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1.
Am J Ophthalmol ; 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31173741

RESUMO

PURPOSE: We evaluated the long-term visual prognosis of a serous retinal detachment (SRD) secondary to tilted disc syndrome with or without an SRD at a final visit and the interventions. DESIGN: A retrospective, observational case series METHODS: This was a multicenter study with an enrollment of 48 eyes of 41 treatment-naïve patients (14 men, 27 women) diagnosed as tilted disc syndrome related SRDs at a first visit. Investigators at each institution decided whether to observe the patients without interventions or to treat with intravitreous injections of anti-vascular endothelial growth factor agents, photodynamic therapy, or combined therapies of both. The patients were followed up for at least 12 months. Main outcome measures were the changes of best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from a baseline. RESULTS: Analyses of all eyes showed improvement from a baseline when best BCVA was measured (p<0.0001), although last BCVA was similar to baseline BCVA (p=0.46). CRT significantly improved from a baseline at a final visit (p<0.0001). When eyes with or without SRD at a final visit were analyzed, baseline BCVAs (p=0.22) were similar, while best BCVA (p=0.05) and last BCVA (p=0.005) were significantly better in eyes without SRD. When eyes with or without the interventions were analyzed, baseline (p=0.70), best (p=0.99), and last (p=0.70) BCVAs were similar. Last CRT significantly decreased from baseline CRT in eyes with the interventions (p<0.0001). CONCLUSIONS: The visual prognosis of SRD secondary to tilted disc syndrome was better when SRD resolved, but was uninfluenced by the treatments.

2.
PLoS One ; 14(2): e0213110, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30818363

RESUMO

We investigated the rates of the use of steroids in Japanese central serous chorioretinopathy (CSC) cases and differences in the characteristics of CSC with and without steroids. A total of 538 eyes of 477 patients diagnosed with CSC, with 3 months or more of follow-up between April 2013 and June 2017 at 8 institutions. Patients with CSC with more than 3 months of follow-up were identified by OCT and fluorescein angiography at 8 institutions. Data collected included patient demographics, history of corticosteroid medication and smoking, spherical errors, findings of angiography, subfoveal choroidal thickness, and changes through the follow-up period. Differences in these findings were analyzed in cases with and without corticosteroid treatment. Among the 477 patients (344 men,133 women), 74 (15.5%) (39 men, 35 women) underwent current or prior steroid treatment. Cases with steroids were higher age (p = 0.0403) and showed no male prevalence, more bilateral involvement (p < 0.0001), and the affected eyes had multiple pigment epithelial detachment (p <0.0001), more fluorescein leakage sites (p < 0.0001), greater choroidal thickness (p = 0.0287) and a higher recurrence rate (p = 0.0412). Steroids can cause severer CSC through an effect on choroidal vessels and an impairment of retinal pigment epithelium.

3.
PLoS One ; 14(2): e0213161, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30818384

RESUMO

PURPOSE: Abnormal fundus autofluorescence (FAF) potentially precedes onset of late age-related macular degeneration (AMD) in Caucasian patients. Many differences exist between Asian and Caucasian patients regarding AMD types and severity, gender, and genetic backgrounds. We investigated the characteristics of abnormal FAF and retinal sensitivity in the fellow eyes of Japanese patients with unilateral neovascular AMD. METHODS: Sixty-six patients with unilateral neovascular AMD and abnormal FAF in the fellow eye were enrolled in this multicenter, prospective, observational study. The best-corrected visual acuity, fundus photographs, FAF images, and retinal sensitivity on microperimetry were measured periodically for 12 months. The FAF images were classified into eight patterns based on the International Fundus Autofluorescence Classification Group. The points measured by microperimetry were superimposed onto the FAF images and fundus photographs and classified as "within," "close," and "distant," based on the distance from the abnormal FAF and other findings. The relationship between the location of the baseline abnormal FAF and retinal sensitivity was investigated. RESULTS: In Japanese patients, patchy (33.3%) and focally increased (30.3%) patterns predominated in the abnormal FAF. Intermediate-to-large drusen was associated predominantly with hyperfluorescence and hypofluorescence. Neovascular AMD developed within 1 year in six (9.1%) eyes, the mean baseline retinal sensitivity of which was 12.8 ± 4.7 dB, significantly (p<0.002) lower than the other eyes. In 44 of the other 60 eyes, microperimetry was measurable at baseline and month 12 and the mean retinal sensitivity improved significantly from 13.5 ± 4.4 to 13.9 ± 4.8 dB (p<0.001), possibly associated with lifestyle changes (e.g., smoking cessation, antioxidant and zinc supplementation). The mean retinal sensitivities of points within and close to the abnormal FAF were 9.9 and 11.7 dB, respectively, which were significantly lower than the 14.0 dB of the points distant from the abnormal FAF. CONCLUSION: In Japanese patients, patchy and focally increased patterns predominated in the abnormal FAF. The retinal sensitivity was lower close to/within the abnormal FAF. FAF and microperimetry are useful to assess macular function before development of neovascular AMD or geographic atrophy.

4.
Jpn J Ophthalmol ; 63(3): 243-254, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30806869

RESUMO

PURPOSE: To evaluate the efficacy of indocyanine-green angiography (ICGA)-guided navigated focal laser photocoagulation for diabetic macular edema (DME). STUDY DESIGN: Prospective, interventional case series. METHODS: Six patients (8 eyes) were enrolled in this study. Fluorescein angiography (FA) and ICGA were performed using the Heidelberg Retina Angiogram 2 (Heidelberg Engineering). Navigated focal laser photocoagulation was delivered to the microaneurysms on ICGA using Navilas® (OD-OS GmbH, Germany). Central retinal thickness (CRT) and macular volume (MV) were measured by Cirrus HD-OCT (Carl Zeiss Meditec). At 6 months, the best-corrected visual acuity (BCVA), CRT and MV were compared to the values measured on day 0. The distances from the center of fovea to the closest microaneurysms (MAs) were measured on the pre-planned Navilas® image. RESULTS: All eyes had previous treatment history. At 6 months, ICGA-guided navigated focal laser photocoagulation significantly reduced the CRT and the MV (p<0.05), and there was improvement in the BCVA (p<0.05). At 3 months, 5 out of the 8 eyes (63%) underwent additional ICGA-guided navigated focal laser photocoagulation due to remnants of MAs that had been confirmed by ICGA. There was no observed recurrence of edema after the ICGA-guided navigated focal laser photocoagulation during the 6-month follow-up. The mean distance from the center of fovea to the closest MAs was 624.8 ± 377.7 µm (range 336.0-1438.9 µm). CONCLUSION: Our data suggest ICGA-guided navigated focal laser photocoagulation may be effective for the treatment of DME.


Assuntos
Retinopatia Diabética/cirurgia , Angiofluoresceinografia/métodos , Verde de Indocianina/farmacologia , Terapia a Laser/métodos , Macula Lutea/patologia , Edema Macular/cirurgia , Cirurgia Assistida por Computador/métodos , Idoso , Corantes/farmacologia , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Feminino , Seguimentos , Fundo de Olho , Humanos , Edema Macular/diagnóstico , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
5.
Int Med Case Rep J ; 11: 293-296, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30464649

RESUMO

We experienced a case of sympathetic ophthalmia in a fellow eye after vitrectomy for subretinal hemorrhage related to polypoidal choroidal vasculopathy. A 60-year-old male consulted us for polypoidal choroidal vasculopathy with subretinal hemorrhage in his left eye. The recurrence of massive subretinal hemorrhage refractory to repeated pars plana vitrectomies leads to phthisis bulbi. Two months later, multiple serous retinal detachments were observed in his right eye. Positive human leukocyte antigen-DR4 and the uveitis were helpful in distinguishing between sympathetic ophthalmia and age-related macular degeneration. High-dose pulse intravenous steroid contributed to recovery of visual acuity after resolution of serous retinal detachment.

6.
Br J Ophthalmol ; 2018 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-30467130

RESUMO

AIMS: To detect collateral vessels using optical coherence tomography angiography (OCTA) in eyes with branch retinal vein occlusion (BRVO) and to investigate the associations with visual outcomes and macular oedema. METHODS: Eyes with macular oedema secondary to BRVO that underwent OCTA at baseline and were followed up for more than 6 months were enrolled. The presence of collaterals, whether the collaterals were leaky or not, and the associations with visual outcomes and macular oedema were investigated. RESULTS: Twenty-eight eyes of 28 patients (8 men and 20 women; mean age, 68 years) were enrolled. Collaterals were detected in 23 eyes (82%) and already existed at the initial visit. Collaterals were more frequently detected in eyes with major BRVO or ischaemic type. One-third of the collaterals were leaky and all of the leaky collaterals had microaneurysms (MAs) inside. Macular oedema in eyes with collaterals was more quickly and frequently resolved than that in eyes without collaterals, but there were no significant differences. Collateral vessel formation did not seem to impact on visual outcomes, but the mean baseline central retinal thickness (CRT) was significantly higher in eyes with collaterals, and the mean CRT reduction at 6 months after treatments was significantly greater than in eyes without collaterals. CONCLUSIONS: These results suggest that collateral vessels are formed at the acute phase in eyes with BRVO. In addition, the presence of collaterals might be associated with absorption of macular oedema, but MAs formed in collaterals sometimes can cause macular oedema.

7.
Ophthalmic Res ; : 1-8, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30359965

RESUMO

PURPOSE: To study the structural and functional changes of retinal ischemia and investigate their association with macular edema (ME) or microaneurysm (MA) formation in eyes with retinal vein occlusion (RVO). METHODS: Sixty eyes of 30 patients (27 eyes with branch [b]RVO, 3 with central RVO, and 30 fellow eyes) were retrospectively reviewed. Optical coherence tomography (OCT), OCT angiography (OCTA), and microperimetry were performed simultaneously to measure retinal thickness and sensitivity. The presence of ME or MA was also assessed using OCT and fluorescein angiography. RESULTS: The mean retinal sensitivity in the nonperfused areas (NPAs) deteriorated, and this was significantly (r = -0.379, p = 0.0391*) and inversely correlated with duration from disease onset. ME and MA were unlikely to be observed around the area where the retinal sensitivity decreased. In the NPAs, the mean retinal thickness of the superficial capillary plexus (SCP) (p < 0.0001), deep capillary plexus (DCP) (p = 0.0323), and outer retina (p = 0.0008) were significantly thinner than those in the fellow eyes, respectively. Multivariate regression analysis revealed that the thicknesses of the DCP (ß: 0.3107, p = 0.0007) and outer retina (ß: 0.3482, p = 0.0001) were the independent correlative factors of the retinal sensitivity, but that SCP thickness was not. CONCLUSION: Deep retinal thinning in NPAs was correlated significantly with a decreased retinal sensitivity, which might be a negative predictor of ME and MA in eyes with RVO.

8.
J Cell Sci ; 132(4)2018 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-30082277

RESUMO

Age-related macular degeneration (AMD) is a leading cause of blindness in people over 50 years of age in many developed countries. Drusen are yellowish extracellular deposits beneath retinal pigment epithelium (RPE) found in aging eyes and considered as a biomarker of AMD. However, the biogenesis of drusen has not been elucidated. We reported previously that multicellular spheroids of human RPE cells constructed a well-differentiated monolayer of RPE with a Bruch's membrane. We determined that RPE spheroids exhibited drusen formation between the RPE and Bruch's membrane with expression of many drusen-associated proteins, such as amyloid ß and complement components, the expression of which was altered by a challenge with oxidative stress. Artificial lipofuscin-loaded RPE spheroids yielded drusen more frequently. In the current study, we showed that drusen originates from the RPE. This culture system is an attractive tool for use as an in vitro drusen model, which might help elucidate the biogenesis of drusen and the pathogenesis of related diseases, such as AMD.

9.
Clin Ophthalmol ; 12: 1487-1494, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30154646

RESUMO

Purpose: The aim of this study is to report the 6-month results after one intravitreal ranibizumab (IVR) injection followed by pro re nata dosing for macular edema (ME) after branch retinal vein occlusion. Patients and methods: The inclusion criteria included a minimal patient age of 18 years, 20 letters or more best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] score, 77 letters or less), and central retinal thickness (CRT) of 250 microns or more. The primary outcome measure was the mean BCVA change from baseline at month 6; the secondary outcomes were mean changes in CRT, residual ME, and microaneurysm formation. Results: Twenty patients were enrolled from March 2014 through October 2016 at Nagoya City University Hospital. The baseline mean ETDRS letters and CRT were 63.1 and 500 microns, respectively; mean time from symptom onset to initial therapy was 1.80 months; and mean ETDRS gain and CRT reduction were 15.2 letters and 230 microns, respectively. The percentages of patients with Snellen equivalent BCVAs of 20/40 (70 ETDRS letters) or better and 20/20 (85 ETDRS letters) were 90% and 15%, respectively. Residual ME and microaneurysms were observed in 85% and 35% of patients. Microaneurysm formation was associated with delayed initial therapy. Conclusion: Prompt initiation of IVR injection provided a better visual prognosis at month 6 and suppressed the microaneurysm formation.

10.
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.

11.
Graefes Arch Clin Exp Ophthalmol ; 256(10): 1823-1829, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29961921

RESUMO

PURPOSE: Pneumatic displacement of submacular hemorrhages (SMHs) with intravitreal injection of sulfur hexafluoride (SF6) gas with or without tissue plasminogen activator (tPA) and prone posturing is an effective minimally invasive treatment. We observed some cases in which simultaneous flattening of hemorrhagic pigment epithelial detachments (PEDs) occurred after prone posturing. This study evaluated the impact of pneumatic displacement using tPA to treat PEDs and visual outcomes in eyes with SMHs secondary to neovascular age-related macular degeneration (AMD). METHODS: This retrospective analysis reviewed the medical records of 32 patients (33 eyes) who underwent pneumatic displacement for AMD-associated SMHs. The SMHs were related to polypoidal choroidal vasculopathy (PCV) in 24 eyes and typical AMD in nine eyes and treated with intravitreal injection of SF6 gas with tPA. We assessed the postoperative best-corrected visual acuities (BCVAs), prevalence and flattening rates of the PEDs, and the number of additional treatments. RESULTS: The mean follow-up period was 35.4 ± 19.8 months. The BCVAs improved significantly in eyes with PCV compared with eyes with typical AMD. Thirty-one (93.9%) of 33 eyes had an accompanying PED. The PEDs flattened in 14 (58.3%) of 24 eyes with PCV but in only one (14.3%) of seven eyes with typical AMD (p = 0.04). A mean of one additional treatment was administered during the first year in 15 eyes with flattened PEDs, which was significantly (p < 0.05) fewer than the 3.6 additional treatments in 16 eyes with persistent PEDs. CONCLUSIONS: PEDs often accompany SMHs secondary to neovascular AMD. Pneumatic displacement of the SMHs using tPA unexpectedly flattened the PEDs, especially in eyes with PCV, and was associated with fewer additional treatments.


Assuntos
Tamponamento Interno/métodos , Descolamento Retiniano/terapia , Hemorragia Retiniana/terapia , Hexafluoreto de Enxofre/administração & dosagem , Ativador de Plasminogênio Tecidual/administração & dosagem , Acuidade Visual , Degeneração Macular Exsudativa/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Fibrinolíticos/administração & dosagem , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Hemorragia Retiniana/complicações , Hemorragia Retiniana/diagnóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/terapia
12.
Eur J Pharm Biopharm ; 129: 267-272, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29906511

RESUMO

Proliferative vitreoretinopathy (PVR) is a challenging pathological condition, often causing failure of retinal detachment surgery. The purpose of this study was to evaluate the feasibility of a delivery system of bioactive proteins using anionic and cationic gelatin microspheres and to establish a new PVR model in rabbits by intraocular sustained delivery of basic fibroblast growth factor (bFGF) and interferon-beta (IFNß). Anionic and cationic gelatin microspheres were prepared and immersed in bFGF and IFNß solution, respectively, to yield a polyion complex between gelatin matrix and a bioactive protein. The bFGF-impregnated microspheres were injected into the subretinal space in rabbit eyes. At week 2, the IFNß-impregnated microspheres also were injected into the same space. Control eyes received gelatin microspheres without bFGF or IFNß, or both. The eyes then were observed for 8 weeks by ophthalmoscopy, fundus photography, and fluorescein angiography. The eyes also were evaluated histologically. In the group with both bFGF and IFNß, the number of eyes with more severe PVR increased over time. Histologic examination showed retinal folds. In contrast, no proliferative changes were seen in any control groups. Subretinal implantation of bFGF and IFNß-impregnated gelatin microspheres induced reproducible PVR in rabbit eyes. This study guaranteed delivery of bioactive proteins with gelatin microspheres.


Assuntos
Modelos Animais de Doenças , Sistemas de Liberação de Medicamentos/métodos , Coelhos , Retina/efeitos dos fármacos , Vitreorretinopatia Proliferativa/induzido quimicamente , Animais , Estudos de Viabilidade , Fator 2 de Crescimento de Fibroblastos/administração & dosagem , Fator 2 de Crescimento de Fibroblastos/toxicidade , Gelatina/química , Humanos , Injeções Intraoculares , Interferon beta/administração & dosagem , Interferon beta/toxicidade , Microesferas , Oftalmoscopia , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/toxicidade , Reprodutibilidade dos Testes , Retina/diagnóstico por imagem , Retina/patologia , Vitreorretinopatia Proliferativa/diagnóstico por imagem , Vitreorretinopatia Proliferativa/patologia
13.
Am J Ophthalmol Case Rep ; 10: 300-303, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29780959

RESUMO

Purpose: Hypotonic maculopathy secondary to cyclodialysis often persists and causes irreversible visual loss despite a variety of treatments proposed. The purpose of this study is to report two cases with persistent hypotonic maculopathy due to a large cyclodialysis cleft treated with a simple, lens-sparing technique of external drainage, diathermy, and suturing under the placement of an infusion cannula. Observations: Both patients had sustained blunt trauma to one eye, causing persisting hypotonic maculopathy. One eye was phakic. The ciliary body was totally detached with a large cyclodialysis cleft. After half-thickness scleral flaps were made and a 25-gauge infusion cannula was placed at the pars plana, external drainage was performed. Transscleral diathermy and interrupted suturing also were done. Results: In both cases, the ciliary detachment promptly improved and the intraocular pressure normalized after transient elevation for a few days. No adverse events were observed. Conclusions and importance: We successfully treated two cases with hypotonic maculopathy by a simple technique with an infusion cannula. This procedure is simple, immediately effective, less invasive, and applicable to all cases including phakic eyes.

14.
Ophthalmic Res ; : 1-8, 2018 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-29788006

RESUMO

PURPOSE: To evaluate the location of microvascular abnormalities using wide-field fluorescein angiography (WFFA) and investigate the impact on visual outcome in eyes with branch retinal vein occlusion (BRVO). METHODS: Forty eyes of 39 patients (24 males and 15 females with an average age of 71 years) were retrospectively reviewed. One patient had BRVO bilaterally. WFFA was performed in all patients to evaluate perfusion status and detect microvascular abnormalities. The WFFA images were divided into 3 zones: zone 1, posterior pole; zone 2, mid-periphery; zone 3, far periphery, in order to document the presence of microvascular abnormalities. Scatter retinal photocoagulation (PC) was performed for retinal neovascularization (NV) and/or widespread nonperfused areas (NPAs). RESULTS: The incidence of microvascular abnormalities in zone 3 was significantly (p < 0.0001) less than in zones 1 and 2. The presence of larger NPAs in zone 1, but not in zone 3, was associated with the incidence of NV and vitreous hemorrhage. The presence of peripheral lesions and the application of PC did not affect the visual outcome. CONCLUSION: The presence of peripheral abnormalities or scatter PC for NPAs did not affect the visual outcome in eyes with BRVO.

15.
Acta Ophthalmol ; 96(8): e904-e910, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29671948

RESUMO

The purpose of this study was to compare the surgical outcomes of vitrectomy with conventional internal limiting membrane (C-ILM) peeling to that with the inverted ILM (I-ILM) flap technique for large macular holes (MHs). This was a retrospective chart review of consecutive cases with a large MH at nine hospitals in Japan. Among the 1342 eyes, 165 eyes of 165 cases met the inclusion criteria. The results for medium-large MHs with a diameter 400-550 µm were compared to that of eyes with an extra-large MH with a diameter >550 µm. In addition, the results of C-ILM peeling were compared to that of the I-ILM technique. In medium-large MHs, the closure rate was 95.2% (59/62) by C-ILM peeling and 100% (19/19) by the I-ILM technique. In extra-large MHs, the closure rate was 88.4% (38/43) by C-ILM peeling and 100% (41/41) by I-ILM. Although the difference between the two methods was not significant, the I-ILM technique was successful in 100% of the cases. Multiple logistic regression analysis showed the best-corrected visual acuity (BCVA) at 6 months was significantly associated with the preoperative BCVA, MH size, age and sex of the patient. Analyses of the eyes with extra-large MHs show that the surgical success is high, and the I-ILM technique is more effective for closure in eyes with extra-large MHs.

16.
Ophthalmic Res ; 59(3): 170-175, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29533953

RESUMO

AIMS: Anti-vascular endothelial growth factor agents effectively treat age-related macular degeneration and myopic choroidal neovascularization (CNV). Tissue plasminogen activator (tPA), a fibrinolytic compound, is used as an adjuvant to displace submacular hemorrhage and to treat type 2 CNV. The purpose of this study was to investigate in in vitro and in vivo experiments the antiangiogenic impact of tPA itself. METHODS: The impact of tPA on the proliferation of human umbilical vein endothelial cells (HUVECs) was assessed by an XTT assay [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide]. A basic fibroblast growth factor-impregnated gelatin hydrogel sheet was implanted into the rabbit cornea to induce corneal neovascularization. Immediately postoperatively, tPA or buffered saline solution (control) was injected intravitreally. RESULTS: The growth and viability of the HUVECs were unaffected by tPA at clinical concentrations. In the control group, the mean lengths of the new vessels were 1.0 ± 0.41, 1.6 ± 0.75, and 3.6 ± 2.1 mm at weeks 1, 2, and 4, respectively. In contrast, tPA significantly (p < 0.01) reduced the corneal neovascularization. CONCLUSION: Although tPA has no direct impact on the vascular endothelial cells in vitro, the fibrinolytic effects of tPA might markedly suppress neovascularization in vivo.


Assuntos
Córnea/irrigação sanguínea , Neovascularização da Córnea/tratamento farmacológico , Ativador de Plasminogênio Tecidual/administração & dosagem , Animais , Contagem de Células , Células Cultivadas , Córnea/efeitos dos fármacos , Córnea/patologia , Neovascularização da Córnea/patologia , Modelos Animais de Doenças , Fibrinolíticos/administração & dosagem , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/patologia , Humanos , Coelhos
17.
J Ophthalmic Inflamm Infect ; 7(1): 16, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28695542

RESUMO

BACKGROUND: The purpose of this study is to report wide-field angiography findings before and after steroid therapy in a case with bilateral Vogt-Koyanagi-Harada (VKH) disease. RESULTS: A 44-year-old woman presented with bilateral blurred vision and metamorphopsia accompanied by symptoms of headache and tinnitus. The baseline best-corrected visual acuity was 20/20 in both eyes. Ophthalmic examination revealed a shallow anterior chamber and panuveitis accompanied by multiple serous retinal detachments in both eyes and ciliochoroidal detachments in the left eye. Wide-field fluorescein angiograms showed hyperfluorescene indicating pooling corresponding to multiple serous retinal detachments in the posterior lesion and vascular leakage in the peripheral retina and choroid, resolved after steroid tapering therapy. Interestingly, wide-field indocyanine angiograms revealed narrowing of choroidal vessels in the acute phase and its normalization with resolution of inflammation after the therapy. CONCLUSIONS: Eyes with Vogt-Koyanagi-Harada disease had peripheral chorioretinal vascular leakage and choroidal vessel narrowing in the acute phase. Wide-field angiography is a useful tool to reveal peripheral chorioretinal findings and assess diameters and density of choroidal vessels.

18.
Ophthalmologica ; 237(3): 159-166, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28171877

RESUMO

PURPOSE: To investigate functional and morphological changes in patients with chronic central serous chorioretinopathy after supplementation with antioxidants containing lutein or a placebo. PROCEDURES: One hundred eyes of 100 patients were randomly divided into 2 groups, one taking tablets with lutein plus other antioxidants and the other taking a placebo for 6 months. Best-corrected visual acuity (BCVA) and the subfoveal fluid height on optical coherence tomography were measured. RESULTS: Seventy-nine patients (37 in the supplementation and 42 in the placebo group) completed the 6-month follow-up. In the supplementation group, mean BCVA showed significant improvement (p = 0.003), while there was no significant change in the placebo group (p = 0.589). The mean subfoveal fluid height was significantly reduced, by 28.6%, in the supplementation group (p = 0.028), in contrast to 3.3% in the placebo group (p = 0.898). CONCLUSIONS: Antioxidant supplementation significantly reduced subfoveal fluid height. The impacts of antioxidant supplementation on BCVA remain to be elucidated in future studies.


Assuntos
Coriorretinopatia Serosa Central/dietoterapia , Suplementos Nutricionais , Luteína/administração & dosagem , Acuidade Visual , Adulto , Idoso , Antioxidantes/administração & dosagem , Coriorretinopatia Serosa Central/diagnóstico , Doença Crônica , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento
19.
Clin Ophthalmol ; 10: 2497-2503, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28008222

RESUMO

PURPOSE: We aimed to evaluate the prevalence of abnormal peripheral fundus autofluorescence (FAF) in wet age-related macular degeneration (AMD) using wide-field imaging instrument. PATIENTS AND METHODS: A retrospective, case-controlled study involving 66 eyes of 46 Japanese wet AMD patients and 32 eyes of 20 control patients was performed. Wide-field FAF images were obtained for typical AMD (37 eyes/28 patients), polypoidal choroidal vasculopathy (PCV) (22 eyes/20 patients), and retinal angiomatous proliferation (RAP) (seven eyes/four patients). Two masked ophthalmologists independently graded the images for mottled, granular, and nummular patterns. Main outcome measures were abnormal peripheral FAF frequencies and relative risks by disease subgroups and treatments. RESULTS: Abnormal peripheral FAF patterns were found in 51.5% of wet AMD eyes compared with 18.8% of control eyes (P<0.001). Mottled, granular, and nummular patterns were found in 45.5%, 31.8%, and 16.7%, respectively, of wet AMD eyes. Each disease subgroup (typical AMD, 54.1%; PCV, 36.4%; and RAP, 85.7%) showed significantly higher frequencies of peripheral FAF (P<0.001, P=0.03, and P<0.001, respectively) than control eyes (18.8%). There were no significant differences (P=0.76) between the frequencies in untreated and treated eyes. CONCLUSION: Eyes of Japanese wet AMD patients had a higher abnormal FAF prevalence compared with control eyes. Among the three disease subtypes, abnormal patterns were least prevalent in PCV eyes.

20.
Clin Ophthalmol ; 10: 2297-2302, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27895460

RESUMO

PURPOSE: The aim of this study was to evaluate the usefulness of preoperative optical coherence tomography (OCT) findings in patients with macular epiretinal membrane (ERM) for the planning of surgical strategy. PATIENTS AND METHODS: One hundred twenty-three eyes of 121 patients (49 men, 72 women; mean age, 66 years) with an idiopathic ERM were enrolled. All patients underwent an ophthalmic examination including indirect ophthalmoscopy and OCT (Cirrus HD-OCT 4000 and/or 5000). OCT images obtained using model 4000 were transferred to the model 5000 system for vitreoretinal interface (VRI) analysis. The retinal thickness in each area, occurrence rate, and locations of the edges and partial detachments of the ERMs were evaluated using OCT. RESULTS: OCT detected identifiable edges in 61 (50%) eyes and partial detachments in 116 (94%) of the 123 eyes. The edges and partial detachments were seen more frequently in the inferior macula. VRI analysis also detected the edges and partial detachments. Excluding the central area, the superior quadrant was the thickest in patients with an ERM. CONCLUSION: Preoperatively acquired OCT images are useful for planning surgical strategies and performing the surgeries smoothly.

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