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1.
Oxid Med Cell Longev ; 2019: 9783429, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30891116

RESUMO

Oxidative stress and inflammation play a critical role in the initiation and progression of age-related ocular abnormalities as cataract, glaucoma, diabetic retinopathy, and macular degeneration. Therefore, phytochemicals with proven antioxidant and anti-inflammatory activities, such as carotenoids and polyphenols, could be of benefit in these diseases. We searched PubMed and Web of Science databases for original studies investigating the benefits of different carotenoids and polyphenols in age-related ophthalmic diseases. Our results showed that several polyphenols (such as anthocyanins, Ginkgo biloba, quercetin, and resveratrol) and carotenoids (such as lutein, zeaxanthin, and mezoxanthin) have shown significant preventive and therapeutic benefits against the aforementioned conditions. The involved mechanisms in these findings include mitigating the production of reactive oxygen species, inhibiting the tumor necrosis factor-α and vascular endothelial growth factor pathways, suppressing p53-dependent apoptosis, and suppressing the production of inflammatory markers, such as interleukin- (IL-) 8, IL-6, IL-1a, and endothelial leucocyte adhesion molecule-1. Consumption of products containing these phytochemicals may be protective against these diseases; however, adequate human data are lacking. This review discusses the role and mechanisms of polyphenols and carotenoids and their possible synergistic effects on the prevention and treatment of age-related eye diseases that are induced or augmented by oxidative stress and inflammation.


Assuntos
Envelhecimento/patologia , Carotenoides/uso terapêutico , Oftalmopatias/tratamento farmacológico , Polifenóis/uso terapêutico , Animais , Oftalmopatias/prevenção & controle , Humanos , Estresse Oxidativo
2.
Eye (Lond) ; 33(6): 1008-1013, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30783256

RESUMO

OBJECTIVES: To examine the causes of congenital nasolacrimal duct obstruction (CNLDO) using dacryoendoscopy, and to evaluate the surgical outcomes of primary transcanalicular endoscopic dacryoplasty. METHODS: The subjects of this study were a total of 56 eyes of 46 Japanese children aged one to five years old (mean, 29.1 ± 14.0 months old) with clinically diagnosed CNLDO. The blockage was visualized and probed using a dacryoendoscope (MD10 with a 20 G probe, Fiber Tech Co., Ltd., Japan) under general anesthesia. We used a self-retaining bicanalicular lacrimal stent (Lacrifast®, Kaneka Co., Ltd., Japan) for nasolacrimal duct intubation. RESULTS: In each case the obstruction was found to be caused by a single focal blockage at the distal end of the duct. A nasolacrimal dacryolith was observed in 5 eyes (9%) and successfully removed using the dacryoendoscope. The success rate of probing by subsequent nasolacrimal duct intubation was 100%. No complications were observed. CONCLUSIONS: We obtained a 100% success rate with primary transcanalicular endoscopic dacryoplasty for the treatment of CNLDO. Direct visualization inside the lacrimal passage allowed for precise probing, even in infants, leading to successful treatment of CNLDO without any complications.

3.
5.
Graefes Arch Clin Exp Ophthalmol ; 256(11): 2089-2096, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30173338

RESUMO

PURPOSE: To evaluate the prognosis and response of neovascular age-related macular degeneration (AMD) to anti-vascular endothelial growth factor (VEGF), according to the components of subretinal hyperreflective material (SHRM) classified using optical coherence tomography angiography (OCTA), is the aim of this study. METHODS: We retrospectively studied 39 eyes of 39 consecutive patients with SHRM associated with exudative AMD, who underwent standard examination and multimodal imaging, including fundus photography, optical coherence tomography (OCT), and OCTA. We classified SHRM into type 2 neovascularization (NV), fibrosis, subretinal hyperreflective exudation (SHE), and hemorrhage using OCTA. If compound SHRM was found, components in the foveal center were considered. All patients except one with fibrosis received anti-VEGF treatment for more than 12 months. The best-corrected visual acuity (BCVA) values measured before treatment and at 3, 6, and 12 months after the first injection were compared according to the components of SHRM. RESULTS: Using OCTA, 11 eyes with type 2 NV showed abnormal blood flow and 1 eye with fibrosis showed strong surface projection. Both SHE and hemorrhage components showed projection artifact with no intrinsic flow. However, OCTA enabled eyes with SHE (17 eyes) to be distinguished from those with hemorrhage (10 eyes) because hemorrhage showed masking of choriocapillaris flow. Eyes with SHE showed a significant improvement in the mean logMAR BCVA as compared with the value at the baseline, which was sustained throughout the 12-month follow-up period (p < 0.05). In eyes with type 2 NV and hemorrhage, no significant difference in the mean BCVA values was observed at any follow-up time-point (all, p > 0.05). CONCLUSION: OCTA was useful to noninvasively distinguish SHRM components. It may be important to consider the components of SHRM to predict the visual acuity in patients with AMD.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Angiofluoresceinografia/métodos , Líquido Sub-Retiniano/efeitos dos fármacos , Tomografia de Coerência Óptica/métodos , Degeneração Macular Exsudativa/classificação , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Prognóstico , Ranibizumab/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Estudos Retrospectivos , Líquido Sub-Retiniano/diagnóstico por imagem , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/diagnóstico
6.
J Hum Genet ; 63(10): 1083-1091, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30054556

RESUMO

To identify factors associated with ranibizumab responses in patients with exudative age-related macular degeneration (AMD), we performed a genome-wide association study (GWAS) and a replication study using a total of 919 exudative AMD patients treated with intravitreal ranibizumab in a Japanese population. In the combined analysis of GWAS and the replication study, no loci reached genome-wide significant level; however, we found four variants showed suggestive level of associations with visual loss at month three (rs17822656, rs76150532, rs17296444, and rs75165563: Pcombined < 1.0 × 10-5). Of the candidate genes within these loci, three were relevant to VEGF-related pathway (KCNMA1, SOCS2, and OTX2). The proportions of patients who worsened visual acuity were 13.7%, 38.8%, 58.0%, and 80.0% in patients with 0, 1, 2, and 3 or more identified risk variants, respectively. Changes in visual acuity decreased linearly as the number of risk variants increased (P = 1.67 × 10-12). The area under the curve using age, baseline visual acuity, and history of previous treatment was 0.607, and improved significantly to 0.713 in combination with identified variants (P < 0.0001). Although further study is needed to confirm their associations, our results offer candidate variants influencing response to ranibizumab therapy.

7.
Sci Rep ; 8(1): 1360, 2018 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-29358594

RESUMO

Central retinal artery occlusion (CRAO) is a severe disease, often causing blindness. We evaluated the efficacy and safety of a surgical procedure for the treatment of acute CRAO in which retinal arterial cannulation with tissue plasminogen activator (tPA) is performed. The surgical procedure consisted of vitrectomy followed by cannulation of the central retinal artery and injection of tPA (200 µg) using a 47-gauge microneedle. Thirteen CRAO patients were treated within 48 hours of the onset of symptoms. The central retinal artery of all 13 eyes was successfully cannulated. The mean interval between the onset of symptoms and surgery was 38.7 hours. The results for all 13 eyes treated showed a statistically significant improvement in mean visual acuity between before and one month after treatment (-1.60 vs. -0.82 logarithmic values for minimum angle resolution (LogMAR), p = 0.0021). Fluorescein angiography showed complete reperfusion and incomplete reperfusion in 10 eyes and 3 eyes, respectively. Recently developed surgical instruments have made retinal-arterial cannulation feasible. Intra-retinal-arterial cannulation has potential as a method of improving visual function and microcirculation in eyes affected by CRAO.

9.
Retina ; 38(10): 2001-2009, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28816730

RESUMO

PURPOSE: To compare the 3-year follow-up results of intravitreal injections of aflibercept between fixed dosing (FD) regimen and a pro re nata (PRN) regimen after three initial monthly doses for the treatment of polypoidal choroidal vasculopathy and to analyze factors influencing improvement in visual acuity. METHODS: We retrospectively studied all treatment-naive patients with polypoidal choroidal vasculopathy who were scheduled to receive intravitreal aflibercept injections FD or PRN after induction treatment between March 2013 and May 2014. Best-corrected visual acuity was evaluated before treatment and at 4, 12, 24, and 36 months after initial treatment. Factors that influence improvement in visual acuity were also investigated. RESULTS: Thirty-three eyes were assessed at the 3-year follow-up examination. Twenty-three eyes were treated with intravitreal aflibercept injections every 2 months for at least 1 year after three initial monthly doses (FD group), and 10 eyes were treated PRN after loading doses (PRN group). In the FD group, during the follow-up period from 1 to 3 years, quarterly dosing with capped PRN or a treat and extend regimen were selected. The mean number of administered intravitreal aflibercept was 15.3 ± 4.6 in the FD group and 9.0 ± 8.9 in the PRN group, with a significant difference between the two groups (P = 0.004). Significant improvement of the mean logarithm of the minimum angle of resolution values for best-corrected visual acuity was shown at 36 months, as compared to baseline values (P = 0.019). No significant difference in the improvement of best-corrected visual acuity between the two groups was observed at baseline or at 4, 12, 24, and 36 months after treatment (all P > 0.05), although there was a trend toward better results in the FD group. Multiple regression analysis showed that the FD group had better visual acuity at 36 months and greater improvement in visual acuity than the PRN group (P = 0.031 for both comparisons). CONCLUSION: Intravitreal aflibercept was effective in improving the vision of patients with polypoidal choroidal vasculopathy, as evaluated at the 3-year follow-up. Fixed treatment might be an important factor influencing improvement in visual acuity.

10.
Ophthalmology ; 124(12): e91, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29157440
11.
Graefes Arch Clin Exp Ophthalmol ; 255(10): 2009-2015, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28711991

RESUMO

PURPOSE: The aim of this study was to evaluate the one-year efficacy, ability to lower intraocular pressure, and tolerability of ripasudil, a rho-kinase inhibitor, in patients with glaucoma inadequately controlled with maximum medical therapy. METHODS: This prospective, non-comparative, interventional case-series study included 39 patients with primary open-angle glaucoma inadequately controlled with maximum medical therapy before treatment with ripasudil. Ripasudil was administered twice per day as adjunctive therapy to ongoing glaucoma treatment. The primary endpoint was the degree of intraocular pressure reduction after 12 months of treatment; the secondary endpoints were the incidence of adverse events. RESULTS: We examined 39 eyes. The intraocular pressure reduction (given as the relative percentage of intraocular pressure reduction) from baseline was -2.6 mmHg (-15.5%; 95% confidence interval, -1.1 to -3.9 mmHg; P < 0.001) after 12 months of treatment. The adverse events were conjunctival hyperemia (all patients), blepharitis (three), allergic conjunctivitis (two), punctate keratitis (two), and ophthalmalgia (one). CONCLUSIONS: Treatment with ripasudil decreased intraocular pressure in patients with glaucoma that was poorly controlled with maximal medical therapy, and it was well-tolerated.


Assuntos
Anti-Hipertensivos/administração & dosagem , Glaucoma de Ângulo Aberto/tratamento farmacológico , Pressão Intraocular/efeitos dos fármacos , Isoquinolinas/administração & dosagem , Sulfonamidas/administração & dosagem , Quinases Associadas a rho/antagonistas & inibidores , Adulto , Idoso , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/administração & dosagem , Estudos Prospectivos , Fatores de Tempo , Tonometria Ocular , Resultado do Tratamento , Adulto Jovem
12.
Clin Ophthalmol ; 11: 797-802, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28490861

RESUMO

PURPOSE: To evaluate the efficacy of intravitreal aflibercept therapy in treatment-naïve Japanese patients with polypoidal choroidal vasculopathy (PCV) using Early Treatment Diabetic Retinopathy Study (ETDRS) letter scores. SUBJECTS AND METHODS: This study was a prospective, nonrandomized, interventional exploratory clinical trial performed in an institutional setting. Patients with PCV were treated with intravitreal aflibercept 2 mg/0.05 mL every 2 months after 3 initial monthly doses, for 1 year. Visual acuity test using the ETDRS chart and indocyanine green angiography was performed at baseline and at 6 and 12 months after initiating the treatment, in addition to routine examinations performed at each visit. The main outcome measure was the proportion of patients who achieved <15 ETDRS letter score loss. RESULTS: Twenty-two patients were enrolled in this study. Nineteen (86%) patients were eligible for analysis. All the patients maintained their visual acuity (<15 ETDRS letter score loss) at 12 months. The ETDRS letter scores were 64.1 at baseline and 69.8 at 12 months (P<0.039). The polyps regressed completely in 14 (74%) patients at 12 months. Cataract progressed in 1 eye, but this progression was considered to be a senile change. CONCLUSIONS: Japanese patients with treatment-naïve PCV, who were treated with intravitreal aflibercept every 2 months after 3 initial monthly doses, exhibited a significant increase in ETDRS letter scores and a high rate of polyp resolution at 12 months.

13.
Ophthalmology ; 124(8): 1136-1142, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28457613

RESUMO

PURPOSE: To report the clinical outcomes of a new technique for transconjunctival intrascleral fixation of an intraocular lens (IOL). DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: One hundred eyes of 97 consecutive patients with aphakia, dislocated IOL, or subluxated crystalline lens who underwent posterior chamber sutureless implantation of an IOL were studied. METHODS: Two angled incisions parallel to the limbus were made by 30-gauge thin-wall needles. Haptics of an IOL were externalized with the needles and cauterized to make a flange of the haptics. The flange of the haptics were pushed back and fixed into the scleral tunnels. MAIN OUTCOME MEASURES: Best-corrected visual acuity (VA), corneal endothelial cell density, IOL tilt, and complications were determined. RESULTS: The IOLs were fixed with exact centration and axial stability. The mean preoperative best-corrected VA was 0.25 logarithm of the minimum angle of resolution (logMAR) units; after surgery, it improved significantly to 0.11 logMAR, 0.09 logMAR, 0.12 logMAR, and 0.04 logMAR at 6, 12, 24, and 36 months, respectively (P < 0.01, P < 0.01, P = 0.03, and P = 0.10, respectively). The mean corneal endothelial cell density decreased from 2341 cells/mm2 before surgery to 2313 cells/mm2, 2240 cells/mm2, 2189 cells/mm2, and 2244 cells/mm2 at 6, 12, 24, and 36 months, respectively (P < 0.01, P < 0.01, P < 0.01, and P = 0.17, respectively). The mean IOL tilt was 3.4°±2.5°. The postoperative complications included iris capture by the IOL in 8 eyes (8%), vitreous hemorrhage in 5 eyes (5%), and cystoid macular edema in 1 eye (1%). There were no incidents of postoperative retinal detachment, endophthalmitis, or IOL dislocation. CONCLUSIONS: We have developed a new technique for intrascleral IOL fixation. The flanged IOL fixation technique is a simple and minimally invasive method for achieving good IOL fixation with firm haptic fixation.


Assuntos
Afacia Pós-Catarata/cirurgia , Migração do Implante de Lente Intraocular/cirurgia , Implante de Lente Intraocular/métodos , Subluxação do Cristalino/cirurgia , Esclera/cirurgia , Técnicas de Sutura , Adulto , Idoso , Idoso de 80 Anos ou mais , Afacia Pós-Catarata/fisiopatologia , Migração do Implante de Lente Intraocular/fisiopatologia , Contagem de Células , Túnica Conjuntiva , Epitélio Posterior/patologia , Feminino , Humanos , Subluxação do Cristalino/fisiopatologia , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Pseudofacia/fisiopatologia , Estudos Retrospectivos , Acuidade Visual/fisiologia
14.
J Glaucoma ; 26(2): 96-100, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27661993

RESUMO

PURPOSE OF THE STUDY: The purpose of the study was to evaluate the intraocular pressure (IOP)-lowering effect and tolerability of ripasudil, a rho-kinase inhibitor, in patients with glaucoma inadequately controlled with maximum medical therapy. PATIENTS AND METHODS: This prospective, noncomparative, interventional case series study included 35 patients with primary open angle glaucoma, in whom the glaucoma was poorly controlled with maximum medical therapy before starting the treatment with ripasudil. Ripasudil was instilled twice a day as adjunctive therapy to the ongoing glaucoma treatment. The primary end point was the degree of IOP reduction after 3 months of treatment, whereas the secondary end points were the percentage of patients reaching the predefined target IOP and the incidence of adverse events. RESULTS: We examined 35 eyes of 35 patients with primary open angle glaucoma. The IOP reduction (relative percentage IOP reduction) from baseline was -2.8 mm Hg (-15.5%; 95% confidence interval, -1.6 to -3.9 mm Hg; P<0.001) after 3 months of treatment. The predefined target IOP was achieved in 48.5% (17/35) of the patients. The adverse events were conjunctival hyperemia (all patients), allergic conjunctivitis (2 patients), and ophthalmalgia (1 patient). CONCLUSIONS: The addition of ripasudil was effective in lowering the IOP in patients with glaucoma poorly controlled with maximal medical therapy; moreover, the drug was well tolerated. In 48.5% of the patients in whom the predefined target IOP was achieved, this adjunctive therapy helped avoid glaucoma surgery at least in the short term.


Assuntos
Inibidores Enzimáticos/uso terapêutico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Isoquinolinas/uso terapêutico , Sulfonamidas/uso terapêutico , Quinases Associadas a rho/antagonistas & inibidores , Idoso , Anti-Hipertensivos/uso terapêutico , Quimioterapia Combinada , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Hipertensão Ocular/tratamento farmacológico , Hipotensão Ocular/tratamento farmacológico , Estudos Prospectivos , Tonometria Ocular
15.
Am J Ophthalmol ; 174: 182-183, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27939299
16.
Retin Cases Brief Rep ; 11(4): 369-372, 2017 Fall.
Artigo em Inglês | MEDLINE | ID: mdl-27504697

RESUMO

PURPOSE: To describe two patients who showed full-thickness macular holes (FTMH) combined with pigment epithelial detachments (PED) and had contrasting outcomes to treatment. METHODS: A retrospective report of two cases. RESULTS: Case 1 was treated with intravitreal antivascular endothelial growth factor and photodynamic therapy, and the PED flattened. Subsequently, a vitrectomy was performed and the FTMH closed. Her visual acuity improved from 20/200 to 20/25. In Case 2, the same medical therapy, with less frequency compared with Case 1, did not affect the PED, and the FTMH failed to close with surgery. Later, a spontaneous collapse of the PED occurred but the FTMH was persistent with an associated poor visual acuity of 20/200. CONCLUSION: Full-thickness macular hole is rare, but can occur in association with large PEDs. Although the pathologic mechanism was uncertain, visual outcomes were dependent on response to treatments of the PED, as well as anatomical closure of the FTMH.


Assuntos
Descolamento Retiniano/terapia , Perfurações Retinianas/terapia , Idoso , Inibidores da Angiogênese/uso terapêutico , Feminino , Humanos , Masculino , Imagem Multimodal , Fotoquimioterapia/métodos , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia/métodos
17.
Am J Ophthalmol ; 172: 28-38, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27640006

RESUMO

PURPOSE: To quantify the temporal properties of the acquired vitelliform lesion (AVL) life cycle, define the clinical characteristics of choroidal neovascularization (NV) in this setting, and determine the predictors of long-term visual outcomes. DESIGN: Retrospective cohort study. METHODS: Clinical and imaging data from 199 eyes of 124 consecutive patients with AVLs associated with age-related macular degeneration (AMD) and adult-onset foveomacular vitelliform dystrophy (AOFVD) were analyzed. Volumetric calculations of vitelliform material were determined using spectral-domain optical coherence tomography and the temporal properties of the AVL life cycle were quantified. The clinical characteristics of NV were assessed, as were the predictors of final best-corrected visual acuity (BCVA) and change in BCVA. RESULTS: Mean age was 79.2 ± 12.1 years. AVLs grew and collapsed at approximately the same rate (P = .275). Fifteen eyes (7.5%) developed NV, of which all were type 1. In 13 of these eyes, NV occurred during the collapse phase of the AVL life cycle, after the peak AVL volume was reached. The risk of NV (P = .006) and the decline in BCVA (P = .001) were both significantly greater among eyes with AMD. Foveal atrophy was the characteristic most significantly associated with final BCVA and change in BCVA from baseline (both P < .0005). The development of NV was not predictive of long-term visual outcomes (all P = .216). CONCLUSIONS: Complications associated with AVLs typically occur during the collapse phase of the AVL life cycle. Visual outcomes and risk of NV are related to the underlying disease associated with AVLs.


Assuntos
Neovascularização de Coroide/etiologia , Acuidade Visual , Distrofia Macular Viteliforme/complicações , Idoso , Neovascularização de Coroide/diagnóstico , Progressão da Doença , Feminino , Angiofluoresceinografia , Seguimentos , Fóvea Central/patologia , Fundo de Olho , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Distrofia Macular Viteliforme/diagnóstico
18.
Ophthalmology ; 123(11): 2352-2367, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27523615

RESUMO

PURPOSE: To determine if the area of the foveal avascular zone (FAZ) is correlated with visual acuity (VA) in diabetic retinopathy (DR) and retinal vein occlusion (RVO). DESIGN: Cross-sectional study. PARTICIPANTS: Ninety-five eyes of 66 subjects with DR (65 eyes), branch retinal vein occlusion (19 eyes), and central retinal vein occlusion (11 eyes). METHODS: Structural optical coherence tomography (OCT; Spectralis, Heidelberg Engineering) and OCT angiography (OCTA; Avanti, Optovue RTVue XR) data from a single visit were analyzed. FAZ area, point thickness of central fovea, central 1-mm subfield thickness, the occurrence of intraretinal cysts, ellipsoid zone disruption, and disorganization of retinal inner layers (DRIL) length were measured. VA was also recorded. Correlations between FAZ area and VA were explored using regression models. Main outcome measure was VA. RESULTS: Mean age was 62.9±13.2 years. There was no difference in demographic and OCT-derived anatomic measurements between branch retinal vein occlusion and central retinal vein occlusion groups (all P ≥ 0.058); therefore, data from the 2 groups were pooled together to a single RVO group for further statistical comparisons. Univariate and multiple regression analysis showed that the area of the FAZ was significantly correlated with VA in DR and RVO (all P ≤ 0.003). The relationship between FAZ area and VA varied with age (P = 0.026) such that for a constant FAZ area, an increase in patient age was associated with poorer vision (rise in logarithm of the minimum angle of resolution visual acuity). Disruption of the ellipsoid zone was significantly correlated with VA in univariate and multiple regression analysis (both P < 0.001). Occurrence of intraretinal cysts, DRIL length, and lens status were significantly correlated with VA in the univariate regression analysis (P ≤ 0.018) but not the multiple regression analysis (P ≥ 0.210). Remaining variables evaluated in this study were not predictive of VA (all P ≥ 0.225). CONCLUSIONS: The area of the FAZ is significantly correlated with VA in DR and RVO and this relationship is modulated by patient age. Further study about FAZ area and VA correlations during the natural course of retinal vascular diseases and following treatment is warranted.


Assuntos
Retinopatia Diabética/fisiopatologia , Angiofluoresceinografia/métodos , Fóvea Central/patologia , Oclusão da Veia Retiniana/fisiopatologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Estudos Transversais , Retinopatia Diabética/diagnóstico , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Oclusão da Veia Retiniana/diagnóstico , Estudos Retrospectivos , Índice de Gravidade de Doença
19.
Retina ; 36(8): e89-90, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27388738
20.
Invest Ophthalmol Vis Sci ; 57(9): OCT314-23, 2016 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-27409488

RESUMO

PURPOSE: To determine the sensitivity of the combination of optical coherence tomography angiography (OCTA) and structural optical coherence tomography (OCT) for detecting type 1 neovascularization (NV) and to determine significant factors that preclude visualization of type 1 NV using OCTA. METHODS: Multicenter, retrospective cohort study of 115 eyes from 100 patients with type 1 NV. A retrospective review of fluorescein (FA), OCT, and OCTA imaging was performed on a consecutive series of eyes with type 1 NV from five institutions. Unmasked graders utilized FA and structural OCT data to determine the diagnosis of type 1 NV. Masked graders evaluated FA data alone, en face OCTA data alone and combined en face OCTA and structural OCT data to determine the presence of type 1 NV. Sensitivity analyses were performed using combined FA and OCT data as the reference standard. RESULTS: A total of 105 eyes were diagnosed with type 1 NV using the reference. Of these, 90 (85.7%) could be detected using en face OCTA and structural OCT. The sensitivities of FA data alone and en face OCTA data alone for visualizing type 1 NV were the same (66.7%). Significant factors that precluded visualization of NV using en face OCTA included the height of pigment epithelial detachment, low signal strength, and treatment-naïve disease (P < 0.05, respectively). CONCLUSIONS: En face OCTA and structural OCT showed better detection of type 1 NV than either FA alone or en face OCTA alone. Combining en face OCTA and structural OCT information may therefore be a useful way to noninvasively diagnose and monitor the treatment of type 1 NV.


Assuntos
Corioide/patologia , Neovascularização de Coroide/diagnóstico , Angiofluoresceinografia/métodos , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Acuidade Visual
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