scholarly journals Photodynamic therapy of subfoveal choroidal neovascularization

2007 ◽  
Vol 135 (11-12) ◽  
pp. 629-634
Author(s):  
Ana Georgijevic ◽  
Zoran Tomic
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Blood Vessels ◽  
Choroidal Neovascularization ◽  
Retinal Pigment ◽  
Photochemical Reactions ◽  
Pathologic Myopia ◽  
Target Tissue ◽  
Choroidal Hemangioma

Introduction Photodynamic therapy (PDT) is a method of treatment of choroidal neovascularization (CNV) with a diode laser used after intravenously administered verteporfin. Verteporfin is a light-activated drug initiating photochemical reactions in the target tissue. This leads to the selective occlusion of blood vessels in the CNV with no damage of photoreceptors, retinal pigment epithelium and retinal blood vessels. Objective To show the results of the treatment of predominantly classic subfoveal CNV with PDT with verteporfin used for the first time in our country. Method From 2003 to 2005, we treated 15 eyes in 15 patients using PDT and verteporfin, because of predominantly classic subfoveal CNV. If macular oedema was present as proved by fluorescein angiography, triamcinolone was administered intravitreally after PDT. Average follow-up period was 7 months (3 months to 2 years). Study design: retrospective, noncomparative, consecutive case series. Results Two thirds of patients had CNV due to AMD, while in others it was caused by pathologic myopia, chorioretinitis, angioid streaks, choroidal hemangioma, except for one patient who had idiopathic CNV. Visual acuity was stabile in 60% (9/15) of patients, of whom in 60% (6/10) of patients with AMD, as well as in patients with pathologic myopia, idiopathic CNV and choroidal hemangioma. Retreatment with PDT was indicated in 40% (6/15) and in 50% (5/10) of patients with AMD, mostly 4-6 months after first PDT, but was done only in one patient (economic reasons). In two patients with AMD, triamcinolone was administered intravitreally for 2-4 months, which resulted in the stabilization of visual acuity. Conclusion Visual acuity was stabile in 60% of all treated patients with predominantly classic subfoveal CNV after only one application of PDT with verteporfin during the average follow-up of 7 months (3 months to 2 years). Retreatment was indicated in 40% of the treated patients, and in 50% of patients with AMD. As confirmed, intravitreal administration of triamcinolone after PDT could stabilize visual acuity. Side effects were not noticed.

Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab

2018 ◽  
Vol 29 (2) ◽  
pp. 239-243
Author(s):  
Gilda Cennamo ◽  
Francesca Amoroso ◽  
Stefano Schiemer ◽  
Nunzio Velotti ◽  
Mariacristina Alfieri ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. Methods: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. Results: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = –2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = –1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = –3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). Conclusion: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.

scholarly journals Combined Hamartoma of the Retina and Retinal Pigment Epithelium in a Patient with Gorlin Syndrome: Spontaneous Partial Resolution of Traction Caused by Epiretinal Membrane

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
José L. Sánchez-Vicente ◽  
Miguel Contreras-Díaz ◽  
Trinidad Rueda ◽  
Enrique Rodríguez de la Rúa-Franch ◽  
Fredy E. Molina-Socola ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Epiretinal Membrane ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Spontaneous Resolution ◽  
Fundus Examination ◽  
Gorlin Syndrome ◽  
Clinical Context

Purpose. To describe the case of spontaneous resolution of epiretinal membrane in a patient with Combined Hamartoma of the Retina and Retinal Pigment Epithelium (CHR-RPE), in the clinical context of Gorlin Syndrome (GS).Methods. Observational case report of a 12-year-old female patient is presented. The diagnosis of CHRRPE was made by OCT and fundus examination, which showed a mound of disorganized tissue originating from retina and retinal pigment epithelium. Epiretinal membrane (EM) was also detected. Genetic study was performed to confirm the diagnosis of GS.Results. The patient was observed for 39 months, showing spontaneous resolution of the traction caused by the EM and improvement in visual acuity (VA), which was 20/80 at initial presentation, rising to 20/40 after follow-up period.Conclusions. The presence of EM in CHR-REP is a cause of reduction of visual acuity. Management of this condition is controversial; however, we would like to highlight that spontaneous resolution of the traction caused by EM is possible, resulting in recovery of VA.

scholarly journals Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy

2015 ◽  
Vol 6 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Bettina Hohberger ◽  
Michael Rudolph ◽  
Antonio Bergua
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Combined Therapy ◽  
Retinal Pigment ◽  
Posterior Pole ◽  
Prednisolone Acetate ◽  
Eye Drops ◽  
Punctate Inner Choroidopathy ◽  
Anti Vegf ◽  
Systemic Medication

Purpose: Choroidal neovascularization (CNV) associated with punctate inner choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported. Case Report: A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yielded hyperfluorescent signals in the affected areas with a diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial layer, consistent with the diagnosis of PIC. Additionally a classic CNV was observed. Results: Anti-inflammatory therapy with local prednisolone acetate eye drops in combination with intravitreal injection of anti-vascular endothelial growth factor (VEGF, bevacizumab) yielded an increased best-corrected visual acuity. As CNV reappeared, systemic medication with prednisone and azathioprine in combination with two further intravitreal injections of anti-VEGF stabilized CNV and increased visual acuity again. Conclusion: Combined therapy of immunosuppression with intravitreal anti-VEGF injections can be considered as therapeutic strategy in the management of recurrent CNV associated with PIC.

scholarly journals Polypoidal choroidal vasculopathy in pachychoroid: combined treatment with photodynamic therapy and Aflibercept

2021 ◽  
Author(s):  
Maria Vadalà ◽  
Massimo Castellucci ◽  
Giulia Guarrasi ◽  
Giovanni Cillino ◽  
Vincenza Maria Elena Bonfiglio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Subretinal Fluid ◽  
Clinical Activity ◽  
Monthly Basis ◽  
Choroidal Vasculopathy

Abstract Introduction To evaluate the effects of combined therapy using intravitreal Aflibercept (IVA) and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy related to pachychoroid disease (PPCV).Methods Patients with PPCV were treated with PDT combined with 3 IVA injections on a monthly basis, followed by pro re nata criteria. The 12-month follow-up consisted of multiple revaluations of visual acuity and SSOCT parameters of clinical activity.Results Nineteen eyes were included in the study; mean age was 65.5 years. Visual acuity improved after 12 months (0.35 ± 0.25 to 0.2 ± 0.20 logMAR, p = 0.005). Percentage of eyes with intraretinal and subretinal fluid reduced from baseline to the 12-month follow-up (from 52.6–10.5%, p = 0.12, and from 89.5–5.3% p = 0.0009, respectively). Central retinal and mean macular thicknesses reduced (258 ± 39.6 to 204.8 ± 38.8 µm p = 0.04 and 293.8 ± 32.1 to 248.1 ± 29.6 µm p = 0.017 respectively). Central choroidal and mean choroidal thicknesses also displayed a reduction (328.6 ± 54.9 to 289.8 ± 44.6 µm p = 0.001 and 314.5 ± 55.3 to 287.9 ± 47.6 µm p = 0.015 respectively). The mean number of injections was 4.6/year.Conclusion The results support the use of a combined therapy with Aflibercept and PDT in PPCV. This treatment would act in synergy, with anti-VEGF controlling exudation and PDT closing the aneurysmal vessel and reducing choroidal congestion.

Surgical management of a case of contractile peripapillary staphyloma with retinal detachment and macular hole

2020 ◽  
pp. 112067212092022
Author(s):  
Sofía H Vidal ◽  
Diego Bueso Ponce ◽  
Juan Esteban Unigarro ◽  
Sergio Arrascue Limo ◽  
Carlos Abdala Caballero
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
Retinal Pigment ◽  
Silicon Oil ◽  
Corrected Visual Acuity ◽  
Intraocular Gas ◽  
Best Corrected Visual Acuity ◽  
Peripapillary Staphyloma

A healthy 4-year-old male presented a fundus examination with a unilateral contractile peripapillary staphyloma surrounded by redundant retina and retinal pigment epithelium atrophy. Five years later, best-corrected visual acuity decreased to hand motion due to a retinal detachment with macular hole. One month after first vitrectomy, scleral buckle and intraocular gas, retina re-detached. Second surgery was performed with silicon oil tamponade and lensectomy without intraocular lens (IOL). Subretinal silicon oil was detected at the third month of follow-up when vitrectomy, inferior retinectomy, and laser photocoagulation of temporal border of staphyloma with silicon oil tamponade were performed. The retina remained attached and best-corrected visual acuity was 20/600 with intraocular silicon oil. A fourth surgery was performed for emulsified silicon oil extraction replaced with intraocular gas. At 6 months of follow-up, the retina re-detached again. This is a challenging vitreoretinal surgery in which re-detachments were due to retinal folds around the contractile staphyloma that raised macular hole. This is the first report of the combined presentation of contractile peripapillary staphyloma, retinal detachment and macular hole with a long-time follow-up period of years.

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