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ABSTRACT: PURPOSE: To determine the optimal time for administration of intravitreal ranibizumab injections before photodynamic therapy (PDT) as combined therapy to treat polypoidal choroidal vasculopathy (PCV). DESIGN: Retrospective, comparative, interventional case series. METHODS: The study included 99 eyes (98 patients) with treatment-naïve subfoveal PCV treated with an intravitreal ranibizumab injection followed by PDT. The combination therapy included 1 ranibizumab injection administered 7 days before PDT (7-day group) or 2 days before PDT (2-day group). All eyes were followed for over 12 months. RESULTS: Intravitreal ranibizumab was administered 7 days before PDT in 59 eyes and 2 days before PDT in 40 eyes. In the 7-day group, the best-corrected visual acuity (BCVA) did not improve significantly at 3 months (P = .086) or 12 months (P = .259) compared with baseline. In the 2-day group, BCVA improved significantly at 3 months (P < .001) and 12 months (P < .001). The polypoidal lesions regressed completely in 46 eyes (78.0%) in the 7-day group and in 34 eyes (85.0%) in the 2-day group; 38 eyes (64.4%) and 35 eyes (87.5%), respectively, did not require additional treatment, which differed significantly (P = .008) between the 2 groups. Subretinal hemorrhages did not develop in either group within 1 month after the combined therapy. CONCLUSIONS: Administration of an intravitreal ranibizumab injection 2 days before PDT achieves significantly better visual outcomes and requires fewer additional treatments compared with administration of the injection 7 days before PDT.
American journal of ophthalmology 04/2013; · 3.83 Impact Factor
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ABSTRACT: PURPOSE: To observe posterior precortical vitreous pockets (PPVPs) using swept-source optical coherence tomography (SS-OCT). METHODS: We performed SS-OCT in both eyes of 58 volunteers (36 men, 22 women) using 12-mm horizontal vertical scans through the macula and optic disc. To minimize age-related changes (liquefaction or posterior vitreous detachment), all subjects were a mean of 26.2 years (range, 22-40 years). The refractive errors ranged from -9.5 diopters (D) to +3.0 D. To estimate the PPVP size, we measured the height between the fovea and the anterior border of the PPVP and the maximal width in the 12-mm horizontal scan through the fovea and disc. RESULTS: SS-OCT visualized the PPVPs as boat-shaped lacunae in the macular area bilaterally in all subjects (maximal width, 3,114-9,887 µm; mean width, 6,420.6; central height, 208-1,877 µm; mean height, 708.1 in the right eyes, with no significant difference in the left eyes). There was a significant correlation between the PPVP height and myopic refractive error. The posterior wall of the PPVP was a thin vitreous cortex, thinnest at the fovea. The septum was between the nasal border of the pocket and Cloquet's canal, which extended forward and tilted superiorly in all cases. A channel connected Cloquet's canal and the PPVPs bilaterally in 54 (93.1%) of 58 cases. CONCLUSION: SS-OCT clarified the boat-shaped PPVP structure in vivo. Although the central height increased with the myopic refractive error, the width was unchanged. A channel connecting Cloquet's canal and PPVP suggested the route of aqueous humor into the PPVP.
Investigative ophthalmology & visual science 04/2013; · 3.43 Impact Factor
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ABSTRACT: PURPOSE:: To investigate the morphologic features of posterior precortical vitreous pockets (PPVPs) with positional changes using spectral domain optical coherence tomography. METHODS:: The authors measured the distance between the fovea and anterior PPVP border on spectral domain optical coherence tomography scans in both eyes of 20 consecutive individuals and compared the differences with changes in position from sitting to supine. RESULTS:: A PPVP was identified in both eyes of 14 individuals (70%). In the vertical scan, the superior portion of the pocket was larger than the inferior portion in all 28 eyes when the participants were sitting. The mean distances between the fovea and the anterior PPVPs that border in the right and left eyes, respectively, were 477.6 ± 40.7 μm and 497.1 ± 31.8 μm when the participants were sitting and 665.6 ± 51.6 μm and 750.5 ± 48.2 μm when the participants were supine. The differences between the 2 positions were significant (P < 0.005). CONCLUSION:: The superior portion of the PPVPs enlarged when the participants were sitting. The anterior border of the pocket moved anteriorly when the participants were supine.
Retina (Philadelphia, Pa.) 03/2013; · 2.93 Impact Factor
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Hiroyo Hirasawa,
Makoto Araie,
Atsuo Tomidokoro,
Hitomi Saito,
Aiko Iwase,
Shinji Ohkubo,
Kazuhisa Sugiyama,
Tomohiro Ootani, Shoji Kishi,
Kenji Matsushita,
Naoyuki Maeda,
Masanori Hangai,
Nagahisa Yoshimura
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ABSTRACT: PURPOSE. TO EVALUATE THE INTER-VISIT REPRODUCIBILITY OF SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY (SD-OCT) MEASUREMENT OF THE MACULAR RETINAL NERVE FIBER LAYER THICKNESS (MRNFLT), COMBINED GANGLION CELL LAYER AND INNER PLEXIFORM LAYER (GCL+IPL) THICKNESS, AND GANGLION CELL COMPLEX (GCC) THICKNESSES (SUM OF MRNFLT AND GCL+IPL THICKNESSES) COMPARED WITH THAT OF CIRCUMPAPILLARY RNFLT (CPRNFLT) AND THE EFFECT OF OCULAR ROTATION ON REPRODUCIBILITY. METHODS. SD-OCT IMAGING WAS PERFORMED TWICE ON DIFFERENT DAYS IN ONE EYE OF 58 NORMAL SUBJECTS AND 73 GLAUCOMA PATIENTS. THE REPRODUCIBILITY WAS EVALUATED FOR THE ENTIRE 4.8 MM X 4.8 MM MACULAR AREA AND SUB-AREAS (UPPER AND LOWER HALVES, 2X2, 4X4 AND 8X8 GRIDS), AND THE 360-DEGREE, UPPER AND LOWER HALVES MEAN CPRNFLT WITH AND WITHOUT CORRECTION OF OCULAR ROTATION. RESULTS. THE COEFFICIENTS OF VARIATION (CVS) OF GCL+IPL AND GCC THICKNESS MEASUREMENTS AVERAGED BELOW 1.0% FOR THE ENTIRE AND UPPER AND LOWER HALF MACULAR AREAS, AND BELOW 4.2% IN THE MACULAR SUB-AREAS IN NORMAL AND GLAUCOMA EYES, WHICH WERE SIGNIFICANTLY SMALLER (P 0.001) THAN THOSE OF MRNFLT MEASUREMENTS IN THE SAME AREAS OF THE SAME EYES. THE CVS OF MRNFLT MEASUREMENTS WERE SIGNIFICANTLY SMALLER THAN THOSE OF THE CPRNFLT ONLY IN THE LOWER HALF MEAN AREA IN NORMAL EYES. THE REPRODUCIBILITY WAS MINIMALLY AFFECTED BY CORRECTION OF OCULAR ROTATION OR PRESENCE OF GLAUCOMA. CONCLUSIONS: The reproducibility of the macular (GCL+IPL) and GCC thickness measurements was better than that of mRFNLT and cpRNFLT in normal and glaucoma eyes and minimally affected by correction of ocular rotation.
Investigative ophthalmology & visual science 03/2013; · 3.43 Impact Factor
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ABSTRACT: To investigate the relationship between age and chorioretinal hemodynamics in normal volunteers examined with Laser speckle flowgraphy (LSFG-NAVI).
107 eyes of 107 healthy volunteers aged from 21 to 78 years old were included. Laser speckle flowgraphy measurements of relative blood velocity (mean blur rate: MBR), skewness in the wave of blood velocity (Skew) and blowout score (BOS), which indicates ease of blood flow, were obtained as parameters of chorioretinal hemodynamics. MBR and BOS were measured on the optic disc and macula, and BOS and Skew were measured in retinal arteries and veins.
There was a negative correlation between age and MBR on the optic disc and macula. There was a negative correlation between age and BOS on the optic disc, macula, retinal arteries and retinal veins.
There was a negative correlation between MBR, BOS and age in all measurement areas. MBR and BOS may serve as indexes for a new interpretation of fundus pathology including age-related arterial sclerosis.
Nippon Ganka Gakkai zasshi 02/2013; 117(2):110-6.
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ABSTRACT: Extramacular branch retinal vein occlusion (BRVO) occasionally causes serous macular detachment. We studied the movement of extravasated fluid from BRVO lesions to the submacular space.
We examined nine eyes from nine patients with serous retinal detachment caused by extramacular BRVO. In addition to a comprehensive ophthalmic examination, optical coherence tomography was performed in all nine eyes. Six of the patients also underwent fluorescein angiography.
Visual acuity ranged from 0.03 to 0.9 (median 0.5). All nine eyes showed localized macular detachment and retinal edema which extended from the extramacular BRVO to the macula. Fluorescein angiography revealed dye leakage in the extramacular area but no macular leakage in the six eyes examined. Optical coherence tomography revealed serous retinal detachment in the macula and intraretinal swelling, with low reflectivity in the outer retina extending from the distant BRVO toward the detached macula in all nine eyes. Six eyes were treated with laser photocoagulation, covering the entire area of BRVO, and the other three eyes were treated with intravitreal bevacizumab. Serous retinal detachment and retinal swelling resolved within 3 months of treatment in all nine eyes.
Distant retinal vascular leakage appears to diffuse through the outer retina to the macula, then permeate into the subretinal space.
Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:81-6.
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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
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ABSTRACT: PURPOSE: To determine the characteristics of the photoreceptor abnormalities in retinitis pigmentosa (RP) and cone-rod dystrophy (CRD). METHODS: We evaluated the photoreceptor abnormalities using spectral-domain optical coherence tomography (SD-OCT) in 28 patients with RP and 17 patients with CRD. The OCT images and full-field electroretinograms were obtained from 21 eyes in normal subjects who were age-matched to patients with RP and CRD and served as controls. RESULTS: Eyes with RP and CRD had markedly decreased rod responses (6.5 and 57.5 % of normal value), maximal responses (9.6 and 51.6 %), cone (16.5 and 25.8 %), and 30-Hz flicker responses (17.8 and 30.1 % of normal value), and their P values were smaller than 0.0003. On comparison of ERG data between RP and CRD, they had statistically significant differences in rod responses (P < 0.0003) and maximal responses (P < 0.0003). However, there were no statistical differences in cone response and a weak difference in 30-Hz flicker responses (P < 0.017). The best-corrected visual acuity was -0.03 ± 0.09 (logMAR, mean ± standard deviation [SD]) in eyes with RP, but 0.57 ± 0.54 in eyes with CRD. SD-OCT showed that eyes with RP had an intact reflective line at the junction between the photoreceptor inner and outer segment (IS/OS) at the fovea, while eyes with CRD had no IS/OS. The extent of the central visual field was correlated with the IS/OS length at the macula in eyes with RP. CONCLUSION: The distribution patterns of the IS/OS line help to differentiate between RP and CRD.
Documenta Ophthalmologica 08/2012; · 2.11 Impact Factor
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ABSTRACT: Purpose. To evaluate the morphologic and functional changes of the primate retina after light exposure using spectral-domain optical coherence tomography (SD-OCT) and electroretinography (ERG). Methods. Seven monkey eyes with light-emitting diode (LED) contact lenses were exposed to light for 8 hours. SD-OCT and ERG were performed bilaterally before, after the light exposure, and on days 1 and 14 in three monkeys. The tests were repeated after 4 months, followed by enucleation 12 hours later. Six eyes of three other animals were enucleated 12 hours after the first light exposure, and two eyes of one monkey were enucleated after 14 days, followed by microscopy. Results. Immediately after light exposure, SD-OCT showed increased reflectivity of the outer segment (OS). Electron microscopy showed intracellular vacuolated and irregular lamellar structures at the proximal OS, while the distal end of the OS was unfolded at the RPE interface. At 14 days, the histologic changes and the OCT images returned to normal. ERG showed decreased cone and rod responses immediately after light exposure and decreased cone responses on day 1. Normalization occurred on day 14. Conclusions. Light exposure caused increased reflectivity of the photoreceptor OS, which corresponded to intracellular vacuolization and irregularity of the lamellar structure of the OS. OCT images returned to normal along with the histologic restoration. Rod and cone responses decreased transiently immediately after light exposure, which might be attributed to incomplete recovery from retinal bleaching.
Investigative ophthalmology & visual science 07/2012; 53(10):6035-44. · 3.43 Impact Factor
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ABSTRACT: We report a case of longitudinal avulsion of the inferior rectus muscle following orbital floor fracture and describe its clinical presentation, computed tomography (CT) features and management. A 53-year-old man felt vertical diplopia in all gaze immediately after the trauma. Orthoptic assessment showed left over right hypertropia of 20 prism diopters and left exotropia of 10 prism diopters in primary position. The left orbital floor fracture and the prolapse of orbital contents into the maxillary sinus were presented by CT. Exploration of the orbit was performed under general anesthesia. The displaced bone fragment was elevated and repositioned below the slastic implant. Diplopia continued in all directions of gaze, although the impairment of depression was reduced postoperatively. A residual left hypertropia of 10 prism diopters and exotropia of 10 prism diopters was present in primary position 1 month after surgery, though there were no enopthalmos or worsening of hypesthesia. Repeated CT revealed the muscle avulsion of inferior rectus at the lateral portion of the belly. The avulsion of a small segment of the inferior rectus and its herniation into maxillary sinus in more posterior views was detected by review of the preoperative images. Muscle avulsion should be considered in the management of orbital fracture if orbital tissue entrapment and nerve paresis are excluded as causes of reduction in ocular motility. A thorough review of the imaging studies for possible muscle injury is required before surgery in all cases of orbital fracture.
Orbit (Amsterdam, Netherlands) 06/2012; 31(3):171-3.
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ABSTRACT: The authors report four cases of vitreomacular traction syndrome with splitting of the posterior vitreous cortex. Spectral-domain optical coherence tomography (SD-OCT) was performed consecutively in 35 patients with vitreomacular traction syndrome between June 2007 and February 2011. SD-OCT showed perifoveal posterior vitreous detachment with splitting of the posterior vitreous cortex in 4 of 35 eyes (at the fovea in 1 eye and the perifovea in 3 eyes). The separated cortex of the posterior lamella adhered to the retina in all 4 eyes. The posterior vitreous cortex may split at the macular area in cases of vitreomacular traction syndrome.
Ophthalmic Surgery Lasers and Imaging 01/2012; 43 Online:e27-9. · 0.62 Impact Factor
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ABSTRACT: Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various mechanisms, rebamipide improves ocular surface conditions. To our knowledge, this is the first clinical case report using rebamipide ophthalmic solution. This drug may provide a novel approach to treat drying diseases of the eye.
Clinical Ophthalmology 01/2012; 6:1403-6.
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ABSTRACT: The outer plexiform layer (OPL) includes the photoreceptor synapse layer and Henle fiber layer (HFL) in the macular area. We attempted to improve optical coherence tomography imaging of the HFL by changing the angle of the measurement beam.
Thirteen normal eyes underwent spectral domain optical coherence tomography. To focus the angle of the measurement beam perpendicular to the obliquely oriented HFL, the beam in the optical coherence tomography system was aimed at the periphery of the pupil.
The cross-sectional image of the macular area was inclined right or left if the beam entered from the periphery of the pupil. The reflectivity of the OPL increased because of strong backscattering of light in the half of the macula that was tilted down in cross-sectional images. On the opposite side, the reflectivity of HFL (the outer two-thirds of the OPL) decreased compared with that of the outer nuclear layer, but the photoreceptor synapse layer (the inner one-third of the OPL) remained highly reflective. The mean thicknesses of the OPL that could be visualized 1.0 mm and 1.5 mm from the central fovea were 73.7 ± 7.0 μm and 64.1 ± 8.2 μm, respectively.
Positioning the measurement beam perpendicular to HFL enhanced visualization performance.
Retina (Philadelphia, Pa.) 03/2011; 31(3):497-501. · 2.93 Impact Factor
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ABSTRACT: To evaluate the improvement in subjective symptoms of conjunctivochalasis after bipolar coagulation.
Forty-three eyes of 26 patients (average age, 75.7 ± 8.4 years) were included in this study. The inferior conjunctivas were cauterized between April 2009 and June 2010. Surgery involved pinching the excess conjunctiva and performing bipolar cauterization after subconjunctival injection of a local anesthetic agent. Patients were asked to describe the postoperative foreign-body sensation and change in subjective symptoms 1 month postoperatively, with the preoperative symptom score defined as 10.
Twenty-two patients (84.6%) reported symptom relief immediately after the procedure, though all patients had a mild gritty sensation for 1-2 weeks postoperatively. The mean postoperative symptom score obtained from the questionnaire was 3.27 ± 3.31, which was significantly lower than the preoperative score (P < 0.0001). No patients had experienced recurrent symptoms at the end of the follow-up period.
Thermal cauterization can achieve conjunctival shrinkage and adherence to the subconjunctival tissues. Operation time is only a few minutes, postoperative pain is not severe, and the procedure can be performed in an outpatient clinic, all of which represent benefits to the patients.
Clinical Ophthalmology 01/2011; 5:1391-6.
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ABSTRACT: A 30-year-old female patient was referred to our institution due to vitreous hemorrhage. Best corrected visual acuity of her right and left eyes at her initial visit was 10/20 and 20/20, respectively. Although hypochromic iris was observed in the superior iris between the 10 and 2 o'clock positions in her right eye, her entire left eye exhibited hypochromic iris. Hypopigmentation of the fundus was seen in the superior part of her right eye. This eye also had a huge neovascularization on the optic disc that was 7 discs in diameter. Conversely, her left fundi showed hypopigmentation of the fundus in the entire region of the left eye, and dot hemorrhages were observed all over the left fundi, although no neovascularization could be seen microscopically. Fluorescein angiography showed a huge neovascularization in the right eye and a tiny neovascularization in the left eye. Gene analysis revealed the presence of the PAX3 gene homeobox domain mutation, which led to her being diagnosed as Waardenburg syndrome type 1. Magnetic resonance angiography showed there was no obstructive region at either of the internal carotid arteries and ophthalmic arteries. The severity of the diabetic retinopathy appeared to be correlated with the degree of hypopigmentation in the posterior fundus. We speculate that hypopigmentation of the fundus in Waardenburg syndrome may be responsible for the reduction in retinal metabolism, which led to a reduction in oxygen consumption and prevented further aggravation of the diabetic retinopathy. Only laser treatments using short wavelengths was effective in this case. While the extinction coefficient for hemoglobin when using green light is higher than when using yellow light, the differences between these wavelengths tend to disappear when oxygenated hemoglobin is present. To the best of the authors' knowledge, this is the first case report of a patient with Waardenburg syndrome and diabetic retinopathy.
Clinical Ophthalmology 01/2011; 5:1717-20.
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Sotaro Ooto,
Masanori Hangai,
Atsuo Tomidokoro,
Hitomi Saito,
Makoto Araie,
Tomohiro Otani, Shoji Kishi,
Kenji Matsushita,
Naoyuki Maeda,
Motohiro Shirakashi,
Haruki Abe,
Shinji Ohkubo,
Kazuhisa Sugiyama,
Aiko Iwase,
Nagahisa Yoshimura
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ABSTRACT: To identify sex-related differences and age-related changes in individual retinal layer thicknesses in a population of healthy eyes across the lifespan, using spectral domain optical coherence tomography (SD-OCT).
In seven institutes in Japan, mean thicknesses of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor inner segment (IS), and photoreceptor outer segment (OS) were measured using SD-OCT with a new automated segmentation protocol in 256 healthy subjects.
Interoperator coefficients of variability for measurements of each layer ranged from 0.012 to 0.038. The RNFL, GCL, IPL, and INL were thinnest in the foveal area, whereas the OPL+ONL and OS were thickest in this area. Mean thicknesses of the INL and the OPL+ONL were significantly greater in men (P = 0.002 and 0.001, respectively). However, mean RNFL thickness was greater in women (P = 0.006). Thicknesses of the RNFL, GCL, IPL, INL, and IS correlated negatively with age. Thickness of the OPL+ONL was not correlated with age, and thickness of the OS correlated positively with age. Inner retinal (RNFL+GCL+IPL) thickness over the whole macula correlated negatively with age (P < 0.001), but outer retinal (OPL+ONL+IS+OS) thickness did not. Thicknesses of layers did not correlate with axial length.
Macular layer thicknesses measured on SD-OCT images in healthy eyes showed significant variations by sex and age. These findings should inform macular layer thickness analyses in SD-OCT studies of retinal diseases and glaucoma.
Investigative ophthalmology & visual science 01/2011; 52(12):8769-79. · 3.43 Impact Factor
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ABSTRACT: The authors report the retinal findings of the healing phase in commotio retinae. Retinal images were obtained using spectral-domain optical coherence tomography (SD-OCT) on 3 eyes from 3 patients with commotio retinae after blunt ocular trauma. The best-corrected visual acuity (BCVA) and fundus appearance from the medical records were retrospectively studied. All cases had commotio retinae in the posterior pole. OCT showed increased reflectivity of the line at the junction between the photoreceptor inner and outer segments (IS/OS) in the area of the opacified retina in all cases. The initial BCVA in cases 1, 2, and 3 was 1.5, 1.2, and 0.7, respectively. In all eyes, the neurosensory retinal edema had resolved and the IS/OS line returned to normal architecture. The final BCVA in cases 1, 2, and 3 was 2.0, 1.5, and 1.5, respectively. The authors found restored photoreceptor outer segment in commotio retinae by SD-OCT and improvement of BCVA.
Ophthalmic Surgery Lasers and Imaging 01/2011; 42 Online:e29-31. · 0.62 Impact Factor
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ABSTRACT: To determine the origin of fundus autofluorescence (AF) patterns in central serous chorioretinopathy (CSC).
Retrospective, observational case series.
We retrospectively studied 30 consecutive eyes of 30 patients with primary CSC using AF and spectral-domain optical coherence tomography (SD-OCT). We measured the AF using the Heidelberg Retina Angiograph with a 488-nm excitation light and a 500-nm cutoff barrier filter and compared the AF patterns with ophthalmoscopy and SD-OCT.
We observed a patchy increased AF in the macular area in 22 eyes (73%), in which the length of the photoreceptor outer segment at the central fovea tended to be longer than the other eyes (P=.06). The punctate increased AF corresponded to the ophthalmoscopic precipitates in 17 eyes with precipitates. AF significantly (P=.017) decreased in eyes with a prominent serous retinal detachment (SRD). Eight eyes (27%) had increased AF in the inferior SRD.
The patchy increased AF appears to originate from elongated photoreceptor outer segments in the detached retina. The autofluorescent fluorophores from the photoreceptor outer segments may be concentrated in precipitates or have settled into the inferior SRD.
American journal of ophthalmology 01/2011; 151(4):617-623.e1. · 3.83 Impact Factor
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ABSTRACT: The posterior precortical vitreous pocket (the pocket) is a premacular liquefied lacuna, the physiologic presence of which was reported in autopsy eyes. We describe the morphologic features of the pocket in normal individuals.
We performed spectral-domain optical coherence tomography in 102 eyes of 51 normal subjects of various ages in a sitting position.
The pocket was identified as an optically lucent space anterior to the posterior fundus in 85 of 102 eyes (83.3%) in the age-group. The vitreous cortex was extremely thin at the central fovea, and it gradually thickened along with age in the perifoveal area. A shallow perifoveal posterior vitreous detachment developed in 16 of 32 eyes (50%) of subjects aged >51 years. The lamellar structure of the vitreous cortex was seen in 7 of the 32 eyes (22%) of subjects aged >51 years.
Spectral-domain optical coherence tomography confirmed the presence of the pocket in all ages. Thickened vitreous cortex and perifoveal posterior vitreous detachment were physiologic findings in older individuals. The lamellar structure of the vitreous cortex may be related to the vitreoschisis.
Retina (Philadelphia, Pa.) 01/2011; 31(7):1400-4. · 2.93 Impact Factor
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ABSTRACT: To retrospectively study the efficacy of intravitreal bevacizumab (IVB) for exudative age-related macular degeneration (AMD) in patients with good visual acuity (VA).
Fifteen eyes of 15 patients (mean age, 69.0 ± 11.3 years) with AMD whose VA was 0.6 or better were treated with IVB 1.25 mg/0.05 ml. The patients were followed for 12 to 29 months (mean, 17.4 ± 4.9 months).
Best-corrected visual acuity (BCVA) ranged from 0.6 to 1.2 (mean, 0.89 ± 0.21) at baseline and was stable in 13 of 15 eyes (86.7%) when BCVA was 0.6 or better at the end of follow-up. The VA levels did not differ significantly (P = 0.42; paired t test) between baseline and the final examination. Two of the 15 eyes underwent photodynamic therapy during follow-up. The mean central retinal thickness significantly decreased from 278.4 ± 71.9 μm at baseline to 240.00 ± 58.5 μm at 3 months after the first IVB treatment (P = 0.02; Wilcoxon signed rank test). During follow-up, a mean of two injections was administered, and 47% of patients required only one injection. No adverse events developed.
IVB was effective for maintaining good vision in exudative AMD in 15 eyes for at least 12 months.
Japanese Journal of Ophthalmology 11/2010; 54(6):565-70. · 0.92 Impact Factor
