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Choroidal neovascular membrane

Keiichi Nishikawa, Akio Oishi, Masayuki Hata, Masahiro Miyake, Sotaro Ooto, Kenji Yamashiro, Manabu Miyata, Hiroshi Tamura, Naoko Ueda-Arakawa, Ayako Takahashi, Yu Kawashima, Akitaka Tsujikawa
Intravitreal injections of anti-vascular endothelial growth factor agents such as ranibizumab and aflibercept are the first-line treatment for neovascular age-related macular degeneration (AMD). However, data about long-term outcome in real-world clinical practice is scarce. We recruited 98 AMD patients and investigated four-year visual outcome. During the four years, 25 patients dropped out. The survivors received 7.0 ± 0.1 injections during the first year and 8.0 ± 7.4 injections in the following three years...
March 6, 2019: Scientific Reports
Mohit Dogra, Simar Rajan Singh, Faisal Thattaruthody
BACKGROUND: Klebsiella endogenous endophthalmitis (EE) is commonly seen in patients with hepato-biliary disease and urinary tract infections. Subretinal abscess with vitreous cells is the usual presentation and requires intensive treatment with systemic and intravitreal antibiotics along with prompt vitrectomy. Subretinal hemorrhage surrounding a choroidal mass has not been reported as the presenting feature of endogenous bacterial endophthalmitis. METHODS: We report a patient with chronic liver disease who developed Klebsiella pneumoniae EE secondary to urinary tract infection that mimicked a choroidal neovascular membrane (CNVM) with subretinal bleed...
February 26, 2019: Ocular Immunology and Inflammation
Saurabh Mistry, Parthopratim Dutta Majumder, Jyotirmay Biswas
Choroidal tuberculoma is a solitary elevated choroidal mass-like lesion regarded often characteristic of intraocular tuberculosis. Serial swept-source optical coherence tomography (SS-OCT) is a very important tool in monitoring the course of choroidal tuberculoma and allows in early detection of complications such as choroidal neovascular membrane (CNVM). We describe a 26-year-old young Indian female, who presented with a solitary choroidal mass lesion in the left eye. Based on positive Mantoux test, biopsy of cervical lymph nodes showing acid-fast bacilli and radiographic findings, a diagnosis of choroidal tuberculoma was made...
January 2019: Oman Journal of Ophthalmology
Parthopratim Dutta Majumder, Jyotirmay Biswas, Amod Gupta
Serpiginous choroiditis (SC) is an asymmetrically bilateral inflammation of the choroid that leads to loss of choriocapillaris atrophy or loss of overlying retinal pigment epithelium. Over the last few decades, SC has passed through a long evolution of nomenclature, etiologies and morphological variations. Initially diagnosed in patients with tuberculosis and syphilis, SC was predominantly considered as autoimmune process. With the advancement of molecular diagnosis, a new aspect of infectious subtypes of SC has emerged out...
March 2019: Indian Journal of Ophthalmology
Massimo Lorusso, Luisa Micelli Ferrari, Eleni Nikolopoulou, Tommaso Micelli Ferrari
Purpose: To describe a case of a 25-year-old man with choroidal neovascularization (CNV) secondary to traumatic choroidal rupture treated with intravitreal bevacizumab and to evaluate the vascular structure of the area near the traumatic choroidal rupture. Methods: The patient underwent complete ophthalmologic evaluation, including best-corrected visual acuity (BCVA), intraocular pressure, anterior segment and funds examination, and optical coherence tomography angiography (OCTA) at baseline and on each follow-up visit...
2019: Case Reports in Ophthalmological Medicine
Dilraj S Grewal, Steve Charles, Barbara Parolini, Kazuaki Kadonosono, Tamer H Mahmoud
PURPOSE: To report the structural and functional outcomes of the autologous neurosensory retinal transplant for closure of refractory large macular holes. DESIGN: Multicenter retrospective consecutive case series PARTICIPANTS: Forty-one eyes of 41 patients (27 female and 14 male) with a full thickness macular hole refractory to prior vitrectomy with internal limiting membrane peel and tamponade. METHODS: All patients underwent pars-plana vitrectomy, autologous neurosensory retinal transplant with either gas, silicone oil tamponade, or short-term Perfluoro-n-octane heavy-liquid tamponade...
January 31, 2019: Ophthalmology
Yuxin Fang, Ran Du, Natsuko Nagaoka, Tae Yokoi, Kosei Shinohara, Xian Xu, Hiroyuki Takahashi, Yuka Onishi, Takeshi Yoshida, Kyoko Ohno-Matsui
PURPOSE: To analyze the choroidal thickness (CT) of each type of myopic maculopathy, and to establish an OCT-based classification of myopic maculopathy. DESIGN: Retrospective, hospital-based, cross-sectional study. PARTICIPANTS: Highly myopic (HM) eyes that were examined by swept-source OCT. METHODS: The CT was measured at the subfovea and at 3 mm nasal, temporal, superior, and inferior to the fovea. Myopic maculopathy was classified as tessellation, diffuse atrophy, patchy atrophy, and macular atrophy (MA) based on the fundus photographs...
January 28, 2019: Ophthalmology
Hibba Quhill, Stephen Stewart, Ian G Rennie
A 75-year-old man presented with deterioration of right eye vision for 6 months. He had no relevant medical history. Fundus examination revealed subretinal fluid, fibrosis, and subretinal hemorrhages. Ocular coherence tomography of the right macula illustrated an underlying subretinal lesion with internal lamellae, resembling trabecular bone elsewhere in the body. Bruch's membrane was clearly intact beneath the lesion, indicating an extrachoroidal location. The lesion appeared highly reflective on B-scan ultrasonography, consistent with ossification...
February 2019: Indian Journal of Ophthalmology
Atsuro Uchida, Deepa Manjunath, Rishi P Singh, Aleksandra V Rachitskaya, Peter K Kaiser, Sunil K Srivastava, Jamie L Reese, Justis P Ehlers
Objective: To evaluate the use of optical coherence tomography angiography (OCTA) to detect choroidal neovascularization (CNV) in eyes with indeterminate CNV features on conventional imaging. Design: The AVATAR study is a prospective observational study of OCTA in patients undergoing routine spectral-domain optical coherence tomography (SD-OCT) for macular disease. Participants: Subjects enrolled in the AVATAR study for which CNV was considered as part of a differential diagnosis based on clinical exam and/or prior imaging, but in whom the presence of CNV was not definitive on SD-OCT and fluorescein angiography (FA) imaging...
November 2018: Ophthalmology Retina
Peter H Tang, Ryan Shields, Ruwan A Silva
BACKGROUND AND OBJECTIVES: To report the acute and long-term choroidal findings in patients with chronic central serous chorioretinopathy (CCSC) undergoing half-fluence photodynamic therapy (PDT). PATIENTS AND METHODS: This is a prospective, consecutive, interventional, noncomparative case series at a tertiary referral vitreoretinal practice. Twenty-one eyes from 21 patients are included. RESULTS: Among 21 eyes, all had improved vision following PDT during a mean of 5...
January 1, 2019: Ophthalmic Surgery, Lasers & Imaging Retina
Barbara Parolini, Attilio Di Salvatore, Sajish Joseph Pinackatt, Andrea Baldi, Gianluca Besozzi, Alessandro Finzi, Daniele Cardillo, Ahmed B Sallam, Rino Frisina
PURPOSE: To evaluate the long-term results of autologous retinal pigment epithelium (RPE) and choroid transplantation (RPE-choroid patch) for exudative and atrophic maculopathies. METHODS: Consecutive chart review of 120 eyes, which underwent RPE-choroid patch, from 2007 to 2017 for RPE atrophy or choroidal neovascular membrane secondary to exudative and hemorrhagic age-related macular degeneration, myopia, angioid streaks, and laser. Eyes were tested with best-corrected visual acuity (BCVA), reading ability, optical coherence tomography, fluorescein angiography and indocyanine green angiography, autofluorescence, and microperimetry...
December 31, 2018: Retina
Stephen H Tsang, Tarun Sharma
Pseudoxanthoma elasticum (PXE) is an autosomal recessive multisystem disorder that involves the skin, GI tract, and heart, as well as the eye. It affects approximately 1 in 50,000 people worldwide and is seen twice as frequently in females as in males. Fundus findings include angioid streaks (Fig. 38.1), reticular macular dystrophy, speckled appearance temporal to the macula (peau d'orange, like the dimpled texture of an orange peel), drusen of the optic nerve, and vitelliform-like deposits. Peau d'orange may precede the development of an angioid streak...
2018: Advances in Experimental Medicine and Biology
Stephen H Tsang, Tarun Sharma
This dominantly inherited disease begins with fine, pale, drusen-like deposits or confluent faint yellow material or sheets beneath the retinal pigment epithelium (RPE), but it eventually progresses to either geographic atrophy with pigmentary clumps or scar due to choroidal neovascular membrane (at about 40 years of age) (Figs. 20.1, 20.2 and 20.3). The patient usually becomes symptomatic, with loss of central vision (about 20/200 or less), in the fourth to sixth decade of life. When neovascular membrane develops, it mimics age-related macular degeneration (AMD), but the age of onset is much earlier...
2018: Advances in Experimental Medicine and Biology
Stephen H Tsang, Tarun Sharma
In these conditions, drusen are present in childhood, but patients are asymptomatic, with good vision, until their 40s or 50s. Drusen are seen at the macula, around the edge of the optic nerve and/or nasal to the disc, in a radiating pattern (in particular, temporal to macula, as in Figs. 18.1, 18.2, 18.3, 18.4 and 18.5). The periphery is usually spared. Drusen increase in size and number with age. Peripapillary drusen are a characteristic finding. Visual loss later in life is due to pigment hyperplasia, geographic atrophy, and choroidal neovascular membrane (Figs...
2018: Advances in Experimental Medicine and Biology
Xiujuan Zhao, Xiaoyan Ding, Cancan Lyu, Songshan Li, Bingqian Liu, Tao Li, Limei Sun, Aiyuan Zhang, Jinge Lu, Xiaoling Liang, Chenjin Jin, Lin Lu
PURPOSE: To investigate the morphological feature, visual acuity, and prevalence of macular complications in highly myopic eyes with different categories of myopic maculopathy (MM) according to the META-PM classification system. METHODS: The clinical records of 1,132 consecutive patients (1,841 eyes) with high myopia (refractive error ≤ -6D and axial length ≥26.5 mm), who visited the High Myopia Clinic at the Zhongshan Ophthalmic Center from January 2014 to July 2017, were reviewed...
December 18, 2018: Retina
Ramesh Venkatesh, Bharathi Bavaharan, Naresh Kumar Yadav, Kumar Saurabh, Priya Srinivasan, Padmalini Mahendradas, Vishma Prabhu, Rupak Roy
Background: To describe the multicolour (MC) imaging characteristics associated with choroidal osteomas (CO) and their secondary complications. Methods: Retrospective descriptive case series of eleven eyes of ten patients with CO. Findings of multicolour imaging were correlated with visual acuity, clinical features, lesion characteristics and findings from other imaging modalities. Results: Infrared reflectance (IR) images showed calcified CO lesions as hyporeflectance (dark) areas while decalcified lesions were seen as iso reflectance (normal) areas...
2018: International Journal of Retina and Vitreous
Serena Fragiotta, Talia R Kaden, K Bailey Freund
Background: Aneurysmal type 1 neovascularization (AT1) is a term recently introduced to better describe the aneurysmal dilatation that may arise from neovascular lesions, more commonly known as polypoidal choroidal vasculopathy. The proposed term, AT1, includes an expanded clinical spectrum of aneurysmal (polypoidal) lesions observed in both different ethnicities and associated with varied clinical phenotypes. Case presentation: A 61-year-old woman of European descent was referred for a new, asymptomatic retinal hemorrhage found on routine examination...
2018: International Journal of Retina and Vitreous
Kai Wang, Haoran Li, Ruipu Sun, Chaxian Liu, Yunfei Luo, Shuhua Fu, Ying Ying
Age-related macular degeneration (AMD) is one of the major causes of irreversible blindness among aging populations in developed countries and can be classified as dry or wet according to its progression. Wet AMD, which is characterized by angiogenesis on the choroidal membrane, is uncommonly seen but more severe. Controlling or completely inhibiting the factors that contribute to the progression of events that lead to angiogenesis may be an effective strategy for treating wet AMD. Emerging evidence has shown that transforming growth factor-β (TGF-β) signaling plays a significant role in the progression of wet AMD...
November 29, 2018: Acta Biochimica et Biophysica Sinica
Rajan Gupta, Rajeev R Pappuru, Vivek P Dave, Jay Chhablani
Combined hamartoma of retina and retinal pigment epithelium (CHRRPE) has been considered as a congenital benign entity with evidence of choroidal neovascularization membranes (CNVM) being associated with it in literature. This case series gives insight into the pathogenesis and the predisposing factors leading to CNVM formation in peripapillary CHRRPE using swept-source optical coherence tomography. In addition, lack of typical markers of CNVM (subretinal fluid/pigment epithelial detachment) in CHRRPE highlights the utility of optical coherence tomography angiography and the subtle optical coherence tomography findings such as "Bridge Sign" that could be instrumental in early diagnosis of CNVM in CHRRPE...
December 2018: Indian Journal of Ophthalmology
Manish Nagpal, Jayesh Khandelwal, Rakesh Juneja, Navneet Mehrotra
Purpose: To evaluate and correlate the functional treatment response using microperimetry (MP3) with the morphological findings on optical coherence tomography angiography (OCTA) in wet AMD pre- and post-treatment with anti-vascular endothelial growth factor (VEGF). This was a single-centre prospective, interventional study. Methods: Patients with wet AMD were treated with 3 injections of intravitreal anti-VEGF at monthly intervals for 3 months and followed at 1, 2, 3, and 6 months postinjection...
December 2018: Indian Journal of Ophthalmology
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