Choroidal neovascularization in a patient with blunt trauma-caused traumatic retinopathy without choroidal rupture

Purpose  

To report a case of choroidal neovascularization (CNV) following blunt trauma without choroidal rupture, with past history of central serous chorioretinopathy (CSC).     

Classic choroidal neovascularization developing after photodynamic therapy in eyes with polypoidal choroidal vasculopathy

Purpose  

To investigate the characteristics of eyes with polypoidal choroidal vasculopathy (PCV) which develop secondary classic choroidal neovascularization (CNV) after photodynamic therapy (PDT).     

Bevacizumab treatment for choroidal neovascularization due to age-related macular degeneration in Japanese patients

Purpose  

To assess intravitreal bevacizumab (IVB) for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) in Japanese patients.     

Anatomic response of occult choroidal neovascularization to intravitreal ranibizumab: a study by indocyanine green angiography

Background  

To investigate changes in indocyanine green angiography (ICGA) features of occult choroidal neovascularization (CNV) after intravitreal ranibizumab injections.     

Monocyte/macrophages promote vasculogenesis in choroidal neovascularization in mice by stimulating SDF-1 expression in RPE cells

Background  

Monocyte-macrophages play important roles in choroidal neovascularization (CNV); however, the mechanism is unclear. This study investigated the effects of monocyte depletion on laser-induced CNV in mice, especially the involvement of bone marrow-derived cells (BMCs) and underlying molecular mechanisms.     

Intravitreal bevacizumab versus photodynamic therapy for myopic choroidal neovascularization in a North-African population

Purpose  

To compare the 1-year functional and anatomical outcomes of intravitreal bevacizumab (IVB) and photodynamic therapy (PDT) in patients with myopic choroidal neovascularization (CNV).     

Intravitreal bevacizumab to treat myopic choroidal neovascularization: 2-year outcome

Background  

Myopic maculopathy is the leading cause of subfoveal choroidal neovascularization (CNV) among patients under 50 years of age. New antiangiogenic drugs are being used off-label to treat myopic CNV and the short-term outcome of these therapies has been reported. The aim of this study is to report the changes in best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) in highly myopic CNV treated by intravitreal bevacizumab at 2 years.     

Concentration of cytokines in age-related macular degeneration after consecutive intravitreal bevacizumab injection

Background  

To evaluate the changes in aqueous humor cytokine levels following consecutive intravitreal bevacizumab (Avastin, Genentech Inc., San Francisco, CA, USA) injections in eyes with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD).     

Near-infrared reflectance imaging of neovascular age-related macular degeneration

Purpose  

To evaluate various types of neovascular age-related macular degeneration (AMD) by near-infrared fundus reflectance (NIR) as compared to fundus fluorescein angiography (FFA) and to test NIR for assessment of leakage due to choroidal neovascularization (CNV).     

Intravitreal injection of triamcinolone combined with bevacizumab for choroidal neovascularization associated with large retinal pigment epithelial detachment in age-related macular degeneration

Purpose  

To discuss the effect and outcome of a combined intravitreal triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in treating choroidal neovascularization (CNV) associated with large retinal pigment epithelial detachment (PED) in age-related macular degeneration (AMD).     

One-year results of intravitreal ranibizumab for neovascular age-related macular degeneration and clinical responses of various subgroups

Purpose  

To report 1-year clinical outcomes of intravitreal ranibizumab treatment for choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) and to identify predictive factors that may influence visual acuity (VA) outcomes in Korean patients.     

Bevacizumab for choroidal neovascularization secondary to pathologic myopia: Is there a decline of the treatment efficacy after 2 years?

Background  

The Verteporfin in Photodynamic Therapy (VIP) Study failed to prove a statistically significant benefit for myopic choroidal neovascularization (CNV) at the end of the second year. Therefore, we wanted to evaluate whether the early effects seen under anti-VEGF treatment can be maintained over longer follow-up intervals.     

Verteporfin PDT for non-standard indications—a review of current literature

Background  

Verteporfin photodynamic therapy (PDT) is approved for the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD), as well as for subfoveal CNV due to pathologic myopia and ocular histoplasmosis syndrome. Verteporfin PDT addresses the underlying pathology of ocular vascular disorders through its angio-occlusive mechanism of action, which reduces both visual acuity loss and the underlying leakage associated with lesions. Verteporfin PDT has also been associated with encouraging treatment outcomes in case studies involving patients with choroidal vascular disorders such as polypoidal choroidal vasculopathy, central serous chorioretinopathy, choroidal haemangioma, angioid streaks, and inflammatory CNV, i.e. conditions currently considered as non-standard indications of verteporfin PDT. In many studies, outcomes were better than expected based on the natural courses of each of these conditions. Although the anti-vascular endothelial growth factor (VEGF) therapies, ranibizumab and pegaptanib, have been approved for CNV due to AMD, their role in these other choroidal vascular disorders remains to be established. We summarize current literature that has documented the use of verteporfin PDT in these conditions.     

Neural stem/progenitor cells circulating in peripheral blood of patients with neovascular form of AMD: a novel view on pathophysiology

Background  

The neovascular form of age-related macular degeneration (AMD) manifested with choroidal neovascularization (CNV) is one of the leading causes of rapid and irreversible visual loss. Recent reports suggest that bone marrow-derived stem/progenitor cells (SPCs) play a crucial role in the development and progression of the disease. The purpose of this study was to investigate whether or not undifferentiated non-haematopoietic stem cells, including those capable of differentiating into neural phenotypes, play a role in the pathological state of CNV formation.     

Two Cases of Focal Choroidal Excavation Detected by Spectral-Domain Optical Coherence Tomography

Purpose

To report the clinical findings of 2 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT).

Methods

Three eyes of 2 patients with a focal macular choroidal excavation detected by SD-OCT were studied. The eyes were examined by fundus autofluorescence (FAF), fluorescein angiography, fundus-related microperimetry, and multifocal electroretinography (mfERG).

Results

In spite of a complaint of metamorphopsia, the visual acuity was normal in 2 eyes. SD-OCT demonstrated a choroidal excavation in the macula but the foveal contour was normal in 3 eyes. The excavation involved the outer retinal layers up to the external limiting membrane in all eyes, and a type 2 secondary choroidal neovascularization (CNV) developed in 1 of the 3 eyes. There were areas of hypoautofluorescence in the FAF images, and areas of decreased retinal sensitivity determined by microperimetry. These areas corresponded to the choroidal excavation in all eyes. The P1 amplitudes of the mfERGs were decreased in the fovea of 1 eye without a CNV.

Conclusions

The choroidal excavation remained stable for 3 years in 2 eyes, a secondary CNV developed in 1 eye during the course of the disease. More cases and longer follow-up periods will be necessary to determine the etiology, clinical course, and visual prognosis of eyes with a choroidal excavation.Key Words: Choroidal excavation, Choroidal neovascularization, Optical coherence tomography     

Treatment of neovascular age-related macular degeneration with a variable ranibizumab dosing regimen and one-time reduced-fluence photodynamic therapy: the TORPEDO trial at 2 years

Background  

The combination of verteporfin photodynamic therapy (PDT) and anti-angiogenics has been shown to be safe and efficacious in the treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). The purpose of this study is to demonstrate long-term prevention of vision loss and improvement in best-corrected visual acuity (BCVA) after treatment with one-time reduced-fluence-rate PDT followed by administration of ranibizumab on a variable dosing regimen over 24 months in patients with neovascular AMD. Secondary outcome measures included the change in central macular thickness (CMT), reinjection frequency, and safety.     

A Case of Choroidal Neovascularization Secondary to Unilateral Retinal Pigment Epithelium Dysgenesis

Aim

To report a case of choroidal neovascularization secondary to unilateral retinal pigment epithelium dysgenesis (URPED), which was resistant to posterior subtenon injection of triamcinolone acetonide (STTA) and intravitreal bevacizumab injection (IVB).

Case Report

An 8-year-old boy was referred to us because of a unilateral unique clinical appearance on funduscopic examination in his left eye (OS). A geometric lesion at the retinal pigment epithelium level of the interpapillomacular area was disclosed OS. The optic nerve was slightly hyperemic OS. Findings from the right fundus examination were normal. Based on these characteristic findings, he was diagnosed as having URPED. Best corrected Landolt ring chart visual acuity (BCVA) was 1.0 in both eyes. Twenty-three months after the first visit, the patient presented with visual disturbance OS. Funduscopic examination showed an expansion of the geometric lesion and the development of a subfoveal choroidal neovascularization (CNV). BCVA was 0.4 OS. Two-time STTA (40 mg/1 ml) was performed at the onset of CNV and 6 months later, and additional IVB (1.25 mg/0.05 ml) was done 10 months later for the treatment of CNV, but the geometric lesion and CNV were resistant to the treatment and continued to expand. Seven years after the first visit, the geometric lesion and the CNV kept expanding steadily.

Conclusion

URPED is a rare clinical entity, and the prognosis of this disease is still unclear. The visual prognosis may depend on whether CNV fully develops.Key words: Unilateral retinal pigment epithelium dysgenesis, Anti-VEGF, Bevacizumab, Choroidal neovascularization, Triamcinolone, Fundus autofluorescence     

Choroidal Nevus in an Eye with Polypoidal Choroidal Vasculopathy

Purpose

To report an eye with polypoidal choroidal vasculopathy (PCV) and a choroidal nevus.

Methods

This is an observational case report.

Results

A healthy 69-year-old woman was referred to the Osaka University Hospital with a diagnosis of a macular tumor. She complained of having distorted vision in her left eye. The medical history of the patient was unremarkable. At the initial examination, her best-corrected visual acuity (BCVA) was 20/20 in both eyes, and the intraocular pressure was 18 mm Hg in both eyes. A slit-lamp examination showed no abnormalities in the anterior segment of both eyes and a fundus examination of the left eye showed a slightly elevated juxtafoveal chorioretinal lesion and polyp-like reddish-orange lesions. The juxtafoveal choroidal lesion was located beneath a choroidal neovascularization (CNV). An optical coherence tomography confirmed CNV with pigment epithelial detachment (PED). Fluorescein angiography showed juxtafoveal hyperfluorescence due to CNV. Indocyanine green angiography demonstrated a branching choroidal vascular network that resembled polypoidal lesions. A fundus autofluorescence showed a mosaic pattern and a slight hyperautofluorescence at the CNV. We diagnosed the patient as having PCV. Aflibercept was injected intravitreally because of her PED. After the injection, PED improved and her visual acuity remained stable during the 12-month follow-up period.

Conclusions

In cases of PCV, FAF images are helpful in determining the status of the posterior pole. Intravitreal injections of aflibercept can improve PED associated with CNV, and the BCVA will remain stable for at least 12 months.Key words: Aflibercept, Autofluorescence, Choroidal nevus, Pigment epithelial detachment, Polypoidal choroidal vasculopathy     

Intravitreal bevacizumab injection in patients with choroidal neovascularization due to choroid rupture after blunt-head trauma

Purpose To describe and report the effect of intravitreal bevacizumab (Avastin) as primary treatment for secondary choroidal neovascularization (CNV) after choroidal rupture due to blunt-head trauma. Design Interventional case report. Methods The study was of the left eye of a patient who presented with choroidal neovascularization secondary to choroidal rupture due to blunt-head trauma. The patient received single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab as treatment for CNV after informed consent was signed. The patient underwent fundus fluorescein angiography (FA) and optic coherence tomography (OCT) before the bevacizumab injection and then again three months after. Visual acuity was also measured before and after treatment. The patient was re-examined on the first day, and monthly thereafter. After intravitreal injection of bevacizumab the visual and anatomic responses were observed. Results The patient showed regression of the neovascularization three months after injection of bevacizumab. There was no loss of vision in the immediate postoperative period and at the 3rd month vision improved from 20/60 to 20/20. Central retinal thickness decreased. No cataract progression, endophthalmitis, or injection-related complications were observed. Conclusions Our study shows that intravitreal 1.25 mg bevacizumab can be an effective alternative treatment for choroidal neovascularization (CNV) due to choroidal rupture. The authors have no proprietary interest in the material used in this study.     

Choroidal Neovascularization in a Patient with Crohn's Disease

Purpose

To report a case of subfoveal choroidal neovascularization (CNV) in a patient with Crohn''s disease (CD) and to discuss a possible association between these two conditions.

Methods

This is an observational case report.

Results

A 69-year-old male affected by CD was referred to our department because of sudden visual acuity drop in the left eye. A subfoveal CNV was diagnosed based on slit-lamp fundus biomicroscopy and fluorescein angiography. Color fundus photography, infrared autofluorescence and spectral-domain optical coherence tomography imaging of both eyes were also performed. Following six intravitreal ranibizumab injections, visual improvement was obtained with no related adverse events.

Conclusion

We report a case of CNV as a possible rare extraintestinal manifestation of CD. The use of ranibizumab successfully impacted on CNV, while not affecting CD, which remained quiescent.Key words: Choroidal neovascularization, Crohn''s disease, Anti-VEGF, Intravitreal ranibizumab, Fluorescein angiography, Optical coherence tomography