Optical Coherence Tomography, Fluorescein Angiography, and Electroretinography Features of Niacin Maculopathy: New Insight Into Pathogenesis

2019 ◽  
Vol 3 (6) ◽  
pp. 474-479
Author(s):  
Jessica G. Lee ◽  
Anu Patel ◽  
Alessandra Bertolucci ◽  
Richard B. Rosen
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Complete Resolution ◽  
Multifocal Erg ◽  
Implicit Time ◽  
Cell Dysfunction ◽  
Ocular Coherence Tomography ◽  
Cirrus Oct ◽  
Insight Into

Purpose: We describe the features of niacin maculopathy in a 61-year old man using ocular coherence tomography (OCT), fluorescein angiography, and electroretinography (ERG). Methods: A case report is presented. Results: A 61-year-old male presented with decreased visual acuity. Cirrus OCT revealed bilateral cystic macular edema, without leakage on fluorescein angiography. Dark-adapted maximal-flash ERG demonstrated an absent b-wave. Light-adapted flicker responses revealed diminished amplitude and delayed implicit time (IT). Multifocal ERG demonstrated diffusely decreased amplitudes. Two months after discontinuation of niacin, OCT demonstrated complete resolution of the macular edema. Dark-adapted maximal-flash ERG showed improvement in the b-wave. Light-adapted flicker responses improved in amplitude and decreased IT. Conclusions: To the best of the authors’ knowledge, this case is the first to demonstrate a reduced b-wave in niacin maculopathy. Discontinuation of niacin led to an improved b-wave response suggesting that niacin maculopathy is caused by niacin induced muller cell dysfunction.

Cystoid Macular Edema Secondary to Paclitaxel Therapy

2019 ◽  
Vol 2 ◽  
pp. 1 ◽  
Author(s):  
Anibal Martin Folgar ◽  
Jorge Oscar Zarate
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Metastatic Breast ◽  
Breast Adenocarcinoma ◽  
Optical Coherence ◽  
Ophthalmoscopic Examination

We present a 57-year-old referred reduced visual acuity who was in treatment with paclitaxel for developing metastatic breast adenocarcinoma. Ophthalmoscopic examination, optical coherence tomography, and autofluorescence show the cystoid macular edema, but fluorescein angiography is normal, without leakage of dye in the late times. The patient responds well 8 weeks after stopping antineoplastic. Paclitaxel can cause cystoid macular edema and lifting a recovery both anatomical and functional of the macula.

Taxane Induced Cystoid Macular Edema: Case Report and Integrated Pathogenic Theory

2019 ◽  
Vol 14 (1) ◽  
pp. 43-47 ◽  
Author(s):  
M. Kanakis ◽  
I. Georgalas ◽  
T. Makatsoris ◽  
N. Pharmakakis
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Additional Treatment ◽  
Published Data ◽  
Optical Coherence

Purpose: To report a case of a 73-year-old man who presented with decreased visual acuity due to bilateral macular edema after paclitaxel administration for prostate cancer. Methods: The ophthalmic evaluation consisted of medical and ocular history, Best Corrected Visual Acuity, slit-lamp biomicroscopy and Spectral-domain optical coherence tomography / Fluorescein Angiography. Results: Optical Coherence Tomography and Fluorescein Angiography revealed silent cystoid macular edema. After consulting with the oncologist, the cessation of paclitaxel therapy was decided. The patient presented a gradual but steady resumption of the retinal edema, with complete restoration of normal retinal morphology and function within two months. The pathogenesis of the silent Cystoid Macular Edema (CME) is still unclear. Based on our case and a critical review of the previous observations and published data, we propose that the underlying cause of Taxane induced CME is the functional failure of Aquaporin mediated water transport at the level of retinal Intermediate and Deep capillary plexuses, and at lesser extent at the level of the Retinal Pigment Epithelium. Conclusion: Taxane induced silent CME should be attributed to the action of Taxanes on the microtubule guided aquaporin vesicles transport to the cell membrane. In our case of Taxane induced silent CME, withdrawal of the taxane was enough for complete recovery, and no additional treatment was needed.

scholarly journals Evaluation of retinal vasculitis among cases of Behçet disease

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M E B Samaan ◽  
A H Saad ◽  
T H Mohammed ◽  
Y A Elzankalony
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Retinal Vasculitis ◽  
Behçet Disease ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Behcet Disease ◽  
Fundus Fluorescein Angiography

Abstract Background Behçet disease is an obliterative and necrotizing systemic vasculitis that involves different organ systems. It affects both arteries and veins, mainly the veins. Ocular affection is one of the major criteria of Behçet disease; the most common ocular presentation is bilateral non-granulomatous panuveitis with retinal vasculitis. Purpose To identify early, evaluate and follow-up properly the posterior segment involvement in Behçet disease cases with the help of Fundus fluorescein angiography and Optical coherence tomography. Patients and Methods This is a descriptive cross sectional study involved 40 eyes. All patients had a complete ophthalmological examination, a comprehensive history taking as well as review of systems and the laboratory tests. This is followed by pupillary dilatation and retinal imaging by fundus fluorescein angiography and optical coherence tomography. Results On ophthalmological examination, 35 eyes had retinal affection due to Behçet disease and 5 eyes are retina-free. The most common retinal affection was vasculitis in 29 eyes, followed by optic nerve affection in 10 eyes then less common was retinitis in 6 eyes. Regarding visual acuity (VA) 14 eyes had low visual acuity of less than (6/60), 21 eyes had VA between (6/60 – 6/12) and 5 eyes had good visual acuity of more than (6/12). Fluorescein angiograms showed that, 36 eyes representing 90% of the total eyes had abnormal angiogram; vascular leakage was the commonest abnormality in 29 eyes, less common was optic disc edema in 12 eyes, then retinitis in 6 eyes. Macular edema was present in the angiogram of 6 eyes. About OCT, there were abnormalities in 33 eyes; macular edema was the most common in 21 eyes, epiretinal membrane (ERM) in 9 eyes, then neurosensory detachment (NSD) and macular hole each was seen in 4 eyes. Conclusion This study demonstrated that posterior pole involvement, retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with worse VA in Behçet retinal vasculitis. This suggests that, use of Fundus Fluorescein Angiography and Optical Coherence Tomography in evaluation of Behçet retinal vasculitis is clinically significant in predicting visual prognosis and determining of treatment efficacy.

Diabetes und Augenerkrankungen

2020 ◽  
Vol 15 (02) ◽  
pp. 122-133
Author(s):  
Rainer Guthoff
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
General Practitioner ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Gold Standard ◽  
Laser Photocoagulation ◽  
Working Population ◽  
Fundus Fluorescein Angiography

AbstractThe frequency of diabetic retinopathy increases and is a leading cause of blindness in the working population. Recommended exams are testing of the visual acuity, ophthalmoscopy with dilated pupils, fundus fluorescein angiography and optical coherence tomography (OCT). By OCT the diagnosis and monitoring of diabetic macular edema has vastly improved. By intravitreal medications such as intravitreal anti-VEGF or intravitreal steroids macular edema can be treated successfully. Panretinal laser photocoagulation is the gold-standard in the therapy of proliferative diabetic retinopathy. Patients benefit from good co-working of general practitioner and ophthalmologist concerning screening and treatment.

Intravitreal bevacizumab in cystoid macular edema associated to maternally inherited diabetes and deafness’s macular dystrophy

2020 ◽  
pp. 112067212096903
Author(s):  
Amelia Marco-Campmany ◽  
Jana Pacheco-Cervera ◽  
Javier Navarrete-Sanchis ◽  
Juan Miguel Tomás-Torrent ◽  
Sara García-Canet ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Dystrophy ◽  
Mitochondrial Mutation ◽  
Case Presentation ◽  
Cystic Changes ◽  
Inherited Diabetes

Introduction: Maternally inherited diabetes and deafness (MIDD) is a rare and infradiagnosed cause of diabetes which can, in a high number of cases, associate a macular dystrophy. Case presentation: We report the case of a 49- year-old man affected of this syndrome, with proven m3243G>A mitochondrial mutation, who developed macular cysts 20 years after the initial presentation of his macular dystrophy. The fluorescein angiography showed no leakage, ruling out a diabetic macular edema. A treatment with intravitreal bevacizumab led to cystic changes resolution and visual acuity recovery. Conclusion: Intravitreal bevacizumab can be successfully employed for this complication of MIDD’s macular dystrophy.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

scholarly journals Predictors for 2-year functional and morphological outcomes of a treat and extend regimen with ranibizumab in patients with diabetic macular edema

2021 ◽  
Author(s):  
Helena Giannakaki-Zimmermann ◽  
Alexandra Behrndt ◽  
Laura Hoffmann ◽  
Maria-Magdalena Guichard ◽  
Cengiz Tuerksever ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Loading Dose ◽  
Treatment Frequency ◽  
Treat And Extend ◽  
Free Treatment ◽  
Younger Age ◽  
One Year ◽  
Treat And Extend Regimen

Abstract Purpose: To investigate longer-term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat and extend regimen (TER) without loading dose under ranibizumab. Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency as well as quantitative and qualitative Spectral-domain Optical Coherence Tomography parameters were assessed. Results: 118 eyes of 87 patients were included. A mean of 9.742.13 injections in the first and 7.632.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to month 12 and 24 (all p<0.001). Percentage of eyes with an intact inner-/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at month 24 (p<0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p=0.017) and after 24 months by 88.1% (p=0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r=-0.345, p<0.001) and better BCVA at one year (r=-0.347, p<0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r=0.305, p=0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p=0.046, p<0.001). Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout two years. The evaluated predictors might help to guide routine clinical treatment in DME.

scholarly journals Multimodal Imaging Findings and Treatment with Dexamethasone Implant in Three Cases of Idiopathic Macular Telangiectasia Type 1

2021 ◽  
pp. 92-97
Author(s):  
Paola Cirafici ◽  
Maria Musolino ◽  
Michela Saccheggiani ◽  
Carlo Enrico Traverso ◽  
Massimo Nicolò
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Multimodal Imaging ◽  
Diagnostic Errors ◽  
Wide Field ◽  
Vascular Changes ◽  
Macular Telangiectasia ◽  
First Choice ◽  
Idiopathic Macular Telangiectasia

This is a report of 3 patients diagnosed with idiopathic macular telangiectasia type 1 (MacTel 1) at Medical Retina Center of the University of Eye Clinic of Genova and then prospectically followed for a mean time of 26 months between 2016 and 2019. It is the first report of patients affected by MacTel 1 treated with dexamethasone (DEX) implant as a first choice of treatment. Aim of our study is to better characterize the disease using a multimodal wide-field imaging and to determine efficacy of DEX implant on MacTel 1 in terms of central macular thickness (CMT) and best-corrected visual acuity (BCVA). MacTel 1 is a rare unilateral disease, characterized by telangiectatic retinal capillaries, cystoid macular edema, and lipid deposition occurring temporal to the fovea. Patients underwent a comprehensive ophthalmic examination, BCVA, swept-source optical coherence tomography (SS-OCT), SS-OCT angiography (SS-OCTA), ultra-widefield (UWF) color, and fluorescein angiography (FA) fundus photograph. All the patients presented monolateral reduced BCVA and macular edema with increased CMT evaluated by SS-OCT. With SS-OCTA, we showed that the telangiectasia-associated vascular changes originate in the deep retinal vascular plexus and as a consequence macular edema and exudation develop causing vision loss. Furthermore, UWF imaging helped us to highlight vascular changes typical of Coats Disease at the far retinal periphery. All the patients were treated with DEX intravitreal implant, showing a decrease in CMT and a stabilization of visual acuity. Due to the recurrent nature of macular edema, patients underwent a mean of 4 DEX implants during the follow-up period. In order to address the clinical features of this uncommon disease avoiding diagnostic errors, it might be important to use a multimodal imaging approach. The anatomical and functional beneficial effects of DEX implant were well evident although transient.

scholarly journals Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

2021 ◽  
Vol 13 ◽  
pp. 251584142110277
Author(s):  
Zahra Ashena ◽  
Thomas Hickman-Casey ◽  
Mayank A. Nanavaty
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Descemet Membrane ◽  
Ocular Coherence Tomography ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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