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Choroidal neovascular membrane

Manas R Biswal, Howard M Prentice, George W Smith, Ping Zhu, Yao Tong, C Kathleen Dorey, Alfred S Lewin, Janet C Blanks
Aberrant growth of blood vessels in the choroid layer of the eye, termed choroidal neovascularization (CNV), is the pathological hallmark of exudative age-related macular degeneration (AMD), causing irreversible blindness among the elderly. Co-localization of proangiogenic factors and hypoxia inducible factors (HIF) in neovascular membranes from AMD eyes suggests the role of hypoxia in pathogenesis of CNV. In order to utilize hypoxic conditions in RPE for therapeutic purposes, we developed an optimized hypoxia regulated, RPE cell-specific gene therapy to inhibit choroidal neovascularization...
August 13, 2018: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
Kazuki Nakagawa, Haruhiko Yamada, Hidetsugu Mori, Keiko Toyama, Kanji Takahashi
This study aimed to investigate the differences between images obtained by optical coherence tomography angiography (OCTA) with those from immunohistochemical labeling of laser-induced choroidal neovascularization (CNV) in a mouse model. CNV was induced by laser photocoagulation (GYC-2000, NIDEK; wavelength 532 nm) in the left eyes of 10 female C57BL/6J mice aged 6 weeks. The laser parameters included a 100-μm spot, 100-ms pulse duration and 200-mW incident power to rupture Bruch's membrane. OCT and OCTA CNV images were obtained using the RS-3000 Advance (NIDEK) 5 days post-laser photocoagulation...
2018: PloS One
Richard I Kaplan, Joseph B Walsh, Richard B Rosen, Meenakashi Gupta
PURPOSE: To report a case of macular vortex vein imaged with indocyanine green angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography. METHODS: Observational case report. RESULTS: A 51-year-old myopic man presented with the complaint of a floater in his left eye for the previous 2 weeks. His visual acuity was 20/25 in the right eye and 20/40 in the left eye. Biomicroscopy was normal. Retinoscopy revealed lattice degeneration and posterior vitreous detachment of both eyes with dilated submacular vasculature in the right eye and submacular hemorrhage in the left eye...
August 6, 2018: Retinal Cases & Brief Reports
Yvonne Nowosielski, Gertrud Haas, Christof Seifarth, Werner Wohlfarter, Ramon Tasan, Michael Verius, Josef Troger, Nikolaos Bechrakis
PURPOSE: to explore whether the NK1 and Y2 receptors are involved in the pathogenesis of laser-induced CNV (choroidal neovascularization) in C57Bl/6N mice. METHODS: CNV was induced by laser damage of Bruch's membrane and the CNV volume was determined by OCT and/or flatmount preparation. First, the development of the CNV volume over time was evaluated. Second, the CNV development in NK1- and Y2 KO mice was analyzed. Third, the effect on the development as well as the regression of CNV by intravitreal injections of the NK1 antagonist SR140333 and the Y2 antagonist BIIEO246 separately and each in combination with Eylea® , was investigated...
August 1, 2018: Experimental Eye Research
Konstantinos Balaskas, Zaria C Ali, Tarik Saddik, Maria Gemenetzi, Praveen Patel, Tariq M Aslam
IMPORTANCE: The study highlights the role of Optical Coherence Angiography in the management of patients with neovascular age-related macular degeneration who have developed subretinal fibrosis. BACKGROUND: Development of subretinal fibrosis in the context of neovascular age-related macular degeneration is known to adversely affect visual function. The aim of this study is to assess structure and flow features obtained through swept-source optical coherence tomography angiography in patients with subretinal fibrosis and associate these with visual acuity...
August 1, 2018: Clinical & Experimental Ophthalmology
Francesco Pichi
PURPOSE: To report a case of pediatric vascularized sarcoid choroidal granuloma complicated by placoid-like inflammation. METHODS: Case report. RESULTS: A 10-year-old girl presented with blurry vision in her right eye and a yellowish macular lesion that had been diagnosed as fibrotic choroidal neovascular membrane and observed for several months. On referral to our clinic, optical coherence tomography revealed a homogeneous hyperreflective lesion obliterating the choroidal vasculature and protruding under the retina with associated subretinal and intraretinal fluid...
July 24, 2018: Retinal Cases & Brief Reports
Maurizio Battaglia Parodi, Pierluigi Iacono, Francesco Romano, Francesco Bandello
Purpose: We compare the fluorescein angiography (FA) patterns with morphologic alterations detectable on spectral-domain OCT (SD-OCT) in myopic choroidal neovascularization (mCNV) and evaluate whether they influence the effects of intravitreal ranibizumab (IVRI) in an as-needed (PRN) regimen. Methods: The 49 patients enrolled in this prospective case series underwent a complete ophthalmologic examination, including best-corrected visual acuity (BCVA), FA, and SD-OCT assessment...
June 1, 2018: Investigative Ophthalmology & Visual Science
Kanika Aggarwal, Aniruddha Agarwal, Vishali Gupta
The authors describe the imaging characteristics and progression of a type 2 choroidal neovascular membrane (CNV) using swept-source optical coherence tomography (SS-OCTA). A 27-year-old male presented with an active possible tubercular choroidal granuloma associated with exudative retinal detachment in the right eye. The patient received anti-tubercular drugs, oral corticosteroids, and intravitreal bevacizumab and showed complete resolution in 3 months. At the 7-month follow-up, SS-OCTA imaging revealed a type 2 CNV...
July 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
Alexander C Barnes, Careen Y Lowder, Angela P Bessette, Kimberly Baynes, Sunil K Srivastava
BACKGROUND AND OBJECTIVE: To report on the use of intravitreal steroids in the management of acute zonal occult outer retinopathy (AZOOR), a rare disorder affecting the outer retina. PATIENTS AND METHODS: Retrospective case series of nine eyes of five patients with AZOOR who received intravitreal triamcinolone acetonide (IVTA), dexamethasone intravitreal implant, and/or fluocinolone acetonide implant. Treatment response was determined by reported symptoms and multimodal imaging findings...
July 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
Jie Xue, Acner Camino, Steven T Bailey, Xiyu Liu, Dengwang Li, Yali Jia
Detecting and quantifying the size of choroidal neovascularization (CNV) is important for the diagnosis and assessment of neovascular age-related macular degeneration. Depth-resolved imaging of the retinal and choroidal vasculature by optical coherence tomography angiography (OCTA) has enabled the visualization of CNV. However, due to the prevalence of artifacts, it is difficult to segment and quantify the CNV lesion area automatically. We have previously described a saliency algorithm for CNV detection that could identify a CNV lesion area with 83% accuracy...
July 1, 2018: Biomedical Optics Express
Xiaoyan Ding, Zongyi Zhan, Limei Sun, Yu Yang, Songshan Li, Aiyuan Zhang, Xiaoling Luo, Lin Lu
PURPOSE: To describe the morphological changes in myopic choroidal neovascularization (mCNV) on spectrum domain optical coherence tomography (SD-OCT) and to find a new strategy to evaluate their activity. METHODS: Characteristics of SD-OCT and fundus fluorescein angiography (FFA) before and after ranibizumab treatment of 52 eyes with active mCNV were analyzed. SD-OCT parameters associated with mCNV activity and the clinical significance of their sensitivity and specificity were analyzed using FFA as a standard reference...
July 7, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Pranita Sahay, Ishan Pandya, Prafulla Kumar Maharana, Jeewan S Titiyal
A 25-year-old male patient presented with complaints of blurred vision in both eyes since 2 years. The patient was a known case of nephrotic syndrome with dyslipidaemia for which he was on diuretics and lipid-lowering agents for 3 years. On examination, his visual acuity was 6/9 in both eyes with cloudy cornea and arcus juvenilis. Fundus examination was within normal limits. On systemic work-up, his lipid profile was deranged with increased serum total cholesterol, very low density lipoprotein, low density lipoprotein and triglyceride...
June 27, 2018: BMJ Case Reports
P M López-Corell, I Pascual-Camps, C Martínez-Rubio, R Molina-Pallete, H Barranco-González
PURPOSE: To describe the anatomical and functional results of intravitreal antiangiogenic treatment in optic nerve head drusen associated with choroidal neovascularisation. CASE REPORT: An 8 year-old male patient with a diagnosis of neovascular membrane in the right eye associated with bilateral optic nerve head drusen. Best-corrected visual acuity (BCVA) was by counting fingers in the right eye and improved to 0.4 after antiangiogenic treatment. A complete consolidation of the lesion was observed with no associated complications arising from the treatment...
June 1, 2018: Archivos de la Sociedad Española de Oftalmología
Joseph B Lin, Abdoulaye Sene, Luke A Wiley, Andrea Santeford, Eric Nudleman, Rei Nakamura, Jonathan B Lin, Harsh V Moolani, Rajendra S Apte
Perturbations in WNT signaling are associated with congenital eye disorders, including familial exudative vitreoretinopathy and Norrie disease. More recently, activation of the WNT pathway has also been shown to be associated with age-related macular degeneration (AMD). In this study, we identified that in choroidal neovascular membranes from AMD patients, β-catenin is activated specifically in the vascular endothelium, suggesting that WNT promotes pathologic angiogenesis by directly affecting vascular endothelial cells...
June 1, 2018: Experimental Eye Research
Richa Ranjan, Manisha Agarwal
A 43-year-old male with chronic Vogt-Koyanagi-Harada syndrome (VKH) presented with subfoveal choroidal neovascular membrane (CNVM) in the right eye with no evidence of active inflammation. He underwent intravitreal bevacizumab and dexamethasone injections. Postinjection he developed fresh keratic precipitates and exudative retinal detachment (RD). He received two more bevacizumab injections with oral corticosteroids and immunosuppressants causing resolution of exudative RD with scarred CNVM. We report this case to highlight that intravitreal injection may act as a trigger for rebound inflammation in VKH patients and may require anti-inflammatory drugs to be started even in the absence of an active inflammation...
June 2018: Indian Journal of Ophthalmology
Konstantinos T Tsaousis, Mohamed Nassr, Bharat Kapoor, Vasileios E Konidaris, Straton Tyradellis, Theo Empeslidis
Introduction: To present a case series of three female patients with punctate inner choroidopathy. We report the outcomes after an essentially long follow-up period of up to 14 years and provide evidence of the effectiveness of intravitreal injections of bevacizumab and dexamethasone 0.7 mg in punctate inner choroidopathy patients with choroidal neovascular membrane formation. Case series presentation: This is a retrospective case series of three female patients with punctate inner choroidopathy who were treated with intravitreal injections anti-vascular endothelial growth factor agent (bevacizumab, 1...
2018: SAGE Open Medical Case Reports
Yi-Sheng Chang, Wan-Ju Lee, Chen-Chee Lim, Shih-Hao Wang, Sheng-Min Hsu, Yi-Chian Chen, Chia-Yi Cheng, Yu-Ti Teng, Yi-Hsun Huang, Chun-Chieh Lai, Sung-Huei Tseng
This study investigated the "real-world" use of ranibizumab for neovascular age-related macular degeneration (nAMD) in Taiwan and assessed the visual outcome. We reviewed the medical records at National Cheng Kung University Hospital, Taiwan, during 2012-2014 for 264 consecutive eyes of 229 patients with nAMD, who applied for ranibizumab covered by national health insurance. A total of 194 eyes (73.5%) in 179 patients (65.5% men; mean ± standard deviation age 69.4 ± 10.7 years) were pre-approved for treatment...
May 10, 2018: Scientific Reports
Laurence A Hutton-Smith, Eamonn A Gaffney, Helen M Byrne, Antonello Caruso, Philip K Maini, Norman A Mazer
Neovascular age-related macular degeneration (wet AMD) results from the pathological angiogenesis of choroidal capillaries, which leak fluid within or below the macular region of the retina. The current standard of care for treating wet AMD utilizes intravitreal injections of anti-VEGF antibodies or antibody fragments to suppress ocular vascular endothelial growth factor (VEGF) levels. While VEGF suppression has been demonstrated in wet AMD patients by serial measurements of free-VEGF concentrations in aqueous humor samples, it is presumed that anti-VEGF molecules also permeate across the inner limiting membrane (ILM) of the retina as well as the retinal pigmented epithelium (RPE) and suppress VEGF levels in the retina and/or choroidal regions...
July 2, 2018: Molecular Pharmaceutics
Maya Barben, Marijana Samardzija, Christian Grimm
In industrialized countries, age-related macular degeneration (AMD) is the leading cause of blindness in elderly people. Hallmarks of the non-neovascular (dry) form of AMD are the formation of drusen and geographic atrophy, whereas the exudative (wet) form of the disease is characterized by invading blood vessels. In retinal angiomatous proliferation (RAP), a special form of wet AMD, intraretinal vessels grow from the deep plexus into the subretinal space. Little is known about the mechanisms leading to intraretinal neovascularization, but age-related changes such as reduction of choroidal blood flow, accumulation of drusen, and thickening of the Bruch's membrane may lead to reduced oxygen availability in photoreceptors...
2018: Advances in Experimental Medicine and Biology
Bärbel Rohrer
Age-related macular degeneration (AMD) is the leading cause of blindness in the USA. Polymorphisms in various complement components are associated with an increased risk for AMD, and it has been hypothesized that an overactive complement system is partially responsible for the pathology of AMD. AMD is classified as early, intermediate, or late AMD, depending on the degree of the associated pathologies. Late AMD can be characterized as either lesions associated with neovascular AMD or geographic atrophy. Both sets of lesions are associated with pathology at the RPE/choroid interface, which include a thickening of Bruch's membrane, presence of drusen, and pigmentary alterations, and deterioration of the blood-retina barrier has been reported...
2018: Advances in Experimental Medicine and Biology
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