No abstract available.
Hepatitis A Antibodies* ; Hepatitis* ; Immunoglobulin M*

PURPOSE: To assess whether a 4 mg/0.05 ml intravitreal triamcinolone acetonide injection can reduce the IOP elevation compared to conventional 4 mg/0.1 ml injection. METHODS: A retrospective case study was performed in 48 patients (48 eyes) who received intravitreal triamcinolone acetonide injection and who had a minimum follow-up time of six months. Patients were randomly assigned to receive 4 mg/0.1 ml or 4 mg/0.05 ml (24 patients in each group). RESULTS: Before injection, mean IOP was 13.8+/-2.2 mmHg and 13.9+/-2.4 mmHg in the 0.1 ml and 0.05 ml group. The difference in IOP elevation between the two groups was statistically significant immediately after injection (P=0.000), one hour after injection (P=0.001), and one day after injection (P=0.000). After injection, the central macular thickness decreased significantly the of two groups. The difference of the central macular thickness decrease between both groups was not statistically significant. CONCLUSIONS: An intravitreal triamcinolone acetonide 4 mg/0.05 ml injection will more quickly reduce the IOP elevation in the early phase compared to 4 mg/0.1 ml injection, while providing a similar effect on the change of central macular thickness.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Retrospective Studies ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

PURPOSE: To evaluate long-term effects and usefulness of combined intravitreal injection of bevacizumab and panretinal photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy. METHODS: The authors retrospectively reviewed the records of 40 patients (40 eyes) with high-risk proliferative diabetic retinopathy who had been treated with PRP alone (laser treatment group, n=20) or intravitreal bevacizumab before PRP (combined treatment group, n=20). Changes in best corrected visual acuity (BCVA), central macular thickness (CMT) and the total area of leakage from active new vessels (NVs) were compared between the groups at one, three, and six months and at one year post-treatment. RESULTS: In the combined treatment group, CMT decreased significantly at one month (p=0.021), and the areas of active NVs decreased significantly at one month (p=0.001) and three months (p=0.014) compared to those of the laser treatment group. However, there were no differences between the two groups after three months. In the combined treatment group, elevated intraocular pressures were found in three cases after one month, and there were vitreous hemorrhages in two cases after three months. CONCLUSIONS: The combined treatment showed significant early improvements in BCVA, CMT, and NVs regression for up to three months. However, long-term follow-up and additional treatment was necessary in the patients with persistent or recurred NVs and macular edema after three months.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage ; Bevacizumab

The medial prefrontal cortex (mPFC) has been implicated in the processing of emotionally significant stimuli, particularly the inhibition of inappropriate responses. We examined the role of the mPFC in regulation of fear responses using a differential fear conditioning procedure in which the excitatory conditioned stimulus (CS+) was paired with an aversive footshock and intermixed with the inhibitory conditioned stimulus (CS-). In the first experiment, using rats as subjects, muscimol, a gamma-amino-butyric acid type A (GABAA) receptor agonist, or artificial cerebrospinal fluid (aCSF) was infused intracranially into the mPFC across three conditioning sessions. Twenty-four hours after the last conditioning session, freezing response of the rats was tested in a drug-free state. Neither the muscimol nor the aCSF infusion had any effect on differential responding. In the second experiment, the same experimental procedure was used except that the infusion was made before the testing session rather than the conditioning sessions. The results showed that muscimol infusion impaired differential responding: the level of freezing to CS- was indiscriminable from that to CS+. Taken together, these results suggest that the mPFC is responsible for the regulation of fear response by inhibiting inappropriate fear expressions.
Animals ; Freezing ; Muscimol ; Prefrontal Cortex ; Rats

PURPOSE: This study compared serum vascular endothelial growth factor (VEGF) concentration between patients given the bilateral and unilateral intravitreal injections of bevacizumab. METHODS: In a prospective manner, serum VEGF levels in treatment-naive patients with age-related macular degeneration who underwent bilateral or unilateral intravitreal injections of bevacizumab were investigated. After informed consent, peripheral blood was collected from in patients who underwent bilateral or unilateral intravitreal injection of bevacizumab before and 1 month after the injection. Serum VEGF levels were measured by enzyme-linked immunosorbent assay after centrifugation. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) before and 1 month after the injection were compared between each group. RESULTS: Twenty patients received bilateral injections (40 eyes) and 20 patients received unilateral injections. The VEGF concentrations (pg/mL) before the bilateral injection were 235.75 +/- 183.16 and 252.53 +/- 233.52 for the unilateral injection. They were significantly reduced to 153.88 +/- 113.26 and 189.42 +/- 251.72 after 1 month, respectively (p = 0.037 and 0.019), which are showing no significant difference between the two groups (p = 0.771). And there were no significant intergroup difference in pre- and postoperative BCVA and CRT. CONCLUSIONS: The bilateral simultaneous intravitreal injection of bevacizumab did not differ greatly from unilateral intravitreal injection in the influence on serum VEGF levels and the therapeutic outcome.
Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal, Humanized/*administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Intravitreal Injections ; Macula Lutea/*pathology ; Macular Degeneration/blood/diagnosis/*drug therapy ; Prospective Studies ; Tomography, Optical ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors/*blood ; Visual Acuity

PURPOSE: This study compared serum vascular endothelial growth factor (VEGF) concentration between patients given the bilateral and unilateral intravitreal injections of bevacizumab. METHODS: In a prospective manner, serum VEGF levels in treatment-naive patients with age-related macular degeneration who underwent bilateral or unilateral intravitreal injections of bevacizumab were investigated. After informed consent, peripheral blood was collected from in patients who underwent bilateral or unilateral intravitreal injection of bevacizumab before and 1 month after the injection. Serum VEGF levels were measured by enzyme-linked immunosorbent assay after centrifugation. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) before and 1 month after the injection were compared between each group. RESULTS: Twenty patients received bilateral injections (40 eyes) and 20 patients received unilateral injections. The VEGF concentrations (pg/mL) before the bilateral injection were 235.75 +/- 183.16 and 252.53 +/- 233.52 for the unilateral injection. They were significantly reduced to 153.88 +/- 113.26 and 189.42 +/- 251.72 after 1 month, respectively (p = 0.037 and 0.019), which are showing no significant difference between the two groups (p = 0.771). And there were no significant intergroup difference in pre- and postoperative BCVA and CRT. CONCLUSIONS: The bilateral simultaneous intravitreal injection of bevacizumab did not differ greatly from unilateral intravitreal injection in the influence on serum VEGF levels and the therapeutic outcome.
Angiogenesis Inhibitors/administration & dosage ; Antibodies, Monoclonal, Humanized/*administration & dosage ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Intravitreal Injections ; Macula Lutea/*pathology ; Macular Degeneration/blood/diagnosis/*drug therapy ; Prospective Studies ; Tomography, Optical ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors/*blood ; Visual Acuity

PURPOSE: To compare the binocular double vision field for diplopia with Goldmann perimetry and Humphrey automated kinetic perimeter. METHODS: Fifty of 70 healthy volunteers with no ocular problem wore the glasses of 14 prism diopters(PD)(7 prism lenses on both eyes, base-in), and 20 of the 70 wore the glasses of 20 PD(10 prism lenses on both eyes, base-out) and of 5 PD(only on right eye, base-up), and then esotropia, exotropia and hypertropia were induced in each group, respectively. Humphrey automated kinetic perimetry and Goldmann perimetry were performed simultaneously and their results were analyzed using mean degrees of meridians and binocular single vision(BSV) score. RESULTS: Diplopia fields of Humphrey automated kinetic perimetry and Goldmann perimetry showed a similar overlap. Mean degree of meridians of Goldmann perimetry and Humphrey automated kinetic perimetry were 34.49/30.26, 32.08/28.31 and 31.93/27.09 degrees at esotropia, exotropia and hypertropia, respectively. BSV scores were 80.43/73.70, 74.34/67.13 and 67.16/62.13%, respectively. Diplopia field areas of Humphrey automated kinetic perimetry were significant larger than those of Goldmann (p<0.05). CONCLUSIONS: This study shows that if results of Humphrey automated kinetic perimetry are corrected by means of multiplying by 1.14, diplopia tests using Humphrey automated kinetic perimetry may be substituted for Goldmann perimetry.

PURPOSE: To evaluate therapeutic effects and usefulness of a combination treatment of intravitreal injection of triamcinolone acetonide (IVTA) and panretinal photocoagulation (PRP) in patients with clinically significant macular edema secondary to proliferative diabetic retinopathy (PDR). METHODS: Visual acuity test, fundoscopy, fluorescein angiography, and optical coherence tomography (OCT) were taken in 20 patients (20 eyes) of macular edema and PDR. A combination of intravitreal injection of triamcinolone acetonide and PRP was performed in 10 patients (10 eyes) and a combination of focal or grid laser photocoaqulation and PRP in the remaining 10 eyes. The postoperative outcomes were compared between the two combination treatments by best corrected visual acuity (BCVA), tonometry, fluorescein angiography, and OCT at 2 weeks, 1, 2, and 3 months. RESULTS: Average BCVA (log MAR) significantly improved from preoperative 0.56+/-0.20 to 0.43+/-0.08 at 1 month (P=0.042) and it was maintained until 3 months after a combination of IVTA and PRP in 10 eyes (P=0.007). The thickness of fovea decreased from average 433.3+/-114.9 micrometer to average 279.5+/-34.1 micrometer at 2 weeks after combined treatment of IVTA and PRP (P=0.005), which was significantly maintained until 3 months, but there was a transient visual disturbance and no significant difference in thickness of the fovea before and after treatment in the groups with PRP and focal or grid laser photocoagulation. CONCLUSIONS: A combination of IVTA and PRP might be an effective treatment modality in the treatment of macular edema and PDR and prevent the subsequent PRP-induced macular edema result in visual dysfunction. In combination with PRP, IVTA might be more effective than focal or grid laser photocoagulation and PRP for reducing diabetic macular edema and preventing aggravation of macular edema without transient visual disturbance in patients requiring immediate PRP.
Vitreous Body ; Triamcinolone Acetonide/*administration & dosage/therapeutic use ; Treatment Outcome ; Middle Aged ; Macular Edema, Cystoid/*drug therapy/etiology/*surgery ; *Laser Coagulation ; Injections ; Humans ; Glucocorticoids/*administration & dosage/therapeutic use ; Diabetic Retinopathy/*complications ; Aged

PURPOSE: To investigate weather an administrated inhibitor (disintegrin) of angiogenic factors inhibits the development of laser-induced experimental choroidal neovascularization (CNV) in rat model. METHODS: Experimental CNV was induced by red argon laser photocoagulation in the eyes of 10 Brown Norway rats. The rats were divided into two groups, the disintegrin (flavoridin)-treated group and control group. Fundus photography and fluorescein angiography were performed to identify late leakage after two weeks of laser photocoagulation. Three days after fluorescein angiography, the expression of vascular endothelial growth factor (VEGF) was identified by immunohistochemical stain. RESULTS: CNV-related fluorescein leakage appeared in forty-four (18 in the flavoridin-treated group, 26 in the control group) of 64 laser spots delivered to the 10 eyes that were tested at two weeks post-treatment. Expression of VEGF on laser-induced CNV lesions was reduced in the flavoridin-treated group. CONCLUSIONS: The results of this study suggest that disintegrin is an inhibitor of ocular angiogenesis; disintegrin reduced CNV in laser-induced experimental model. We expect that disintegrin may have a potent effect in age-related macular degeneration.
Angiogenesis Inducing Agents ; Animals ; Argon ; Choroidal Neovascularization ; Fluorescein ; Fluorescein Angiography ; Light Coagulation* ; Macular Degeneration ; Models, Animal ; Models, Theoretical ; Norway ; Photography ; Rats ; Retina* ; Vascular Endothelial Growth Factor A ; Weather