ABSTRACT
PURPOSE: To describe multimodal imaging of two cases of bilateral non-vascularized pigment epithelial detachments (PED) in young patients with a long-term follow-up. METHODS: A complete ophthalmological examination was performed at each follow-up visit including best corrected visual acuity (BCVA), intraocular pressure, slit lamp examination, spectral domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography, OCT angiography. RESULTS: Multimodal imaging of two women presenting avascular PED, aged 43 and 57, respectively, was described. In both patients, SD-OCT revealed a high central macular hyporeflective elevation corresponding with PED. Both patients showed a choroidal layer thicker than 420 µm. Fluorescein and indocyanine green angiography didn't show any choroidal neovascularization either at early or late frames. Cross-sectional and en face optical coherence tomography angiography (OCTA) didn't show any flow beneath the PED. During the follow up period one eye showed a retinal pigment epithelium tear and all eyes showed the presence of apical sub-retinal fluid and hyperreflective material on the top of the PED. None of the two patients showed any sign of atrophy during the follow-up period. CONCLUSION: The peculiar characteristics of the presented cases suggest that specific pathogenetic mechanisms, not necessarily related to age related macular degeneration, may play a key role in the development of these lesions. Whether early onset of such drusenoid PED is a specific entity resulting from a genetic deficit of lipid transporters in the RPE is unknown. Further genetic and metabolic studies should be conducted.
Subject(s)
Choroidal Neovascularization , Retinal Detachment , Humans , Female , Indocyanine Green , Cross-Sectional Studies , Fluorescein Angiography/methods , Choroidal Neovascularization/diagnosis , Tomography, Optical Coherence/methods , Retinal Detachment/diagnosis , Retinal Detachment/pathology , Retinal Pigment Epithelium/pathology , Fluorescein , Multimodal Imaging , Retrospective StudiesABSTRACT
Short-term exposure to particulate matter (PM) air pollution is associated with an increased cardiovascular mortality. Chronic exposure to PM is also associated with cardiovascular risk. Myocardial infarction and heart failure are the most common cardiovascular events associated with PM pollution. The pathophysiological mechanisms related to PM pollution are inflammation, thrombosis, vasomotion abnormalities, progression of atherosclerosis, increased blood pressure, and cardiac remodeling. A decrease in PM exposure may be particularly beneficial in subjects with a high cardiovascular risk.
