Background: There is a need for alternative treatments for the management of exudative age-related macular degeneration (AMD). The purpose of this paper is to determine the feasibility, safety, and clinical effect of ...Background: There is a need for alternative treatments for the management of exudative age-related macular degeneration (AMD). The purpose of this paper is to determine the feasibility, safety, and clinical effect of indocyanine green (ICG)-mediated photothrombosis (IMP) combined with intravitreal triamcinolone acetonide (TA) in patients with subfoveal choroidal neovascularization (CNV) in AMD. Methods: Thirty-one eyes of 26 patients who were treatedwith IMP immediately followed by an intravitreal injection of 4 mg of TA were investigated in the study. The patients had a mean follow-up of 9 months (range 3 months to 26 months). Patients underwent one to four sessions of IMP combined with intravitreal TA. Results: Visual acuity showed stability in 19 eyes (61.3%), improvement of visual acuity (VA) in seven eyes (22.6%), and worsening of VA in five eyes (16.1%). A significant regression of the CNV, and diminishing of subretinal fluid, was demonstrated with fluorescein angiography and optical coherence tomography. We found no complications associated with the intravitreal injection procedure or IMP. Five (16.1%) eyes developed an increase in intraocular pressure related to the presence of TA in the vitreous cavity. However, it was medically controlled with topical antiglaucoma medications. Nineteen of 31 eyes (61.2%) required at least one re-treatment (mean 1.7; range 1-4) during the study period. Conclusions: Combined IMP and intravitreal TA may provide stability or improvement in visual acuity and fundus findings in choroidal neovascularization. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.展开更多
Aim:To assess the repeatability of Eger macular stressometer(EMS)measures of photostress recovery and determine their association with other measures of visual function.Methods:EMS photostress recovery time was measur...Aim:To assess the repeatability of Eger macular stressometer(EMS)measures of photostress recovery and determine their association with other measures of visual function.Methods:EMS photostress recovery time was measured in 90 patients with bilateral exudative age related macular degeneration(AMD),19 with bilateral atrophic AMD and 47 with both forms of the condition(mean age 79(SD 13)years).Measurements were made on two occasions separated by 1 year.Intrasession repeatability was assessed by repeating the measures after a 10 minute recovery period at the first visit.Distance visual acuity was measured with a logMAR chart,near visual acuity with a MNRead chart at 25 cm,contrast sensitivity with a Pelli-Robson chart,and the presence of central visual disturbance assessed with an Amsler grid.A questionnaire was used to assess self reported difficulties with glare recovery.Results:The average EMS recovery time was 11.0(SD 8.9)seconds,decreasing by 1.6(5.2)seconds on repeated measurement(p< 0.05).EMS photostress recovery was not correlated with visual function measures or subjective difficulties with lights(p >0.05).EMS photostress recovery time did not predict those whose vision decreased over the following year compared with those among whom it remained stable.Conclusions:The EMS test is not a useful tool in determining the severity or progression of AMD.展开更多
Purpose:Age-related macular degeneration(AMD)is the most frequent cause of severe visual impairment in western countries,but its aetiology remains unclear.A growing body of evidence suggests that inflammation contribu...Purpose:Age-related macular degeneration(AMD)is the most frequent cause of severe visual impairment in western countries,but its aetiology remains unclear.A growing body of evidence suggests that inflammation contributes to the pathogenesis of AMD,similarly to that shown for atherosclerosis.In view of a number of shared risk factors between the two entities and the hypothesized link between Chlamydia pneumoniae infection and atherosclerosis,we investigated whether C.pneumoniae might be involved in exudative AMD.Methods:To examine whether C.pneumoniae contributes to the development of subretinal neovascular(SRNV)membranes in AMD,13 consecutive SRNV membranes surgically excised from patients with exudative AMD were collected and assayed for the presence of C.pneumoniae or other bacterial pathogens by means of polymerase chain reaction(PCR).Results:The age of patients ranged from 68 to 85 years(median 73.5 years).In all 13 SRNV membranes,no DNA of either C.pneumoniae or other pathogens was found by PCR.Conclusions:These findings indicate that C.pneumoniae is not associated with the development of SRNV membranes in exudative AMD.展开更多
文摘Background: There is a need for alternative treatments for the management of exudative age-related macular degeneration (AMD). The purpose of this paper is to determine the feasibility, safety, and clinical effect of indocyanine green (ICG)-mediated photothrombosis (IMP) combined with intravitreal triamcinolone acetonide (TA) in patients with subfoveal choroidal neovascularization (CNV) in AMD. Methods: Thirty-one eyes of 26 patients who were treatedwith IMP immediately followed by an intravitreal injection of 4 mg of TA were investigated in the study. The patients had a mean follow-up of 9 months (range 3 months to 26 months). Patients underwent one to four sessions of IMP combined with intravitreal TA. Results: Visual acuity showed stability in 19 eyes (61.3%), improvement of visual acuity (VA) in seven eyes (22.6%), and worsening of VA in five eyes (16.1%). A significant regression of the CNV, and diminishing of subretinal fluid, was demonstrated with fluorescein angiography and optical coherence tomography. We found no complications associated with the intravitreal injection procedure or IMP. Five (16.1%) eyes developed an increase in intraocular pressure related to the presence of TA in the vitreous cavity. However, it was medically controlled with topical antiglaucoma medications. Nineteen of 31 eyes (61.2%) required at least one re-treatment (mean 1.7; range 1-4) during the study period. Conclusions: Combined IMP and intravitreal TA may provide stability or improvement in visual acuity and fundus findings in choroidal neovascularization. Further evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to accurately assess the safety and efficacy of this new treatment modality.
文摘Aim:To assess the repeatability of Eger macular stressometer(EMS)measures of photostress recovery and determine their association with other measures of visual function.Methods:EMS photostress recovery time was measured in 90 patients with bilateral exudative age related macular degeneration(AMD),19 with bilateral atrophic AMD and 47 with both forms of the condition(mean age 79(SD 13)years).Measurements were made on two occasions separated by 1 year.Intrasession repeatability was assessed by repeating the measures after a 10 minute recovery period at the first visit.Distance visual acuity was measured with a logMAR chart,near visual acuity with a MNRead chart at 25 cm,contrast sensitivity with a Pelli-Robson chart,and the presence of central visual disturbance assessed with an Amsler grid.A questionnaire was used to assess self reported difficulties with glare recovery.Results:The average EMS recovery time was 11.0(SD 8.9)seconds,decreasing by 1.6(5.2)seconds on repeated measurement(p< 0.05).EMS photostress recovery was not correlated with visual function measures or subjective difficulties with lights(p >0.05).EMS photostress recovery time did not predict those whose vision decreased over the following year compared with those among whom it remained stable.Conclusions:The EMS test is not a useful tool in determining the severity or progression of AMD.
文摘Purpose:Age-related macular degeneration(AMD)is the most frequent cause of severe visual impairment in western countries,but its aetiology remains unclear.A growing body of evidence suggests that inflammation contributes to the pathogenesis of AMD,similarly to that shown for atherosclerosis.In view of a number of shared risk factors between the two entities and the hypothesized link between Chlamydia pneumoniae infection and atherosclerosis,we investigated whether C.pneumoniae might be involved in exudative AMD.Methods:To examine whether C.pneumoniae contributes to the development of subretinal neovascular(SRNV)membranes in AMD,13 consecutive SRNV membranes surgically excised from patients with exudative AMD were collected and assayed for the presence of C.pneumoniae or other bacterial pathogens by means of polymerase chain reaction(PCR).Results:The age of patients ranged from 68 to 85 years(median 73.5 years).In all 13 SRNV membranes,no DNA of either C.pneumoniae or other pathogens was found by PCR.Conclusions:These findings indicate that C.pneumoniae is not associated with the development of SRNV membranes in exudative AMD.
