-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV). METHODS: We retrospectively reviewed 57 treatment-naïve eyes of 57 patients. Thirty-two patients were treated with standard fluence PDT (PDT group), and 25 patients were treated with three consecutive monthly intravitreal injections of ranibizumab and standard fluence PDT (ranibizumab plus PDT group). All patients were followed for at least 24 months. RESULTS: In the ranibizumab plus PDT group, the mean best-corrected visual acuity (BCVA) levels of decimal (logMAR equivalent) significantly improved from 0.30 (0.52) at baseline to 0.55 (0.26) at 24 months (P < 0.001). In the PDT group, the BCVA levels stabilized from 0.26 (0.58) at baseline to 0.25 (0.60) at 24 months. The mean changes in the BCVA in the ranibizumab plus PDT group and the PDT group were improvement of 2.63 lines and decline of 0.16 lines respectively (P = 0.010). The mean number of PDTs at 24 months in the ranibizumab plus PDT group and the PDT group were 1.4 and 2.6 respectively. Increased subretinal hemorrhages were seen in eight (18.0 %) eyes, all of which were belonging to the PDT group. CONCLUSIONS: Combined intravitreal ranibizumab and PDT was significantly more effective in maintaining and improving VA for PCV patients compared with PDT monotherapy over 24 months.
Albrecht von Graæes Archiv für Ophthalmologie 04/2013; · 2.17 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE: To evaluate changes in choroidal thickness adjacent to the area of laser application after photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV) using enhanced depth imaging spectral-domain optical coherence tomography. METHODS: Masked observers measured the choroidal thickness at the subfovea and superior, inferior and temporal areas adjacent to the area of laser application before, 2 days, 1 week and 1 and 3 months after treatment. RESULTS: Thirty-seven patients with PCV treated with PDT with verteporfin were included. The mean subfoveal choroidal thickness decreased significantly (P < 0.001) from 256 ± 115 μm at baseline to 207 ± 111 μm at 3 months; the mean outside choroidal thickness including the superior, inferior and temporal areas decreased significantly (P < 0.001) from 240 ± 92 μm at baseline to 209 ± 86 μm at 3 months. CONCLUSION: PDT affected not only the subfoveal choroid, but also the choroid outside the area of laser application in PCV.
Japanese Journal of Ophthalmology 02/2013; · 0.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: : To clarify the nature of submacular choroidal neovascularization (CNV) and underlying choroidal circulatory disturbances in tilted disk syndrome.
: We retrospectively examined patients with submacular CNV associated with tilted disk syndrome using fluorescein angiography and indocyanine green angiography in this observational case series. The axial lengths were measured by ultrasonography. Eyes with myopia exceeding -6.0 diopters were excluded.
: Eleven consecutive eyes (mean patient age ± standard deviation, 60.5 ± 12.1 years) were included. The axial lengths ranged from 21.7 mm to 24.6 mm (mean, 23.61 ± 0.95 mm). Classic CNV in nine eyes and polypoidal choroidal vasculopathy in two eyes developed at the macula along the superior margin of the inferior posterior staphyloma that crossed the macula in all eyes. The superior margin of the inferior posterior staphyloma was hyperfluorescent on fluorescein angiography and hypofluorescent on indocyanine green angiography, with the latter larger than the former. The inferior staphyloma contained fewer and smaller choroidal arteries and veins. During follow-up, the submacular CNV and polypoidal choroidal vasculopathy spontaneously regressed and the subretinal hemorrhage resorbed, leaving a fibrotic scar in eight eyes. Newly developed CNV at the initial no-leakage site on fluorescein angiography developed in one eye and the CNV located in the area of band-shaped hypofluorescence on indocyanine green angiography.
: Stretching of the ocular wall might result in occluded choriocapillaris and degeneration of the retinal pigment epithelium. These changes along the border of the inferior posterior staphyloma predispose to submacular CNV and polypoidal choroidal vasculopathy in tilted disk syndrome.
Retina (Philadelphia, Pa.) 01/2013; 33(1):71-6. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE: To clarify the efficacy of a combination of intravitreal anti-vascular endothelial growth factor (VEGF) injections and photodynamic therapy (PDT), over 24 months, for patients with symptomatic retinal angiomatous proliferation (RAP). METHODS: We retrospectively reviewed 13 treatment-naïve eyes of 12 patients (7 men, 5 women; age range (mean), 63-92 (77) years) treated with intravitreal bevacizumab (IVB) plus PDT as initial treatment. Retreatment was performed with IVB plus PDT until February 2009 or intravitreal ranibizumab and PDT from March 2009. RESULTS: Mean best-corrected visual acuity (BCVA) significantly improved from 0.26 at baseline to 0.40 at 24 months (P = 0.013). The mean improvement in BCVA at 24 months from baseline was 1.79 lines. The central retinal thickness decreased significantly from 431 to 142 microns at 24 months (P < 0.0001). Complete occlusion of the retinal-retinal anastomosis was achieved in seven of the 10 eyes at 24 months. The mean number of PDT treatments during 24 months was 2.8 and the mean number of injections was 3.4. Geographic atrophy was seen in four eyes without significant decline of VA at 24 months. CONCLUSION: Combined anti-VEGF and PDT for RAP patients effectively maintained or improved VA and reduced exudation, without severe adverse events, over 24 months.
Japanese Journal of Ophthalmology 12/2012; · 0.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the retinal and choroidal thickness changes following intravitreal ranibizumab injection (IVR) for exudative age-related macular degeneration (AMD).
Twenty-eight eyes of 28 patients (average age 72.2) with newly diagnosed AMD (typical AMD 24 and PCV 4) were retrospectively examined during a 1-year follow-up. All cases first received 3 consecutive monthly injections and thereafter pro re nata (PRN) retreatment. Central retinal thickness and subfoveal choroidal thickness were measured before and 1, 3, 6 and 12 months after initial treatment using optical coherence tomography.
The average number of injections was 5.2 times. Mean central retinal thickness significantly decreased from 456 microm at baseline to 337 microm 1 month after IVR and 280 microm 1-year after initial IVR (respectively, p<0.01). Mean subfoveal choroidal thickness was 225 microm (typical AMD was 227 microm at baseline) at baseline, 225 microm 6 months after initial IVR and 220 microm 1-year after initial IVR. There was no significant difference compared to baseline (p = 0.78 and 0.45).
Although central retinal thickness of AMD decreased even 1-year after initial IVR, subfoveal choroidal thickness remained at 6 months and 1-year after initial IVR. Subfoveal choroidal thickness of AMD is less affected by IVR in the long term.
Nippon Ganka Gakkai zasshi 07/2012; 116(7):643-9.
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated retrospectively the morphologic choroidal and scleral characteristics in eyes with pathologic myopia using high-penetration optical coherence tomography (HP-OCT) or swept-source OCT (SS-OCT).
The subfoveal choroidal and scleral thicknesses were measured using the prototype HP-OCT with a 1060 nm light source. We also measured the scleral thickness 3 mm superior, inferior, nasal, and temporal to the fovea on the horizontal and vertical OCT sections. The axial length (AL) in all eyes was measured using optical biometry.
We examined 58 eyes of 35 patients (7 men and 28 women, mean age 65.5 years) with an AL exceeding 26.5 mm. The mean AL was 29.0 ± 1.4 mm. The full-thickness choroid and sclera were visualized in all eyes. The mean subfoveal choroidal and scleral thicknesses were 52 ± 38 and 335 ± 130 μm, respectively. The mean scleral thicknesses 3 mm superior, inferior, nasal, and temporal to the fovea were 266 ± 78 (n = 57), 259 ± 72 (n = 56), 324 ± 109 (n = 39), and 253 ± 79 (n = 58) μm, respectively. The subfoveal sclera was thicker than 3 mm outside the fovea (P < 0.05, for each comparison).
The full-thickness choroid and sclera in all eyes with pathologic myopia were visualized using a prototype HP-OCT. The subfoveal sclera was thicker than 3 mm outside the fovea. HP-OCT is a useful tool for morphologic analyses of pathologic myopia.
Investigative ophthalmology & visual science 05/2012; 53(7):3834-8. · 3.43 Impact Factor
-
American journal of ophthalmology 05/2012; 153(5):1005. · 3.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy in patients with symptomatic polypoidal choroidal vasculopathy.
We retrospectively reviewed 28 naive eyes of 28 patients (17 men, 11 women; mean age, 73.4 years; range, 55-85 years) with 20/40 or less baseline visual acuity treated with 3 consecutive monthly intravitreal injections of ranibizumab (0.5 mg/0.05 mL) and photodynamic therapy and followed-up for at least 12 months. Photodynamic therapy was administered 1 day or 2 days after the initial injection of ranibizumab.
: The mean best-corrected visual acuity levels significantly (P < 0.0001) improved from 0.33 at baseline to 0.61 at 12 months. The mean improvement in best-corrected visual acuity 12 months from baseline was 2.65 lines. The best-corrected visual acuity at 12 months improved in 15 eyes (53.6%) by ≥3 lines and was stable (defined as a loss of <3 lines of vision) in 13 eyes (46.4%). The central retinal thickness significantly (P < 0.0001) decreased from 366 µm to 151 µm at 12 months. The mean numbers of photodynamic therapy treatments and injections during 12 months including the treatments during the initial regimen were 1.1 and 3.7, respectively. No complications developed.
Combined intravitreal ranibizumab and photodynamic therapy for polypoidal choroidal vasculopathy maintained or improved visual acuity and reduced the exudation without adverse events.
Retina (Philadelphia, Pa.) 03/2012; 32(7):1272-9. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To clarify the efficacy of ranibizumab for treating age-related macular degeneration in patients with baseline visual acuity exceeding 20/40.
We retrospectively reviewed 40 eyes of Japanese patients with age-related macular degeneration (32 men, 8 women) treated with intravitreal injections of ranibizumab (0.5 mg/0.05 mL) (ranibizumab group). We compared the results with observation of 52 eyes (control group). All patients were followed-up for at least 12 months.
In the ranibizumab group, the mean logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) with typical age-related macular degeneration (22 eyes) and polypoidal choroidal vasculopathy (18 eyes) statistically significantly (P < 0.0001, P = 0.015, respectively) improved from 0.17 (20/29) and 0.14 (20/28) at baseline to 0.07 (20/24) and 0.07 (20/24) at Month 12, respectively (mean numbers of treatments, 4.6 and 4.9). The central retinal thickness decreased from 262 ± 105 μm at baseline to 187 ± 62 μm at Month 12 in the ranibizumab group. In the control group, the mean logarithm of the minimum angle of resolution best-corrected visual acuity in eyes with typical age-related macular degeneration (19 eyes) and polypoidal choroidal vasculopathy (33 eyes) statistically significant (P = 0.017, P = 0.023, respectively) declined from 0.08 (20/24) and 0.10 (20/25) at baseline to 0.18 (20/30) and 0.23 (20/34) at Month 12, respectively.
Intravitreal ranibizumab maintained or improved visual acuity and anatomic changes in patients with age-related macular degeneration with better than 20/40 visual acuity.
Retina (Philadelphia, Pa.) 03/2012; 32(7):1250-9. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate circadian changes in subfoveal choroidal thickness (SFCT) and the relation to systemic factors in healthy subjects.
Thirty-eight eyes of 19 healthy volunteers were enrolled. SFCT was measured by using prototype high-penetration optical coherence tomography. Intraocular pressure (IOP), systolic blood pressure (SBP), diastolic blood pressures (DBP), and heart rate (HR) were measured every 3 hours over a 24-hour period. Circadian changes in the mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP) were calculated. The difference between the maximal and minimal SFCTs was analyzed, and correlations between the SFCT and other systemic factors were evaluated.
There was a significant circadian variation in SFCT (P < 0.0001). The total mean SFCT was 280.3 ± 106.1 μm. At 6 PM, the mean SFCT (271.9 ± 103.5 μm) was the thinnest and at 3 AM it was the thickest (290.8 ± 110.8 μm). The SFCTs in 32 of 38 eyes were thickest between 3 and 9 AM and in 27 of 38 eyes, thinnest between 3 and 9 PM. The mean SFCT was significantly negatively correlated with the mean SBP (R(2) = 0.59, P = 0.02) in all eyes. There were no significant correlations between the mean SFCT and the mean DBP, MAP, HR, IOP, and MOPP in all eyes.
We investigated the circadian change of choroidal thickness using high-penetration optical coherence tomography in healthy volunteers. The significant diurnal change was found and the choroid was thicker at night and thinner in daytime. Fluctuations in the choroidal thickness may be related to SBP.
Investigative ophthalmology & visual science 03/2012; 53(4):2300-7. · 3.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate near-infrared autofluorescence (IR-AF) patterns and related changes in patients with idiopathic choroidal neovascularization (CNV) treated with intravitreal bevacizumab (IVB).
Retrospective observational consecutive case series.
Bevacizumab was intravitreally injected into 12 eyes of 12 patients with idiopathic CNV as the primary treatment. Color fundus photographs, optical coherence tomography (OCT), fluorescein angiography and indocyanine green angiography (ICGA), and autofluorescence imaging short-wavelength and near-infrared autofluorescence (SW-AF and IR-AF) were performed at baseline. Changes in the autofluorescence patterns were evaluated after IVB.
All 12 eyes had classic CNV on fluorescein angiography at baseline. OCT showed CNV above the retinal pigment epithelium (RPE) in all eyes. After treatment, the final best-corrected visual acuity improved significantly (P < .001) compared with baseline. IR-AF showed ring-shaped hyperautofluorescence surrounding the CNV corresponding to the dark rim on ICGA in 6 of the 12 eyes on IR-AF at baseline. During the follow-up period after IVB, all 12 eyes had ring-shaped hyperautofluorescence. The intensity of the ring-shaped autofluorescence and its contrast increased as the CNV regressed. The contrast of the ring-shaped autofluorescence partially decreased in all 3 eyes with a recurrence.
Ring-shaped hyperautofluorescence on IR-AF in the eyes with idiopathic CNV may indicate an involutional process of CNV enveloped by the RPE because its area corresponded to the dark rim on ICGA that reflects regression of idiopathic CNV. IR-AF can be a useful noninvasive adjunctive examination to evaluate the involution of CNV.
American journal of ophthalmology 02/2012; 153(2):314-9. · 3.83 Impact Factor
-
Isao Nakata,
Kenji Yamashiro,
Ryo Yamada,
Norimoto Gotoh,
Hideo Nakanishi,
Hisako Hayashi,
Yumiko Akagi-Kurashige,
Akitaka Tsujikawa,
Atsushi Otani,
Masaaki Saito, Tomohiro Iida,
Akio Oishi,
Keitaro Matsuo,
Kazuo Tajima,
Fumihiko Matsuda,
Nagahisa Yoshimura
[show abstract]
[hide abstract]
ABSTRACT: To determine whether genetic variants in the complement component 2 and factor B gene (C2/CFB) locus are associated with the risk for typical age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV) in a Japanese population.
Four single nucleotide polymorphisms (SNPs) were genotyped across the C2/CFB locus of patients with typical AMD (n = 455) or PCV (n = 581) and of 865 controls. Differences in the observed genotypic distribution between the case and control groups were tested by logistic regression analysis for age and sex adjustments. Significant associations were confirmed using a second control group of 336 cataract patients. A further model adjusting for age-related maculopathy susceptibility 2 (ARMS2) A69S, complement factor H (CFH) I62V, age, sex and smoking status was performed, to confirm their independent association from other covariates.
C2 rs547154 and CFB rs541862 were significantly associated with typical AMD and PCV in this Japanese sample (P < 0.05). These two SNPs were also significantly associated with typical AMD and PCV in evaluation of the second control cohort (P < 0.05). Furthermore, an independent association of C2/CFB variants was found for both typical AMD and PCV with age, sex, smoking, and genetic background of ARMS2 A69S and CFH I62V (vs. typical AMD: P = 0.0073, odds ratio [OR] = 0.47; vs. PCV: P = 0.0083, OR = 0.53).
C2/CFB variants play a protective role in the risk of developing neovascular AMD and PCV in the Japanese.
Investigative ophthalmology & visual science 02/2012; 53(2):794-8. · 3.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Idiopathic macular telangiectasia (MacTel) is classified into aneurysmal telangiectasia (type 1), perifoveal telangiectasia (type 2) and occlusive telangiectasia (type 3). Most instances of telangiectasia in Western countries are type 2. This study reports clinical and demographic features of MacTel in Japanese patients.
Newly diagnosed patients with MacTel were examined retrospectively. All patients underwent fluorescein angiography and optical coherence tomography.
Thirty-four eyes of 27 patients with MacTel were included. Twenty eyes of 20 patients (74.1%) had type 1, ten eyes of five patients (18.5%) had type 2, and four eyes of two patients (7.4%) had type 3. Foveal capillary dilatation and microaneurysms were observed in all except for one eye of early stage type 2 MacTel. Optical coherence tomography revealed cystoid macular edema in type 1, temporal foveal thinning and a loss of boundary between the inner and outer segments of photoreceptors in type 2, and thinning of all retinal layers around the fovea in type 3.
The most frequent among our patients was aneurysmal MacTel, whereas perifoveal MacTel was not common. Although the clinical characteristics were similar, the most common type was different from that in Western countries.
Japanese Journal of Ophthalmology 01/2012; 56(2):152-8. · 0.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Sodium hyaluronate and autologous serum eye drops are used to treat ocular surface disease (OSD) and are reported to prevent and treat late-onset bleb leaks following trabeculectomy with mitomycin C. In this study, we evaluated the efficacy of a combination of sodium hyaluronate and autologous serum eye drops and treatment for obstructive meibomian gland dysfunction as a therapy for late-onset bleb leaks after trabeculectomy with mitomycin C.
This was a retrospective, interventional, nonsimultaneous study of 12 subjects (12 eyes) of mean age of 64.3 ± 18.3 years with OSD and apparent late-onset bleb leaks following trabeculectomy with mitomycin C between 1998 and 2008. We compared patients diagnosed with leakages before July 2005, who had been treated with separate eye drop solutions containing 0.1% sodium hyaluronate, 50% autologous serum, and 0.3% ofloxacin (sodium hyaluronate and autologous serum group, n = 7), with patients diagnosed from August 2005 to December 2008, who were treated with a combination of eye drops (0.1% sodium hyaluronate, 50% autologous serum, and 0.08% levofloxacin hydrate) and eyelid massage and warm compresses for obstructive meibomian gland dysfunction (combination eye drop group, n = 5).
Leakage was resolved in one patient (14.3%) in the separately treated sodium hyaluronate and autologous serum eye drop group and in five patients (100%) in the combination eye drop group (P = 0.015). The period after resolution of leakage with conservative treatment was 23 months in the one eye in the sodium hyaluronate and autologous serum group and 36-61 (mean 52.4 ± 10.1) months in the five eyes in the combination eye drop group.
Late-onset bleb leaks following trabeculectomy with mitomycin C can be treated effectively using a combination of sodium hyaluronate and autologous serum eye drops, eyelid massage, and warm compresses. Furthermore, combining eye drops may improve patient adherence to the drug regimen by decreasing the frequency of administration.
Clinical Ophthalmology 01/2012; 6:1273-9.
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to evaluate the angiographic results of retinal-retinal anastomosis (RRA) and retinal-choroidal anastomosis (RCA) for eyes with retinal angiomatous proliferation (RAP) after treatment with intravitreal bevacizumab injections as monotherapy or intravitreal bevacizumab combined with photodynamic therapy.
In this interventional, consecutive case series, we retrospectively reviewed five naïve eyes from four patients (mean age 80 years) treated with three consecutive monthly intravitreal bevacizumab (1.25 mg/0.05 mL) injections as initial treatment, and followed up for at least 3 months. In cases with over 3 months of follow-up and having recurrence of RAP or leakage by fluorescein angiography, retreatment was performed with a single intravitreal bevacizumab injection and photodynamic therapy.
Indocyanine green angiography showed RRA in three eyes with subretinal neovascularization and RCA in two eyes with choroidal neovascularization at baseline. At 3 months after baseline (month 3), neither the RRA nor RCA was occluded in any eye on indocyanine green angiography. Retreatment with intravitreal bevacizumab plus photodynamic therapy was performed in three eyes at months 3 (persistent leakage on fluorescein angiography), 6, and 7 (recurrence of RAP lesion), which achieved obvious occlusion of the RRA and RCA. Mean best-corrected visual acuity improved from 0.13 to 0.21 at month 3 (P = 0.066). No complications or systemic adverse events were noted.
Although intravitreal bevacizumab for RAP was effective in improving visual acuity during short-term follow-up, intravitreal bevacizumab could not achieve complete occlusion of RRA and RCA, which could lead to recurrence of a RAP lesion and exudation. Retreatment with intravitreal bevacizumab plus photodynamic therapy ultimately achieved complete occlusion of the RRA and RCA.
Clinical Ophthalmology 01/2012; 6:1385-91.
-
[show abstract]
[hide abstract]
ABSTRACT: Purpose. To describe the findings of fundus autofluorescence (FAF) and optical coherence tomography (OCT) in patients with branch retinal vein occlusion (BRVO). Methods. In this institutional, retrospective, observational case series, FAF was evaluated in 65 eyes with BRVO in 64 consecutive patients and compared with visual acuity, OCT findings, and other clinical observations. Results. Five types of autofluorescence appeared during the course of BRVO: (1) petaloid-shaped hyperautofluorescence in the area of macular edema and (2) hyperautofluorescence coincident with yellow subretinal deposits. (3) Diffuse hyperautofluorescence appeared within the area of serous retinal detachment (SRD) and OCT showed precipitates on the undersurface of the retina in 5/5 of these eyes (100%). (4) The area of vein occlusion showed diffuse hyperautofluorescence after resolution of the retinal bleeding. (5) Hard exudates exhibited hyper- or hypoautofluorescence. OCT indicated that most of the hard exudates with hyperautofluorescence were located on the retinal pigment epithelium. Conclusions. Hyperautofluorescence associated with subretinal fluid or hard exudate appeared in the subretinal space. This type of hyperautofluorescence may be attributed to blood cell or macrophages. FAF and OCT are noninvasive modalities that provide additional information regarding macular edema due to BRVO.
Journal of Ophthalmology 01/2012; 2012:638064.
-
[show abstract]
[hide abstract]
ABSTRACT: To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy (PDT) in patients with symptomatic retinal angiomatous proliferation.
Retrospective, interventional, consecutive case series.
We retrospectively reviewed 20 treatment-naïve eyes of 16 patients (8 men, 8 women; age range, 79 to 92 years; mean age, 84.8 years) treated with 3 consecutive monthly intravitreal injections of ranibizumab (0.5 mg/0.05 mL) and PDT and followed up for at least 12 months. PDT was applied 1 or 2 days after the initial injection. Retreatment was performed as a combined therapy of a single intravitreal ranibizumab injection and PDT.
The mean best-corrected visual acuity (BCVA) levels significantly improved from 0.24 at baseline to 0.43 at 12 months (P < .001). The mean improvement in BCVA at 12 months from baseline was 2.51 lines. The BCVA at 12 months improved in 10 eyes (improved by 3 lines or more) and was stable (defined as a loss of less than 3 lines of vision) in 10 eyes. No patient had a decrease in the BCVA of 3 lines or more during any 12 months. The central retinal thickness decreased significantly from 444 μm at baseline to 143 μm at 12 months (P < .0001). Complete occlusion of the retinal-retinal anastomosis was achieved in 17 of the 19 eyes at 12 months. The mean numbers of PDT treatments and injections during 12 months, including the treatments in the initial regimen, were 1.8 and 3.8, respectively. No complications or systemic adverse events developed.
Combined intravitreal ranibizumab and PDT for patients with retinal angiomatous proliferation effectively maintained or improved visual acuity and reduced the exudation without adverse events.
American journal of ophthalmology 11/2011; 153(3):504-514.e1. · 3.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The origin of autofluorescence in the subretinal space and the autofluorescence properties of the cells were investigated in surgically collected subretinal fluid.
Subretinal fluid was surgically collected from four eyes of patients with rhegmatogenous retinal detachment (three eyes) and Coats' disease (one eye). After cytocentrifuge preparation of the cells in the fluid and immunofluorescence staining, a cytologic examination was conducted by using confocal scanning laser microscopy. The autofluorescence of the cells was elucidated by measuring the fluorescence spectra with spectroscopy, to obtain different excitation laser light emission fingerprints.
The cells from the subretinal fluid were classified into three types: CD68-negative cells containing numerous pigmented granules, CD68-positive cells containing few pigments, and CD68-negative cells with no pigmented granules. Autofluorescence was observed in the inclusions of the cells classified into the former two types. When the cells were excited by a 458- or 488-nm laser light, emission spectra in autofluorescence showed little difference between CD68-positive and -negative cells. Peak analysis confirmed that the two types of cells showed the same emission peaks within this range of excitation light.
Autofluorescent inclusions appeared in the CD68-positive and -negative cells in the subretinal fluid. The macrophages in the subretinal fluid possess autofluorescence that is spectroscopically similar to lipofuscin. Autofluorescence of macrophages can be attributed to degenerated outer segments and debris from apoptotic photoreceptors. Clinicians should consider migration of macrophages, in addition to retinal pigment epithelium, as the possible source when abnormal fundus autofluorescence is observed using an ordinary set of fluorescence filters.
Investigative ophthalmology & visual science 10/2011; 52(11):8534-41. · 3.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To retrospectively evaluate choroidal thickness 1 year after photodynamic therapy in eyes with central serous chorioretinopathy using optical coherence tomography.
Central serous chorioretinopathy was diagnosed using fluorescein angiography, and indocyanine green angiography was used to evaluate choroidal vascular hyperpermeability. We measured the subfoveal choroidal thickness using enhanced depth imaging optical coherence tomography.
Thirteen eyes (13 patients; average age, 56.8 years) with central serous chorioretinopathy were observed 1 year after half-dose photodynamic therapy with verteporfin. The mean subfoveal choroidal thickness decreased significantly from 397 ± 108 μm at baseline to 323 ± 120 μm at 1 month, 312 ± 117 μm at 3 months, 317 ± 117 μm at 6 months, and 321 ± 122 μm at 1 year (P < 0.01, for each comparison with baseline). However, the subfoveal choroid thickness significantly increased 2 days after photodynamic therapy to 441 ± 120 (P < 0.01) compared with baseline. Central serous chorioretinopathy did not recur in any patient. Indocyanine green angiography images at 3 months showed less choroidal vascular hyperpermeability compared with baseline.
Half-dose photodynamic therapy for central serous chorioretinopathy resulted in thinner subfoveal choroidal thickness 1 month after treatment, decreased the choroidal vascular hyperpermeability, and maintained the remission for 1 year. Enhanced depth imaging optical coherence tomography was helpful for monitoring the pathophysiologic choroidal changes in central serous chorioretinopathy.
Retina (Philadelphia, Pa.) 08/2011; 31(9):1921-7. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To clarify the efficiency of ranibizumab for polypoidal choroidal vasculopathy in patients with regressed polypoidal lesions after previous photodynamic therapy (PDT) applications but recurrent or residual exudation from branching vascular network vessels.
We retrospectively reviewed 59 eyes of 59 Japanese patients (47 men and 12 women) with polypoidal choroidal vasculopathy. Treatments were chosen according to the period. Thirty-four patients were treated with PDT (PDT group) and 25 patients were treated with intravitreal injections of ranibizumab (ranibizumab group).
In the ranibizumab group, the mean best-corrected visual acuity levels at baseline and 6 months were 0.27 and 0.41, respectively, showing a significant (P < 1× 10) improvement from baseline. In the PDT group, the mean best-corrected visual acuity levels at baseline and 6 months were 0.29 and 0.24, respectively, showing a significant (P < 0.01) decline from baseline. The mean numbers of treatments at 6 months in the ranibizumab and the PDT groups were 3.6 and 1.4, respectively. A subretinal hemorrhage (>1 disk diameter) developed in 5 eyes in the PDT group.
Intravitreal ranibizumab is an effective treatment for maintaining or improving visual acuity and the anatomical changes in patients with polypoidal choroidal vasculopathy with recurrent or residual exudation from branching vascular network vessels.
Retina (Philadelphia, Pa.) 06/2011; 31(8):1589-97. · 2.93 Impact Factor
