483 results on '"Choroid Diseases complications"'
Search Results
2. A Case of Refractory Posterior Scleritis with Marked Retinochoroidal Detachment Associated with Panuveitis.
- Author
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Nakagawa Y, Suzuki T, Sahashi A, Tan X, and Suzuki Y
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- Humans, Male, Aged, 80 and over, Treatment Outcome, Fluorescein Angiography methods, Choroid diagnostic imaging, Choroid pathology, Choroid Diseases etiology, Choroid Diseases diagnostic imaging, Choroid Diseases diagnosis, Choroid Diseases complications, Scleritis etiology, Scleritis diagnosis, Scleritis diagnostic imaging, Scleritis complications, Retinal Detachment etiology, Retinal Detachment diagnostic imaging, Retinal Detachment diagnosis, Panuveitis diagnosis, Panuveitis etiology, Panuveitis complications, Prednisolone administration & dosage, Visual Acuity, Tomography, Optical Coherence
- Abstract
An 84-year-old man presented with decreased right-eye visual acuity. Upon initial examination, the rightand left-eye visual acuities were 0.03 and 1.2, respectively; moreover, the right- and left-eye intraocular pressure was 12 mmHg and 13 mmHg, respectively. Examination revealed a shallow anterior chamber of the right eye, anterior chamber inflammation, vitreous opacity, and marked retinochoroidal detachment. Optical coherence tomography (OCT) revealed retinal detachment (RD) and choroidal folds; moreover, B-scan ultrasonography (B-scan) showed RD as well as thickened sclera with fluid in Tenon's space. Fluorescent fundus angiography revealed hyperfluorescence in the optic disc and vascular hyperpermeability in the right eye. The left eye lacked extra-ocular symptoms or abnormalities. The right ocular axis measured 23.4 mm with no apparent subretinal fluid migration due to positional changes. Accordingly, the patient was diagnosed with panuveitis associated with posterior scleritis and immediately started on 40 mg prednisolone, which improved his symptoms. However, at 3 post-treatment months, choroidal folds were observed and was restarted on 20 mg prednisolone. The choroidal folds subsequently disappeared, with a current visual acuity of 0.3 in the right eye and no recurrence. Our findings indicated the utility of accurate diagnosis of posterior scleritis by B-scan and prompt systemic steroid administration.
- Published
- 2024
3. SCLEROCHOROIDAL CALCIFICATION WITH OPTIC NERVE CALCIFICATION IN A PATIENT WITH PRIMARY HYPERPARATHYROIDISM AND SEVERE VISION LOSS.
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Sood S and Friedman S
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- Humans, Female, Aged, Optic Nerve Diseases diagnosis, Optic Nerve Diseases etiology, Scleral Diseases diagnosis, Scleral Diseases complications, Choroid Diseases diagnosis, Choroid Diseases etiology, Choroid Diseases complications, Visual Acuity, Blindness etiology, Blindness diagnosis, Tomography, Optical Coherence methods, Calcinosis complications, Calcinosis diagnosis, Calcinosis pathology, Hyperparathyroidism, Primary complications, Hyperparathyroidism, Primary diagnosis
- Abstract
Background/purpose: To present a case of sclerochoroidal calcification (SCC) associated with dural calcification along the optic nerves and severe visual loss., Methods: Case report., Results: A 74-year-old white female patient with a 25-year history of primary hyperparathyroidism and surgical removal of a single parathyroid gland presented with blurred vision. On presentation, she had a calcium level of 12.6 mg/dL (reference range: 8.7-10.3 mg/dL). Her best-corrected visual acuity (BCVA) was 20/40 in both eyes, and she was diagnosed with bilateral SCC. After 2 years, the patient returned with a complaint of progressive vision loss, and the BCVA was 20/150 in the right eye and hand motion in the left eye. She had stable focal SCC on fundus examination with no significant changes from the previous examination. The fluorescein angiogram was unremarkable with no leakage. Optical coherence tomography (OCT) of the macula showed no edema or subretinal fluid and was not significantly changed from the first OCT. B-scan showed areas of calcification in the sclera consistent with the SCC. Computerized tomography (CT) scans showed dural calcifications along both optic nerves. She had no enlargement of SCC lesions and no other ocular or neurologic pathology associated with her vision loss., Conclusion: We present a patient with bilateral SCC and associated calcification in both globes. Unlike previous reports of SCC, our case demonstrated progressive severe vision loss because of dural calcification along the optic nerves. Patients with SCC and decreased vision should receive a CT scan to look for this rare associated finding.
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- 2024
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4. SUCCESSFUL TREATMENT OF SEVERE PERIPAPILLARY PACHYCHOROID SYNDROME WITH ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY.
- Author
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Abraham N, Bousquet E, Santina A, Somisetty S, Romero-Morales V, and Sarraf D
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- Humans, Female, Male, Vascular Endothelial Growth Factor A antagonists & inhibitors, Aged, Middle Aged, Retrospective Studies, Visual Acuity, Fluorescein Angiography methods, Tomography, Optical Coherence methods, Syndrome, Macular Edema drug therapy, Macular Edema etiology, Macular Edema diagnosis, Choroid Diseases drug therapy, Choroid Diseases diagnosis, Choroid Diseases complications, Receptors, Vascular Endothelial Growth Factor therapeutic use, Receptors, Vascular Endothelial Growth Factor administration & dosage, Recombinant Fusion Proteins therapeutic use, Intravitreal Injections, Angiogenesis Inhibitors therapeutic use
- Abstract
Purpose: To describe two cases of severe peripapillary pachychoroid syndrome successfully managed with monthly intravitreal aflibercept therapy., Methods: Medical and imaging records were retrospectively reviewed. Patients were imaged with ultra-widefield fluorescein, indocyanine green angiography, and fundus autofluorescence. Spectral-domain optical coherence tomography was performed to evaluate macular edema and choroidal thickness. Optical coherence tomography angiography excluded macular neovascularization., Results: This report summarizes two cases of peripapillary pachychoroid syndrome complicated by very severe bilateral macular edema. In all four eyes, the diffuse intraretinal and subretinal fluid remarkably improved or completely resolved after monthly intravitreal aflibercept injections with commensurate improvement of visual acuity. Multimodal imaging documented the significant improvement of fluid and the reduction in choroidal thickening in response to anti-vascular endothelial growth factor therapy in each case., Conclusion: Severe cases of peripapillary pachychoroid syndrome associated with vision loss can be successfully treated with intravitreal aflibercept therapy.
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- 2024
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5. Focal choroidal excavation in solitary congenital hypertrophy of the retinal pigment epithelium.
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Üçer MB
- Subjects
- Humans, Retinal Pigment Epithelium diagnostic imaging, Hypertrophy diagnosis, Hypertrophy congenital, Tomography, Optical Coherence, Fluorescein Angiography, Choroid diagnostic imaging, Choroid abnormalities, Choroid Diseases complications, Choroid Diseases diagnosis, Central Serous Chorioretinopathy
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- 2024
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6. Brolucizumab after failure of aflibercept with photodynamic therapy in polypoidal choroidal vasculopathy: A case report.
- Author
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Yuan PH, Khan HM, Sumita FAG, Ribeiro Monteiro ML, Preti RC, and Navajas EV
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- Humans, Polypoidal Choroidal Vasculopathy, Choroid Diseases drug therapy, Choroid Diseases complications, Photochemotherapy
- Abstract
We describe one case of polypoidal choroidal vasculopathy with persistent subretinal fluid despite multiple treatment with intravitreal Bevacizumab, Ranibizumab and Aflibercept, as well as Aflibercept associated with photodynamic therapy. The patient reached complete resolution after intravitreal Brolucizumab injection, but experienced recurrence of subretinal fluid 12 weeks after discontinuation. Brolucizumab might be an option in treating subretinal fluid after failure of other anti-VEGF agents associated with photodynamic therapy., (Copyright © 2023 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
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7. Clinical Characteristics and Visual Outcomes of Acute Syphilitic Posterior Placoid Chorioretinopathy.
- Author
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Mirzania D, Zacks DN, Zhou Y, and Huvard MJ
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- Adult, Humans, Female, Middle Aged, Retrospective Studies, Fluorescein Angiography, Tomography, Optical Coherence, Syphilis diagnosis, Chorioretinitis diagnosis, Eye Infections, Bacterial diagnosis, Eye Infections, Bacterial drug therapy, Eye Infections, Bacterial complications, Choroid Diseases complications
- Abstract
Purpose: To evaluate presenting features and visual outcomes in eyes with acute syphilitic posterior placoid chorioretinopathy (ASPPC)., Design: Retrospective cohort study., Subjects: A total of 24 eyes of 17 adult patients with ASPPC., Methods: Chart review of patients with ASPPC who presented to the University of Michigan W. K. Kellogg Eye Center between January 1, 2012, and November 4, 2022. Demographic and clinical information, fundus photographs, fundus autofluorescence, and spectral-domain-OCT (SD-OCT) findings were reviewed., Main Outcome Measures: Clinical characteristics and visual acuity (VA) on presentation and follow-up examination., Results: The median age was 46 (interquartile range [IQR], 38-51) years. At presentation, 20 (83.3%) eyes had subjectively decreased vision, with a median initial VA of 0.54 (IQR, 0.35-1.00) logarithm of the minimum angle of resolution (logMAR); at 45 days, median logMAR VA was 0.096 (IQR, 0.02-0.17). Initial VA was positively associated with posterior pole-sparing lesions (coefficient estimate [CE], -0.75; 95% confidence interval [CI], -1.38 to -0.12); P = 0.03), and negatively associated with ellipsoid zone (EZ) disruption (CE, 0.72; 95% CI, 0.03-1.42; P = 0.04), subfoveal EZ disruption (CE, 0.62; 95% CI, 0.02-1.23; P = 0.046), and initial hyperreflective foci on SD-OCT (CE, 0.66; 95% CI, 0.09-1.23; P = 0.03). Female eyes were more likely (hazard ratio [HR], 3.36; 95% CI, 1.07-10.6; P = 0.04), and eyes with optic nerve abnormality were less likely (HR, 0.34; 95% CI, 0.12-0.96; P = 0.04), to achieve a VA ≥ 20/40 (logMAR, 0.30)., Conclusions: This study of patients with ASPPC showed that symptomatic eyes had an improvement from a median VA of 20/69 on presentation to a median VA of 20/25 at 45 days. Female sex and absence of optic nerve involvement were associated with higher probability of achieving ≥ 20/40. These findings provide refined guidance for counseling patients who present with decreased vision due to ASPPC., Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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8. Central serous chorioretinopathy complicated by uveal effusion syndrome: Case report.
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Xu D and Chen M
- Subjects
- Humans, Fluorescein Angiography, Tomography, Optical Coherence, Central Serous Chorioretinopathy complications, Central Serous Chorioretinopathy diagnosis, Uveal Effusion Syndrome, Choroid Diseases complications, Choroid Diseases diagnosis
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- 2023
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9. Simultaneous macular hole with retinal and hemorrhagic choroidal detachments.
- Author
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Breazzano MP
- Subjects
- Humans, Retina, Retinal Perforations complications, Retinal Perforations diagnosis, Choroid Diseases complications, Choroid Diseases diagnosis, Choroidal Effusions, Retinal Detachment complications, Retinal Detachment diagnosis
- Published
- 2023
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10. Central serous chorioretinopathy: A review.
- Author
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Fung AT, Yang Y, and Kam AW
- Subjects
- Humans, Choroid pathology, Fundus Oculi, Fluorescein Angiography methods, Tomography, Optical Coherence methods, Central Serous Chorioretinopathy therapy, Central Serous Chorioretinopathy drug therapy, Choroid Diseases complications, Photochemotherapy methods
- Abstract
Central serous chorioretinopathy (CSC) is the fourth most common non-surgical retinopathy associated with fluid leakage. The pathogenesis is not yet completely understood, but changes in the choroid, sclera and RPE have been described associated with venous congestion of choroidal outflow. CSC can be categorised into acute, chronic, and recurrent subtypes with recent classifications of simple and complex based on the area of RPE change seen on fundus autofluorescence. A multimodal imaging approach is helpful in the diagnosis and management of CSC and secondary complications such as type 1 neovascularisation. Although spontaneous resolution with relatively good visual outcomes is common, treatment should be considered in patients with persistent or recurrent SRF. Treatment options include laser, systemic medications, intravitreal therapy, and surgery. Of these, argon laser for focal extramacular fluid leaks and photodynamic therapy of leakage identified by indocyanine-green angiography currently have the greatest supportive evidence., (© 2023 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.)
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- 2023
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11. Primary and secondary focal choroidal excavation morphologic phenotypes, associated ocular disorders and prognostic implications.
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Capellan P, Gonzalez LA, Abdallah Mahrous M, Weiss SJ, Botsford B, Lenis TL, Ryan M, Orlin A, Papakostas T, Kiss S, D'Amico D, and Kovacs K
- Subjects
- Humans, Prognosis, Fluorescein Angiography, Visual Acuity, Choroid pathology, Tomography, Optical Coherence methods, Retrospective Studies, Choroid Diseases complications, Vitelliform Macular Dystrophy pathology, Central Serous Chorioretinopathy complications
- Abstract
Aims: To characterise and classify the morphological, clinical and tomographic characteristics of focal choroidal excavation (FCE) lesions to determine their prognostic implications., Methods: 36 eyes with FCE (32 patients) underwent multimodal imaging, including spectral domain optical coherence tomography and fundus autofluorescence. FCE lesions were classified into three subtypes: (1) type 1: myopic (central choroidal thickness: <100 µm), (2) type 2: suspected congenital (central choroidal thickness: 100-200 µm, without associated chorioretinal pathology) and (3) type 3: secondary or acquired (central choroidal thickness: >200 µm, with associated chorioretinal pathology)., Results: 80.6% of eyes were followed longitudinally (26.8±18.8 months). There were 9 type 1 FCEs (myopic), 8 type 2 FCEs (U-shaped, congenital) and 19 type 3 FCEs (V-shaped, secondary). Type 2 FCEs trended towards larger maximum widths (p=0.0563). Type 3 FCEs were associated with central serous chorioretinopathy or pachyvessels (47.4%), but were also seen in pattern dystrophy, geographic atrophy, inactive choroiditis, torpedo maculopathy and adult-onset vitelliform dystrophy. Choroidal neovascular membranes (CNVMs) were more prevalent in type 3 FCE (41.2% compared with 11.1% for type 1 FCE, p=0.251, and 0% for type 2 FCE, p=0.043)., Conclusions: The FCE types, stratified by central choroidal thickness, demonstrated distinct morphological characteristics and associated findings. The classification scheme held prognostic implications as type 3 FCE with V shapes were associated with other chorioretinal conditions and were more likely to develop CNVM., Competing Interests: Competing interests: KK: consultant for Regenxbio. DD’A: consultant—Alcon, IVERIC bio and Aufbau Holdings; equity—IVERIC bio and Aufbau Holdings; intellectual property—Aufbau Holdings. Szilárd Kiss: consultant—Adverum, Alcon, Novartis, Optos and Genentech/Roche; research funding—Allergan, Novartis, Optos, Genentech/Roche and Regeneron; equity—Adverum, Regenxbio and Fortress Bio; intellectual property—gene therapy for age-related macular degeneration and T cells for CMV retinitis, assigned to Cornell University., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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12. [Choroidal granuloma in miliary tuberculosis; a case report].
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Hamma A and Lakhdar Fouatih A
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- Humans, Choroid, Granuloma complications, Tuberculosis, Miliary complications, Tuberculosis, Miliary diagnosis, Choroid Diseases etiology, Choroid Diseases complications, Tuberculosis, Ocular complications, Tuberculosis, Ocular diagnosis
- Published
- 2023
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13. MASSIVE BILATERAL SEROUS RETINAL DETACHMENT IN A YOUNG PATIENT WITH HYPERTENSIVE CHORIORETINOPATHY AND CHRONIC KIDNEY DISEASE.
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Arévalo Simental DE, Sepulveda Tinajero LH, Villarreal Contreras FA, Becerra Cota MG, and Ingolotti M
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- Male, Humans, Adolescent, Fluorescein Angiography, Retinal Detachment etiology, Retinal Detachment complications, Choroid Diseases complications, Choroid Diseases diagnosis, Retinal Diseases complications, Hypertension complications, Renal Insufficiency, Chronic complications
- Abstract
Purpose: Report a case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment in a young patient with chronic kidney disease., Methods: Observational case report., Results: An 18-year-old man with Grade 5 chronic kidney disease, systemic high blood pressure, secondary acute pulmonary edema, and acute uremic syndrome was referred to our service complaining of bilateral decreased vision starting one week ago. The patient was treated at that moment with hemodialysis and losartan. At initial examination, the patient's blood pressure was 170/120 mmHg; dilated fundus examination evidenced optic disk edema, hypertensive chorioretinopathy, and massive serous retinal detachment with best-corrected visual acuity of hand motion in both eyes. The case was diagnosed as undertreated hypertension and was referred to the nephrologist for treatment adjustments. At 1-month follow-up, blood pressure was 160/90 mmHg; there was clinical improvement in both eyes but with ischemic sequelae. At the final follow-up 6 months later, blood pressure was 100/60 mmHg, best-corrected visual acuity was 20/80 in the right eye and count fingers at 2 min the left eye, and there was a complete resolution of the retinal serous detachment in both eyes., Conclusion: Patients with massive serous detachments due to systemic hypertension are atypical so it is of immense importance for the ophthalmologists to recognize the ocular manifestations of systemic diseases that put the patient's life at risk as in this case.
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- 2023
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14. Hellp syndrome-related hypertensive chorioretinopathy: A multimodal imaging and optical coherence tomography angiography (OCTA) study.
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Interlandi E, Pellegrini F, Silvestrin C, Pece A, and Pavesio C
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- Female, Pregnancy, Humans, Tomography, Optical Coherence methods, Fluorescein Angiography methods, Choroid, Multimodal Imaging methods, HELLP Syndrome diagnosis, Central Serous Chorioretinopathy, Choroid Diseases etiology, Choroid Diseases complications, Hypertension
- Abstract
Introduction: Pregnancy may be associated to unique retinal disorders and is associated to worsening of retinal disease that also occurs in non-pregnant females. We report a case of chorioretinopathy caused by pre-eclampsia associated to HELLP (Hemolysis-Elevated-Liver enzymes and Low Platelet count) syndrome., Methods: Multimodal Imaging features of HELLP syndrome-related hypertensive chorioretinopathy including retinography, Spectral Domain-Optical Coherence Tomography (SD-OCT), Fluorescein angiography (FA), Indocyanine-green angiography (ICG) along with OCT-angiography (OCTA) are presented and discussed., Results: Multimodal imaging and OCTA show both retinal and choroidal involvement by HELLP syndrome, resolved after hypertension treatment., Conclusions: Multimodal imaging is useful to study HELLP syndrome-related hypertensive chorioretinopathy. Moreover, OCTA is a new technology able to study and follow the circulatory status of the choriocapillaris during the disease.
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- 2023
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15. Bilateral secondary angle-closure glaucoma and ciliochoroidal effusion as an initial manifestation of systemic lupus erythematosus.
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Senthilkumar VA, Vineela P, Mishra C, and Ramesh S
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- Humans, Choroid Diseases complications, Choroid Diseases etiology, Choroidal Effusions, Glaucoma, Angle-Closure complications, Glaucoma, Angle-Closure etiology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic diagnosis
- Abstract
Competing Interests: None
- Published
- 2022
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16. CD146 as a promising therapeutic target for retinal and choroidal neovascularization diseases.
- Author
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Xue B, Wang P, Yu W, Feng J, Li J, Zhao R, Yang Z, Yan X, and Duan H
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- Animals, CD146 Antigen, Humans, Hypoxia, Neovascularization, Pathologic drug therapy, Vascular Endothelial Growth Factor A metabolism, Choroid Diseases complications, Choroidal Neovascularization drug therapy, Choroidal Neovascularization etiology, Choroidal Neovascularization pathology, Retinal Diseases metabolism, Retinal Neovascularization drug therapy
- Abstract
Blood vessel dysfunction causes several retinal diseases, including diabetic retinopathy, familial exudative vitreoretinopathy, macular degeneration and choroidal neovascularization in pathological myopia. Vascular endothelial growth factor (VEGF)-neutralizing proteins provide benefits in most of those diseases, yet unsolved haemorrhage and frequent intraocular injections still bothered patients. Here, we identified endothelial CD146 as a new target for retinal diseases. CD146 expression was activated in two ocular pathological angiogenesis models, a laser-induced choroid neovascularization model and an oxygen-induced retinopathy model. The absence of CD146 impaired hypoxia-induced cell migration and angiogenesis both in cell lines and animal model. Preventive or therapeutic treatment with anti-CD146 antibody AA98 significantly inhibited hypoxia-induced aberrant retinal angiogenesis in two retinal disease models. Mechanistically, under hypoxia condition, CD146 was involved in the activation of NFκB, Erk and Akt signalling pathways, which are partially independent of VEGF. Consistently, anti-CD146 therapy combined with anti-VEGF therapy showed enhanced impairment effect of hypoxia-induced angiogenesis in vitro and in vivo. Given the critical role of abnormal angiogenesis in retinal and choroidal diseases, our results provide novel insights into combinatorial therapy for neovascular fundus diseases., (© 2021. Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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17. MULTIMODAL IMAGING IN HELLP-RELATED CHORIORETINOPATHY.
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Van Rysselberge C, Balikova I, Judice L, Makhoul D, and Postelmans L
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- Female, Fluorescein Angiography methods, Humans, Multimodal Imaging methods, Pregnancy, Tomography, Optical Coherence methods, Central Serous Chorioretinopathy diagnosis, Choroid Diseases complications, Choroid Diseases diagnostic imaging, HELLP Syndrome diagnosis, Retinal Detachment diagnostic imaging, Retinal Detachment etiology, Retinal Diseases diagnostic imaging, Retinal Diseases etiology
- Abstract
Purpose: To illustrate with multimodal imaging a case of HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) complicated by bilateral multifocal serous retinal detachments, subretinal exudation, and papilledema., Methods: Case report. Fundus photography, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography were performed at presentation and the day after. We also present the SD-OCT follow-up at 8 days, 1 year, and 4 years., Results: A 25-year-old 5-month-pregnant Guinean woman complained about decreased visual acuity in the right eye. Eye fundus and multimodal imaging were abnormal in both eyes. Spectral domain optical coherence tomography showed the presence of multifocal serous retinal detachments, subretinal deposits, and intraretinal cysts. Indocyanin green angiography revealed an irregular choroidal perfusion and localized choroidal ischemia. Spectral domain optical coherence tomography also provided assessment of retinal changes during the long-term follow-up, showing tissue damage in the outer retina., Conclusion: Serous retinal detachments during pregnancy can be the leading sign of HELLP syndrome-a potentially life-threatening condition. Spectral domain optical coherence tomography is a noninvasive and useful tool for its diagnosis and follow-up. ICG is important to confirm the choroidal ischemia and choroidal vascular abnormalities, underlying conditions leading to main sign of HELLP syndrome in the eye.
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- 2022
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18. Visuopathy of prematurity: is retinopathy just the tip of the iceberg?
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Ingvaldsen SH, Morken TS, Austeng D, and Dammann O
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- Child, Humans, Infant, Newborn, Neovascularization, Pathologic complications, Retina, Choroid Diseases complications, Infant, Newborn, Diseases, Retinopathy of Prematurity complications
- Abstract
Research on retinopathy of prematurity (ROP) focuses mainly on the abnormal vascularization patterns that are directly visible for ophthalmologists. However, recent findings indicate that children born prematurely also exhibit changes in the retinal cellular architecture and along the dorsal visual stream, such as structural changes between and within cortical areas. Moreover, perinatal sustained systemic inflammation (SSI) is associated with an increased risk for ROP and the visual deficits that follow. In this paper, we propose that ROP might just be the tip of an iceberg we call visuopathy of prematurity (VOP). The VOP paradigm comprises abnormal vascularization of the retina, alterations in retinal cellular architecture, choroidal degeneration, and abnormalities in the visual pathway, including cortical areas. Furthermore, VOP itself might influence the developmental trajectories of cerebral structures and functions deemed responsible for visual processing, thereby explaining visual deficits among children born preterm., (© 2021. The Author(s).)
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- 2022
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19. CHORIORETINAL FOLDS IN PATIENTS WITH CENTRAL SEROUS CHORIORETINOPATHY.
- Author
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Cohen SY, Ducos de Lahitte G, Gaudric A, and Mrejen S
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- Adult, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Humans, Hyperopia complications, Hyperopia diagnostic imaging, Male, Middle Aged, Tomography, Optical Coherence, Central Serous Chorioretinopathy complications, Central Serous Chorioretinopathy diagnostic imaging, Choroid Diseases complications, Choroid Diseases diagnostic imaging
- Abstract
Background and Purpose: To the best of our knowledge, there is no study of patients with central serous chorioretinopathy associated with chorioretinal folds, since a short mention in Gass' stereoscopic atlas. We report here six cases with this association., Methods: Six patients with both conditions were examined in our institution and underwent fluorescein angiography and optical coherence tomography., Results: Patients were 3 men and 3 women, aged 44 years to 82 years. All patients were hyperopic and two received corticosteroids. Fluorescein angiography showed pigmentary changes, diffuse leakage areas typical of chronic central serous chorioretinopathy, and chorioretinal folds mainly located in the upper temporal part of the fundus. Enhanced depth imaging optical coherence tomography was performed in 5 cases and revealed a thick choroid in all cases (mean subfoveal choroidal thickness: 381 µm, range: 280-510 µm)., Conclusion: Although possibly coincidental, the presence of chorioretinal folds in hyperopic central serous chorioretinopathy eyes could be due to the excessive thickness of the choroid in eyes with hyperopia related to short axial length.
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- 2022
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20. Lupus choroidopathy: A case report.
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Mahjoub A, Dlensi A, Ben Abdesslem N, Amri M, Sellem I, Ghorbel M, Mahjoub H, Knani L, and Krifa F
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- Fluorescein Angiography, Humans, Choroid Diseases complications, Choroid Diseases etiology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic diagnosis, Retinal Detachment etiology
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- 2022
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21. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS OF CLASSIC CHOROIDAL NEOVASCULARIZATION IN POLYPOIDAL CHOROIDAL VASCULOPATHY.
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Izumi T, Koizumi H, Maruko I, Hasegawa T, and Iida T
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- Aged, Choroid diagnostic imaging, Choroid Diseases complications, Choroid Diseases drug therapy, Choroidal Neovascularization drug therapy, Choroidal Neovascularization etiology, Cross-Sectional Studies, Female, Follow-Up Studies, Fundus Oculi, Humans, Intravitreal Injections, Male, Polyps complications, Polyps drug therapy, Retrospective Studies, Visual Acuity, Angiogenesis Inhibitors administration & dosage, Choroid blood supply, Choroid Diseases diagnosis, Choroidal Neovascularization diagnosis, Fluorescein Angiography methods, Polyps diagnosis, Tomography, Optical Coherence methods
- Abstract
Purpose: To evaluate the flow signals in subretinal hyperreflective material (SHRM) that represents classic choroidal neovascularization (CNV) on fluorescein angiography in eyes with polypoidal choroidal vasculopathy., Methods: We retrospectively reviewed 20 eyes with polypoidal choroidal vasculopathy that appeared to have classic CNV on fluorescein angiography, accompanied by SHRM on optical coherence tomography (OCT) at the same location. Using OCT angiography (OCTA), we analyzed intrinsic flow signals in the SHRM (cross-sectional B-scans and en face). The possible association between pretreatment OCT angiography findings and fibrotic scar formation after antivascular endothelial growth factor (VEGF) treatment was evaluated., Results: Six of 20 eyes (30%) showed vascular SHRM; the remaining 14 eyes (70%) showed avascular SHRM at the classic CNV site at baseline. The SHRM corresponded with polypoidal lesions seen on indocyanine green angiography in 5 of 6 eyes with vascular SHRM and in all 14 eyes with avascular SHRM. After anti-VEGF treatment, all 6 eyes with vascular SHRM left a fibrotic scar, whereas all 14 eyes with avascular SHRM showed no scar formation (P < 0.001)., Conclusion: Using OCT angiography, we evaluated the flow signals in SHRM that represented classic CNV in eyes with polypoidal choroidal vasculopathy and successfully differentiated true Type 2 macular neovascularization from pseudo classic CNV.
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- 2022
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22. Rapid resolution of severe exudation in uveal effusion syndrome with anti-vascular endothelial growth factor alone in a case of bilateral nanophthalmos: a case report.
- Author
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Song L, Dong F, and Yi C
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- Adult, Exudates and Transudates, Humans, Male, Choroid Diseases complications, Choroid Diseases drug therapy, Microphthalmos, Retinal Detachment drug therapy, Uveal Effusion Syndrome
- Abstract
Background: Uveal effusion syndrome is a rare disease characterized by exudative detachments of the choroid, ciliary body, and retina. Various surgical procedures and nonsurgical strategies have been described to treat uveal effusion syndrome with limited success. The treatment for uveal effusion syndrome remains a serious challenge for clinicians. To the best of our knowledge, no previous report has described a severe uveal effusion syndrome patient with nanophthalmos treated by using an anti-vascular endothelial growth factor agent alone. We report here one such case with unexpected positive results., Case Presentation: A 30-year-old Chinese male patient presented with painless vision loss in both eyes that had persisted for 2 months. Examination of the right eye revealed a best corrected visual acuity of 0.03; the best corrected visual acuity of the left eye was finger count/20 cm. The intraocular pressure was normal on both eyes. A-scan revealed an right eye axial length of 15.88 mm and a left eye axial length of 16.21 mm. In the right eye, half of the peripheral choroid and nearly three-fourths of the retina were detached. The left fundus was not visible because of the total retinal detachment located just behind the lens, which could be clearly observed directly with a slit lamp. Considering all the possibilities and available treatments as well as the patient's intentions after discussion, we first administered an intravitreal injection of ranibizumab 0.5 ml into both eyes. The patient's visual perception improved 3 days after the injection. One month later, most of the effusion under the choroid and retina was absorbed. Visual acuity improved from finger count to 0.05 in both eyes, and vision quality was remarkably improved. Encouraged by this good result, the patient opted to undergo a second injection 1 month later. Choroidal and retinal detachment completely vanished 30 days after the second injection., Conclusions: Using an anti-vascular endothelial growth factor agent alone may be a potentially effective and safe method for managing some types of uveal effusion syndrome, such as in nanophthalmos. The injection may be administered before considering more aggressive procedures in some uveal effusion syndrome patients., (© 2021. The Author(s).)
- Published
- 2021
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23. Partial Vision Loss After Orbital Decompression in a Patient With Thyroid Eye Disease, Chorioretinal Folds, and Disc Edema.
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DeMaria LN, Tran AQ, Tooley AA, Elmalem VI, and Belinsky I
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- Blindness diagnosis, Blindness physiopathology, Choroid Diseases complications, Choroid Diseases diagnosis, Follow-Up Studies, Graves Ophthalmopathy complications, Graves Ophthalmopathy diagnosis, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Papilledema complications, Papilledema diagnosis, Retinal Diseases complications, Retinal Diseases diagnosis, Tomography, Optical Coherence methods, Visual Acuity, Blindness etiology, Choroid Diseases surgery, Decompression, Surgical adverse effects, Graves Ophthalmopathy surgery, Papilledema surgery, Postoperative Complications, Retinal Diseases surgery
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Abstract: Concomitant chorioretinal folds with disc edema can be seen in cases of thyroid eye disease presenting with compressive optic neuropathy and may portend optic nerve ischemia. We describe an unusual case of a 64-year-old man who developed partial vision loss after orbital decompression., Competing Interests: V. I. Elmalem: Thyroid Eye Disease Advisory Board 8/24/2019, Horizon Therapeutics, Plc; I. Belinsky: Thyroid Eye Disease Advisory Board 7/31/2020, Horizon Therapeutics, Plc. The remaining authors report no conflicts of interest., (Copyright © 2021 by North American Neuro-Ophthalmology Society.)
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- 2021
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24. Massive submacular haemorrhage in polypoidal choroidal vasculopathy versus typical neovascular age-related macular degeneration.
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Cho SC, Cho J, Park KH, and Woo SJ
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- Aged, Choroid Diseases diagnosis, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Incidence, Male, Polyps diagnosis, Republic of Korea epidemiology, Retinal Hemorrhage diagnosis, Retinal Hemorrhage epidemiology, Retrospective Studies, Tomography, Optical Coherence methods, Wet Macular Degeneration diagnosis, Choroid blood supply, Choroid Diseases complications, Polyps complications, Retinal Hemorrhage etiology, Visual Acuity, Wet Macular Degeneration complications
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Purpose: To investigate the incidence rate of massive submacular haemorrhage (SMH) and risk factors in polypoidal choroidal vasculopathy (PCV) and typical neovascular age-related macular degeneration (tnAMD)., Methods: A total of 465 patients who were diagnosed with either PCV (n = 245) or tnAMD (n = 220) from 2003 to 2014 were enrolled. Cumulative incidence of massive SMH in PCV and that in tnAMD were compared. Risk factors of massive SMH were also analysed., Results: Massive SMH occurred in 32 patients (13.1%) with PCV and 9 patients (4.1%) with tnAMD. Incidence rates of massive SMH 5 and 10 years after the first visit were 11.1% and 29.9% in PCV and 4.3% and 9.9% in tnAMD, respectively. Incidence rates of massive SMH in PCV were significantly higher than those in tnAMD (hazard ratio [HR], 2.66; p = 0.007). Cox regression analysis revealed that mean number of photodynamic therapies (PDTs) per year (HR, 4.24; p < 0.001), cluster type of polypoidal lesion (HR, 3.42; p = 0.003) in PCV, and mean number of anti-VEGF injections per year (HR, 1.58; p < 0.001) in tnAMD were significantly associated with risk of massive SMH. For patients with severe vision loss, proportion of incident massive SMH was significantly higher in PCV (29.5%) than in tnAMD (6.9%, p < 0.001)., Conclusion: The incidence rate of massive SMH in eyes with PCV was about three times higher than that in eyes with tnAMD. Treatment methods that can reduce the incidence of massive SMH should be considered, especially for eyes with PCV., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
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- 2021
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25. THE INCIDENCE, CHARACTERISTICS, MANAGEMENT, PROGNOSIS, AND CLASSIFICATION OF BREAKTHROUGH VITREOUS HEMORRHAGE SECONDARY TO POLYPOIDAL CHOROIDAL VASCULOPATHY.
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Zhao XY, Luo MY, Meng LH, Zhang WF, Li B, Wang EQ, Liu SZ, Yu WH, and Chen YX
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- Aged, China epidemiology, Choroid diagnostic imaging, Choroid Diseases diagnosis, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Incidence, Male, Polyps diagnosis, Prognosis, Retrospective Studies, Tomography, Optical Coherence methods, Vitreous Hemorrhage classification, Vitreous Hemorrhage etiology, Choroid blood supply, Choroid Diseases complications, Polyps complications, Visual Acuity, Vitreous Hemorrhage epidemiology
- Abstract
Purpose: To describe breakthrough vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV)., Methods: Patients with the diagnosis of PCV from January 2005 to March 2020 at Peking Union Medical College Hospital were retrospectively reviewed, cases with breakthrough vitreous hemorrhage were analyzed. Subgroup analysis was conducted regarding pachychoroid PCV and nonpachychoroid PCV., Results: Among 722 PCV patients (834 eyes), 103 eyes with breakthrough vitreous hemorrhage (12.4%) were included. Pars plana vitrectomy and proper further interventions could significantly improve the best-corrected visual acuity from logMAR 2.15 ± 0.48 (Snellen 20/2825) to 1.65 ± 0.67 (20/893). Hemorrhagic retinal detachment, baseline central macular thickness, and best-corrected visual acuity were factors associated with final best-corrected visual acuity (P < 0.05). In the pachychoroid PCV group, patients were younger, all had hemorrhagic pigment epithelial detachment, with a higher prevalence of choroidal vascular hyperpermeability and hemorrhagic retinal detachment, thicker subfoveal choroidal thickness, and thinner central macular thickness; besides, the initial pars plana vitrectomy were more complicated, more additional surgeries had to be performed. More eyes in the nonpachychoroid PCV group had received anti-vascular endothelial growth factor or photodynamic therapy, mostly fibrovascular pigment epithelial detachment, the best-corrected visual acuity and the status of the fellow eye were significantly worse. For the final ocular status, more eyes in nonpachychoroid PCV group were taking anti-vascular endothelial growth factor monotherapy, whereas more eyes in pachychoroid PCV group were stable. The choroidal parameters of these two groups were all significantly different., Conclusion: Breakthrough vitreous hemorrhage is a troublesome complication of PCV. Pars plana vitrectomy and additional interventions are required for better prognosis. Vitreous hemorrhage secondary to pachychoroid PCV or nonpachychoroid PCV have different characteristics and prognosis.
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- 2021
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26. PRESUMED FOVEAL BACILLARY LAYER DETACHMENT IN A PATIENT WITH TOXOPLASMOSIS CHORIORETINITIS AND PACHYCHOROID DISEASE.
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Mehta N, Chong J, Tsui E, Duncan JL, Curcio CA, Freund KB, and Modi Y
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- Adult, Humans, Male, Tomography, Optical Coherence, Choroid Diseases complications, Retinal Detachment diagnostic imaging, Toxoplasmosis, Ocular complications
- Abstract
Purpose: To report a detachment that apparently separated photoreceptor inner segment myoids from inner segment ellipsoids as a manifestation of toxoplasmosis chorioretinitis in a patient with pachychoroid spectrum disease., Methods: Multimodal imaging including fundus photography, spectral domain and enhanced-depth imaging optical coherence tomography (OCT), indocyanine green angiography, and OCT angiography., Results: A 33-year-old man with a history of toxoplasmosis chorioretinitis reported 1 week of decreased vision to 20/200 in his right eye. Examination of the right eye demonstrated mild vitritis with recurrent chorioretinitis inferior to the fovea and adjacent to a chorioretinal scar. A dome-shaped, foveal photoreceptor layer-splitting detachment was noted on OCT. Because degenerating cone photoreceptors are capable of shedding their inner segments, we inferred the location of the detachment at the level of the inner segment myoid and provided a histological example of such from an unrelated donor case. In addition, multimodal imaging revealed dilated choroidal veins (pachyvessels) with attenuation of the inner choroid in both eyes and asymptomatic findings of central serous chorioretinopathy in the left eye. After 1 month of antibiotic and steroid therapy, the chorioretinitis resolved, as did the detachment. Hyperreflective foci on the vitreoretinal interface were appreciated with en face OCT that appeared to aggregate throughout the course of therapy, induce inner retinal striae, and resolve without inducing epiretinal membrane formation., Conclusion: Patients with preexisting pachychoroid spectrum disease may manifest a more significant retinal fluid accumulation in the setting of superimposed chorioretinal inflammation. In this case of macular toxoplasmosis chorioretinitis, inflammation manifested as a retinal detachment at the level of photoreceptor inner segment myoids that we named as a bacillary layer detachment. In this case, inflammatory sequelae of toxoplasmosis reactivation responded well to oral and intravitreal therapy.
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- 2021
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27. Structure of the Retinal Margin and Presumed Mechanism of Retinal Detachment in Choroidal Coloboma.
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Tanaka S, Yokoi T, Katagiri S, Yoshida-Uemura T, Nishina S, and Azuma N
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- Adolescent, Adult, Child, Choroid Diseases complications, Coloboma complications, Female, Humans, Male, Retinal Detachment complications, Retrospective Studies, Young Adult, Choroid abnormalities, Choroid Diseases diagnosis, Coloboma diagnosis, Retinal Detachment diagnosis, Tomography, Optical Coherence methods
- Abstract
Purpose: To describe the vitreoretinal structure at the margin of the choroidal coloboma in infants and older patients using swept-source (SS) OCT., Design: Retrospective case series., Participants: Nineteen eyes of 16 patients with choroidal coloboma (7 males, 9 females; average age, 12.3 ± 7.1 years)., Methods: The patients were classified into 2 groups: infants 1 year of age or younger (3 eyes) and older patients (16 eyes). Each finding on SS OCT was documented according to previously defined histopathologic findings., Main Outcome Measures: Description of the SS OCT features of choroidal colobomas., Results: Swept-source OCT showed that the extracolobomatous retina centrally traversed the margin to continue as the marginal intercalary membrane (MICM), whereas the outer layers of the MICM were reversed at the point (point of reversal [POR]). The expected duplication was seen in all infant eyes, but in none of the older eyes whose outer layers of the MICM were ambiguous. However, at the boundary between the layered MICM and monolayered central intercalary membrane (CICM), the POR was detectable in all patients. Further SS OCT analysis showed that the MICM schisis and CICM schisis occurred simultaneously with vitreous traction. Retinal detachments (RDs) seen in 4 eyes were connected to the only MICM schisis, and a MICM break was identified in 1 eye. Swept-source OCT showed that retinal pigment epithelial hyperplasia adhered tightly to the retina and that the glial triangle was adhered tightly to the sclera, indicating barriers to the development of RD after MICM schisis., Conclusions: Swept-source OCT first visualized the POR in infant eyes and showed that the POR was identifiable despite the atrophic changes in the outer layer of the MICM in the older eyes. Based on the POR location, we confirmed that the intercalary membranes reported in previous OCT studies were clearly differentiated between the MICM and CICM. We also showed that the presence of MICM and CICM schisis resulted from vitreous traction at the coloboma margin and that MICM breaks induced RD only if the barrier that prevented the development of RD was broken., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
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- 2021
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28. Two different treatment regimens of ranibizumab 0.5 mg for neovascular age-related macular degeneration with or without polypoidal choroidal vasculopathy in Chinese patients: results from the Phase IV, randomized, DRAGON study.
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Li X, Zhu Q, Egger A, Chang L, Wolf S, Song Y, Zhang J, Dong F, Xu X, and Weisberger A
- Subjects
- Aged, Female, Humans, Male, Middle Aged, China, Choroid Diseases complications, Double-Blind Method, Drug Administration Schedule, Injections, Intraocular, Vascular Endothelial Growth Factor A antagonists & inhibitors, Angiogenesis Inhibitors administration & dosage, Angiogenesis Inhibitors adverse effects, Macular Degeneration complications, Macular Degeneration drug therapy, Ranibizumab administration & dosage, Ranibizumab adverse effects
- Abstract
Purpose: To evaluate the efficacy and safety of monthly and pro re nata (PRN, guided by visual acuity stabilization and disease activity criteria) ranibizumab regimens in Chinese patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV)., Methods: This double-masked study randomized nAMD patients (1:1) to ranibizumab monthly from baseline to Month (M) 11 to a PRN regimen from M12 to M23 (monthly group, n = 167) versus ranibizumab three monthly doses followed by a PRN regimen up to M23 (PRN group, n = 166). Subgroups were assessed based on the presence/absence of PCV (indicated by indocyanine green angiography)., Results: Of 334 randomized patients, 41.7% had PCV at baseline. Mean average best-corrected visual acuity (BCVA) change from M3 to M4 through M12 was 3.3 letters with monthly and 1.7 letters with PRN (mean difference: 1.6; 95% CI: -2.95, -0.20, primary end-point). Mean change in BCVA from baseline (monthly/PRN, 53.8/53.7) to M12 and M24 was 12.3 and 11.3 letters in monthly and 9.6 and 9.3 letters in PRN group. Corresponding values for patients with PCV/without PCV were 12.7/12.1 letters (M12) and 12.3/10.6 letters (M24) in monthly and 9.4/9.4 letters (M12) and 9.7/8.7 letters (M24) in PRN groups. The mean number of injections was 11.4 (monthly) and 8.2 (PRN) from Day 1 to M11 and 4.8 (monthly) and 5.0 (PRN) from M12 to M23. No new safety findings were reported., Conclusions: The study results support the use of either ranibizumab monthly or PRN regimens in Chinese patients with nAMD, regardless of presence of PCV., (© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
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- 2021
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29. Changes in complement activation products after anti-VEGF injection for choroidal neovascularization in age-related macular degeneration and pachychoroid disease.
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Tanaka K, Oguchi Y, Omori T, Ishida Y, Shintake H, Tomita R, Kasai A, Ogasawara M, Sugano Y, Itagaki K, Ojima A, Machida T, Sekine H, and Sekiryu T
- Subjects
- Aged, Choroidal Neovascularization etiology, Choroidal Neovascularization metabolism, Choroidal Neovascularization pathology, Female, Humans, Male, Middle Aged, Prospective Studies, Angiogenesis Inhibitors pharmacology, Choroid blood supply, Choroid Diseases complications, Choroidal Neovascularization drug therapy, Complement Activation, Macular Degeneration complications, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
We evaluated changes in the complement system resulting from anti-vascular endothelial growth factor (VEGF) in eyes with age-related choroidal neovascularization (CNV) including neovascular age-related macular degeneration, pachychoroid neovasculopathy, and polypoidal choroidal neovasculopathy. We measured the concentrations of the complement activation products (C3a, C4a), VEGF, and monocyte chemotactic protein-1 in the aqueous humor during intravitreal anti-VEGF injections for CNV. The VEGF level decreased significantly (P < 0.001), while the C3a and C4a levels increased significantly (P < 0.001 for both comparisons) 1 month after two monthly anti-VEGF injections. The VEGF level was correlated with the C3a (R = 0.328, P = 0.007) and C4a (R = - 0.237, P = 0.055) levels at baseline, but the correlation between the VEGF and C3a levels (R = - 0.148, P = 0.242) changed significantly (P = 0.028 by analysis of covariance) after anti-VEGF treatment. The C3a increase after anti-VEGF therapy did not change the visual outcomes in eyes with CNV for 1 year. Dysregulation of the complement system can be induced after anti-VEGF therapy.
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- 2021
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30. Morphological features of focal choroidal excavation and its association with macular pathology in Asian Indian eyes.
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Priya BV, Gupta I, Poornachandra B, Jayadev C, Pereira A, Mohapatra A, Krishna SG, and Yadav NK
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- Adult, Aged, Aged, 80 and over, Choroid, Female, Fluorescein Angiography, Humans, Male, Middle Aged, Retrospective Studies, Tomography, Optical Coherence, Visual Acuity, Young Adult, Choroid Diseases complications, Choroid Diseases diagnosis
- Abstract
Purpose: To study the characteristics of focal choroidal excavation (FCE) in Indian eyes based on spectral-domain optical coherence tomography (SD-OCT) findings and their association with macular pathologies., Methods: Retrospective study of 26 patients diagnosed with FCE. All patients' clinical and imaging data were reviewed., Results: There were eight females and 18 males aged between 24 and 85 years. FCE was noted in 31 eyes of 26 patients - unilateral in 21 and bilateral in 5. The conforming type was noted in 13 and nonconforming in 19 eyes. The location was extrafoveal in 16 and subfoveal in 15 eyes. The morphology was bowl-shaped in 24, cone-shaped in six eyes, and mixed type in one eye. Associated pathologies were central serous chorioretinopathy in nine eyes, choroidal neovascular membrane in seven eyes, Stargardt's disease in three eyes, Best disease in four eyes, other retinal dystrophies in two eyes, polypoidal choroidal vasculopathy and moderate non-proliferative diabetic retinopathy, each in one eye. The mean FCE width was 1667.2 ± 817.7 μ, mean depth was 95.7 ± 46.4 μ, and the mean choroidal thickness under the FCE was 234.8 ± 85.9 μ. No abnormal choroidal tissue was found under any FCE., Conclusion: FCE is a relatively common entity and frequently associated with macular pathologies. The presence of an FCE did not alter the course or management of these conditions., Competing Interests: None
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- 2021
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31. Electroconvulsive Therapy Is Safe in a Patient With Punctate Inner Chorodiopathy.
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Zukerman N, Yedidya R, and Nitzan U
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- Female, Humans, Middle Aged, Anxiety Disorders therapy, Choroid Diseases complications, Depressive Disorder, Major therapy, Electroconvulsive Therapy, Somatoform Disorders therapy
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- 2020
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32. Choroidal folds associated with non-specific orbital inflammation.
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Haddar S, Ben Abdesslem N, Mahjoub A, Ben Mrad S, Knani L, Ghorbel M, and Mahjoub H
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- Adult, Choroid pathology, Choroid Diseases complications, Exophthalmos diagnosis, Exophthalmos etiology, Exophthalmos pathology, Humans, Inflammation complications, Male, Orbital Diseases complications, Tomography, Optical Coherence, Tunisia, Choroid diagnostic imaging, Choroid Diseases diagnosis, Inflammation diagnosis, Orbital Diseases diagnosis
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- 2020
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33. Quantitative measures of vortex veins in the posterior pole in eyes with pachychoroid spectrum diseases.
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Matsumoto H, Hoshino J, Arai Y, Mukai R, Nakamura K, Kikuchi Y, Kishi S, and Akiyama H
- Subjects
- Adult, Aged, Central Serous Chorioretinopathy complications, Choroid pathology, Choroid Diseases complications, Choroid Diseases pathology, Choroidal Neovascularization diagnostic imaging, Choroidal Neovascularization pathology, Disease Progression, Female, Fluorescein Angiography, Fundus Oculi, Humans, Male, Middle Aged, Posterior Eye Segment blood supply, Posterior Eye Segment diagnostic imaging, Retinal Detachment diagnostic imaging, Retinal Detachment pathology, Retinal Pigment Epithelium diagnostic imaging, Retinal Pigment Epithelium pathology, Retinal Vein pathology, Retrospective Studies, Tomography, Optical Coherence, Central Serous Chorioretinopathy diagnostic imaging, Central Serous Chorioretinopathy pathology, Choroid blood supply, Choroid diagnostic imaging, Choroid Diseases diagnostic imaging, Retinal Vein diagnostic imaging
- Abstract
Pachychoroid spectrum diseases have attracted increasing attention, though their pathophysiology has yet to be fully elucidated. In this study, we assessed the vascular diameters of vortex veins in pachychoroid spectrum diseases such as central serous chorioretinopathy (CSC), pachychoroid neovasculopathy without polypoidal lesions (PNV), and pachychoroid neovasculopathy with polypoidal lesions (polypoidal choroidal vasculopathy: PCV). In a retrospective case series of 94 eyes with CSC, 60 eyes with PNV and 57 with PCV, we binarized en face optical coherence tomography (OCT) images of choroidal vortex veins and analyzed the mean diameter of vortex veins. The presence of anastomosis between the superior and inferior vortex veins and central choroidal thickness (CCT) were also evaluated using OCT images. CSC showed significantly larger mean diameter of vortex veins than PCV (P < 0.05). Anastomosis between superior and inferior vortex veins was observed in over 90% of eyes with each pachychoroid spectrum disease. The patients with CSC were the youngest, followed by PNV patients, and then patients with PCV. The largest CCT values were observed in CSC eyes, followed by PNV eyes, and then PCV eyes. CCT correlated with the mean diameter of vortex veins (rs = 0.51, P < 0.01). These findings suggest that congestion of vortex veins might show gradual amelioration corresponding to the development of anastomosis between the superior and inferior vortex veins during the course of progression of pachychoroid spectrum diseases. Moreover, the mean diameter of vortex veins can be used as a parameter indicating choroidal congestion.
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- 2020
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34. Choroid Plexus Cyst of the Fourth Ventricle Associated with Intermittent Obstructive Hydrocephalus.
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Draghi R, Mongardi L, Panzacchi R, Godano U, Barni I, Calbucci F, and Borghesi I
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- Aged, Central Nervous System Cysts diagnostic imaging, Central Nervous System Cysts surgery, Choroid Diseases diagnostic imaging, Choroid Diseases surgery, Endoscopy, Female, Gait Disorders, Neurologic etiology, Headache etiology, Humans, Hydrocephalus diagnostic imaging, Hydrocephalus surgery, Magnetic Resonance Imaging, Neurosurgical Procedures, Reoperation, Treatment Outcome, Vomiting etiology, Central Nervous System Cysts complications, Choroid Diseases complications, Fourth Ventricle diagnostic imaging, Fourth Ventricle surgery, Hydrocephalus etiology
- Abstract
Background: Choroid plexus cysts (CPCs) are a type of neuroepithelial cysts, benign lesions located more frequently in the supratentorial compartment. Symptomatic CPCs in the posterior fossa are extremely rare and can be associated with obstructive hydrocephalus., Case Description: A previously healthy elderly woman suffered intermittent attacks of headache and vomiting associated with gait instability. Magnetic resonance imaging documented a large cystic lesion occupying all the fourth ventricle. An endoscope-assisted fenestration of the lesion through a telovelar approach determined only temporary improvement, hence a second surgery with gross total resection of the cyst was performed, with successful long-term clinical and radiologic resolution. Histology revealed CPC., Conclusions: Fourth ventricle symptomatic CPCs are extremely rare lesions, especially in the elderly. Their presence must be carefully evaluated as a possible rare cause of intermittent obstructive hydrocephalus. Even though cyst fenestration with restoration of the cerebrospinal fluid pathway represents the best treatment in the majority of cases, a more aggressive resection is sometimes necessary., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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35. [Bilateral retinal detachment associated with chorioretinal Coloboma].
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Chekhchar M, Achibane A, Abouelhouda H, Belghmaidi S, Hajji I, and Moutaouakil A
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- Adult, Choroid Diseases complications, Choroid Diseases diagnostic imaging, Coloboma complications, Coloboma diagnostic imaging, Female, Humans, Retinal Detachment complications, Retinal Detachment diagnostic imaging, Retinal Diseases complications, Retinal Diseases diagnostic imaging, Choroid Diseases diagnosis, Coloboma diagnosis, Retinal Detachment diagnosis, Retinal Diseases diagnosis
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- 2020
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36. [Hypertensive choroidopathy: Contribution of optical coherence tomography angiography OCT-A].
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Ben Mrad S, Mahjoub A, Ben Abdesslem N, Zinelabidine K, Kallel A, Knani L, and Mahjoub H
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- Adult, Female, Fluorescein Angiography methods, Humans, Hypertension diagnosis, Choroid Diseases complications, Choroid Diseases diagnosis, Hypertension complications, Tomography, Optical Coherence methods
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- 2020
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37. Large choroidal excavation in retinitis pigmentosa: A case report.
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Iacono P, Battaglia Parodi M, Parravano M, and Varano M
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- Adult, Alcohol Oxidoreductases genetics, Choroid Diseases diagnostic imaging, Female, Fluorescein Angiography, Humans, Lens Implantation, Intraocular, Phacoemulsification, Retinitis Pigmentosa diagnostic imaging, Retinitis Pigmentosa genetics, Tomography, Optical Coherence, Visual Acuity physiology, Choroid Diseases complications, Retinitis Pigmentosa complications
- Abstract
Purpose: To report the morphological and clinical features of a case of retinitis pigmentosa with large choroidal excavation., Methods: The patient underwent a complete ophthalmologic examination including best-corrected visual acuity assessment, anterior segment and dilated fundus examination and spectral-domain optical coherence tomography., Results: A 41-year-old woman affected by retinitis pigmentosa with genetic confirmation with mutation in RDH12 gene had a best-corrected visual acuity of 20/50 in both eyes. Dilated fundus examination revealed waxy pallor of the optic disc, diffuse narrowing of the retinal arterioles and a generalized retinal pigment epithelium mottling with bony spicule associated with diffuse retinal atrophy. At the posterior pole, an extended bilateral chorioretinal atrophy was evident with a partial sparing of the macular area. On spectral-domain optical coherence tomography, a bilateral large choroidal excavation could be clearly detected and it was associated with a diffuse retinal thinning at the posterior pole and a partial sparing of the fovea., Conclusion: Large choroidal excavation has been rarely reported. Although the pathogenetic mechanisms leading to the formation of large choroidal excavation are still a matter of debate, a combination of primary degenerative-inflammatory factors could be retained responsible for the large choroidal excavation development.
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- 2020
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38. Pachychoroid disease: a new perspective on exudative maculopathy.
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Yanagi Y
- Subjects
- Central Serous Chorioretinopathy diagnosis, Central Serous Chorioretinopathy etiology, Choroid Diseases diagnosis, Choroidal Neovascularization diagnosis, Choroidal Neovascularization etiology, Consensus, Exudates and Transudates, Humans, Macular Degeneration diagnosis, Polyps diagnosis, Polyps etiology, Choroid Diseases complications, Macular Degeneration etiology
- Abstract
Background: Pachychoroid, or the structural and functional abnormalities of the choroid, is one of the most important causes of exudative maculopathies. The purpose of this article is to review the current definitions of pachychoroid and their potential consequences. Most publications are from Asian countries. Although no consensus diagnosis has been reached, pachychoroid is defined by thickened choroid and choroidal vascular hyperpermeability, pachyvessels with inner choroidal attenuation; it is closely linked to pachydrusen. Although some studies suggest choroidal congestion may play a role in its pathogenesis, the exact causes of this condition are still unknown. Pachychoroid is associated with exudative maculopathies including central serous chorioretinopathy, pachychoroid neovasculopathy and polypoidal choroidal vasculopathy (PCV). It is widely accepted that macular neovascular membranes may develop secondary to pachychoroid. Recent clinical observations illustrate the importance of pachychoroid in the etiology of macular neovascularization including neovascular age-related macular degeneration (nAMD)., Conclusion: Pachychoroid is an important cause of exudative maculopathies. Both drusen and pachychoroid are increasingly recognized as important causes of macular neovascularization, and eyes formally categorized as typical nAMD or PCV can be further sub-categorized based on the presence or absence of pachychoroid and drusen. There is a need to develop a consensus definition, which will greatly enhance our understanding of pachychoroid and facilitate the development of individual interventions in pachychoroid diseases.
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- 2020
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39. Diagnosis and treatment of peripheral exudative haemorrhagic chorioretinopathy.
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Vandefonteyne S, Caujolle JP, Rosier L, Conrath J, Quentel G, Tadayoni R, Maschi C, Le Mer Y, Dot C, Aknin I, Thariat J, and Baillif S
- Subjects
- Adult, Aged, Aged, 80 and over, Choroid Diseases complications, Choroid Diseases therapy, Female, Fundus Oculi, Humans, Intravitreal Injections, Male, Middle Aged, Retinal Hemorrhage etiology, Retinal Hemorrhage therapy, Retrospective Studies, Treatment Outcome, Ultrasonography methods, Angiogenesis Inhibitors administration & dosage, Choroid Diseases diagnosis, Cryotherapy methods, Fluorescein Angiography methods, Laser Coagulation methods, Retinal Hemorrhage diagnosis
- Abstract
Purpose: Peripheral exudative haemorrhagic chorioretinopathy (PEHCR) is a rare disorder that is often misdiagnosed. The aim of this study was to better characterise PEHCR and to assess treatment options., Material and Methods: Retrospective multicentric chart review., Results: Of 84 eyes (69 patients) with PEHCR referred between 2005 and 2017, the most common referral diagnosis was choroidal melanoma (41.3%). Bilateral involvement was found in 21.7% of cases. Haemorrhagic retinal pigment epithelium detachment was the most common peripheral lesion (53.6%). Maculopathy was associated with peripheral lesions in 65.8% of cases. PEHCR lesions were mostly heterogeneous (58.8%) on B-scan ultrasonography. Choroidal neovascularisation was found in 10 eyes (26.3%) out of 38 eyes that underwent fluorescein angiography. Polyps were observed in 14 eyes (58.3%) out of 24 eyes that underwent indocyanine green angiography. Fifty-one eyes were treated (62.2%). Intravitreal injections (IVTI) of antivascular endothelial growth factor (VEGF) were the most used treatment (36.6%) before laser photocoagulation, photodynamic therapy, vitrectomy and cryotherapy. Only vitrectomy improved visual acuity. Most lesions (65.6%) regressed at the last follow-up visit., Conclusion: In case of PEHCR, multimodal imaging is useful to avoid misdiagnosis, to characterise PEHCR lesions and to guide treatment strategies. Regression of PEHCR lesions was observed in two-thirds of the patients. Vitrectomy improved visual acuity. More than a third of patients underwent anti-VEGF IVTI. Further studies are needed to assess IVTI's efficacy., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2020
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40. Comparison of choriocapillary flow density between fellow eyes of polypoidal choroidal vasculopathy and neovascular age-related macular degeneration.
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Luo M, Zhao X, Zhao N, Yuan M, Yang J, Dai R, and Chen Y
- Subjects
- Aged, Choroid Diseases complications, Cross-Sectional Studies, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Male, Middle Aged, Polyps complications, Retrospective Studies, Tomography, Optical Coherence methods, Wet Macular Degeneration diagnosis, Choroid blood supply, Choroid Diseases diagnosis, Polyps diagnosis, Visual Acuity, Wet Macular Degeneration complications
- Abstract
Background: To compare the choriocapillary flow density (CFD) among the fellow eyes of polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nAMD), and healthy controls using spectral-domain optical coherence angiography tomography (SD-OCTA)., Methods: This is a cross-sectional study that includes the fellow eyes of 38 patients with unilateral PCV, 36 patients with unilateral nAMD, and 36 eyes from 36 healthy volunteers. The PCV group was further classified into polypoidal CNV (P-CNV) and typical PCV (T-PCV) for subgroup analysis. The age, subfoveal choroidal thickness (SFCT), Age-Related Eye Disease Study (AREDS) classification, and fellow eye diagnosis were acquired. All subjects underwent SD-OCTA with a 6.0-mm scan pattern. Circles with radius of 1.00, 1.50, and 3.00 mm were manually selected in the choriocapillaris (CC) slab, and the CFD was calculated as the percentage of the flow area to the whole selected area as CFD-1.00, 1.50, and 3.00, respectively. Univariate and multivariate analysis were performed to study the correlation between the aforementioned factors with CFD., Results: The mean CFD-1.00, 1.50, and 3.00 of the nAMD group were 61.51, 63.18, and 66.20, respectively; these were significantly lower than those of the PCV group (65.90, 66.89, and 67.94; P < 0.001, P < 0.001, and P = 0.010; respectively) and control group (66.28, 66.96, and 68.42; P < 0.001, P < 0.001, and P = 0.001, respectively), and no difference was detected between the PCV and control group or between PCV subtypes. The AREDS classification and fellow eye diagnosis were correlated with CFD in univariate analysis; however, only the fellow eye diagnosis showed a significant correlation after multiple linear regression., Conclusions: The CFD of nAMD fellow eyes was significantly lower than that of PCV and control eyes, and no difference was detected between PCV and control group, indicating that CC loss plays a different role in the early pathogenesis of nAMD and PCV.
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- 2020
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41. Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report.
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Chino M, Yoshikawa Y, Kanno J, Nagashima T, Sakaki Y, Katsumoto T, Shibuya M, Shoji T, Makita J, and Shinoda K
- Subjects
- Aged, Choroid Diseases diagnosis, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Male, Polyps diagnosis, Remission, Spontaneous, Retinal Hemorrhage diagnosis, Retinal Perforations etiology, Tomography, Optical Coherence methods, Choroid blood supply, Choroid Diseases complications, Macula Lutea pathology, Polyps complications, Retinal Hemorrhage complications, Retinal Perforations diagnosis, Visual Acuity
- Abstract
Background: Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure., Case Presentation: A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later., Conclusion: Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.
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- 2020
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42. POSTTREATMENT POLYP REGRESSION AND RISK OF MASSIVE SUBMACULAR HEMORRHAGE IN EYES WITH POLYPOIDAL CHOROIDAL VASCULOPATHY.
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Cho JH, Park YJ, Cho SC, Ryoo NK, Cho KH, Park SJ, Park KH, and Woo SJ
- Subjects
- Aged, Bevacizumab administration & dosage, Choroid Diseases diagnosis, Choroid Diseases drug therapy, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Intravitreal Injections, Male, Polyps diagnosis, Polyps drug therapy, Prognosis, Ranibizumab administration & dosage, Retinal Hemorrhage diagnosis, Retrospective Studies, Tomography, Optical Coherence methods, Angiogenesis Inhibitors administration & dosage, Choroid blood supply, Choroid Diseases complications, Photochemotherapy methods, Polyps complications, Retinal Hemorrhage etiology, Visual Acuity
- Abstract
Purpose: To study the association between the risk of massive submacular hemorrhage (SMH) and polyp regression after initial treatment of polypoidal choroidal vasculopathy using long-term follow-up data., Methods: Retrospective study of 223 patients who were diagnosed with polypoidal choroidal vasculopathy and were followed up for up to 11 years. Subjects were categorized into "regression" and "no regression" groups, according to their polyp status after the initial treatment. Kaplan-Meier survival analyses were performed on development of massive SMH. The association between treatment methods and the occurrence of massive SMH was also analyzed., Results: The incidence rates of massive SMH at 3, 6, and 9 years in the "no regression" group were 6.50, 22.59, and 38.03%, respectively, and in the "regression" group were 1.14, 6.47, and 10.92%, respectively (P = 0.005, log-rank test). The hazard ratio of massive SMH was 3.677 for cluster-type polyps and 0.271 for polyp regression after initial treatment. A higher rate of polyp regression was associated with photodynamic therapy (PDT) than anti-VEGF monotherapy (64.4 vs. 33.3%, P < 0.001). Additional anti-VEGF treatments after initial PDT showed lower risk of massive SMH than PDT only. (9.5 vs 38.5%, P = 0.005)., Conclusion: The long-term risk of massive SMH after initial treatment on polypoidal choroidal vasculopathy is significantly higher in eyes with persistent polyps than those with regressed polyps. Ophthalmologists should pay attention to the risk of massive SMH and the polyp status when treating polypoidal choroidal vasculopathy.
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- 2020
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43. THE OCCURRENCE, CHARACTERISTICS, MANAGEMENT, AND PROGNOSIS OF RETINAL PIGMENT EPITHELIUM TEARS IN PATIENTS WITH POLYPOIDAL CHOROIDAL VASCULOPATHY: A Retrospective Study of 397 Patients.
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Zhao XY, Xia S, Luo MY, Wang EQ, and Chen YX
- Subjects
- Aged, Angiogenesis Inhibitors administration & dosage, Choroid Diseases diagnosis, Choroid Diseases drug therapy, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Intravitreal Injections, Male, Polyps diagnosis, Polyps drug therapy, Prognosis, Retinal Perforations drug therapy, Retinal Perforations etiology, Retrospective Studies, Tomography, Optical Coherence methods, Vascular Endothelial Growth Factor A antagonists & inhibitors, Visual Acuity, Choroid blood supply, Choroid Diseases complications, Polyps complications, Ranibizumab administration & dosage, Retinal Perforations diagnosis, Retinal Pigment Epithelium pathology
- Abstract
Purpose: To investigate retinal pigment epithelium (RPE) tears in patients with polypoidal choroidal vasculopathy., Method: A retrospective review of polypoidal choroidal vasculopathy cases with confirmed RPE tears was conducted. Patients' comprehensive clinical data were collected and analyzed. The treatment strategy was a loading dose of one intravitreal antivascular endothelial growth factor injection, combined with additional injections if exudative activities or visual deterioration were detected., Results: Among 397 polypoidal choroidal vasculopathy patients, 33 patients with RPE tears (8.3%) were included. 42.4% of them happened spontaneously. Pigment epithelial detachment (PED) occurred more frequently in RPE tear patients and most of them had serous vascularized or hemorrhagic PED. The height and greatest linear diameter of PED, and the subfoveal choroidal thickness of these cases were significantly larger, whereas the central foveal thickness was significantly smaller. Most of the RPE tears occurred at the edge of the PED. After our treatment strategy, patients' best-corrected visual acuity improved significantly from 2.13 ± 1.24 (median 20/52) to 1.32 ± 1.31 (median 20/166). Large subretinal hemorrhage may increase the risk of the formation of subretinal fibrosis (P < 0.05)., Conclusion: Retinal pigment epithelium tears in polypoidal choroidal vasculopathy are associated with high subRPE hydrostatic pressure, produced by a large PED or hemorrhage. After our intervention strategy, this condition may not necessarily result in poor prognosis.
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- 2020
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44. Long-term Clinical Course after Vitrectomy for Breakthrough Vitreous Hemorrhage Secondary to Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy.
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Kim JH, Kim JW, Kim CG, and Lee DW
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- Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Retrospective Studies, Choroid Diseases complications, Macular Degeneration complications, Vitrectomy, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery
- Abstract
To investigate the long-term clinical course after vitrectomy for breakthrough vitreous hemorrhage secondary to neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). This retrospective study included 45 eyes that underwent vitrectomy due to breakthrough vitreous hemorrhage secondary to neovascular AMD. The patients were divided into 2 groups: neovascular AMD group and PCV group. Within each group, the status of the eye within 6 months after the surgery and that at the final follow-up was identified. The visual acuity at the final visit was additionally compared between the 2 groups. The patients were followed up for a mean period of 39.9 ± 19.4 months after the surgery. In the neovascular AMD group (n = 17), re-bleeding requiring vitrectomy was noted in 4 eyes and extensive scar formation was noted in 6 eyes within 6 months after the surgery. At the final visit, treatment was discontinued due to poor visual outcome in 10 eyes. In the PCV group (n = 28), re-bleeding requiring vitrectomy was noted in 1 eye, and extensive scar formation was noted in 4 eyes within 6 months after the surgery. At the final visit, treatment was discontinued in 8 eyes. The visual acuity at the final visit was significantly better in the PCV group (P = 0.003). The long-term clinical course after vitrectomy for breakthrough vitreous hemorrhage was markedly different between neovascular AMD and PCV, showing significantly better long-term visual outcomes in PCV.
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- 2020
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45. Long-Term Incidence and Growth of Chorioretinal Atrophy in Patients with Polypoidal Choroidal Vasculopathy.
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Choi EY, Park SE, Lee SC, Koh HJ, Kim SS, Byeon SH, Kim M, and Lee CS
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- Aged, Atrophy diagnosis, Atrophy epidemiology, Atrophy etiology, Choroid pathology, Choroid Diseases diagnosis, Female, Fluorescein Angiography methods, Follow-Up Studies, Fundus Oculi, Humans, Incidence, Male, Polyps diagnosis, Republic of Korea epidemiology, Retrospective Studies, Time Factors, Tomography, Optical Coherence methods, Vascular Endothelial Growth Factor A, Choroid blood supply, Choroid Diseases complications, Polyps complications, Retina pathology, Visual Acuity
- Abstract
Purpose: To investigate the long-term incidence and growth rate of chorioretinal atrophy (CRA) in patients with polypoidal choroidal vasculopathy (PCV) and determine the associated risk factors., Methods: The medical records of 88 patients with unilateral symptomatic PCV who received anti-vascular endothelial growth factor (anti-VEGF) injections with or without photodynamic therapy (PDT) were analyzed retrospectively. Near-infrared fundus imaging and spectral domain optical coherence tomography were used to measure the CRA area and growth rate. Kaplan-Meier survival analysis was performed to estimate the CRA incidence. Logistic and linear regression analyses were used to investigate risk factors (e.g., age, frequency of abnormal OCT findings, PDT history, total injection number, and choroidal thickness) associated with the CRA incidence and growth rate, respectively., Results: The overall CRA incidence was 40.8% at 5 years. The absence of subretinal fluid, the presence of intraretinal fluid, and a thin choroid were significant risk factors for CRA occurrence with a history of PDT. Overall 5-year CRA growth rate was 0.69 mm2/year. Faster CRA growth was significantly related to the presence of subretinal hyperreflective material and thin choroid. PDT history was not significantly related to CRA growth., Conclusions: Thin choroid may be a significant risk factor for long-term development and growth of CRA in eyes with PCV. Intraretinal fluid seems to promote the development of CRA, while subretinal fluid seems to be associated with CRA prevention. The history of PDT was significantly related to the occurrence of CRA, but not to the growth rate of CRA., (© 2019 S. Karger AG, Basel.)
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- 2020
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46. Pars-plana vitrectomy with phacofragmentation for hyperdense cataracts in eyes with severe microcornea and chorio-retinal coloboma: A novel approach.
- Author
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Sen AC, Kohli GM, Mitra A, Tripathi S, Shetty SB, and Gupta S
- Subjects
- Adolescent, Adult, Aged, Cataract complications, Cataract diagnosis, Choroid Diseases diagnosis, Choroid Diseases surgery, Coloboma complications, Coloboma diagnosis, Corneal Diseases complications, Corneal Diseases diagnosis, Female, Humans, Male, Middle Aged, Retinal Diseases diagnosis, Retinal Diseases surgery, Retrospective Studies, Severity of Illness Index, Young Adult, Choroid Diseases complications, Coloboma surgery, Corneal Diseases surgery, Phacoemulsification methods, Retinal Diseases complications, Vitrectomy methods
- Abstract
Purpose: To report the outcomes of pars-plana approach for the management of brunescent cataract in eyes with severe microcornea and associated chorio-retinal coloboma., Methods: This was a retrospective, single center, interventional case series performed in a tertiary eyecare center in central Medical records of consecutive cases of microcornea with coloboma who underwent pars-plana vitrectomy with phacofragmentation (PF) between January 2015 and December 2017 were reviewed., Results: The study group comprised of 30 eyes of 30 patients, of which 18 (60%) were males and 12 (40%) were females. The mean age of the patients was 41.9 years (range of 17-70 years). The mean corneal diameter was 6.7 mm with a range of 4-8 mm and all the eyes had dense cataract with nuclear sclerosis of grade 4 or more. The mean preoperative visual acuity was 1.97 (+/-0.067) Log MAR and the mean postoperative vision at 1 month was 1.6 (+/-0.39) Log MAR. Postoperatively, 21 patients (70%) gained ambulatory vision. The visual gain in all the patients was maintained over a mean follow-up period of 15.5 months., Conclusion: Pars-plana vitrectomy with PF can be considered in eyes with severe microcornea and brunescent cataracts, where cataract surgery through the limbal (anterior) approach is not only difficult but at times impossible due to anatomical restraints., Competing Interests: None
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- 2020
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47. Sorsby fundus dystrophy with polypoidal choroidal vasculopathy: Extending TIMP3 phenotypes.
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Koutresi D, Clarke B, Lotery AJ, and De Salvo G
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- Aged, Choroid Diseases diagnosis, Choroid Diseases genetics, Female, Fluorescein Angiography methods, Fundus Oculi, Humans, Macular Degeneration diagnosis, Macular Degeneration genetics, Male, Middle Aged, Phenotype, Polyps diagnosis, Tissue Inhibitor of Metalloproteinase-3 metabolism, Tomography, Optical Coherence methods, Choroid blood supply, Choroid Diseases complications, Macular Degeneration complications, Polyps complications, Retina pathology, Tissue Inhibitor of Metalloproteinase-3 genetics
- Published
- 2019
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48. A 24-year-old woman with sudden-onset, unilateral vision loss.
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Khalili P, Adib NE, Jafari HK, Shamsi R, and Dehghani S
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- Choroid Diseases diagnosis, Diagnosis, Differential, Female, Fluorescein Angiography, Fundus Oculi, Humans, Remission, Spontaneous, Retinal Vessels pathology, Tomography, Optical Coherence, Vision Disorders diagnosis, Vision Disorders physiopathology, Young Adult, Choroid pathology, Choroid Diseases complications, Vision Disorders etiology, Visual Acuity
- Published
- 2019
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49. Chorioretinal folds: a proposed diagnostic algorithm.
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Bagnis A, Cutolo CA, Corallo G, Musetti D, Nicolò M, and Traverso CE
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- Choroid Diseases complications, Fundus Oculi, Humans, Retinal Diseases complications, Visual Acuity, Algorithms, Choroid pathology, Choroid Diseases diagnosis, Fluorescein Angiography methods, Retina pathology, Retinal Diseases diagnosis, Tomography, Optical Coherence methods
- Abstract
Purpose: To create a diagnostic algorithm for the management of chorioretinal folds., Methods: We reviewed the existing literature about chorioretinal folds focusing our attention on three specific conditions and created a diagnostic algorithm in order to otpimize the choice and the number of investigations., Results: Chorioretinal folds are visible striations of the fundus usually arranged in parallel lines and disposed horizontally. They may be either unilateral or bilateral, symptomatic or asymptomatic and are often associated with different possible ocular and extra ocular pathologies, including systemic diseases like autoimmune disorders and intracranial hypertension. They are named idiopathic when no apparent cause for their development is detectable. However, with improved diagnostic testing, the patients with idiopathic choroidal folds are likely to represent only a smaller portion of the total., Conclusions: Since choroidal folds be the sole sign of an underlying disease possibly requiring a multidisciplinary approach, an appropriate work-up varying according to the specific clinical features of each case is needed to define the etiology and the treatment. A diagnosting algorithm may be useful in order to optimize the diagnostic approach and management.
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- 2019
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50. Spontaneous formation and closure of full thickness macular hole after treatment with anti-vascular endothelial growth factor therapy in polypoidal choroidal vasculopathy.
- Author
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Sethia A, Sheth J, Gopalakrishnan M, and Anantharaman G
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- Angiogenesis Inhibitors administration & dosage, Choroid Diseases complications, Choroid Diseases diagnosis, Female, Fluorescein Angiography, Fundus Oculi, Humans, Intravitreal Injections, Middle Aged, Polyps complications, Polyps diagnosis, Receptors, Vascular Endothelial Growth Factor antagonists & inhibitors, Remission, Spontaneous, Retinal Perforations etiology, Tomography, Optical Coherence, Bevacizumab administration & dosage, Choroid blood supply, Choroid Diseases drug therapy, Polyps drug therapy, Retinal Perforations diagnosis
- Abstract
Full-thickness macular hole (FTMH) formation in Polypoidal choroidal vasculopathy (PCV) after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment is a rare complication. Spontaneous closure of FTMH following anti-VEGF therapy has not been described in PCV till date. We present a case of Asian woman with PCV who developed a FTMH following treatment with intra-vitreal anti-VEGF injections which subsequently closed spontaneously on further course of treatment., Competing Interests: There are no conflicts of interest.
- Published
- 2019
- Full Text
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