR lines) and remained stable during follow-up (median 14 months, range 7–28). There was no statistically significant difference in the median time interval between injections before phacoemulsification and after phacoemulsification. Conclusions. Phacoemulsification significantly improved BCVA in patients with choroidal neovascular AMD. This effect persisted during follow-up with no increased need for anti-VEGF injections to keep macula dry.

Early treatment with dexamethasone intravitreal implants in diabetic macular edema: Naïve versus refractory patients

2021 ◽  
pp. 112067212110248
Author(s):  
Anna V Bux ◽  
Francesca Fortunato ◽  
Antonio Barone ◽  
Vincenzo Russo ◽  
Nicola Delle Noci ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
First Line ◽  
Corrected Visual Acuity ◽  
Real World Setting ◽  
Treatment Naïve ◽  
Group 2 ◽  
Group 1

Purpose: To assess the efficacy and safety of dexamethasone 0.7 mg implants (DEX-I) in patients with diabetic macular edema (DME) either naïve to therapy or refractory to anti-VEGF treatment, in a single-center, real-world setting. Methods: Patients diagnosed with DME and treated with DEX-I were retrospectively enrolled in the study and split in two groups: naïve (Group 1, n = 64) and refractory (Group 2, n = 64) to treatment. Patients were evaluated at baseline, at 1 month, and every 3 months after each DEX-I implant. Main outcome measures were change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline to follow-up visits. Results: Significant improvements in BCVA were observed in treatment-naïve patients at 6 months following the first and second DEX-I injection ( p = 0.0023 and p = 0.0063, respectively), with significant reductions in mean CMT at 6 months after all DEX implants. In treatment-refractory patients, mean CMT was significantly reduced from baseline to 6 months ( p < 0.05) after all DEX-I injections, although no changes were observed in BCVA. Conclusions: DEX-I improved visual acuity and macular edema mostly in treatment-naïve patients, suggesting DEX-I may be a viable first-line treatment option in DME.

scholarly journals Surgery Outcomes of Lamellar Macular Eyes with or without Lamellar Hole-Associated Epiretinal Proliferation: A Meta-Analysis

2020 ◽  
Author(s):  
hanyue xu ◽  
Ling Qin ◽  
Yifan Zhang ◽  
Ming Zhang
Keyword(s):  
Retrospective Studies ◽  
Meta Analysis ◽  
Lamellar Macular Hole ◽  
Pooled Data ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Surgery Outcomes ◽  
The Stability ◽  
Lamellar Hole

Abstract Background: To compare the visual outcomes and rate of restored ellipsoid zone (REZ) after surgery of lamellar macular hole (LMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Method: Publications up to November 2019 that compared the outcomes of LMH patients with and without LHEP who were managed by surgery were included. Forest plots were created using a weighted summary of proportion meta-analysis. A random effects mode was used and I2 heterogeneity estimates were calculated. Sensitivity analysis was carried out to evaluate the stability of the meta-analysis. Result: Eight pertinent publications studying a total of 176 eyes without LHEP and 173 eyes with LHEP were identified. They were all retrospective studies and had a mean follow-up of at least 6 months. In all studies, the best corrected visual acuity (BCVA) had no significant differences before surgery and improved in both groups, and in two studies the post-operative BCVA had no significant differences between two groups. The rate of REZ were different among studies included. Meta-analytic pooling of the improved BCVA between with and without LHEP groups was 0.18 (95 % CI, 0.10 to 0.26; P< 0.01), and the pooled data revealed an odd ratio of 0.80 (95% CI, 0.26 to 2.44; p = 0.69) in the rate of REZ, comparing the group without LHEP and the group with LHEP. In conclusion, patients without LHEP had better postoperative BCVA than patients with LHEP. No significant difference was found in REZ among the two groups.

scholarly journals Clinical Outcome, PROM’s, Power and Structural Integrity after Arthroscopic Subscapularis Tendon Repair

2021 ◽  
Author(s):  
Milad Farkhondeh Farkhondeh Fal ◽  
Knut Schwalba ◽  
Achim Hedtmann ◽  
Jörn Kircher
Keyword(s):  
Structural Integrity ◽  
Constant Score ◽  
Tendon Repair ◽  
Scoring Systems ◽  
Lesion Size ◽  
Contralateral Side ◽  
Shoulder Function ◽  
Subscapularis Tendon ◽  
Significant Difference

Abstract PurposeThe objective of this study is to assess tendon integrity, shoulder function and subscapularis (SCP) power in comparison to the contralateral normal shoulder after arthroscopic SCP repair using the SICK stitch technique.MethodsThis study assessed 32 patients with arthroscopically repaired SCP lesions. The mean age was 63.3years. All patients were assessed with a clinical examination and ultrasound pre and postoperatively. Shoulder function was evaluated using specific clinical tests and established scoring systems. The muscular strength was measured using an Isoforce Control EVO2 device in two positions for SCP (standing and sitting).ResultsAt a mean follow up of 18 months n=30 patients showed significantly improved range of motion and clinical scores (pre, post), Constant score (39.2, 66.7), subjective shoulder test (3.5, 92.32), subjective shoulder value (46.6, 88.2) and disabilities of arm, shoulder and hand score (69.3, 34). All tendons showed full integration in ultrasound and there was no significant difference for lesion size or additional SSP lesion. In comparison to the contralateral side a good restoration of power was observed.ConclusionsAfter arthroscopic repair of the subscapularis tendon using the SICK-stich technique, patients show a good restoration of shoulder function and power accompanied by good patient satisfaction. Additionally treated lesions did not significantly affect the surgical outcome.

scholarly journals Two-year Changes in Postoperative Central Macular Thickness and Subfoveal Choroidal Thickness in Epiretinal Membrane Patients

2021 ◽  
Vol 62 (12) ◽  
pp. 1607-1616
Author(s):  
Woo Seok Choi ◽  
Jihae Park ◽  
Kyoo Won Lee ◽  
Hyun Gu Kang
Keyword(s):  
Epiretinal Membrane ◽  
Choroidal Thickness ◽  
Macular Thickness ◽  
Control Group ◽  
Central Macular Thickness ◽  
Subfoveal Choroidal Thickness ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
The Mean

Purpose: To evaluate changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) after phacovitrectomy over a 2-year period in idiopathic epiretinal membrane (ERM) patients.Methods: The records of 52 idiopathic ERM patients (52 eyes) who underwent phacovitrectomy, without recurrence of the condition over a 2-year follow-up period, were reviewed retrospectively. Changes in CMT and SFCT, as measured by optical coherence tomography, were analyzed and compared with those of a normal control group over a 2-year period.Results: The mean preoperative CMT and SFCT were 425.67 ± 84.67 and 257.56 ± 90.13 μm, respectively. Postoperative CMT was reduced significantly to 372.17 ± 45.26 μm at 1 year and 363.15 ± 47.35 μm at 2 years (p < 0.001). SFCT at 1 and 2 years postoperatively was significantly reduced to 238.85 ± 84.85 and 230.31 ± 87.95 μm, respectively (p < 0.001). In the control group, there was no significant change in CMT; however, the SFCT decreased by 11.09 ± 22.36 μm during the 2-year follow-up (p = 0.007). In contrast, in the patient group, CMT and SFCT decreased by 62.52 ± 71.45 and 27.25 ± 41.97 μm, respectively, showing a significant difference from the control group (p < 0.001 and p = 0.043, respectively). Both before surgery and at 1 year postoperatively, the thinner the CMT, the better the best-corrected visual acuity (BCVA) (p = 0.010 and p = 0.018, respectively). A better postoperative BCVA at 2 years was associated with a thinner CMT and better BCVA before surgery (p < 0.001 and p < 0.001, respectively).Conclusions: Following a phacovitrectomy procedure, ERM patients showed significant reductions in both the CMT and SFCT at the 2-year follow-up.

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