Top PDF A STUDY TO COMPARE FUNDUS FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY IN AGE RELATED MACULAR DEGENERATION

A STUDY TO COMPARE FUNDUS FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE  TOMOGRAPHY IN AGE RELATED MACULAR DEGENERATION

A STUDY TO COMPARE FUNDUS FLUORESCEIN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY IN AGE RELATED MACULAR DEGENERATION

Maximum no of patients affected belonged to the age group of 50-70 years and 60% were females. The most common symptom was defective vision accounting for 92%. Hypertension and hyperlipidemia were the most common risk factors. 12% of the cases had unilateral disease and 88% had bilateral disease. 6% of eyes were normal in both FFA and OCT. 62% of the eyes by FFA and 61% of the eyes by OCT had dry ARMD and 32 % of the eye by FFA and 33 % by OCT had wet ARMD.

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Intravitreal ranibizumab and bevacizumab for the treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration

Intravitreal ranibizumab and bevacizumab for the treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration

This study was approved by the Human Subjects Review Committee of The University of Iowa Hospitals and Clinics. Patients were collected from the practice of Dr. James Folk at The University of Iowa. Every patient under active treatment with either bevacizumab or ranibizumab for neovascular AMD during the consecutive two month period from May 2008 to June 2008 was potentially eligible. A retrospective chart review was performed for all included patients. Fundus fluorescein angiography (FFA) obtained at the time of initial presentation was reviewed to confirm the diagnosis of AMD and to deter- mine if the choroidal neovascularization extended beneath the center of the fovea. Inclusion criteria included neovascu- larization within the macula that did not extend beneath the center of the foveal avascular zone (FAZ), along with at least one large drusen (≥125 µ) or many intermediate size (63-124 µ) drusen. Specific exclusion criteria included: geographic atro- phy of the RPE that involved the fovea, fundus changes com- patible with myopic degeneration, angioid streaks, chorio- retinal scars in the macula which could indicate choroidal in- flammatory disease, or history of any previous treatment for CNV or any other retinal disease in the treatment eye.
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Optical Coherence Tomography in Ophthalmology

Optical Coherence Tomography in Ophthalmology

Optical coherence tomography (OCT) is an optical signal acquisition and processing method that captures microm- eter-resolution three-dimensional images from within bio- logical tissues. In recent years, OCT has become an impor- tant imaging technology used in diagnosing and follow- ing macular pathologies. It has complemented fluorescein angiography in many cases, especially in the diagnosis and management of various retinal disorders, including macular edema and age-related macular degeneration. In addition, further development enabled application of optical coher- ence tomography in evaluation of the integrity of the nerve fiber layer, optic nerve cupping, anterior chamber angle, or corneal topography.
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Optical coherence tomography angiography features of choroidal nevi

Optical coherence tomography angiography features of choroidal nevi

criteria were a history of microvascular abnormalities, age- related macular degeneration (AMD), glaucoma and intraocular inflammation. We selected 21 patients who had undergone a complete ocular examination including best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp examination and dilated fundus examination. Multimodal imaging with fundus color photography, US, EDI-OCT, FAF and OCT-A had also been performed in all patients. When clinically indicated, some patients had undergone FA and indocyanine green angiography (ICGA). Information on patient characteristics, including demographics, medical/ocular history and referral symptoms, were analyzed from the records. Structural features of the tumor and retina were extracted from multimodal imaging. We defined the macula according to ETDRS grid (3 mm from the foveola) and the location of the tumor was defined as macular or extramacular, according to its epicenter.
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Braz. Dent. J.  vol.21 número5

Braz. Dent. J. vol.21 número5

This study used optical coherence tomography (OCT) compared to scanning electron microscopy (SEM) and optical microscopy (OM) to evaluate qualitatively crack propagation and final fracture in restorative composite materials - Filtek Z250 and Filtek Z350 (3M ESPE) - with fiber reinforcement after cyclic loading. Samples were made using a split mold. Initially, 3-point bending tests were performed to determine the maximum force and tension at the fracture moment using samples without fiber reinforcement. Then, mechanical cycling tests were performed using samples with glass fiber embedded internally. The failures were analyzed using the 3 methods described before. OCT permitted good characterization of internal crack propagation of the dental composites, which, however, could not be visualized by either SEM or OM. OCT was proven to be laboratory research tool that is easy to use, does not require any specific preparation of the samples, and is less expensive than SEM.
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Risk factors of age-related macular degeneration in Argentina

Risk factors of age-related macular degeneration in Argentina

Risk analysis was performed with a main effects model for logis - tic regression and ordinal logistic regression. Antioxidant status (taking antioxidants or not) was omitted from the potential list of variables because about 15% of data were missing for the cases and controls. Age and gender were checked but not included in any simple logistic regression models as they are controlled for in the case matching. Race was categorized as White, Mestizo, and other (Indigenous, Black, or Asian), with White as reference. BMI was cal - culated by dividing weight in kilograms by the square of height in meters and categorized as being normal/slightly underweight (>18.5 kg/m 2 and <25 kg/m 2 ), overweight (25-29.9 kg/m 2 ), and
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Normative values for optical coherence tomography parameters in healthy children and interexaminer agreement for choroidal thickness measurements

Normative values for optical coherence tomography parameters in healthy children and interexaminer agreement for choroidal thickness measurements

com o comprimento axial (r=0.245, p=0.007). A espessura da coroide aumentou com a idade (r=0.291, p=0.001) e diminuiu com o comprimento axial (r=­0.191, p=0.037). A espessura global da camada de fibras nervosas da retina diminuiu com o comprimento axial (r=­0.247, p=0.007) e aumenta com a espessura central da córnea (r=0.208, p=0.022). A espessura global da camada de fibras nervosas da retina foi correlacionada positivamente com a espessura coroidal (r=0.354, p<0.001). A espessura global da camada de fibras nervosas da retina (r=0.223, p=0.014) e a espessura coroide (r=0.272, p=0.003) aumentaram com o equivalente esférico (D). Conclusões: os parâmetros de tomografia de coerência óptica parecem mostrar uma ampla gama de variabilidade em crianças. A espessura da camada de fibra nervosa da retina, a espessura macular central, a espessura coroidea estão inter­relacionadas ou correlacionadas com a idade, espessura corneana central, comprimento axial e erros refractivos. Além disso, as medidas manuais da espessura coroidea apresentaram alta concordância entre examinadores. Deve­se ter em mente que os valores normativos dos parâmetros da tomografia de coerência óptica diferem em crianças, portanto, as medidas devem ser interpretadas de acordo com uma determinada base de dados apropriada para idade.
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A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.

A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.

There are limitations to this study. The observational design aims to capture the current treatment pattern of exudative AMD in an Asian setting in Singapore. Variations in treatment preference between individual clinicians, between countries and regions are to be expected. Variations in reimbursement systems between countries will also influence the treatment pattern. Practice pattern, such as injection number, is likely to evolve with time and injection numbers may increase with increasing acceptance of the need for long-term therapy. We did not perform secondary grading of PCV but decided to follow the initial clinical diagnosis by the treating clinician. Therefore PCV diagnosis may be less stringent, and some of the PCV cases in this series may represent possible/probable PCV (mixed cases) in addition to definite PCV cases. Due to logistic constraints, OCT examination was performed using SD-OCT other than the Cirrus OCT in some cases. Therefore the OCT thickness measurements in these Figure 2. Distribution of Initial Treatment Modalities by diagnosis of Age-related Macular Degeneration (AMD-CNV) (left) and Polypoidal Choroidal Vasculopathy (PCV) (right).
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Modelling the genetic risk in age-related macular degeneration.

Modelling the genetic risk in age-related macular degeneration.

Genomic DNA was extracted from peripheral blood leukocytes according to established protocols. Genotyping of SNPs was achieved by direct sequencing, restriction enzyme digestion of PCR products, TaqMan SNP Genotyping (Applied Biosystems, Foster City, USA) or primer extension of multiplex PCR products with detection of the allele-specific extension products by the matrix-assisted laser desorption/ionization time of flight (MALDI- TOF) mass spectrometry method (Sequenom, San Diego, USA) (Table S3). Direct sequencing was performed with the Big Dye Terminator Cycle Sequencing Kit Version 1.1 (Applied Biosys- tems, Foster City, USA) according to the manufacturer’s instructions. Reactions were analyzed with an ABI Prism Model 3130xl Sequencer (Applied Biosystems). TaqMan Pre-Designed SNP Genotyping Assays (Applied Biosystems) were performed according to the manufacturer’s instructions. Additionally, some variants were genotyped by PCR followed by restriction enzyme digestion (New England Biolabs, Ipswich, USA) and subsequent restriction fragment length analysis. The c.del443ins54 variant in the 3 9-region of the ARMS2 locus was genotyped by a single PCR with oligonucleotide primers 59-ACTCATCACGTCATCAC- CAAT-3 9 and 59-CTCTCTGCAGCCCTCATTTG-39 resulting in distinct fragment sizes due to the presence or absence of the deletion/insertion polymorphism.
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Metabolome-wide association study of neovascular age-related macular degeneration.

Metabolome-wide association study of neovascular age-related macular degeneration.

The cross-validation analysis suggests that significant metabolic heterogeneity exists within the NVAMD patients. Thus, NVAMD patients who are clinically indistinguishable may actually have very different metabolic characteristics and could potentially be subclassified by metabolic phenotype. Such metabolic subclassifi- cation could lead to improved prevention and treatment strategies. In summary, these data reveal that NVAMD pathophysiology may involve a map of diverse metabolic components that range from peptides, bile acids, and vitamin D to broader pathways like that of tyrosine metabolism. Our results suggest two advantages of a high-resolution metabolomic approach: it can provide relative quantification of a large number of metabolites to facilitate comprehensive analysis of environmental impact on disease status, and, secondly, it can discern metabolic profiles and pathways that distinguish NVAMD cases from controls. Such plasma metabolic phenotyping could improve current diagnostic methods for AMD by substantiating evidence of disease or disease risk prior to clinical manifestation.
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Arq. Bras. Oftalmol.  vol.80 número2

Arq. Bras. Oftalmol. vol.80 número2

findings are not unique to CZV and may also be seen with other congenital infections, including cytomegalovirus, West Nile virus, and Toxoplasma gondii. Because visually important anatomical structures, including the optic disk and macula, are involved, the long-term visual outcomes in CZS remain to be explored.

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Arq. Bras. Oftalmol.  vol.63 número6

Arq. Bras. Oftalmol. vol.63 número6

An interim report of the 12-month data was recently repor- ted, showing vision improvement, no change, or loss of < 3 lines, occurred in 61.4% of the verteporfin-treated group and 45.9% of the placebo, while vision improvement of > 1 line occurred in 16% of that group compared to 7% of the placebo group. Eyes treated with verteporfin were more likely to avoid a six-line or greater loss (85%) when compared to those with placebo (76%). Based on estimates from Kaplan-Meier rates, at every follow-up examination after study entry, the propor- tion of eyes with > 3 line loss or > 6 line loss was less in the verteporfin-treated group. The mean number of contrast sensitivity letters lost was approximately one in the verte- porfin-treated eyes compared to approximately three to five in placebo-treated eyes in every follow-up visit at the 12-month examination. Some subgroup analyses have also been performed. When the entire study population was separated by the presence or absence of occult CNV, the subgroup with no occult CNV had a substantial treatment benefit. Speci- fically, 23% of the verteporfin-treated eyes compared to 73% of the placebo-treated eyes had lost > 3 lines of vision. If occult CNV was present, 45% of the verteporfin-treated eyes compared to 47% of the placebo-treated eyes lost > 3 lines. A substantial treatment benefit was also seen when > 50% of the lesion area was classic CNV. Other secondary endpoints like lesion growth also favored the verteporfin-treated group. By the month 12 examination, verteporfin-treated patients recei- ved an average of 3.4 treatments per subject compared to 3.7 treatments per subject for placebo-treated patients. Treat- ments were well tolerated with < 2% withdrawing because of adverse events. Photosensitivity reactions occurred in 2% of the participants, and resolved within 24 hours 117 .
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Rev. bras.oftalmol.  vol.71 número6

Rev. bras.oftalmol. vol.71 número6

Purpose: To report the response of choroidal neovascularization (CNV) to intravitreal ranibizumab treatment in the setting of age- related macular degeneration (AMD) with extensive pre-existing geographic atrophy (GA) and a revision paper. Methods: This is a revision paper and a retrospective case series of 10 eyes in nine consecutive patients from a photographic database. The patients were actively treated with ranibizumab for neovascular AMD with extensive pre-existing GA. Patients were included if they had GA at or adjacent to the foveal center that was present before the development of CNV. The best corrected visual acuity and optical coherence tomography (OCT) analysis of the central macular thickness were recorded for each visit. Serial injections of ranibizumab were administered until there was resolution of any subretinal fluid clinically or on OCT. Data over the entire follow-up period were analyzed for overall visual and OCT changes. All patients had been followed for at least 2 years since diagnosis. Results: The patients received an average of 6 ± 3 intravitreal injections over the treatment period. Eight eyes had reduced retinal thickening on OCT. On average, the central macular thickness was reduced by 94 ± 101 µm. Eight eyes had improvement of one or more lines of vision, whereas one eye had dramatic vision loss and one had no change. The average treatment outcome for all patients was -0.07 ± 4.25 logMAR units, which corresponded to a gain of 0.6 ± 4.4 lines of Snellen acuity. The treatment resulted in a good anatomic response with the disappearance of the subretinal fluid, improved visual acuity, and stabilized final visual results. Conclusion: The results of this case series suggest that the use of an intravitreal anti-vascular endothelial growth factor (VEGF) agent (ranibizumab) for CNV in AMD with extensive pre-existing GA is effective. Our results are not as striking as published results from large-scale trials of anti-VEGF therapy for subfoveal CNV, presumably due to the limitation in the baseline visual acuity caused by the underlying GA. The good anatomic response with the disappearance of the subretinal fluid, improved visual acuity, and stabilized final visual results were consistent with other ranibizumab studies.
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Arq. Bras. Oftalmol.  vol.76 número4

Arq. Bras. Oftalmol. vol.76 número4

This study has some limitations. The number of patients included in the study was not satisfactory because of the one year follow-up period and the retreatment indications were not standardized becau- se of the retrospective study design. Indocyanin angiography could not performed to patients. Furthermore, some of the patients had previously been treated with anti-VEGF drugs. Despite these limita- tions, this retrospective case series showed that intravitreal anti-VEGF therapy preserved vision and reduced PED height in PED patients in a one-year follow-up period. It is important to note, however, that PED is still difficult to treat and the use of anti-VEGF drugs was not entirely adequate in completely resolving PED in ARMD patients. We need prospective large-scale studies on this subject.
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Interaction of complement factor h and fibulin3 in age-related macular degeneration.

Interaction of complement factor h and fibulin3 in age-related macular degeneration.

Age-related macular degeneration (AMD) is a major cause of vision loss. It is associated with development of characteristic plaque-like deposits (soft drusen) in Bruch’s membrane basal to the retinal pigment epithelium (RPE). A sequence variant (Y402H) in short consensus repeat domain 7 (SCR7) of complement factor H (CFH) is associated with risk for ‘‘dry’’ AMD. We asked whether the eye-targeting of this disease might be related to specific interactions of CFH SCR7 with proteins expressed in the aging human RPE/choroid that could contribute to protein deposition in drusen. Yeast 2-hybrid (Y2H) screens of a retinal pigment epithelium/choroid library derived from aged donors using CFH SCR7 baits detected an interaction with EFEMP1/Fibulin 3 (Fib3), which is the locus for an inherited macular degeneration and also accumulates basal to macular RPE in AMD. The CFH/Fib3 interaction was validated by co-immunoprecipitation of native proteins. Quantitative Y2H and ELISA assays with different recombinant protein constructs both demonstrated higher affinity for Fib3 for the disease-related CFH 402H variant. Immuno-labeling revealed colocalization of CFH and Fib3 in globular deposits within cholesterol-rich domains in soft drusen in two AMD donors homozygous for CFH 402H (H/H). This pattern of labeling was quite distinct from those seen in examples of eyes with Y/Y and H/Y genotypes. The CFH 402H/Fib3 interaction could contribute to the development of pathological aggregates in soft drusen in some patients and as such might provide a target for therapeutic intervention in some forms of AMD.
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Netrin-1 - DCC Signaling Systems and Age-Related Macular Degeneration.

Netrin-1 - DCC Signaling Systems and Age-Related Macular Degeneration.

The putative role of NTN1-DCC binding in AMD is most intriguing to us because the dem- onstrated capacity of these molecules exists for a highly localized influence on cell migration, cell-substrate adhesion, elaboration of vascular networks, inflammation, and protein transla- tion[7]. These processes may be triggered by altered metabolism and inflammation in retinal neurons, glia, immune cells and vessels affected in AMD and may explain the adaptive capacity for a sparing pattern of the fovea until late stages of the disease. The influence of netrin-driven responses on localized hypoxia-induced inflammation has been examined with in vivo models in epithelium of mucosal organs to demonstrate the role of netrin in regulation of inflamma- tory cell migration.[11] If these findings can be linked to the channeling of retinal resources[8] and the efficacy of tacrolimus and INCA-6 in animal models of retinal neovascularization[22], additional study of netrin-based signaling in the retina will likely elucidate promising venues for applied clinical research on AMD prevention and treatments.
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Rev. bras.oftalmol.  vol.74 número5

Rev. bras.oftalmol. vol.74 número5

The high resolution of the images obtained in seconds and without direct contact with the eye are some of the advantages of the method. Its high sensitivity allows an early diagnosis even of the most difficult retinal lesions to be detected by ophthalmoscopy and/or digital angiography. However, despite the excellence when it comes to high resolution imaging, its application in eye oncology is still limited in our environment, not only due to the high cost of portable equipment which is more suitable to assess pediatric patients, but also due to its application be still restricted to small and medium tumors located in the pos- terior pole of the globe 10 .
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O efeito da suspensão do tabagismo em estruturas oculares posteriores

O efeito da suspensão do tabagismo em estruturas oculares posteriores

ABSTRACT | Purpose: This study evaluated changes in cho­ roidal and macular thickness in healthy volunteers and chronic smokers. Methods: Thirty­three eyes of 33 chronic smokers (study group) and 33 eyes of 33 healthy controls who had never smoked were prospectively evaluated. Comprehensive ophthalmic assessment included slit lamp biomicroscopy, stereoscopic fundus examination, and intraocular pressure measurement. Spectral domain optical coherence tomography was used to measure choroidal and macular thickness 1 month before smoking cessation (smoking period) and after 3 months of smoking cessation (nonsmoking period). Results: The mean age of the participants was 41.88 ± 6.52 years (range, 26­52), and the average smoking duration was 8.6 ± 2.5 years (range, 5­16). The thickness of the paracentral choroid (nasal: 1,500 μm, p=0.001 and temporal: 1,500 µm, p=0.001) had significantly decreased after 3 months of smoking cessation. The thicknesses of the subfoveal choroid in the smoking and nonsmoking periods were not significantly different (p=0.194). The mean central macular thickness was 267.21 ± 18.42 µm in the smoking period and 268.42 ± 18.28 μm in the nonsmoking period (p=0.022). Conclusions: Smoking was associated with statistically significant changes in paracentral choroidal and central macular thickness in healthy volunteers. Pathological studies should be performed to evaluate the effects of smoking on posterior ocular structures.
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Arq. Bras. Oftalmol.  vol.77 número6

Arq. Bras. Oftalmol. vol.77 número6

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT ) findings of two consecutive patients who presen- ted with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluo- rescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal mela- nocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.
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Arq. Bras. Oftalmol.  vol.79 número4

Arq. Bras. Oftalmol. vol.79 número4

study, the previous study also investigated macular thickness, and it was determined that the central and nasal macular regions were thicker in the severe OSAS group than in the control group. The author compared the decreased choroid thickness and increased macular thickness to indings in diabetic retinopathy, and noted that macular thickening can result from vascular damage and increased permeability. In our study, at irst glance, the existence of no diferen- ce between the groups can be interpreted as there was no efect on vascular structures and that damage occurred. But, vascular damage and the appearance of the efects of this damage are determined by diferent elapsed times and personal variations of tissue reaction. In any case, a change in macular thickness was observed and choroidal thinning took place during the follow-ups.
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