Objectives: To compare topographic features of surgically excised subfoveal choroidal neovascularization with preoperative and postoperative fluorescein angiographic features from Submacular Surgery Trials (SST) patie...Objectives: To compare topographic features of surgically excised subfoveal choroidal neovascularization with preoperative and postoperative fluorescein angiographic features from Submacular Surgery Trials (SST) patients,and to compare histological and angiographic features with preoperative and postoperative visual acuities (VAs). Methods: Patients enrolled in the SST GroupsN,B,and H trials between October 1999 and September 2001 and assigned to the surgery arm had surgically removed choroidal neovascularization sent to the SST Pathology Center. Grossly intact specimens were sectioned serially for 2-dimensional reconstruction and were assigned to growth pattern groups based on topographic mapping of the location of cellular components relative to the retinal pigment epithelium (RPE): sub-RPE,subretinal,combined,or indeterminate. These features were compared with preoperative fluorescein angiographic features. The histological choroidal neovascularization growth pattern was compared with preoperative VAs. Results: Two-dimensional reconstructions of surgically excised choroidal neovascularization could not be matched point for point to fluorescein angiographic features. Among the 52 specimens selected,the growth pattern could be determined by 2-dimensional reconstruction in 34 instances (65% ),including 28 (80% ) of 35 Group N specimens,2 (40% ) of 5 Group B specimens,and 4 (33% ) of 12 Group H specimens. Among the choroidal neovascularization growth patterns that could be determined from specimens submitted,the majority of GroupN specimens were combined,and the majority of Group H specimenswere subretinal. In most instances for GroupBspecimens,the growth pattern was indeterminate. The postoperative abnormalities on fluorescein angiography were generally larger than measurements of excised specimens. The subretinal growth pattern was associated with the smallest decrease in 3-month postoperative average VA. Conclusions: Among the 52 specimens from the SST with adequate tissue to try to evaluate the growth pattern 展开更多
PURPOSE:To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium.To our knowledge,this is the first report of this finding after intraocular antivascular endothelial g...PURPOSE:To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium.To our knowledge,this is the first report of this finding after intraocular antivascular endothelial growth factor therapy.DESIGN:Observational case reports.METHODS:Two patients presented with occult choroidal neovascularization and associated serous pigment epithelial detachment that was a result of agerelated macular degeneration.Both patients were treated with an intravitreal injection of pegaptanib sodium.RESULTS:One patient developed a retinal pigment epithelium tear one week after the intravitreal injection.The second patient developed a retinal pigment epithelium tear eight weeks after treatment.CONCLUSIONS:Although these cases may represent natural history,there should be a high index of suspicion for retinal pigment epithelium tears in patients who report significant visual deterioration after intravitreal injection of pegaptanib sodium.Further studies are needed to determine whether angiographic subtypes of choroidal neovascular membranes are more susceptible to developing retinal pigment epithelium tears after treatmentwith antivascular endothelial growth factor agents.展开更多
Purpose:To evaluate whether transpupillary thermotherapy(TTT)reduces the risk of moderate visual loss in patients with occult choroidal neovascularization(CNV)secondary to agerelated macular degeneration(AMD).Methods:...Purpose:To evaluate whether transpupillary thermotherapy(TTT)reduces the risk of moderate visual loss in patients with occult choroidal neovascularization(CNV)secondary to agerelated macular degeneration(AMD).Methods:A group of 25 patients were recruited and randomized in to TTT or placebo groups.Patients were included if they had a subfoveal purely or predominantly(> 50%)occult CNV secondary to AMD with best corrected visual acuity(BCVA)of 6/60 or better and the lesion was not larger than 4.5 mm.Treatment was carried out using an 810-nm Oculight diode laser with a fixed spot size covering the whole lesion according to the standard protocol.The same procedure was used for the control group,except that the power was set at zero.The patients were followed up at 6 weeks,3 months and then every 6 months for up to 2 years.A maximum of three treatments were administered in both groups if there was evidence of persistent leakage from CNV.Results:At the 12-month follow-up,there was no significant difference in the mean values for BCVA distance and near or contrast sensitivity between the treatment and control groups.The Mann-Whitney test was used to assess the differences in BCVA and contrast sensitivity between the groups,both at baseline and at the 12-month follow-up.No statistically significant difference was found;both groups lost on average two lines of BCVA.Conclusion:Transpupillary thermotherapy appeared to have been of no benefit in preventing further visual loss in patients with occult CNV in this pilot study.展开更多
Aim: To evaluate long term results after transpupillary thermotherapy (TTT) in eyes with exudative age related macular degeneration. Methods: In a prospective clinical study eyes with occult or predominantly occult ch...Aim: To evaluate long term results after transpupillary thermotherapy (TTT) in eyes with exudative age related macular degeneration. Methods: In a prospective clinical study eyes with occult or predominantly occult choroidal neovascularisation and no pretreatment were scheduled to have a TTT with a power of 630 mW. Visual acuity for far and near distances as well as contrast sensitivity were evaluated 6, 12, and 24 months postoperatively and statistically analysed. Results: 47 eyes fulfilled the inclusion criteria. Overall, 70%of the patients showed an improved (14%) or had unchanged (56%) ETDRS vision after 24 months. Reading vision was stabilised (51%) or better (5%) in 56%of the eyes at this time. However, the increasing number of eyes with severe deterioration resulted in a significant decrease of both parameters over time (p=0.0002 and p=0.0003, respectively). Contrast sensitivity could be maintained (70%) or improved (9%) in 79%. Statistical analyses indicated a trend but no significant decrease over time (p=0.056). Conclusion: Although in the majority of patients far and near distance acuity could be stabilised on average a significant decrease over time after TTT was observed. Statistical comparison of months 12 and 24 showed no further deterioration.展开更多
文摘Objectives: To compare topographic features of surgically excised subfoveal choroidal neovascularization with preoperative and postoperative fluorescein angiographic features from Submacular Surgery Trials (SST) patients,and to compare histological and angiographic features with preoperative and postoperative visual acuities (VAs). Methods: Patients enrolled in the SST GroupsN,B,and H trials between October 1999 and September 2001 and assigned to the surgery arm had surgically removed choroidal neovascularization sent to the SST Pathology Center. Grossly intact specimens were sectioned serially for 2-dimensional reconstruction and were assigned to growth pattern groups based on topographic mapping of the location of cellular components relative to the retinal pigment epithelium (RPE): sub-RPE,subretinal,combined,or indeterminate. These features were compared with preoperative fluorescein angiographic features. The histological choroidal neovascularization growth pattern was compared with preoperative VAs. Results: Two-dimensional reconstructions of surgically excised choroidal neovascularization could not be matched point for point to fluorescein angiographic features. Among the 52 specimens selected,the growth pattern could be determined by 2-dimensional reconstruction in 34 instances (65% ),including 28 (80% ) of 35 Group N specimens,2 (40% ) of 5 Group B specimens,and 4 (33% ) of 12 Group H specimens. Among the choroidal neovascularization growth patterns that could be determined from specimens submitted,the majority of GroupN specimens were combined,and the majority of Group H specimenswere subretinal. In most instances for GroupBspecimens,the growth pattern was indeterminate. The postoperative abnormalities on fluorescein angiography were generally larger than measurements of excised specimens. The subretinal growth pattern was associated with the smallest decrease in 3-month postoperative average VA. Conclusions: Among the 52 specimens from the SST with adequate tissue to try to evaluate the growth pattern
文摘PURPOSE:To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium.To our knowledge,this is the first report of this finding after intraocular antivascular endothelial growth factor therapy.DESIGN:Observational case reports.METHODS:Two patients presented with occult choroidal neovascularization and associated serous pigment epithelial detachment that was a result of agerelated macular degeneration.Both patients were treated with an intravitreal injection of pegaptanib sodium.RESULTS:One patient developed a retinal pigment epithelium tear one week after the intravitreal injection.The second patient developed a retinal pigment epithelium tear eight weeks after treatment.CONCLUSIONS:Although these cases may represent natural history,there should be a high index of suspicion for retinal pigment epithelium tears in patients who report significant visual deterioration after intravitreal injection of pegaptanib sodium.Further studies are needed to determine whether angiographic subtypes of choroidal neovascular membranes are more susceptible to developing retinal pigment epithelium tears after treatmentwith antivascular endothelial growth factor agents.
文摘Purpose:To evaluate whether transpupillary thermotherapy(TTT)reduces the risk of moderate visual loss in patients with occult choroidal neovascularization(CNV)secondary to agerelated macular degeneration(AMD).Methods:A group of 25 patients were recruited and randomized in to TTT or placebo groups.Patients were included if they had a subfoveal purely or predominantly(> 50%)occult CNV secondary to AMD with best corrected visual acuity(BCVA)of 6/60 or better and the lesion was not larger than 4.5 mm.Treatment was carried out using an 810-nm Oculight diode laser with a fixed spot size covering the whole lesion according to the standard protocol.The same procedure was used for the control group,except that the power was set at zero.The patients were followed up at 6 weeks,3 months and then every 6 months for up to 2 years.A maximum of three treatments were administered in both groups if there was evidence of persistent leakage from CNV.Results:At the 12-month follow-up,there was no significant difference in the mean values for BCVA distance and near or contrast sensitivity between the treatment and control groups.The Mann-Whitney test was used to assess the differences in BCVA and contrast sensitivity between the groups,both at baseline and at the 12-month follow-up.No statistically significant difference was found;both groups lost on average two lines of BCVA.Conclusion:Transpupillary thermotherapy appeared to have been of no benefit in preventing further visual loss in patients with occult CNV in this pilot study.
文摘Aim: To evaluate long term results after transpupillary thermotherapy (TTT) in eyes with exudative age related macular degeneration. Methods: In a prospective clinical study eyes with occult or predominantly occult choroidal neovascularisation and no pretreatment were scheduled to have a TTT with a power of 630 mW. Visual acuity for far and near distances as well as contrast sensitivity were evaluated 6, 12, and 24 months postoperatively and statistically analysed. Results: 47 eyes fulfilled the inclusion criteria. Overall, 70%of the patients showed an improved (14%) or had unchanged (56%) ETDRS vision after 24 months. Reading vision was stabilised (51%) or better (5%) in 56%of the eyes at this time. However, the increasing number of eyes with severe deterioration resulted in a significant decrease of both parameters over time (p=0.0002 and p=0.0003, respectively). Contrast sensitivity could be maintained (70%) or improved (9%) in 79%. Statistical analyses indicated a trend but no significant decrease over time (p=0.056). Conclusion: Although in the majority of patients far and near distance acuity could be stabilised on average a significant decrease over time after TTT was observed. Statistical comparison of months 12 and 24 showed no further deterioration.
