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1.
Zhonghua Yan Ke Za Zhi ; 60(7): 566-569, 2024 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-38955758

RESUMO

Fundus imaging plays a pivotal role in diagnosing retinal and choroidal diseases. Optical coherence tomography angiography (OCTA), by capturing signals to reconstruct vascular structures, offers a clear depiction of retinal vasculature with notable advantages such as rapid scanning and non-invasiveness. Although OCTA, due to its underlying principles, cannot dynamically assess vascular function, exploring its future applications and potential to eventually replace traditional fundus angiography remains a key focus in the medical community. OCTA provides multiple parameters that conventional fundus angiography cannot obtain. With the expanding coverage area of OCTA scans and improvements in artifact elimination, the detection rate of various retinal and choroidal diseases has significantly increased, making the widespread clinical application of OCTA an inevitable trend. Although ultra-widefield OCTA cannot yet fully replace angiography in clinical practice, with continued clinical practice, expanded clinical research, and ongoing technological innovation, OCTA is expected to gradually replace fundus angiography in the future.


Assuntos
Angiofluoresceinografia , Fundo de Olho , Doenças Retinianas , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem
2.
Sci Rep ; 14(1): 13236, 2024 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-38853166

RESUMO

This study aimed to evaluate visual function and perform multimodal imaging on patients with focal choroidal excavation without any chorioretinal disease (idiopathic focal choroidal excavation [iFCE]). Seventeen eyes of 15 patients with iFCE (8 men, 7 women; mean ± standard deviation age, 56.0 ± 10.8 years) were assessed for visual function including visual acuity, metamorphopsia, aniseikonia, and retinal sensitivity. Multimodal imaging included optical coherence tomography (OCT), fundus autofluorescence (FAF), and OCT angiography. This study found that the maximum width and depth of the excavation were 597 ± 330 (238-1809) µm and 123 ± 45 (66-231) µm, respectively, and that FAF showed normal or hypoautofluorescence corresponding to iFCE. The fundus examination findings were stable during the follow-up period (96 ± 48 months). None of the eyes showed any abnormalities in central retinal sensitivity or aniseikonia. Metamorphopsia was detected using Amsler grid testing and M-CHARTS in two eyes. Therefore, this study is the first to quantitatively and qualitatively study metamorphopsia of patients with iFCE. Our results showed that most patients with iFCE did not have visual impairments, despite the presence of morphological changes in the outer retina and choroid.


Assuntos
Doenças da Coroide , Imagem Multimodal , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Imagem Multimodal/métodos , Tomografia de Coerência Óptica/métodos , Idoso , Adulto , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/patologia , Corioide/diagnóstico por imagem , Corioide/patologia , Angiofluoresceinografia/métodos , Retina/diagnóstico por imagem , Retina/patologia , Transtornos da Visão/diagnóstico por imagem
3.
Invest Ophthalmol Vis Sci ; 65(6): 33, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38904639

RESUMO

Purpose: Recent studies have shown that the retinal pigment epithelium (RPE) relies on fatty acid oxidation (FAO) for energy, however, its role in overall retinal health is unknown. The only FAO disorder that presents with chorioretinopathy is long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD). Studying the molecular mechanisms can lead to new treatments for patients and elucidate the role of FAO in the RPE. This paper characterizes the chorioretinopathy progression in a recently reported LCHADD mouse model. Methods: Visual assessments, such as optokinetic tracking and fundus imaging, were performed in wildtype (WT) and LCHADD mice at 3, 6, 10, and 12 months of age. Retinal morphology was analyzed in 12-month retinal cross-sections using hematoxylin and eosin (H&E), RPE65, CD68, and TUNEL staining, whereas RPE structure was assessed using transmission electron microscopy (TEM). Acylcarnitine profiles were measured in isolated RPE/sclera samples to determine if FAO was blocked. Bulk RNA-sequencing of 12 month old male WT mice and LCHADD RPE/sclera samples assessed gene expression changes. Results: LCHADD RPE/sclera samples had a 5- to 7-fold increase in long-chain hydroxyacylcarnitines compared to WT, suggesting an impaired LCHAD step in long-chain FAO. LCHADD mice have progressively decreased visual performance and increased RPE degeneration starting at 6 months. LCHADD RPE have an altered structure and a two-fold increase in macrophages in the subretinal space. Finally, LCHADD RPE/sclera have differentially expressed genes compared to WT, including downregulation of genes important for RPE function and angiogenesis. Conclusions: Overall, this LCHADD mouse model recapitulates early-stage chorioretinopathy seen in patients with LCHADD and is a useful model for studying LCHADD chorioretinopathy.


Assuntos
Modelos Animais de Doenças , Epitélio Pigmentado da Retina , Animais , Camundongos , Epitélio Pigmentado da Retina/metabolismo , Epitélio Pigmentado da Retina/patologia , Camundongos Endogâmicos C57BL , 3-Hidroxiacil-CoA Desidrogenase de Cadeia Longa/metabolismo , Doenças da Coroide/genética , Doenças da Coroide/metabolismo , Masculino , Doenças Retinianas/genética , Doenças Retinianas/metabolismo , Doenças Retinianas/fisiopatologia , Microscopia Eletrônica de Transmissão
4.
Turk J Ophthalmol ; 54(3): 140-148, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38940356

RESUMO

Objectives: Yasunari nodules are choroidal lesions observed in patients diagnosed with neurofibromatosis type 1 (NF-1) and characterized by relatively irregular dome-shaped, plaque-like, or patchy boundaries. The present study examines the multimodal imaging characteristics of Yasunari nodules and their value in the diagnosis of NF-1. Materials and Methods: Medical records including optical coherence tomography (OCT), enhanced depth imaging OCT, infrared reflectance (IR) imaging, OCT angiography, and color fundus images of NF-1 patients who were examined at the Department of Ophthalmology in Dokuz Eylül University Faculty of Medicine between January 2022 and December 2023 were retrospectively reviewed for the presence of Yasunari nodules. Results: A total of 54 eyes of 27 patients were included in the study. At least one choroidal nodule was detected on IR imaging in 52 eyes (96.3%). In 31 (72.1%) of the 43 eyes (79.6%) with available high-quality OCT angiography images, choroidal nodules were observed as areas showing a flow deficit in the choriocapillaris layer. Of the total 54 eyes included, Lisch nodules without choroidal nodules were observed in 2 eyes (3.7%). In 16 eyes (29.6%), Lisch nodules were not detected despite the presence of choroidal nodules. Both Lisch nodules and choroidal nodules were detected in the other 36 eyes (66.7%). Conclusion: Yasunari nodules are frequently observed in NF-1 cases and can be easily detected with multimodal imaging techniques, especially IR imaging. The ability to visualize choroidal nodules before the appearance of Lisch nodules demonstrates the importance of Yasunari nodules in the diagnosis of NF-1.


Assuntos
Angiofluoresceinografia , Imagem Multimodal , Neurofibromatose 1 , Tomografia de Coerência Óptica , Humanos , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/complicações , Feminino , Masculino , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Adulto , Angiofluoresceinografia/métodos , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Criança , Corioide/patologia , Corioide/diagnóstico por imagem , Doenças da Coroide/diagnóstico , Fundo de Olho
5.
Tokai J Exp Clin Med ; 49(2): 85-88, 2024 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-38904240

RESUMO

An 84-year-old man presented with decreased right-eye visual acuity. Upon initial examination, the rightand left-eye visual acuities were 0.03 and 1.2, respectively; moreover, the right- and left-eye intraocular pressure was 12 mmHg and 13 mmHg, respectively. Examination revealed a shallow anterior chamber of the right eye, anterior chamber inflammation, vitreous opacity, and marked retinochoroidal detachment. Optical coherence tomography (OCT) revealed retinal detachment (RD) and choroidal folds; moreover, B-scan ultrasonography (B-scan) showed RD as well as thickened sclera with fluid in Tenon's space. Fluorescent fundus angiography revealed hyperfluorescence in the optic disc and vascular hyperpermeability in the right eye. The left eye lacked extra-ocular symptoms or abnormalities. The right ocular axis measured 23.4 mm with no apparent subretinal fluid migration due to positional changes. Accordingly, the patient was diagnosed with panuveitis associated with posterior scleritis and immediately started on 40 mg prednisolone, which improved his symptoms. However, at 3 post-treatment months, choroidal folds were observed and was restarted on 20 mg prednisolone. The choroidal folds subsequently disappeared, with a current visual acuity of 0.3 in the right eye and no recurrence. Our findings indicated the utility of accurate diagnosis of posterior scleritis by B-scan and prompt systemic steroid administration.


Assuntos
Pan-Uveíte , Prednisolona , Descolamento Retiniano , Esclerite , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Masculino , Esclerite/etiologia , Esclerite/diagnóstico , Esclerite/diagnóstico por imagem , Esclerite/complicações , Descolamento Retiniano/etiologia , Descolamento Retiniano/diagnóstico por imagem , Descolamento Retiniano/diagnóstico , Idoso de 80 Anos ou mais , Pan-Uveíte/diagnóstico , Pan-Uveíte/etiologia , Pan-Uveíte/complicações , Prednisolona/administração & dosagem , Resultado do Tratamento , Angiofluoresceinografia/métodos , Corioide/diagnóstico por imagem , Corioide/patologia , Doenças da Coroide/etiologia , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/diagnóstico , Doenças da Coroide/complicações
7.
BMC Ophthalmol ; 24(1): 199, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38671442

RESUMO

BACKGROUND: Although choroidal thickening was reported as a sign of active inflammation in ocular sarcoidosis, there has been no research on the choroidal changes in non-ocular sarcoidosis (defined as systemic sarcoidosis without overt clinical signs of ocular involvement). Therefore, this study aimed to investigate choroidal structural changes in patients with non-ocular sarcoidosis. METHODS: This retrospective case-control study was conducted at Asan Medical Center, a tertiary referral center. We evaluated 30 eyes with non-ocular sarcoidosis and their age- and spherical equivalent-matched healthy control eyes. The subfoveal choroidal thickness, area ratio (Sattler layer-choriocapillaris complex [SLCC] area to Haller layer [HL] area), and choroidal vascularity index (CVI, luminal area to choroidal area) were analyzed using enhanced depth imaging in optical coherence tomography. Systemic and ocular factors associated with the choroidal thickness were investigated. RESULTS: Compared with the healthy control group, the non-ocular sarcoidosis group had significantly thicker subfoveal choroid (total and all sublayers [SLCC and HL]) and lower area ratio. There were no significant differences in the CVIs at all sublayers between groups. In the non-ocular sarcoidosis group, eyes under oral steroid treatment had thinner choroid than eyes under observation. In the control group, eyes with older age and more myopic spherical equivalent had thinner choroidal thickness. CONCLUSION: Total and all sublayers of the subfoveal choroid were significantly thicker without significant vascularity changes in non-ocular sarcoidosis eyes than in healthy control eyes. The degree of choroidal thickening was disproportionally greater at HL than at SLCC. These characteristic choroidal changes may be the subclinical manifestations in non-ocular sarcoidosis.


Assuntos
Doenças da Coroide , Corioide , Sarcoidose , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Masculino , Feminino , Sarcoidose/diagnóstico , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Pessoa de Meia-Idade , Corioide/patologia , Corioide/diagnóstico por imagem , Corioide/irrigação sanguínea , Estudos de Casos e Controles , Doenças da Coroide/diagnóstico , Doenças da Coroide/etiologia , Doenças da Coroide/diagnóstico por imagem , Adulto , Idoso , Acuidade Visual
8.
Jpn J Ophthalmol ; 68(3): 211-215, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38609716

RESUMO

PURPOSE: To investigate the association between the arm-to-choroidal circulation time (ACT) on indocyanine green angiography (IA) and clinical profile in patients with polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Single-center retrospective study. METHODS: We included 38 eyes of 38 patients with PCV diagnosed using multimodal imaging and did not undergo previous treatment. All patients were treated with monthly aflibercept injections for 3 months and treat-and-extend regimens for the subsequent 12 months. Posterior vortex vein ACT was assessed on the first visit using Heidelberg IA. The patients were divided into two groups: ACT ≥20 s (L group; eight eyes) and ACT <20 s (S group; 30 eyes). The clinical profiles before and after treatment were analyzed to assess associations with ACT. RESULTS: The mean ACT was 16.39±3.3 s (L group: 21.25±1.49 s, women:men=2:6, mean age: 77.3±6.5 years; S group: 15.10±2.17 s, women:men=7:23, mean age: 75.5±6.9 years). No significant difference was observed in the mean subfoveal choroidal thickness between the L and the S groups (176±75 µm vs. 230±79 µm, P=0.10). However, there were significant differences between the L and S groups in retinal fluid accumulation and hemorrhage recurrence (eight/eight eyes, 100% vs. 13/30 eyes, 43%, P<0.001), mean aflibercept injections (8.8±1.6 vs. 7.0±1.6, P<0.01) during the 12-month period, and the number of polypoidal lesions (1.8±0.7 vs. 1.3±0.5, P<0.05). CONCLUSION: Patients with PCV and ACT >20 s are more likely to experience exudative change recurrence in the retina during treatment because they have more polypoidal lesions.


Assuntos
Corioide , Angiofluoresceinografia , Fundo de Olho , Injeções Intravítreas , Pólipos , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Feminino , Masculino , Estudos Retrospectivos , Corioide/irrigação sanguínea , Corioide/diagnóstico por imagem , Idoso , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , Pólipos/diagnóstico , Pólipos/tratamento farmacológico , Pólipos/fisiopatologia , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Proteínas Recombinantes de Fusão/uso terapêutico , Verde de Indocianina/administração & dosagem , Seguimentos , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/fisiopatologia , Corantes/administração & dosagem , Idoso de 80 Anos ou mais , Doenças da Coroide/diagnóstico , Doenças da Coroide/tratamento farmacológico , Doenças da Coroide/fisiopatologia , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/uso terapêutico , Fluxo Sanguíneo Regional/fisiologia , Imagem Multimodal , Velocidade do Fluxo Sanguíneo/fisiologia , Vasculopatia Polipoidal da Coroide
10.
Korean J Ophthalmol ; 38(3): 185-193, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38584441

RESUMO

PURPOSE: To evaluate the efficacy of intravitreal brolucizumab in polyp regression of treatment-naive polypoidal choroidal vasculopathy (PCV) patients and its effect on 1-year treatment outcome. METHODS: Medical records of 31 treatment-naive PCV patients, who received three monthly intravitreal brolucizumab injections followed by as-needed injections for at least a year, were retrospectively reviewed. Visual and anatomical outcomes were evaluated at 3, 6, and 12 months. Complete polyp regression rate and percentage change of vascular lesion and polyp area were evaluated after three monthly injections of brolucizumab. The effect of complete polyp regression and the impact of vascular lesion and polyp reduction rate on 1-year treatment outcome were also evaluated. RESULTS: In terms of visual outcome, best-corrected visual acuity significantly improved after 12-month follow-up (p < 0.001). In terms of anatomical outcome, central macular thickness (CMT) and central choroidal thickness significantly decreased after 12-month follow-up (p < 0.001). Complete polyp regression was observed in 23 patients (74.2%) after three monthly injections. Group with complete polyp regression had a higher rate of achieving dry macula at 3 months (p = 0.026) and fewer number of injections (p < 0.001) compared to the group without complete polyp regression. Higher polyp reduction rate was significantly associated with higher CMT change from baseline at 3 months (p = 0.048) while higher vascular lesion reduction rate was significantly associated with higher CMT change from baseline at 12 months (p = 0.031) and fewer number of injections (p = 0.012). CONCLUSIONS: Intravitreal brolucizumab injection effectively improved visual and anatomical outcomes and achieved significant polyp regression in treatment-naive PCV patients. Complete polyp regression and the reduction rate of vascular lesion size and polyp size after loading injection significantly influence the treatment outcome of PCV patients. However, careful monitoring and preoperative warning is warranted due to occurrence of brolucizumab-related IOI.


Assuntos
Inibidores da Angiogênese , Anticorpos Monoclonais Humanizados , Corioide , Angiofluoresceinografia , Injeções Intravítreas , Pólipos , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pólipos/tratamento farmacológico , Pólipos/diagnóstico , Angiofluoresceinografia/métodos , Inibidores da Angiogênese/administração & dosagem , Idoso , Tomografia de Coerência Óptica/métodos , Corioide/irrigação sanguínea , Corioide/patologia , Resultado do Tratamento , Seguimentos , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Pessoa de Meia-Idade , Fundo de Olho , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/fisiopatologia , Fatores de Tempo , Doenças da Coroide/tratamento farmacológico , Doenças da Coroide/diagnóstico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Vasculopatia Polipoidal da Coroide
11.
Indian J Ophthalmol ; 72(7): 956-961, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38622849

RESUMO

This study aims to investigate the relationship between pachychoroid spectrum disorders and retinitis pigmentosa (RP) or rod-cone dystrophy through a comprehensive literature review. The purpose is to explore the association between these disorders, understand their underlying mechanisms, and summarize the existing hypotheses and opinions. A thorough review of the literature was conducted using PubMed, focusing on articles related to central serous chorioretinopathy (CSC), RP, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy, focal choroidal excavation, peripapillary pachychoroid neovasculopathy, and peripheral exudative hemorrhagic chorioretinopathy. Relevant studies were selected for a detailed narrative review and analysis. Several studies have reported the coexistence of CSC and RP, indicating a potential association between the two conditions. The dysfunction of the retinal pigment epithelium is proposed as a common factor. Choroidal thinning is observed in RP, but conflicting results exist regarding choroidal thickness (CT). While some studies support choroidal thinning in RP, others suggest preserved or increased thickness. Additionally, cases of pachychoroid neovasculopathy and polypoidal choroidal vasculopathy in RP have been reported, suggesting an overlap between these conditions. The literature suggests conflicting reports on CT changes in RP. Future research should focus on large-scale studies using comprehensive imaging techniques, genetic analysis, and long-term follow-up to uncover the underlying mechanisms and determine the prevalence of pachychoroid spectrum disorders in RP patients.


Assuntos
Corioide , Angiofluoresceinografia , Fundo de Olho , Retinose Pigmentar , Tomografia de Coerência Óptica , Humanos , Retinose Pigmentar/diagnóstico , Tomografia de Coerência Óptica/métodos , Angiofluoresceinografia/métodos , Corioide/irrigação sanguínea , Corioide/patologia , Corioide/diagnóstico por imagem , Doenças da Coroide/diagnóstico , Epitélio Pigmentado da Retina/patologia , Coriorretinopatia Serosa Central/diagnóstico , Acuidade Visual
12.
BMC Ophthalmol ; 24(1): 147, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38566166

RESUMO

PURPOSE: This study aims to present long-term observation of 5 eyes with focal choroidal excavation (FCE), focusing on morphological changes in conformity of the lesion. METHODS: A retrospective case series was conducted, including 5 eyes of 5 patients with FCE. The study utilized multimodal imaging including color fundus photography, optical coherence tomography (OCT), enhanced depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA), fundus autofluorescence (FAF), red free imaging, and OCT angiography. RESULTS: The mean age at diagnosis was 51 ± 10.65 years, with a mean follow-up period 37 ± 13.59 months. All cases were unilateral, with 1 presenting FCE as an isolated lesion, and one patient exhibiting 2 FCEs in one eye. The mean choroidal thickness measured by EDI-OCT was 268.2 ± 63.39 µm in the affected eye. One patient displayed choroidal thickening and pachyvessels. Of the 5 eyes, one had conforming and 4 non-conforming FCE. We observed a conversion in conformity in all patients, with 4 cases transitioning from non-conforming FCE to conforming type (3 spontaneously, 1 treatment-induced). In conforming FCE, a hyporeflective space appeared twice between neuroretina and retinal pigment epithelium with spontaneous regression. CONCLUSION: We observed change in shape from the conforming to non-conforming FCE and vice versa in all patients. We consider this small change in the hyporeflective space as non-pathologic and clinically insignificant.


Assuntos
Coriorretinopatia Serosa Central , Doenças da Coroide , Humanos , Adulto , Pessoa de Meia-Idade , Doenças da Coroide/diagnóstico por imagem , Doenças da Coroide/patologia , Seguimentos , Estudos Retrospectivos , Coriorretinopatia Serosa Central/patologia , Corioide/patologia , Tomografia de Coerência Óptica/métodos , Angiofluoresceinografia/métodos
14.
Zhonghua Yan Ke Za Zhi ; 60(7): 618-622, 2024 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-38462951

RESUMO

A 65-year-old man presented with decreased visual acuity in the left eye for 1 month. The diagnosis of hemorrhagic retinal detachment (submacular hemorrhage), which was caused by idiopathic polypoid choroidal vasculopathy, was confirmed by the ultra-wide-angle fundus examination, optical coherence tomography, and B-ultrasound. A vitrectomy combined with an ophthalmic surgical robot-assisted retinal puncture and injection was performed. The recombinant tissue plasminogen activator was injected accurately by the ophthalmic surgical robot between the retinal nerve epithelium and retinal pigment epithelium through a micro-injection needle. During the 2-month follow-up, the subretinal hemorrhage was significantly regressive, the visual acuity of the left eye was improved from hand movement to 0.1, and no other complications were observed. (This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on March 15, 2024).


Assuntos
Doenças da Coroide , Hemorragia Retiniana , Humanos , Masculino , Idoso , Hemorragia Retiniana/etiologia , Doenças da Coroide/etiologia , Vitrectomia/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Ativador de Plasminogênio Tecidual/administração & dosagem , Corioide , Acuidade Visual , Punções , Procedimentos Cirúrgicos Robóticos/métodos , Descolamento Retiniano/etiologia , Retina , Tomografia de Coerência Óptica
16.
Transl Vis Sci Technol ; 13(2): 13, 2024 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-38376864

RESUMO

Purpose: Chorioretinal atrophy growth after voretigene neparvovec has been reported recently with its positive correlation with successful treatment. This finding raised the question on long-term effects and the etiology of the chorioretinal atrophy. Methods: Using local retinal functional diagnostics, we tested whether the atrophy growth is connected to the initial local functional improvement after the therapy. Results: The results describe factors predicting the development of atrophy. First, the atrophy emerges after approximately 3 months in an area with local functional rescue before. The areas of the greatest gain in the number of functionally rescued rods are prone to be the initial spots of atrophy growth in almost one-half of the cases and the retinotopy corresponds with the area of a high number of post-treatment functioning rods. Second, the dark-adapted perimetry shows that the atrophy growth is in the area with functioning rescued rods. However, the rods with the greatest sensitivity gain are not the parts of the growing atrophy in the first 2 years after intervention. This preservation of rods with the greatest sensitivity seems to explain the excellent profile of rods rescue over the long term measured by full-field stimulus threshold and reported earlier. Conclusions: A disbalance between the increase of functional rods and their threshold shortly after treatment could be an indicator for a metabolic origin of chorioretinal atrophy after voretigene neparvovec. Translational Relevance: A basic understanding of the photoreceptor rescue aspects after gene therapy can demonstrate a metabolic causal influence of the efficacy on the development of side effects, such as chorioretinal atrophy.


Assuntos
Doenças da Coroide , Retina , Humanos , Atrofia/genética , Terapia Genética
17.
Arch Soc Esp Oftalmol (Engl Ed) ; 99(5): 213-217, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38342228

RESUMO

We present a case report on sclerochoroidal calcification (SCC), a rare condition involving calcium pyrophosphate deposits in the posterior pole of the eye in a 70-year-old patient. We provide an account of the clinical presentation and its appearance in multimodal images, using color fundus photography, swept-source optical coherence tomography (SS-OCT), ocular ultrasound, and the novel retro-mode imaging (RMI) technique. Visual acuity was 20/25 in the right eye (OD) and 20/20 in the left eye (OS). Color fundus photography revealed yellowish deposits located in the upper temporal arcade of both eyes. SS-OCT demonstrated masses of scleral origin. Ocular ultrasounds confirmed the calcification of these masses. RMI detected hyper-reflective images with marked superficial elevation. Systemic laboratory results did not detect any abnormalities, leading to the diagnosis of bilateral idiopathic SCC.


Assuntos
Calcinose , Doenças da Coroide , Imagem Multimodal , Doenças da Esclera , Tomografia de Coerência Óptica , Humanos , Idoso , Doenças da Esclera/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Masculino , Ultrassonografia
18.
Retina ; 44(6): 1083-1091, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38308567

RESUMO

PURPOSE: To investigate the imaging and clinical features of polypoidal choroidal vasculopathy (PCV) with pulsation. METHODS: The PCV eyes were classified into pulsatile and nonpulsatile PCV groups according to the pulsation on indocyanine green angiography. Imaging features including the dye filling time of the polyp and clinical features were compared. RESULTS: A total of 75 eyes were classified into the pulsatile PCV (30 eyes) and the nonpulsatile PCV (45 eyes) groups. The initial filling time and complete filling time of the polyp of the pulsatile PCV group (2.59 ± 0.93 and 8.33 ± 3.42 seconds) were shorter than those of the nonpulsatile PCV group (4.11 ± 1.87 and 10.63 ± 3.81 seconds, P < 0.001 and P = 0.010, respectively). The pigment epithelial detachment height of the pulsatile PCV group (414.90 ± 377.15 µ m) was greater than that of the nonpulsatile PCV group (247.81 ± 164.07 µ m, P = 0.030). The pulsatile PCV group showed a higher prevalence of subretinal hemorrhage (43.33%) after intravitreal injection than the nonpulsatile PCV group (13.95%, P = 0.005) during 12 months. The mean number of injections during 12 months of the pulsatile PCV group (5.48 ± 1.46) was greater than that of the nonpulsatile PCV group (4.09 ± 1.21, P < 0.001). CONCLUSION: Eyes with pulsatile PCV showed shorter filling time of the polyp, greater pigment epithelial detachment height, higher prevalence of subretinal hemorrhage, and more intravitreal injection numbers during 12 months. These might suggest that PCV has distinct imaging and clinical features according to the polyp pulsation.


Assuntos
Corioide , Angiofluoresceinografia , Pólipos , Tomografia de Coerência Óptica , Humanos , Feminino , Angiofluoresceinografia/métodos , Masculino , Idoso , Pólipos/diagnóstico , Pólipos/fisiopatologia , Corioide/irrigação sanguínea , Tomografia de Coerência Óptica/métodos , Estudos Retrospectivos , Pessoa de Meia-Idade , Acuidade Visual/fisiologia , Fundo de Olho , Verde de Indocianina/administração & dosagem , Corantes/administração & dosagem , Doenças da Coroide/diagnóstico , Doenças da Coroide/fisiopatologia , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/fisiopatologia , Neovascularização de Coroide/tratamento farmacológico , Idoso de 80 Anos ou mais , Injeções Intravítreas , Vasculopatia Polipoidal da Coroide
19.
Ophthalmic Surg Lasers Imaging Retina ; 55(4): 231-234, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38319058

RESUMO

A 50-year-old woman had visual disturbance in her left eye. Optical coherence tomography (OCT) revealed an epiretinal membrane (ERM) and a giant peripapillary intrachoroidal cavitation (ICC). Best-corrected visual acuity (BCVA) was 15/50 in the left eye with central visual field (VF) impairment. We performed vitrectomy with internal limiting membrane "stuffing" into the sinkhole, as well as peeling of the ERM. One year after surgery, even though ocular blood flow had decreased and the VF impairment had worsened, OCT demonstrated that the ICC had completely disappeared, and BCVA had improved to 25/50. Although this technique can increase BCVA, the potential surgical risk of exacerbating VF impairment calls for careful consideration on a case-by-case basis. [Ophthalmic Surg Lasers Imaging Retina 2024;55:231-234.].


Assuntos
Membrana Epirretiniana , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia , Humanos , Feminino , Pessoa de Meia-Idade , Vitrectomia/métodos , Tomografia de Coerência Óptica/métodos , Membrana Epirretiniana/cirurgia , Membrana Epirretiniana/diagnóstico , Doenças da Coroide/diagnóstico , Doenças da Coroide/cirurgia
20.
Ophthalmol Retina ; 8(7): 710-722, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38302056

RESUMO

PURPOSE: To evaluate the imaging and clinical features of unusual calcified lesions seen in the fundus of patients with mosaic RASopathy. DESIGN: Single-center retrospective observational study. SUBJECTS: Ten eyes with calcified fundus lesions in 7 patients with mosaic RASopathy. METHODS: The lesions were evaluated with fundus photography, oral fundus fluorescein angiography, B-scan ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT) scan where available. MAIN OUTCOME MEASURES: The imaging characteristics of calcified fundus lesions were assessed. RESULTS: We found 7 patients with mosaic RASopathies, 5 men and 2 women (3 with linear sebaceous nevus syndrome, 3 with oculoectodermal syndrome, and 1 with encephalocraniocutaneous lipomatosis) with molecular confirmation in 5 cases, all 5 having KRAS-pathogenic variants. Calcified fundus lesions were identified in 10 eyes (bilateral in 3 patients), appearing as slightly elevated, creamy-yellow lesions around or adjacent to the optic nerve, extending supero-nasally; all but 2 of these lesions involved both the choroid and sclera, with 2 of them only involving the sclera at the time of examination. One case developed a choroidal neovascular membrane necessitating intravitreal bevacizumab injections. All 7 patients had B-scan ultrasonography, and the lesion appeared as a hyperechogenic area with an acoustic shadow posteriorly despite reduced gain. Five patients had MRI, and where fundus lesions were present, there was a focal defect in the sclero-choroidal layer. Four patients had a CT scan, and all 4 showed calcifications affecting both the posteromedial sclero-choroid and adjacent medial rectus muscle. Two of these patients had normal eye movements, 1 had a unilateral fixed adducted eye and a vestigial fibrous medial rectus muscle seen in imaging and intraoperatively, and the fourth had marked exotropia with a right gaze deficit affecting both eyes. CONCLUSIONS: We propose that the lesions seen in this cohort are calcified sclero-choroidal choristomas and should be suspected in mosaic RASopathies when creamy-yellow lesions are seen in the fundus. If identified, the possibility of choroidal neovascularization should be considered during follow-up. In all cases where a CT scan was performed, a novel sign of sclero-muscular calcification involving the medial rectus muscle was seen. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.


Assuntos
Calcinose , Coristoma , Angiofluoresceinografia , Imageamento por Ressonância Magnética , Doenças da Esclera , Humanos , Masculino , Feminino , Estudos Retrospectivos , Calcinose/diagnóstico , Calcinose/diagnóstico por imagem , Angiofluoresceinografia/métodos , Imageamento por Ressonância Magnética/métodos , Doenças da Esclera/diagnóstico , Coristoma/diagnóstico , Adulto , Síndromes Neurocutâneas/diagnóstico , Adolescente , Criança , Fundo de Olho , Tomografia Computadorizada por Raios X , Adulto Jovem , Nevo Sebáceo de Jadassohn/diagnóstico , Doenças da Coroide/diagnóstico , Corioide/patologia , Corioide/diagnóstico por imagem , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/genética , Displasia Ectodérmica/complicações , Pré-Escolar , Lipomatose/diagnóstico , Oftalmopatias
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