1.Intravitreal bevacizumab for neovascular age-related macular degeneration
Junn R. Pajarillo ; Harvey S. Uy ; Milagros H. Arroyo
Philippine Journal of Ophthalmology 2009;34(2):37-43
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
2.Comment on: Choroidal Blood Flow Change in Eyes with High Myopia.
Korean Journal of Ophthalmology 2016;30(1):78-78
No abstract available.
Choroid/*blood supply
;
Choroidal Neovascularization
;
Humans
;
*Myopia
3.A Case of Idiopathic Choroidal Neovascularization.
Journal of the Korean Ophthalmological Society 1987;28(1):197-201
Choroidal neovascularization, also called subtetinal or subpigment epithelial neovasculariztation, may occur in the absence of any associated disorder and with no known etiology; in such cases, it is designated as idiopathic. Idibpathic chormdal neovascularization is characterized generally by an isolated neovascular membrane in the macula and is usually associated with a serous and/or hemorrhagic detachment of the overlying and adjacent sensory retina. The classic angiographic findings are lacy, nodular, or irregular, hyperfluorescence in the early phase, with pooling of dye in the subsensory retinal space during the late phase. The authors experienced a case of idiopathic choroidal neovascularization. A brief review of literature is described.
Choroid*
;
Choroidal Neovascularization*
;
Membranes
;
Retina
;
Retinaldehyde
4.Laser-Induced Choroidal Neovascularization in Central Serous Chorioretinopathy: 4 Cases.
Seung Hyen LEE ; Hyewon CHUNG ; Hyung Chan KIM
Journal of the Korean Ophthalmological Society 2012;53(6):886-894
PURPOSE: To report the choroidal neovascularization of 4 patients in central serous chorioretinopathy treated with laser treatment. CASE SUMMARY: We reported 4 patients with central serous chorioretinopathy. Three patients were treated with focal laser photocoagulation, and 1 patient with photodynamic treatment. All patients newly developed choroidal neovascularization (CNV) after treatment at the area of laser treatment. Three patients received intravitreal anti-VEGF injection and 1 patient received argon laser photocoagulation for the treatment of CNV. After the treatment, the CNV was resolved with improved visual acuity. CONCLUSIONS: Laser treatment may be efficacious tool to achieve rapid resolution in central serous chorioretinopathy until now. However, more caution at the time of treatment and close follow-up after treatment are warranted.
Argon
;
Central Serous Chorioretinopathy
;
Choroid
;
Choroidal Neovascularization
;
Humans
;
Light Coagulation
5.Preferential Hyperacuity Perimeter in Exudative AMD With Pigment Epithelial Detachment.
Seung Chan LEE ; Seung Jun LEE
Journal of the Korean Ophthalmological Society 2009;50(4):551-557
PURPOSE: To analyze the hyperacuity defects by preferential hyperacuity perimeter (PHP) in exudative age-related macular degeneration (AMD) and correlate them with the properties of pigment epithelial detachment (PED) obtained by optical coherence tomography (OCT). METHODS: Thirty eyes with exudative AMD with choroidal neovascularization (CNV) diagnosed by fluorescein angiography underwent PHP for hyperacuity defect and OCT for PED length and height. We compared hyperacuity defect with the shape of the PED by OCT. RESULTS: 26 eyes with exudative AMD with CNV tested positive for hyperacuity defects. The size of the hyperacuity defect by PHP and the PED length by OCT showed positive correlation (p=0.010). In the 4 eyes that tested negative for hyperacuity defects, the PED was not high although the size was large. CONCLUSIONS: Our results suggest that PHP is a useful method to detect a change of pigment epithelial layer in AMD and the presences of a hyperacuity defect is more sensitive for PED height than size. These results suggest that PHP is useful to detect the state and the activity of CNV lesion.
Choroidal Neovascularization
;
Eye
;
Fluorescein Angiography
;
Macular Degeneration
;
Tomography, Optical Coherence
6.Effects of Intravitreal Amniotic Membrane Injection in a Rat Model of Choroidal Neovascularization.
Jong Hyun LEE ; Jae Lim CHUNG ; Samin HONG ; Hyoung Jun KOH
Journal of the Korean Ophthalmological Society 2008;49(7):1154-1158
PURPOSE: To evaluate the effects of an intravitreal amniotic membrane (AM) injection on a rat model of laser-induced choroidal neovascularization (CNV). METHODS: Intravitreal injection of AM (12.5 microgram/mL) into the left eyes and phosphate-buffered saline into the fellow eyes of 15 rats was performed immediately after laser injury. At week 2, after angiography, the rats were sacrificed, and histopathologic analysis was performed. Angiographic and histopathologic assessments of the effects of AM injection on CNV growth were compared between the two groups. RESULTS: CNV thickness was found to have increased more in the AM treatment group (141.54+/-8.12 micrometer) than in the experimental control group (65.23+/-16.90 micrometer) (p=0.010). CONCLUSIONS: Intravitreal AM injection demonstrated histopathologic pro-angiogenic properties in a rat model of CNV.
Amnion
;
Angiography
;
Animals
;
Choroid
;
Choroidal Neovascularization
;
Eye
;
Intravitreal Injections
;
Rats
7.ICGA Findings and Clinical Features of Idiopathic Choroidal Neovascularization.
Ki Young SONG ; Ha Kyoung KIM ; Hyung Chan KIM
Journal of the Korean Ophthalmological Society 2001;42(10):1408-1414
PURPOSE: The purspose of this study was to investigate the ICGA findings and clinical features of idiopathic choroidal neovascularization (CNV) which is one of the important causes of CNV developed under 50 years of age. METHOD: We performed FAG and ICG angiography in 26 eyes (25 patients) which were diagnosed as idiopathic CNV and investigated the visual acuity, associated retinal findings, and treatment modality. RESULTS: The locations of CNV were subfoveal in 11 eyes, juxtafoveal in 11 eyes, extrafoveal in 4 eyes. All CNV were less than 1 disc diameter in size. On ICG angiography, hyperfluorescent neovascular network CNV was visible in early phase in 22 out of 26 eyes. Twelve eyes had dark rim surrouding the CNV, and 10 eyes had focal choroidal vascular dilation near the CNV. Twelve eyes showed obvious choroidal hyperpermeability in late phase, and 3 eyes showed the hypofluorescent dark spot near the CNV. Final visual acuity was improved in 9 eyes, decreased in 4 eyes, and unchanged in 13 eyes. CONCLUSION: Idiopathic CNV was small in size and located mostly in foveal area. ICG angiography showed CNV with various angiographic patterns, and the visual prognosis was relatively good.
Angiography
;
Choroid*
;
Choroidal Neovascularization*
;
Prognosis
;
Retinaldehyde
;
Visual Acuity
8.Management of Relapsed Inflammatory Choroidal Neovascularization in Punctate Inner Choroidopathy after Bevacizumab.
Hyun Woong KIM ; Yong Wun CHO ; In Young CHUNG
Journal of the Korean Ophthalmological Society 2016;57(3):513-517
PURPOSE: To report a rare case of relapsed inflammatory choroidal neovascularization (CNV) in a young female patient after intravitreal bevacizumab (IVB) treatment for subfoveal CNV secondary to punctate inner choroidopathy (PIC). CASE SUMMARY: A 25-year-old myopic female presented with PIC complicated by subfoveal CNV in the right eye. Her lesion initially responded to three monthly 1.25 mg IVB injections, but the lesion recurred two months after the final injection, and the size of the lesion was larger than that observed before treatment. Further treatment with systemic steroids and IVB resulted in successful anatomic and visual improvement. CONCLUSIONS: This report presents a rare case of relapsed inflammatory CNV in a young female patient after IVB treatment for subfoveal CNV secondary to PIC. Systemic steroid and IVB were performed after relapse, which successfully improved and maintained vision for longer than 18 months.
Adult
;
Choroid*
;
Choroidal Neovascularization*
;
Female
;
Humans
;
Recurrence
;
Steroids
;
Bevacizumab
9.Choroid in Myopic Choroidal Neovascularization Measured Using SD-OCT.
Jin Sung PARK ; Young Wook CHO ; Ji Hye JANG
Journal of the Korean Ophthalmological Society 2014;55(9):1313-1319
PURPOSE: Using the spectral domain optical coherence tomography (SD-OCT), we studied the difference in the choroidal morphology between the choroidal neovascularization (CNV) area and the area surrounding CNV. METHODS: This retrospective study consisted of 19 patients with myopic CNV lesion in eye; fellow eyes were used as controls. All eyes were analyzed by measuring the choroidal thickness and large choroidal vessel size using SD-OCT. Eyes with CNV were divided into groups; the neovascular lesion was defined as group 1, the surrounding area as group 2. Subfovea of the fellow eye was defined as group 3. RESULTS: The choroidal thickness was 80.00 +/- 68.31 in group 1, 63.44 +/- 67.75 in group 2 and 71.11 +/- 65.69 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.038). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.365, p = 0.314). The large choroidal vessel size was 57.47 +/- 39.78 in group 1, 40.45 +/- 34.69 in group 2 and 45.63 +/- 37.00 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.025). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.123, p = 0.325). CONCLUSIONS: Choroidal thickness and large choroidal vessel size at the center of the CNV were greater than in the area surrounding CNV. The results suggest that although the CNVs were due to a thinned choroid caused by severe choroidal ischemia, the development of CNV requires maintenance of choriocapillaris and large choroid vessels.
Choroid*
;
Choroidal Neovascularization*
;
Humans
;
Ischemia
;
Retrospective Studies
;
Tomography, Optical Coherence
10.Evaluation of Confocal Laser Scanning Indocyanine Green Angiography Images of Occult Choroidal Neovascularization.
Jeong Seok KOH ; Won Ki LEE ; Ha Kyoung KIM
Journal of the Korean Ophthalmological Society 1997;38(10):1764-1775
For the interpretation of the confocal laser scanning indocyanine green angiography(Heidelberg Retina Angiograph, HRA) in patients with choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD), we analyzed the early and the late phase images comparatively. HRA was carried out in 41 eyes of 36 patients that revealed occult CNV or undetectable CNV on fluorescein angiograms. In all patients, the image qualitites of HRA was excellent in the early as well as in the late phase studies and CNV was detected in 38 eyes(93%). In 25 eyes(66%), we could get all the possible information of CNV with the early phase images which revealed CNV as fine neovascular networks or vascular structures of lnear or dot pattern usually surrounded by hypofluorescent margins. And when the hypofluorescent margin surrounded the neovascular structure completely, a well-defined CNV could be diagnosed. In 9 eyes(24%), more accurate evaluation of the nature, size and geometry of CNV could be made with the help of more late phase images. In these cases, as the initially identified neovascular structures were stained in the late phase, more intensely leaking portions or more widespread minimally stained areas could be detected. In remaining 4 eyes(10%), CNV could b detected in the late phase without apparent evidence of vascular structure in the early phase. Our study suggests that careful reading of the whole sequence of ICG angiograms and comparative analysis of the early and late phase images are required to get the clinically useful information from HRA.
Angiography*
;
Choroid*
;
Choroidal Neovascularization*
;
Fluorescein
;
Humans
;
Indocyanine Green*
;
Retina