Vitelliform changes in the central retina occurring in adults

Introduction. Vitelliform lesions of the central retinal area in adult patients represent a heterogeneous group of diseases. This article describes different variants of vitelliform changes in adults, based on the published literature data. Materials and methods. We have analyzed and described different variants of vitelliform changes in adults, based on literature data, examples from own clinical practice using multimodal approach are included. Discussion. Vitelliform lesions of the central retinal area are can debut at various ages, occurring in mono- or multifocal way, have various stages of degradation of vitelliform material, masquerading as other lesions of the macular area and of the posterior pole. Many of these diseases appear due to mutations in determined genes, though, a fairly large proportion of cases is considered to be sporadic. Nowadays, characteristic signs of different diseases with the vitelliform material are described. But differential diagnosis with other similar diseases (some age-related macular degeneration forms and those of central serous chorioretinopathy) is fairly difficult and requires a multimodal ophthalmologic approach, and in some cases genetic studies. Conclusions. Vitelliform lesions of the central retinal area, occurring in adult patients are a group of diseases that are difficult to diagnose and masquerade themselves as other diseases of the central retina, which requires certain doctors knowledge and ability to carry out a multimodal imaging and prescribe the appropriate treatment if needed.

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Study of Brolucizumab in Adult Patients With Suboptimal Anatomically Controlled Neovascular Age-related Macular Degeneration

Case Medical Research ◽

10.31525/ct1-nct04264819 ◽

2020 ◽

Author(s):

Keyword(s):

Macular Degeneration ◽

Adult Patients ◽

Age Related Macular Degeneration ◽

Age Related

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Longitudinal choriocapillaris changes in the presence of reticular pseudodrusen

Scientific Reports ◽

10.1038/s41598-021-97771-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Christoph R. Clemens ◽

Jost L. Lauermann ◽

Boris Schmitz ◽

Nicole Eter ◽

Florian Alten

Keyword(s):

Signal Intensity ◽

Multimodal Imaging ◽

Optical Coherence Tomography Angiography ◽

Age Related Macular Degeneration ◽

Significant Group ◽

Mean Intensity ◽

Reticular Pseudodrusen ◽

Time Interaction ◽

Age Related

AbstractTo determine longitudinal changes in choriocapillaris (CC) measures in eyes with reticular pseudodrusen (RPD) using optical coherence tomography angiography (OCTA). In this observational prospective study, 20 patients with exclusively RPD and no other alteration due to age-related macular degeneration were included. Eight RPD patients were re-examined at 5-year follow-up. Multimodal imaging was performed at baseline and at 5-year follow-up. OCTA CC images were analyzed for number, size and total area of flow deficits (FD), mean signal intensity, signal intensity standard deviation and kurtosis of signal intensity distribution in the ring area between a circle of 4 mm diameter and a circle of 6 mm diameter and in the superior ring quadrant. Area affected by RPD increased from 19.36 ± 8.39 mm2 at baseline to 37.77 ± 9.03 mm2 at 5-year follow-up. At baseline, percent of CC FD area was greater in RPD eyes (quadrant: p < 0.001; ring: p < 0.001) compared to controls. Besides, RPD eyes revealed a lower mean intensity signal (quadrant: p < 0.001; ring: p < 0.001). Evaluation of CC parameters suggested significant group × time interaction effects for CC FD (p = 0.04) and mean intensity signal (p = 0.004), in that RPD eyes presented increased CC FD and decreased mean intensity signal at follow-up. OCTA CC decorrelation signal further decreases in RPD patients over 5 years in both RPD-affected and RPD-unaffected macular areas.

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Macular Evaluation wıth Spectral Domain Type Optic Coherence Tomography in Eyes with Acute Nonarteritic Ischemic Optic Neuropathy at the Presentation Visit

The Open Ophthalmology Journal ◽

10.2174/1874364101711010017 ◽

2017 ◽

Vol 11 (1) ◽

pp. 17-23

Author(s):

Oya Donmez ◽

Gamze Kocaoglu ◽

Aylin Yaman ◽

Meltem Soylev Bajin ◽

Ali Osman Saatci

Keyword(s):

Subretinal Fluid ◽

Posterior Pole ◽

Age Related Macular Degeneration ◽

Spectral Domain ◽

Ischemic Optic Neuropathy ◽

Optic Coherence Tomography ◽

Vitreomacular Adhesion ◽

Domain Type ◽

Age Related ◽

Fellow Eyes

Purpose: To evaluate the macula with spectral domain type optic coherence tomography (OCT) in eyes with acute nonarteritic anterior ischemic optic neuropathy (NAION) at the presentation visit. Methods: Medical charts of the 133 patients who received the diagnosis of acute NAION between January 2008 and July 2014 at the Neuro-ophthalmology unit of Dokuz Eylul University were reviewed retrospectively. Sixtythree patients within 30 days of symptom onset with available baseline spectral domain type macular OCT were included in this study. Clinical and macular characteristics of the affected eye were assessed and compared to the fellow eyes. Results: Sixty-three eyes of 63 patients comprised the study group. Twenty one study eyes (33.3%) had normal posterior pole, 22 (34.9%) some evidence of subretinal fluid, 10 (15.8%) vitreomacular adhesion, five (7%) age-related macular degeneration related changes, four (6%) epiretinal membrane and one (1%) previous grid laser scars. On the other hand, 41 of 63 the fellow eyes (65%) had normal posterior pole, ten (15.8%), vitreomacular adhesion, seven (10.7%), age-related macular degeneration related changes, three (4%) epiretinal membrane and two (3%) other type of changes. OCT scan passing through the fovea exhibited 10 or more hyperreflective dots in 10 (15%) of the study eyes whereas two of the fellow eyes (3.2%) had 10 or more hyperreflective dots. Conclusion: Macular OCT can be a part of the routine neuroophthalmologic examination in patients with acute NAION not only to show the NAION related changes such as the subretinal fluid accumulation but also to identify the other coexistent macular abnormalities.

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Common age-related eye diseases and visual impairment

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0151 ◽

2017 ◽

pp. 1165-1170

Author(s):

Jacqueline Chua ◽

Ching-Yu Cheng ◽

Tien Yin Wong

Keyword(s):

Diabetic Retinopathy ◽

Visual Impairment ◽

Macular Degeneration ◽

Refractive Error ◽

Vision Loss ◽

Age Related Macular Degeneration ◽

Age Related ◽

Eye Disorders ◽

Appropriate Treatment ◽

Uncorrected Refractive Error

General physicians have an essential role in preventing vision loss in older people. However, most vision-threatening eye disorders are initially asymptomatic and often go underdiagnosed. Therefore screening, early detection, and timely intervention are important in their management. The most common cause of visual impairment is uncorrected or undercorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. Spectacles and cataract surgery can successfully restore sight for uncorrected refractive error and cataract, respectively. Visual impairment as a result of age-related macular degeneration, glaucoma, and diabetic retinopathy can be prevented with appropriate treatment if they are identified early enough. This chapter provides an overview of common age-related eye disease and visual impairment.

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Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

BMC Ophthalmology ◽

10.1186/s12886-019-1244-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Jingyuan Yang ◽

Mingzhen Yuan ◽

Erqian Wang ◽

Song Xia ◽

Youxin Chen

Keyword(s):

Polypoidal Choroidal Vasculopathy ◽

Multimodal Imaging ◽

High Sensitivity ◽

Age Related Macular Degeneration ◽

Fundus Photography ◽

Diagnostic Strategy ◽

Imaging Features ◽

Imaging Methods ◽

Age Related ◽

Choroidal Vasculopathy

Abstract Purpose To investigate the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing PCV from typical neovascular age-related macular degeneration (nvAMD). Methods Retrospective study. Imaging features of noninvasive multimodal imaging methods, including fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence, of 103 eyes with PCV or typical nvAMD were reviewed. Diagnostic strategy was established based on imaging features and was validated in other 105 eyes with PCV or typical nvAMD. Results Features of subretinal orange nodule on FP, thumb-like PED on OCT, notched PED on OCT, bubble sign on OCT, and Bruch’s membrane depression under serosanguinous PED on OCT were more common. When the diagnostic strategy of using at least 2 of 5 features was performed, there is 0.88 sensitivity and 0.92 specificity for diagnosing PCV. The results of the validation test further confirmed the diagnostic strategy with 0.94 sensitivity and 0.93 specificity. Conclusions Noninvasive multimodal imaging, especially FP and B-scan OCT, provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical nvAMD, when at least 2 of 5 suggestive imaging features are present.

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A Multimodal Imaging Guide to the Evaluation and Management of Neovascular Age-Related Macular Degeneration

ESASO Course Series - Medical Retina ◽

10.1159/000471825 ◽

2017 ◽

pp. 14-31

Author(s):

Sean T. Garrity ◽

K. Bailey Freund ◽

David Sarraf

Keyword(s):

Macular Degeneration ◽

Multimodal Imaging ◽

Age Related Macular Degeneration ◽

Age Related

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Choroidal neovascular membranes secondary to intraocular tuberculosis misdiagnosed as neovascular age-related macular degeneration

European Journal of Ophthalmology ◽

10.5301/ejo.5001047 ◽

2017 ◽

Vol 28 (2) ◽

pp. 216-224 ◽

Cited By ~ 3

Author(s):

Alessandro Invernizzi ◽

Aniruddha Agarwal ◽

Maura Di Nicola ◽

Fabio Franzetti ◽

Giovanni Staurenghi ◽

...

Keyword(s):

Macular Degeneration ◽

Choroidal Neovascularization ◽

Multimodal Imaging ◽

Age Related Macular Degeneration ◽

Enhanced Depth Imaging ◽

Fundus Photography ◽

Imaging Features ◽

Neovascular Amd ◽

Age Related ◽

Intraocular Tuberculosis

Purpose: Intraocular tuberculosis (IOTB) can be complicated by choroidal neovascularization (CNV). However, when the CNV development is not accompanied by clear signs of inflammation, the etiology can be missed, especially in countries nonendemic for tuberculosis. We describe the clinical and imaging features of CNVs presenting as the first sign of IOTB initially misdiagnosed as exudative age-related macular degeneration (AMD). Methods: A retrospective review of clinical and imaging data of patients initially misdiagnosed with neovascular AMD later diagnosed with inflammatory CNV secondary to IOTB at tertiary referral centers was conducted. Features of fundus photography, fluorescein angiography, indocyanine green angiography, and enhanced depth imaging optical coherence tomography were analyzed. Distinguishing features between neovascular AMD and IOTB-associated CNV were evaluated. Results: Five patients over 55 years of age, erroneously diagnosed with exudative AMD, were included in the study. Multimodal imaging analysis allowed identification of peculiar choroidal alterations such as choroidal granulomas or choroiditis suggestive for posterior uveitis. Systemic workup for granulomatous uveitis including immunologic investigations such as tuberculin skin test or QuantiFERON TB Gold® and radiologic investigations revealed tubercular etiology in all the cases, allowing correct diagnosis and management of the uveitis and related CNV. Conclusions: Choroidal neovascularization represents a rare and unusual presenting sign of IOTB that can be misleading especially when it occurs in the elderly living in countries with low prevalence of the disease. Multimodal imaging can be helpful and should be employed, especially in atypical cases of CNV, in order to avoid misdiagnosis and/or diagnostic delays.

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