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1.
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.

2.
Invest Ophthalmol Vis Sci ; 59(13): 5542-5547, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30480742

RESUMO

Purpose: Central serous chorioretinopathy (CSC) is a retinal disorder that often affects the vision of middle-aged people yet the molecular mechanisms of CSC remain unknown. This study was conducted to identify genetic factors influencing individual differences in susceptibility to CSC. Methods: A two-stage genome-wide association study (GWAS) was conducted with a total of 320 unrelated Japanese idiopathic CSC cases and 3245 population-based controls. In a discovery stage, 137 unrelated Japanese idiopathic CSC cases and 1174 population-based controls were subjected to GWAS, followed by a replication study using an additional 183 individuals with idiopathic CSC and 2071 population-based volunteers. The results of the discovery and replication stages were combined to conduct a meta-analysis. Results: In the two-stage GWAS, rs11865049 located at SLC7A5 in chromosome 16q24.2 was identified as a novel disease susceptibility locus for CSC, as evident from the discovery and replication results using meta-analysis (combined P = 9.71 × 10-9, odds ratio = 2.10). Conclusions: The results of the present study demonstrated that SLC7A5 might be the potential candidate gene associated with CSC, indicating a previously unidentified molecular mechanism of CSC.

3.
Clin Ophthalmol ; 12: 1789-1799, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30271112

RESUMO

Purpose: To compare the efficacy and safety of ranibizumab 0.5 mg with or without verteporfin photodynamic therapy in Japanese patients with polypoidal choroidal vasculopathy over 12 months. Study design: EVEREST II was a 24-month, Phase IV, multicenter, randomized, double-masked study in Asian patients with symptomatic macular polypoidal choroidal vasculopathy. Methods: Of the 322 enrolled patients, 84 patients, including 46 patients who received ranibizumab + verteporfin photodynamic therapy (combination therapy arm) and 38 patients who received ranibizumab/sham PDT (monotherapy arm), were Japanese who were evaluated in this subanalysis. Mean change in best-corrected visual acuity (BCVA) and complete polyp regression at Month 12, ranibizumab treatment exposure, and safety over 12 months were assessed. Results: Baseline demographics were well balanced between the arms. At Month 12, mean change in BCVA letter score was +8.5 with combination therapy versus +6.4 with monotherapy. Complete polyp regression was higher with combination therapy than with monotherapy at Month 12 (70.5% vs 27.3%). Over 12 months, patients in the combination arm received a median of 4.0 ranibizumab injections vs 7.0 in the monotherapy arm. Serious adverse events were generally low in both arms, and retinal hemorrhage, an adverse event, was reported in one patient (2.2%). Conclusion: The results from the Japanese cohort were in agreement with the EVEREST II study. Combination therapy was effective in improving BCVA and achieving a higher rate of complete polyp regression with a lower number of ranibizumab injections than monotherapy. No new safety signals were reported, and safety events were comparable between both arms over 12 months.

4.
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.

5.
Medicine (Baltimore) ; 97(25): e11188, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29924037

RESUMO

This study aimed to explore predictors of long-term stabilization of polypoidal choroidal vasculopathy (PCV) lesions and vision in response to injection of intravitreal ranibizumab (IVR). The treated eyes had a baseline best corrected visual acuity (BCVA) of at least 0.6 (logarithm of the minimal angle of resolution (logMAR) 0.22).We treated 45 eyes showing BCVA between 0.6 (logMAR 0.22) and 1.0 (logMAR 0), with IVR for 3 consecutive months. All eyes were confirmed to have subfoveal PCV prior to starting this treatment regimen. Additional IVR was administered at the subsequent monthly visits, if necessitated by evidence of persistent PCV, for up to 23 months after the first ranibizumab injection. The subjects were then carefully followed-up for 24 months, allowing detailed retrospective evaluation of changes in mean BCVA, central retinal thickness (CRT), serous retinal detachment (SRD), hemorrhage, and polypoidal lesion numbers. The relationships between retreatment and each of the baseline characteristics and SRD development during follow-up were analyzed.The mean logMAR BCVAs were 0.111 ±â€Š0.076, 0.068 ±â€Š0.206 (P = .0033) and 0.115 ±â€Š0.265 (P = .27) at baseline and at 12 and 24 months, respectively. At 24 months, 87% of eyes had BCVA of 20/40 or better. Not requiring retreatment between 12 and 23 months was found to be significantly associated with the absence of retinal pigment epithelial detachment (RPED) at baseline (odds ratio: 0.262 (95% confidence interval (CI): 0.073-0.946). The rates of retreatment from 12 to 23 months were significantly higher in eyes with SRD at 6 and 12 months than in those without SRD (P = .004 and P < .001).In conclusion, during 24 months of antivascular endothelial growth factor (VEGF) therapy using ranibizumab for PCV, BCVA was maintained in those with good visual acuity at baseline. Comprehensive analyses revealed RPED at baseline and SRD development during follow-up to correlate significantly with the need for retreatment between 12 and 23 months. Our observations might facilitate tailoring treatments to individual PCV patients.


Assuntos
Doenças da Coroide/tratamento farmacológico , Corioide/irrigação sanguínea , Ranibizumab/uso terapêutico , Doenças Vasculares/tratamento farmacológico , Acuidade Visual/efeitos dos fármacos , Idoso , Inibidores da Angiogênese/uso terapêutico , Coriorretinopatia Serosa Central/tratamento farmacológico , Doenças da Coroide/patologia , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Pólipos/patologia , Valor Preditivo dos Testes , Ranibizumab/administração & dosagem , Descolamento Retiniano/tratamento farmacológico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Resultado do Tratamento , Doenças Vasculares/patologia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia
6.
J Alzheimers Dis ; 62(1): 239-245, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29439351

RESUMO

BACKGROUND: Histopathological studies have confirmed that soft drusen contains amyloid-ß (Aß). OBJECTIVE: To examine the relationship between the area of soft drusen in the macular area and cerebral Aß accumulation or plasma Aß level in elderly persons without dementia. METHODS: Fourteen consecutive patients (18 eyes) aged ≥50 years with macular soft drusen were studied prospectively. From color fundus photographs, the area of soft drusen (pixel) within a 6,000 µm diameter with the macula as center was measured. Standard uptake value ratio (SUVR) was obtained from positron emission tomography using florbetapir, which indicates the ratio of cerebral cortical-to-cerebellar Aß accumulation. Ratio of plasma Aß1-42 to Aß1-40 level was calculated. RESULTS: Mean age was 73.3±7.6 years. The soft drusen area was 4.32±2.42 mm2. The SUVR was 1.08±0.15. Plasma Aß1-42/Aß1-40 ratio was 0.17±0.08. When SUVR ≥1.10 was defined as positive and <1.10 as negative, the soft drusen area in SUVR-positive patients (6.19±1.14 mm2) was significantly (p = 0.0043) larger than that in SUVR-negative patients (3.13±2.27 mm2). Multivariate regression analysis showed that SUVR positivity correlated with soft drusen area (p = 0.0484) and with Voxel-based Specific Regional Analysis System for Alzheimer's Disease score (p = 0.0360). However, there was no correlation with gender (p = 0.1921), age (p = 0.2361), Alzheimer's Disease Assessment Scale score (p = 0.6310), Mini-Mental State Examination score (p = 0.4246), or plasma Aß1-42/Aß1-40 ratio (p = 0.8398). CONCLUSION: Among elderly persons without dementia, the area of soft drusen was larger in those with more extensive cerebral Aß accumulation. The area of soft drusen may be a biomarker of cerebral Aß accumulation.

7.
Jpn J Ophthalmol ; 62(2): 137-143, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29224056

RESUMO

PURPOSE: In this study (AMD2000), we aimed to determine the visual prognosis of Japanese patients with age-related macular degeneration (AMD). METHODS: This was a multicenter prospective observational cohort study. In total, 460 patients with AMD were recruited from April 2006 to March 2009 from 18 clinical trial sites in Japan. They were followed up for 5 years, as they continued to receive medical treatment. RESULTS: Of the 409 study eyes followed up for at least 1 year, 243 eyes (59.4%) were treated with photodynamic therapy (PDT) using verteporfin, and 58 eyes (14.2%) were treated with intravitreal injections of antivascular endothelial growth factor agents as the initial treatment. The mean best-corrected visual acuities (BCVA) for typical AMD (tAMD; 0.688 ± 0.498) and polypoidal choroidal vasculopathy (PCV; 0.451 ± 0.395) were significantly less at 2 years (tAMD, 0.779 ± 0.632, P < 0.05; PCV, 0.534 ± 0.618, P < 0.05) and at 5 years (AMD, 0.873 ± 0.718, P < 0.05; PCV, 0.635 ± 0.668, P < 0.05) than at baseline. In eyes with tAMD, absence of blocked fluorescence was associated with 5-year maintenance of the baseline BCVA. Regarding PCV, the presence of polypoidal lesions and cystoid macular edema as well as the lesion size was associated with 5-year maintenance of the baseline BCVA. In some patients, the diagnosis changed: of the 192 eyes initially diagnosed with typical AMD, 19 were newly diagnosed with PCV during follow-up. CONCLUSION: Maintaining the baseline BCVA over the long term is difficult in Japanese eyes with wet AMD.


Assuntos
Fotoquimioterapia/métodos , Porfirinas/administração & dosagem , Acuidade Visual , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Incidência , Injeções Intravítreas , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/administração & dosagem , Prognóstico , Estudos Prospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento , Verteporfina , Degeneração Macular Exsudativa/diagnóstico , Degeneração Macular Exsudativa/epidemiologia
8.
Int Ophthalmol ; 38(2): 767-770, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28374275

RESUMO

PURPOSE: To report a case developing a severe retinal fold (RF), resembling a roll cake on optical coherence tomography (OCT), after retinal detachment (RD) surgery. CASE REPORT: A 61-year-old man underwent vitrectomy for a limited macula-on-superior rhegmatogenous RD and gas tamponade at another hospital. Despite remaining prone for 4 days, RF was noted after gas disappearance and he was referred to us. OCT showed a roll cake-like RF, which resolved after vitrectomy with internal limiting membrane (ILM) peeling, creation of a new detachment, perfluorocarbon liquid injection, air-fluid exchange, silicone oil tamponade and prone positioning. CONCLUSION: ILM peeling including the area of the retinal fold, followed by new detachment creation and finally perfluorocarbon liquid injection, effectively flattened the severe RF. To our knowledge, this is the most severe case of RF to be documented by OCT and illustrates that broad ILM peeling, including the RF, is effective for treating RF.


Assuntos
Membrana Epirretiniana/cirurgia , Descolamento Retiniano/cirurgia , Vitrectomia/métodos , Tamponamento Interno/métodos , Fluorcarbonetos/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
9.
Jpn J Ophthalmol ; 62(2): 127-136, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29270814

RESUMO

PURPOSE: To report research participants' baseline characteristics in the AMD2000 study, a prospective, multicenter, 5-year, observational cohort study of Japanese age-related macular degeneration (AMD). The characteristics were determined using multimodal imaging. METHODS: Patients with AMD were recruited at 18 clinical sites in Japan between April 2006 and March 2009. Each patient underwent a complete ophthalmic examination, including measurement of best-corrected visual acuity (Landolt chart), indirect ophthalmoscopy, slit-lamp biomicroscopy with a contact lens, optical coherence tomography imaging, fundus photography, and fluorescein and indocyanine green angiography. RESULTS: Four hundred sixty participants (326 men [70.9%]) were included in the study. At enrollment, 131 eyes (28.5%) had hard drusen and 125 eyes (27.2%) had soft drusen in the macular area. A total of 455 eyes (98.9%) were diagnosed as having wet AMD, and 5 eyes (1.1%), as having dry AMD. Of the 455 eyes with wet AMD, 209 eyes (45.4%) had typical AMD, 228 eyes (49.6%) had polypoidal choroidal vasculopathy (PCV), and 18 eyes (3.9%) had retinal angiomatous proliferation. The size of choroidal neovascularization (CNV) was significantly smaller with indocyanine green angiography than with fluorescein angiography (P < 0.001). Poor baseline visual acuity was associated with cystoid macular edema, older age, scar, extrafoveal macular edema, subfoveal CNV, large branching vascular network, and hard exudates. CONCLUSION: Japanese patients with AMD are predominantly male, lack drusen, and have a high rate of PCV.


Assuntos
Diagnóstico por Imagem/métodos , Macula Lutea/diagnóstico por imagem , Acuidade Visual , Degeneração Macular Exsudativa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Incidência , Japão/epidemiologia , Masculino , Microscopia Acústica , Pessoa de Meia-Idade , Oftalmoscopia , Estudos Prospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Degeneração Macular Exsudativa/epidemiologia , Degeneração Macular Exsudativa/fisiopatologia
10.
Can J Ophthalmol ; 52(4): 398-402, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28774523

RESUMO

OBJECTIVE: This study aimed to evaluate the usefulness of a new wet laboratory (wet lab) system using porcine eyes with eyelids. DESIGN: Teaching device trial. PARTICIPANTS: Porcine eyes with orbital tissues and eyelids. METHODS: Twenty porcine eyes with orbital tissues and eyelids were enucleated from pigs butchered at age 6 months. These eyes were positioned in the eye sockets of a model head and stabilized with a pin. Eye draping, dressing with tape, and speculum placement were conducted. The vertical and horizontal widths of the palpebra under the speculum setting were compared with those of 55 patients who underwent cataract surgery. The rotation and torsion of the porcine eye in the new wet lab system were also compared with those of a conventional wet lab system. For comparison with actual cataract surgery, 5 ophthalmologists, including residents, were asked to respond to a questionnaire survey. RESULTS: The horizontal widths of the palpebra under the speculum setting were 27.5 ± 3.1 mm in porcine eyes and 28.6 ± 5.1 mm in human eyes, and the vertical widths were 16.9 ± 1.3 mm and 16.1 ± 1.5 mm (p = 0.53, 0.05). The amounts of rotation and torsion were significantly greater with the new wet lab system. Ophthalmologists evaluated the new wet lab system as being more realistic than the conventional system, in terms of both natural eye movement and restriction of the surgical field by the eyelid and the speculum. CONCLUSIONS: Wet lab training using porcine eyes with eyelids is more practical than older systems as it reproduces an ocular surgical field very similar to that of humans.


Assuntos
Extração de Catarata/educação , Educação de Pós-Graduação em Medicina/métodos , Enucleação Ocular/educação , Pálpebras/cirurgia , Oftalmologia/educação , Cirurgia Vitreorretiniana/educação , Idoso , Animais , Feminino , Humanos , Masculino , Suínos
11.
Ophthalmic Surg Lasers Imaging Retina ; 48(4): 302-310, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-28419395

RESUMO

BACKGROUND AND OBJECTIVE: To evaluate the choriocapillaris using optical coherence tomographic angiography (OCTA) after half-dose verteporfin photodynamic therapy (hd-PDT) for chronic central serous chorioretinopathy (CSC). PATIENTS AND METHODS: We studied six eyes (six patients) with chronic CSC treated by hd-PDT. OCTA was performed before, 1 week after, and 1 month after hd-PDT. The area of flow abnormality at the choriocapillaris level within the PDT spot after hd-PDT was compared with that before hd-PDT. RESULTS: Serous retinal detachment was diminished in all eyes, with three achieving complete resolution at 1 month. On OCTA, all eyes showed irregular choriocapillaris flow before hd-PDT. The areas of abnormal flow shrank progressively at 1 month after hd-PDT. CONCLUSION: On OCTA, choriocapillaris flow tended to recover at 1 month after hd-PDT. OCTA may be clinically useful for evaluating choriocapillaris and the therapeutic effects of hd-PDT for chronic CSC. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:302-310.].


Assuntos
Coriorretinopatia Serosa Central/tratamento farmacológico , Corioide/irrigação sanguínea , Angiofluoresceinografia/métodos , Fotoquimioterapia/métodos , Porfirinas/administração & dosagem , Tomografia de Coerência Óptica/métodos , Adulto , Coriorretinopatia Serosa Central/diagnóstico , Corioide/diagnóstico por imagem , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/administração & dosagem , Estudos Retrospectivos , Resultado do Tratamento , Verteporfina
12.
Ophthalmologica ; 238(1-2): 17-22, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28402983

RESUMO

PURPOSE: The aim of this study was to clarify the 1-year outcomes of pro re nata (PRN) and bimonthly intravitreal injections of aflibercept (IVA) for typical neovascular age-related macular degeneration (tAMD) after the initial 3 monthly IVA. METHODS: We conducted a prospective, interventional study. Fifty-eight treatment-naïve patients with tAMD were randomly assigned to the PRN (30 patients) or the bimonthly (28 patients) treatment group. Both groups initially received 3 monthly IVA. Visual acuity, central macular retinal thickness (CRT), and central choroidal thickness (CCT) were evaluated at 12 months. Subanalysis was performed to identify factors associated with the best-corrected visual acuity (BCVA). RESULTS: BCVA was significantly improved only in the bimonthly group at 12 months. CRT and CCT were significantly decreased in both groups. Subanalysis showed that the only factor associated with BCVA improvement at 12 months was the existence of pigment epithelial detachment at baseline. CONCLUSIONS: BCVA showed significant improvement only in the bimonthly group but not in the PRN group at 12 months.


Assuntos
Macula Lutea/patologia , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Degeneração Macular Exsudativa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Corioide/patologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fatores de Tempo , Resultado do Tratamento , Degeneração Macular Exsudativa/diagnóstico
13.
Acta Ophthalmol ; 95(5): e373-e378, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28271619

RESUMO

PURPOSE: To verify that ocular surface irrigation with 0.025% povidone-iodine (PI) or 0.0025% polyvinyl alcohol-iodine (PAI) during cataract surgery minimizes bacterial contamination of the anterior chamber. METHODS: The study was a prospective, interventional case series. First, the bactericidal effect of PI or PAI against Staphylococcus aureus was evaluated in vitro. Next, in 400 eyes undergoing cataract surgery, the ocular surface was irrigated every 20 seconds during surgery with balanced salt solution (BSS; 200 eyes) or BSS containing 0.025% PI (100 eyes) or 0.0025% PAI (100 eyes). At the completion of surgery, anterior chamber fluid was cultured bacteriologically. Visual acuity (VA) and corneal endothelial cell density were measured before and 7 days after surgery. RESULTS: A marked bactericidal effect was observed when S. aureus was directly exposed for 15 seconds to 0.01% PI or 0.001% PAI diluted in BSS. When the two solutions were stored at room temperature, bactericidal effect did not attenuate after 60 min. The bacterial detection rate at the completion of surgery was significantly reduced in 0.025% PI (0%, 0/100 eyes) or 0.0025% PAI group (0%, 0/100 eyes) compared to BSS group (5%, 10/200 eyes) (p = 0.0340). No differences in postoperative visual acuity and postoperative corneal endothelial cell density were observed between three groups. CONCLUSION: In cataract surgery, irrigation every 20 seconds of the operative field with 0.025% PI or 0.0025% PAI, both of which contain 0.0025% available iodine concentration, achieved a very low bacterial contamination rate in the anterior chamber.


Assuntos
Câmara Anterior/microbiologia , Extração de Catarata , Infecções Oculares Bacterianas/prevenção & controle , Povidona-Iodo/administração & dosagem , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/isolamento & purificação , Infecção da Ferida Cirúrgica/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos Locais/administração & dosagem , Infecções Oculares Bacterianas/microbiologia , Feminino , Seguimentos , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Estudos Prospectivos , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Infecção da Ferida Cirúrgica/microbiologia , Irrigação Terapêutica , Resultado do Tratamento
14.
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
15.
BMC Res Notes ; 10(1): 16, 2017 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-28057069

RESUMO

BACKGROUND: We investigated choroidal thicknesses at five sites in two siblings (four eyes) with nanophthalmos using swept-source optical coherence tomography. CASE PRESENTATION: Case 1, a 51-year-old Japanese female with high hyperopia (Right: +20.5 Dioptors, Left: +19.5 Dioptors), had axial lengths of 15.6 mm in both eyes. Case 2, a 55-year-old Japanese male with high hyperopia (Right: +22.5 Dioptors, Left: +22.8 Dioptors), had axial lengths of 14.8 and 14.7 mm in the right and left eyes, respectively. Choroidal thickness was measured at five sites in each eye using swept-source optical coherence tomography; subfoveal, nasal, temporal, superior and inferior (the 4 non-subfoveal sites were measured 3000 µm from the fovea). CONCLUSION: The mean choroidal thickness was 355.8 ± 63.6 µm at the subfoveal, 466.3 ± 85.1 µm at the nasal, 274.8 ± 77.2 µm at the temporal, 396.8 ± 54.6 µm at the superior, and 480.8 ± 66.8 µm at the inferior (mean ± standard deviation) site. Choroidal thickness was maximal at the inferior site. The choroid was thinnest, in diminishing order, at the nasal, superior, subfoveal and temporal sites.


Assuntos
Corioide/patologia , Oftalmopatias Hereditárias/diagnóstico , Hiperopia/diagnóstico , Acuidade Visual , Oftalmopatias Hereditárias/patologia , Feminino , Humanos , Hiperopia/patologia , Masculino , Pessoa de Meia-Idade , Esclera/patologia , Irmãos , Tomografia de Coerência Óptica
16.
Br J Ophthalmol ; 101(1): 51-55, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27913447

RESUMO

PURPOSE: To compare the findings of optical coherence tomography angiography (OCTA) with indocyanine green angiography (ICGA) in polypoidal choroidal vasculopathy (PCV) that was divided into two types: polypoidal choroidal neovascularisation (CNV) and typical PCV (type 2 PCV). METHODS: We studied a retrospective case series of 32 patients with treatment-naïve PCV (24 men, eight women; mean age 65.4 years). PCV was categorised into polypoidal CNV (type 1 PCV) and type 2 PCV based on ICGA findings. OCTA was performed using the RTVue XR Avanti. Macular cubes (3×3 or 6×6 mm) were acquired. To evaluate the locations of polyps and branched vessel networks (BVNs), we used B-mode scan. RESULTS: OCTA clearly depicted only 17% of the type 1 PCV polyps and 46% of the type 2 PCV polyps which were detectable by ICGA. All type 1 PCV polyps detectable by OCTA were located just beneath the retinal pigment epithelium (RPE). On the other hand, type 2 PCV polyps were detected in various locations. All BVNs of type 1 PCV were located between the RPE and Bruch's membrane on OCTA images. However, the BVNs in type 2 PCV were located mainly under the RPE, though some were located in the choroid. CONCLUSIONS: Polyps of type 1 PCV were more difficult to detect with OCTA than those of type 2 PCV. Polyps of type 1 PCV were located just beneath the RPE. The BVNs of type 1 PCV were located between the RPE and Bruch's membrane.


Assuntos
Doenças da Coroide/diagnóstico por imagem , Angiofluoresceinografia/métodos , Verde de Indocianina/administração & dosagem , Tomografia de Coerência Óptica/métodos , Idoso , Corioide/patologia , Neovascularização de Coroide/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/diagnóstico por imagem , Estudos Retrospectivos
17.
Ophthalmologica ; 236(2): 108-13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27606681

RESUMO

PURPOSE: To reveal vascular signals at the choriocapillaris level in central serous chorioretinopathy (CSC) using optical coherence tomographic angiography (OCTA). PROCEDURES: We analyzed vascular signals at the choriocapillaris level in 58 CSC and 51 contralateral eyes by OCTA (RTVue XR Avanti with AngioVue; Optovue Inc., Fremont, Calif., USA). Data analysis included age, best corrected visual acuity (BCVA), disease duration and serous retinal detachment (SRD) height. RESULTS: Morphologically, abnormal signals at the choriocapillaris level were detected in all CSC eyes (100%), and then classified into three patterns. Age, BCVA, disease duration and SRD height showed no significant correlation with signal patterns. Thirty-one contralateral eyes (61%) showed abnormal signals at the choriocapillaris level on OCTA, while 20 (39%) had a normal pattern. CONCLUSIONS: OCTA revealed three types of abnormal signals not only in CSC eyes but also in fellow eyes without SRD. OCTA may provide information for elucidating the underlying pathogenesis of CSC.


Assuntos
Coriorretinopatia Serosa Central/diagnóstico , Corioide/irrigação sanguínea , Angiofluoresceinografia/métodos , Verde de Indocianina/farmacologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Capilares/patologia , Corantes/farmacologia , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Acuidade Visual
18.
Ophthalmologica ; 236(2): 100-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27532435

RESUMO

PURPOSE: To identify locations of hypofluorescent lesions on late-phase indocyanine green angiography (ICGA) in patients with central serous chorioretinopathy (CSC) using en-face optical coherence tomography (OCT). PROCEDURES: We retrospectively studied 25 consecutive untreated CSC patients, using swept-source OCT and ICGA. En-face swept-source OCT images were automatically segmented and flattened with Bruch's membrane (BrM). We compared the sizes of hyperreflective areas in the 25 CSC and 25 contralateral eyes on en-face images and hypofluorescent areas on ICGA after 30 min. RESULTS: All 25 CSC eyes and 13 contralateral eyes showed abnormal hypofluorescent areas on late-phase ICGA and hyperreflective areas on en-face OCT from BrM to the choriocapillaris, and these findings correlated with the abnormal areas (r = 0.9988; p < 0.001). CONCLUSIONS: In CSC patients, we detected abnormal hypofluorescence on ICGA in the late phase, which corresponded to abnormal hyperreflective areas from BrM to the choriocapillaris level in en-face images.


Assuntos
Coriorretinopatia Serosa Central/diagnóstico , Corioide/patologia , Angiofluoresceinografia/métodos , Verde de Indocianina/farmacologia , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Idoso , Coriorretinopatia Serosa Central/etiologia , Coriorretinopatia Serosa Central/fisiopatologia , Corantes/farmacologia , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Ophthalmologica ; 235(4): 208-14, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27043351

RESUMO

PURPOSE: The aim of this study was to clarify the characteristic findings in patients with geographic atrophy with or without hyperautofluorescent choroidal vessels within macular atrophic areas on short-wavelength fundus autofluorescence imaging. PROCEDURES: Sixty-seven eyes of 43 consecutive patients with macular atrophic areas were divided into groups with (group 1) and without (group 2) hyperautofluorescent choroidal vessels on fundus autofluorescence imaging and then retrospectively studied using spectral-domain optical coherence tomography. RESULTS: In group 1 (n = 21), the average subfoveal choroidal thickness was 61.5 ± 20.1 µm, and the average foveal retinal thickness was 93.0 ± 51.3 µm. On the other hand, in group 2 (n = 46), the average subfoveal choroidal thickness was 200.7 ± 83.1 µm, and the average foveal retinal thickness was 109.2 ± 58.5 µm. Although retinal thickness did not differ significantly between the two groups (p = 0.28), the difference in choroidal thickness was statistically significant (p < 0.001). CONCLUSIONS: Choroidal thinning might contribute to the hyperautofluorescence of choroidal vessels.


Assuntos
Corioide/irrigação sanguínea , Degeneração Macular/diagnóstico , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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