Objective: To determine the range of macular pigment optical density (MPOD) levels in healthy Filipino adults using both the MPS II and the macuscope and to investigate whether age and sex were related to inter-subject variations in MPOD. Methods: This was a prospective, cross sectional study of 168 healthy Filipino patients who underwent heterochromic filter photometry to measure macular pigment levels using the MPS II and the macuscope. The MPOD levels were averaged per age group and analyzed as to variations among age and gender. Results: One hundred thirty (130) and thirty-eight (38) patients underwent MPS II and macuscope testing respectively. The mean MPOD level for MPS II was 0.39(±0.16) and for macuscope 0.27(±0.07). MPOD values were similar across all age groups and gender, but they were lower when measured with the macuscope. Conclusions MPOD levels measured among healthy Filipino adults were lower with the macuscope compared to the MPS II. These differences should take into consideration the differences in apparatus and techniques of measurement.
Macular Degeneration ; Zeaxanthins

Objectives: Anti-vascular endothelial growth factor (anti-VEGF) drugs delivered intravitreally have been proven effective and safe for the treatment of patients diagnosed with neovascular age-related macular degeneration (ARMD). This study evaluated the short-term biologic efficacy and safety of multiple intravitreal injections of bevacizumab in patients with neovascular ARMD. Methods: A prospective, interventional, placebo-controlled, randomized clinical trial was done involving patients with active subfoveal neovascular ARMD. Excluded were patients with significant media opacity, concomitant retinal/ocular diseases, previous intravitreal injections, recent laser treatment or intraocular surgery, and contraindications to the drug. Demographic data were taken and a complete ocular examination, fluorescein angiogram (FA), and optical coherence tomogram (OCT) were performed. Patients received either 3 monthly intravitreal injections of 1.25mg bevacizumab or sham injections. Best-corrected visual acuity (BCVA) and central macular thickness were recorded at baseline, 2, 4, 8, and 12 weeks follow-up. Ocular/Periocular or systemic drug-related side effects or toxicities and iatrogenic complications were noted. Results: Thirty eyes (15 per group) were included in the final analysis. Both treatment and control groups were comparable in baseline characteristics. There was a significant increase in the mean visual acuity (p < 0.001) in eyes treated with bevacizumab across all time periods. The average gain at the end of the study was 11.6 letters. This paralleled a similar significant decrease in central macular thickness for the treatment group (p < 0.02). No major ocular adverse events were noted. Conclusion This study supported the growing body of evidence that intravitreal injections of bevacizumab 1.25 mg result in short-term anatomical as well as functional improvement with minimal adverse events in patients with neovascular ARMD.
Choroidal Neovascularization ; Macular Degeneration ; Bevacizumab

Objectives: The aim of this review was to examine the effects of PDT in the treatment of neovascular ARMD.
PHOTOCHEMOTHERAPY ; RETINAL NEOVASCULARIZATION ; MACULAR DEGENERATION

PURPOSE: To evaluate the efficacy of 3 bimonthly aflibercept injections for neovascular age-related macular degeneration (AMD) that showed limited response to 3 initial ranibizumab injections. METHODS: Three bimonthly aflibercept injections were performed for 21 eyes with neovascular AMD that was refractory to 3 monthly ranibizumab injections. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured at diagnosis, 1 month after 3 ranibizumab injections, and 1 month after 3 aflibercept injections, and these values were compared. RESULTS: The mean logarithm of minimal angle of resolution (logMAR) BCVA at diagnosis, after ranibizumab therapy, and after aflibercept therapy was 0.62 ± 0.29, 0.73 ± 0.31, and 0.65 ± 0.28, respectively. The CRT at the aforementioned times was 427.0 ± 98.7 µm, 409.5 ± 78.7 µm, and 315.9 ± 98.2 µm, respectively. When compared with the value measured after ranibizumab therapy, CRT was significantly decreased after aflibercept therapy (p < 0.001), whereas there was no significant difference in BCVA (p = 0.092) between the two times. Improved BCVA was noted in 8 eyes (38.1%) after aflibercept therapy and BCVA was unchanged in 11 eyes (52.4%). Decreased CRT was noted in 18 eyes (85.7%) after aflibercept therapy. CONCLUSIONS: Three bimonthly aflibercept injections were found to be useful in terms of improving or maintaining visual acuity, as well as reducing retinal thickness in neovascular AMD that showed limited response to 3 initial ranibizumab injections.
Diagnosis ; Macular Degeneration* ; Ranibizumab* ; Retinaldehyde ; Visual Acuity

PURPOSE: To investigate the peripapillary choroidal thickness (PCT) of polypoidal choroidal vasculopathy (PCV) and exudative age-related macular degeneration (AMD) and to evaluate their responses to anti-vascular endothelial growth factor (VEGF). METHODS: Thirty eyes with PCV and 25 eyes with exudative AMD who were treatment naïve were included in this study. PCT and subfoveal choroidal thickness were evaluated both before and after intravitreal anti-VEGF. RESULTS: The initial mean PCT of PCV (153.78 ± 56.23 µm) was thicker than that of exudative AMD (88.77 ± 23.11 µm, p < 0.001). Temporal, superior, nasal, and inferior PCTs of PCV were all thicker than those observedin exudative AMD (all p < 0.05). After anti-VEGF, the mean PCT of PCV was significantly reduced (134.17 ± 41.66 µm, p < 0.001), but the same was not true not in exudative AMD (86.87 ± 22.54 µm, p = 0.392). PCTshowed a similar tendency in all quadrants. CONCLUSIONS: PCV exhibits a thick choroid in the peripapillary region. PCT decreases after anti-VEGF in PCV but not in exudative AMD. In exudative AMD, subfoveal choroidal thickness decreased, but that in the peripapillary region did not.
Choroid* ; Endothelial Growth Factors* ; Macular Degeneration

PURPOSE: To compare SLO (scanning laser ophthalmoscope) retromode images with conventional color fundus photography for the detection of drusen. METHODS: We obtained color fundus photography and SLO retromode images of the ten fellow eyes of ten patients with unilateral exudative age-related macular degeneration (AMD) and twenty eyes of 20 patients who had only drusen without exudative AMD. The numbers of druse in each image were compared within the same retinal boundary. RESULTS: In the fellow eyes of unilateral exudative AMD, an average number of 63.1 +/- 81.9 drusen in color fundus photography and an average number of 141.3 +/- 124.1 drusen in SLO retromode images were detected (p = 0.005). In the eyes with only drusen, an average number of 57.0 +/- 43.9 drusen in color fundus photography and an average number of 112.2 +/- 82.0 drusen in SLO retromode images were detected (p = 0.000). In the presence of media opacity like cataract, drusen were better detected in SLO retromode images than they were in color fundus photography. CONCLUSIONS: About twice as many drusen were detected in SLO retromode images than in color fundus photography. Drusen were also better detected in SLO retromode images in cases of media opacity. SLO retromode images might provide more sensitive images for the detection of drusen than does color fundus photography.
Cataract ; Eye ; Humans ; Macular Degeneration ; Photography ; Retinaldehyde

We report three cases of Bardet-Biedl syndrome (BBS) among which a young female and two siblings from a separate family, presented with common features of obesity, postaxial (ulnar) polydactyly, speech delay, developmental delay with learning difficulties and progressive deterioration of vision. Fundus examination revealed maculopathy and other remarkable findings in these patients. In this image of endocrinology, we describe the BBS phenotypes of these cases highlighting the fundus photography features with a plan for close follow up on obesity and endocrine complications.
Polydactyly ; Obesity ; Macular Degeneration ; Bardet-Biedl Syndrome

Preretinal hemorrhage, which is located between the retina and vitreous face and is commonly developed on the macula, causes impaired central vision and if it persists, it may cause complications, such as epimacular membrane. A 49-year-old male who had dry type of age-related macular degeneration in both eyes and had an oval shaped premacular hemorrhage of unknown etiology in his left eye. We applied Q-switched Nd:YAG laser on membrane anterior to preretinal hemorrhage and ruptured it. Preretinal hemorrage was drained to inferior vitreous cavity and his central vision was rapidly improved.
Hemorrhage* ; Humans ; Macular Degeneration ; Male ; Membranes ; Middle Aged ; Punctures* ; Retina

PURPOSE: To compare the changes in subfoveal choroidal thickness between intravitreal aflibercept and ranibizumab injection in wet age-related macular degeneration (AMD). METHODS: Fifty patients with wet AMD patients who were treated with aflibercpet or ranibizumab were evaluated retrospectively. All patients were treated with pro re nata after 3 consecutive monthly injections and were followed up for at least 6 months. We measured subfoveal choroidal thickness (SFCT) using enhanced depth imaging spectral-domain optical coherence tomography before the first injection and 1, 2, 3, and 6 months after initial injection. RESULTS: The SFCT measures before initial injection and 1, 2, 3, and 6 months after initial injection were 244.94 ± 103.77 µm, 219.04 ± 95.89 µm, 208.74 ± 91.03 µm, 203.64 ± 91.35 µm, and 226.98 ± 96.79 µm in the aflibercept group (25 eyes) and 222.68 ± 102.04 µm, 210.23 ± 95.91 µm, 203.66 ± 99.39 µm, 197.27 ± 100.25 µm, and 210.32 ± 111.86 µm in the ranibizumab group (28 eyes). Mean change in SFCT was greater in the aflibercept group at 1 month, 2 months, and 3 months after initial injection (p < 0.05), but there was no significant difference in the mean change in SFCT between the two groups at 6 months after initial injection (p > 0.05). CONCLUSIONS: The decrease in SFCT was greater after aflibercept injection than ranibizumab injection in 3 consecutive months. However, at 6 months after initial injection, the difference in the change in SFCT was not significant.
Choroid* ; Humans ; Macular Degeneration* ; Ranibizumab* ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: To evaluate outcomes of intravitreal aflibercept in cases resistant to bevacizumab and ranibizumab in neovascular age-related macular degeneration. METHODS: Twenty patients with neovascular age-related macular generation who were resistant to treatment with bevacizumab and ranibizumab were evaluated. After switching to aflibercept the best corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared at baseline and at 1 month after injection. Additionally, changes in the intraretinal fluid, subretinal fluid and pigment epithelial detachment were evaluated. RESULTS: The mean BCVA was 0.83 +/- 0.56 log MAR and the mean CRT was 294.20 +/- 12.99 microm before aflibercept treatment. After switching to aflibercept the mean BCVA was 0.86 +/- 0.61 log MAR with no statistical difference (p = 0.406) and the mean CRT was decreased to 232.45 +/- 12.05 microm (p = 0.011). After 1 month of aflibercept injections, a reduction of intraretinal fluid in 4 eyes (80%), reduction of subretinal fluid in 11 eyes (78.6%) and reduction of pigment epithelial detachment in 5 eyes (50%) were observed. Increases in fluid or new lesions were not observed. CONCLUSIONS: Aflibercept injection appears beneficial in patients with neovascular age-related macular generation who are resistant to bavacizumab and ranibizumab treatment.
Humans ; Macular Degeneration* ; Retinaldehyde ; Subretinal Fluid ; Visual Acuity ; Bevacizumab ; Ranibizumab