OBJECTIVE: To compare the macular pigment optical density (MPOD) among Filipinos with and without age¬related macular degeneration (AMD).

METHODS: Consecutive patients with AMD and without posterior segment disease were recruited into the study Baseline MPOD measurements using an autofluorescence spectrometer were obtained. MPOD in the 0.5 degree retinal eccentricity and the average of 3 measurements (MPOD Max) was the primary outcome measure.

RESULTS: 120 patients, aged 50 to 80 years, were included into 3 groups: group 1 (n=40) without retinal disease, group 2 (n=40) with non-neovascular AMD, and group 3 (n=40) with neovascular AMD. The mean baseline MPOD were: 0.382 ± 0.10 DU for group 1, 0.333 ± 0.07 DU for group 2, and 0.283 ± 0.07 DU for group 3. Significant differences were present comparing the MPOD values of the 3 groups.

CONCLUSION: Eyes without retinal disease had higher MPOD than those with early non-neovascular or neovascular AMD.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Macular Pigment ; Macular Degeneration ; Retina ; Retinal Diseases ; Outcome Assessment (health Care)

Stargardt's disease, first described in detail by Stargardt in 1909, is a recessively inherited macular dystrophy which evidences itself by reduced visual acuity, bilaterality, slowly progressive lesion, occurring familially, starting in youth (8 to 15 years). We have recently seen macular dystrophies occurring in siblings, three out of six. All developed this disease between 9 to 15 years and vision deteriorate progressively to the adult hood. Ophthalmoscopic examination revealed slight pale dise, narrowing of retinal vessels, definite alterations in the macular region associated with the development of red-yellow flecks in the center surrounded by yellow-white flecks in the paracentral region. Angiogram showed the evidence of marked alteration in the retinal pigment epithelium on the macula bilaterally. All cases were noted by ring shaped area of mottled hyperfluorescene but central flecks were nonfluorescent. Field examination showed the central scotoma to a small targets and ERG the subnormal in photopic and scotopic responces. The Ishihara test disclosed a mild to moderate red-green dyschromatopsia.
Adolescent ; Adult ; Humans ; Macular Degeneration ; Retinal Pigment Epithelium ; Retinal Vessels ; Scotoma ; Siblings ; Visual Acuity

PURPOSE: To evaluate choroidal thickness at the outside of the fovea in patients with diabetic retinopathy using spectral-domain optical coherence tomography. METHODS: We examined 87 eyes of 87 patients with diabetic retinopathy and 40 eyes of 40 normal patients. Patients with diabetic retinopathy were divided into 3 groups according to the grade of diabetic retinopathy and macular edema. The choroidal thickness was obtained at the fovea and outside of the fovea using enhanced depth imaging of Spectralis optical coherence tomography. One foveal and 8 peripheral images were selected and choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border. RESULTS: Subfoveal choroidal thickness was thinner with increasing severity of diabetic retinopathy. However, there was no significant difference between groups without the nasal side of the fovea. A statistically significant difference was observed over the fovea at the superotemporal area. CONCLUSIONS: The choroidal thickness outside of the fovea was thinner with the severity of diabetic retinopathy and was more pronounced in the superotemporal area.
Choroid* ; Diabetic Retinopathy* ; Humans ; Macular Edema ; Retinal Pigment Epithelium ; Tomography, Optical Coherence*

PURPOSE: To compare the outer retinal thickness in normal fellow eyes of patients with unilateral age-related macular degeneration (AMD) and normal control eyes. METHODS: We retrospectively reviewed the medical records of 60 patients with unilateral exudative AMD including polypoidal choroidal vasculopathy and 60 normal controls. Spectralis optical coherence tomography was performed in the normal fellow eyes of patients with unilateral AMD and in the normal group. The thicknesses between the retinal pigment epithelium (RPE) line and the cone outer segment tips (COST) line, between the COST line and the photoreceptor inner segment/outer segment (IS/OS) line, and between the IS/OS line and the external limiting membrane (ELM) line were measured at the fovea in both groups. RESULTS: The thickness between the RPE and COST lines was 32.4 ± 3.0 µm in normal fellow eyes of patients with unilateral AMD and 35.3 ± 3.5 µm in the normal group (p < 0.001). Total retinal thickness, thicknesses between the COST and the IS/OS lines and the IS/OS and the ELM lines in fellow eyes were not significantly different from those of normal eyes (p = 0.126, 0.615, 0.874). There was no significant difference in total retinal thickness or each outer retinal thickness measured in normal fellow eyes between patients with neovascular AMD and polypoidal choroidal vasculopathy. CONCLUSIONS: The thickness between the RPE and the COST lines was thinner in the fellow eyes of patients with unilateral AMD than in the normal eyes. We suggest that less thickness between the RPE and COST lines might indicate a greater risk of AMD.
Choroid ; Humans ; Macular Degeneration* ; Medical Records ; Membranes ; Retinal Pigment Epithelium ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence

Subretinal neovascularization(SRNV) can occur from any pathologic processes that result in an abnormality at the level of the retinal pigment epithelium (RPE)-Bruch's membrane-choriocapillaris complex. Especially, SRNV located under the foveal center usually has a poor visual prognosis. Recently, we undertook surgical removal of six consecutive subfoveal neovascular membranes in an attempt to restore and/or preserve central vision. The cause of SRNV in 3 eyes was age-related macular degeneration(ARMD) and 3 eyes idiopathic. Mean follow-up ranged 11.7 months. Overall visual improvement was achieved in 5 of 6 eyes and significant visual improvement(defined as 2 lines) was shown in 1 of 3 eyes with ARMD and in 2 of 3 eyes with idiopathic membrane. Subfoveal RPE was relatively intact in eyes with good visual outcome as compared to eyes with poor visual outcome. Post operative complication included cataracts(2), subretinal hemorrhages(2), and retinal detachment(1). Recurrence of subfoveal neovascular membranes, however, was not found throughout the follow-up period. These results suggested that subfoveal neovascular membranes can be surgically removed with improvement and/or stabilization of central vision. Visual prognosis depends on the intergrity of the subfoveal RPE after removal of the membrane.
Follow-Up Studies ; Macular Degeneration ; Membranes* ; Pathologic Processes ; Prognosis ; Recurrence ; Retinal Pigment Epithelium ; Retinaldehyde

PURPOSE: Preferential hyperacuity perimeter (PHP) is a device that measures metamorphopsia in the central 14 degrees of the macular visual field which is presented by hyperacuity defect. We elucidated a hyperacuity defect lesion of PHP in exudative age-related macular degeneration (AMD) by Optical coherence tomography (OCT). METHODS: Nineteen eyes of 18 patients with exudative AMD diagnosed by fundus examination and fluorescein angiography (FA) underwent PHP. We then elucidated any hyperacuity defect lesion of PHP by fundus photography, FA and OCT. For a control, 20 eyes of 10 age-matched persons who had no ophthalmological abnormality underwent PHP and OCT to determine if hyperacuity defect would appear. RESULTS: Hyperacuity defect lesion appeared in 18 eyes (95%) of AMD patients. There was good locational correlation between the hyperacuity defect lesions and lesions in the fudoscopic examination in 16 eyes of 18, but there was a counterpart relation at the superior-inferior and left-right in 2 eyes. Hyperacuity defect lesion in PHP was of smooth or irregular elevation of the retinal pigment epithelium (RPE) in OCT. In the control, hyperacuity defect lesion appeared in 1 eye (5%) and it was normal in OCT. CONCLUSIONS: PHP showed a highly positive rate in detecting AMD-related lesion. The hyperacuity defects that are noted by the PHP are produced from elevation of the RPE.
Fluorescein Angiography ; Humans ; Macular Degeneration* ; Photography ; Retinal Pigment Epithelium ; Tomography, Optical Coherence ; Vision Disorders ; Visual Fields

We examined a 28-year-old male patient with pseudohypopyon in vitelliform macular dystrophy. The ocular fundi showed round cystoid lesions in the macula with clear fluid superiorly and yellow material inferiorly. Fluorescein angiography showed hyperfluorescent defects in the retinal pigment epithelium of the superior half of the lesion and blocked fluorescence in the area of the yellow material in feriorly. The electroretinography was normal and the electro-oculographic findings were abnormal.
Adult ; Electroretinography ; Fluorescein Angiography ; Fluorescence ; Humans ; Male ; Retinal Pigment Epithelium ; Vitelliform Macular Dystrophy*

Cell cultures of adults bovine retinal pigment epithelium(RPE) were propagated from central and peripheral regions of the same eyes to study the topographical differences in cell growth and to compare the differences in growth rate between two areas. The results obtained were as follows: A regional variation in the morpholgy was observed between the RPE from central and that from peripheral regions. Retinal pigment epithelium from central region attached to culture dish more slowly(average 4 days) than those from peripheral region(average 3.5 days) The growth rate of retinal pigment epithelium declined with serial passage in culture. The growth rate of retinal pigment epithelium from peripheral region at the first generation was highest. And there was a statistical difference in growth rate with passing in generation(P<0.05). This study reveals that growth rate and cell activity of RPE from central region are lower than from peripheral region.
Adult ; Cell Culture Techniques ; Humans ; Macular Degeneration ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Serial Passage

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.

Human ; Male ; Female ; Adult ; Macular Pigment ; Cross-sectional Studies ; Prospective Studies ; Photometry

PURPOSE: To evaluate the long-term clinical outcomes of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration (AMD). METHODS: The authors performed a retrospective chart review of 13 eyes of 13 patients who developed RPE tears after intravitreal anti-VEGF injection between February 2009 and June 2013. We investigated continuation of the treatment after tear, visual acuity, presence of cystoid macular edema, and central macular thickness (CMT) using optical coherence tomography (OCT) before and after treatment and visual outcomes depending on foveal sparing. RESULTS: After RPE tear, 12 of 13 patients continued injection of an anti-VEGF agent. The average number of injections was 6.08 +/- 5.18. Mean visual acuity immediately after tear was 1.65 +/- 0.8 log MAR, and that at the last visit was 1.82 +/- 0.88 log MAR. Nine eyes with macular edema in OCT continued receiving injection, and improvement of macular edema was observed in four eyes at the final visit. The final visual acuity of patients with foveal involvement was 2.17 +/- 0.49 log MAR, which was worse than the 1.51 +/- 1.06 log MAR in patients without foveal involvement, although the difference was not significant (p = 0.295). CONCLUSIONS: When anti-VEGF injections were continued after RPE tear, no improvement in visual acuity was observed, although better anatomical outcomes did result. Patients with foveal involvement had worse visual acuity than patients without foveal involvement, but the difference was not significant.
Endothelial Growth Factors ; Humans ; Intravitreal Injections ; Macular Degeneration* ; Macular Edema ; Retinal Pigment Epithelium ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity