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Biomedical subjects

A Pece

Publications and source records attributed to A Pece.

At least 37 records · Page 2Linked to original sources

Hypertensive choroidopathy: a case report.

The authors report a case of exudative retinal detachment of the posterior pole and peripheral choroidal detachment in a patient with renovascular accelerated hypertension. The peculiar clinical situation of this patient was comparable with experimental models of hypertension recently reported in the literature. Both the retinal and the choroidal detachment regressed after blood pressure stabilization with systemic antihypertensive therapy, supporting a choroidal pathogenesis for the chorioretinal lesions.

Aged↗

Electroretinographic findings in panretinal photocoagulation for diabetic retinopathy. A randomized study with blue-green argon and red krypton lasers.

A total of 16 patients (16 eyes) with type II diabetes mellitus and proliferative retinopathy were studied electroretinographically before panretinal photocoagulation, during intervals between the treatment sittings, within 36 h of the final treatment and 4 months after its conclusion. Treatments were carried out with blue-green argon (eight eyes) and red krypton (eight eyes) lasers; the type of laser was randomly chosen. The analysis of the results obtained showed a significant and marked reduction in peak amplitudes of both a- and b-waves in photopic and dark-adapted conditions as early as between the multiple treatments. Electroretinograph (ERG) tracks did not change significantly at subsequent checks. Amplitude reductions were higher for scotopic b-waves and in eyes that had the less altered baseline tracks. Implicit times did not change significantly. The type of laser used did not significantly influence ERG evolution.

Aged↗

Photocoagulation scar expansion after laser therapy for choroidal neovascularization in degenerative myopia.

The authors performed a prospective study of 36 eyes affected by pathologic myopia with macular subretinal neovascularization (SRNV) successfully treated with either argon green, dye orange (590 nm), or krypton red lasers. Re-treated eyes were excluded. Evolution of the laser scar was carefully monitored for 12 months. Scar expansion was noted in 35 cases (97%), without a significant loss of visual acuity during the first year after treatment. The scar enlarged more conspicuously during the first 3 months after photocoagulation, with a mean increase of 103% in the first year. Expansion was not related to laser wavelength, patient age, SRNV size, or degree of myopia. Scar enlargement was greatest in the same direction as that of maximal extension of the myopic peripapillary crescent; inspection of the morphologic configuration of the peripapillary crescent before laser treatment may be helpful in evaluating the potential risk of post-laser scar expansion toward the fovea.

Adult↗

[Degenerative myopia: recurrence of subretinal neovessels after laser photocoagulation].

Macular subretinal neovascularization is one of the most important causes of impaired vision in eyes affected by pathologic myopia. Results of studies concerning the natural history of subretinal neovascularization are inconclusive and contradictory. Like in other macular degenerations, laser photocoagulation could be useful in treating neovascular membranes. Available results indicate that laser treatment can reduce the risk of severe visual loss. However recurrent neovascularization may complicate laser treatment with further visual loss. The authors have reviewed the records of 98 eyes affected by pathologic myopia (axial length à 26.5 mm) and macular subretinal neovascularization that underwent laser photocoagulation. 41 eyes (42%) developed one or more recurrences during a 12 months follow-up period. No relationship was found between sex, age, axial length, distance from the center of the foveal avascular zone or size of neovascular membrane, and recurrence rate. Eyes that experienced recurrences had a final visual acuity significantly worse than the others (p = 0.02). 65% of recurrences was observed in the first 3 months after treatment. 67% of such neovascularizations was located at the foveal side of the laser scar. These data underscore the necessity for close, careful follow-up of all patients who have undergone treatment of a subretinal neovascularization.

Adult↗

[Laser treatment of macular subretinal neovascularization in angioid streaks].

The authors examined 17 eyes with macular subretinal neovascularization in angioid streaks treated by direct laser photocoagulation. Two eyes were treated with dye laser (590 nm), two with blue-green argon, three with green argon and ten with red krypton laser. At twelve-month follow-up, the visual acuity was of 0.21, a statistically significant decrease respect to the presenting vision. Poor functional results are due to the frequent recurrences of neovascularization.

Adult↗

[Laser treatment of subretinal macular neovascularization in pathologic myopia].

The authors evaluated retrospectively 100 eyes with pathological myopia and a macular subretinal neovascular membranes (SRNV) which was treated with direct laser photocoagulation. Argon green, krypton red and orange dye (590 nm) laser were used to treat, respectively, 19, 63 and 18 eyes. The follow-up period was of 12 months. Mean initial visual acuity was 0.33 and mean final visual acuity was 0.31, with no statistically significative difference between them. One or more recurrence was observed in 44% of the eyes. Recurrences could be treated in 80% of cases. At the end of the follow-up period SRNV had disappeared in 83 eyes and extended into the foveola in the remaining 17.

Adult↗

Dye laser photocoagulation of macular subretinal neovascularization in pathological myopia. A randomized study of three different wavelengths.

The authors present a randomized study of 27 eyes affected by pathological myopia with macular subretinal neovascularization which were treated with a tunable dye laser. The effectiveness of three different wavelengths (577, 590 and 620 nm) in the direct treatment of subretinal neovascularizations was evaluated in 3 groups of 9 patients each. Statistical analysis of both visual and anatomical results did not show significant differences among the three wavelengths used.

Adult↗

Enucleation after argon laser photocoagulation for choroidal melanoma.

We report the case of a choroidal melanoma 3 disc-diameter in size and 1 mm in thickness located superiorly at 2 disc-diameters from the optic disc. Argon laser photocoagulation was done in 1977. No recurrence was observed for eight years. In 1985, the melanoma suddenly reappeared, invading the posterior pole and causing secondary retinal detachment. The histologic examination after enucleation revealed a spindle-cell melanoma. Considering the fluorescein angiographic findings, we question the effectiveness of argon laser photocoagulation of choroidal melanoma.

Argon↗

Eight-year follow-up of central serous chorioretinopathy with and without laser treatment.

A long-term retrospective study was conducted on two groups of patients affected with typical central serous chorioretinopathy (CSCR). One group was not treated and the other was treated by direct argon laser photocoagulation. CSCR shows a long-term good prognosis of visual acuity. The visual acuity of laser-treated eyes improves significantly (P less than or equal to 0.05), particularly in single focus cases (P less than or equal to 0.01). Unfortunately, these results cannot be statistically compared to the natural course of the non-treated patients because of the initial inhomogeneity of the two groups. Laser treatment did not produce any long-term complications. The recurrence rate in treated and untreated eyes was similar.

Adult↗

Laser treatment of macular subretinal neovascularizations in angioid streaks.

A serous hemorrhagic maculopathy with a subretinal neovascular membrane appears in about 70% of cases of angioid streaks. In this study a series of 60 eyes (31 patients) was reviewed. In 13 eyes macular subretinal neovascularizations were photocoagulated with blue-green argon laser, green argon laser, dye laser (rhodamine 6G) at 590 nm and red krypton laser. The authors present and discuss the results obtained and suggest that photocoagulation of subretinal new vessels not involving the fovea can be worth performing.

Adolescent↗

[Hyperplastic primary vitreous with persistent hyaloid artery in 2 non-twin brothers].

The authors describe the case of two brothers afflicted with persistent anterior hyperplasic primary vitreous and hyaloid artery. The occurrence of combination in two members of the same family is unusual, also moreover one of the patients was affected by macular retinoschisis. The two cases were clinically different; the first was typical, complicated by cataract; the second presented alterations mostly located in the posterior vitreous. In one eye fluorescein angiography showed a very slow and delayed filling of the hyaloid artery. Blood flow was directed from its anterior portion towards the optic disk. Nd: YAG laser photoresection of the hyaloid artery, performed in order to obtain a better visualization of the macula did not lead to remarkable hemorrhages. In an other eye fluorescein angiography could be performed after Nd: YAG laser photoresection of a vitreous membrane located in front of the posterior pole: remnants of the hyaloid vascular system with retrograde blood filling were present also in this case. The mechanisms leading to this reverse filling of the vessels are discussed.

Adult↗

[Idiopathic macular retinoschisis in the young subject associated with preretinal and prepapillary neovessels].

Idiopathic juvenile retinoschisis is a sex-linked disease, which generally involves the macula and the retinal periphery in 50% of cases. The authors report a case of juvenile retinoschisis in which the central schisis was associated with wide non-perfused retinal areas causing the growth of retinal and epipapillary neovascularizations in one eye. The new vessels produced an intravitreal hemorrhage. The arising of non-perfused retinal areas is probably determined by capillary insufficiency secondary to the alteration of its vascular trophism due to the retinal detachment. This may cause a break of the blood-retinal barrier with subsequent capillary occlusions. We performed laser photocoagulation of the non-perfused areas, and complete regression of the neovascularization was obtained.

Child↗

Evaluation of fixation one year after perifoveal laser treatment of subfoveal choroidal neovascularization.

The natural prognosis of subfoveal neovascularization is severe visual acuity loss. Perifoveal laser photocoagulation is meant to spare a small portion of the central retina so as to possibly preserve foveal fixation. The aim of this retrospective study was to detect the persistence of central fixation and to evaluate the visual function of patients who had undergone perifoveal laser photocoagulation one year before, due to the presence of age-related macular degeneration with subfoveal neovascularization. The visual function was assessed by means of visual acuity (VA) measurement, central perimetry, scanning laser ophthalmoscope (SLO) scotometry and capability of using low-vision aids with success. Twelve eyes of 12 patients, 5 males and 7 females, with mean age 72.6 +/- 9.62 years, were included in the Study Group. Mean VA was 0.22 +/- 0.089 before laser treatment, 0.17 +/- 0.054 one week after laser treatment (p = 0.0152) and 0.13 +/- 0.063 one year after laser treatment (p = 0.045), with a statistically significant reduction of VA overtime (initial-final p = 0.0015). Mean lesion size was 2.12 +/- 0.528 disc diameters on the last follow-up fluorescein angiogram. One year after laser treatment, perimetry showed the persistence of central fixation in 2 eyes, while 10 eyes seemed to have lost it. SLO scotometry revealed central dot stimulus perception in 6 eyes and no central residual in 6 eyes. The SLO fixation plot showed persistence of central fixation also in 1 eye in which static perimetry had not detected it. The preferential retinal locus was located on the upper or upper-right margin of the lesion in 8 of the 9 eyes with paracentral fixation. All patients achieved a useful reading VA using low-vision aids, with 7.16 +/- 6.1 mean magnification power. The eyes with central visual residual on SLO scotometry had a final VA slightly higher than those without central residuals (VA 0.158 +/- 0.03 and 0.098 +/- 0.07, respectively), though the difference was not statistically significant (p = 0.0977).

Aged↗

Indocyanine green angiography in the juvenile haemorrhagic choroidopathy.

Juvenile haemorrhagic choroidopathy (JHC) is an idiopathic syndrome marked by macular choroidal neovascularization (CNV) in patients under the age of 50. We used fluorescein angiography (FA) and indocyanine green angiography (ICGA) to examine 17 patients with macular CNV and JHC. CNV was always unilateral. On ICGA examination the CNV were weakly fluorescent in 59% of cases, hyperfluorescent in the remaining 41%. ICGA showed up the following alterations: a) areas with diffuse choroidal hyperfluorescence at the posterior pole or in the peripapillary region in 11 affected eyes (65%), in the fellow eye too in 5 patients; b) areas of choroidal hypofluorescence at the posterior pole but also outside the vascular arcades in 2 affected eyes (12%). In conclusion, ICGA does not appear indispensable for detecting CNV in JHC but this method does show up diffuse choroidal alterations not detectable with FA. The pathogenetic implications of the ICGA findings are discussed.

Adolescent↗

Updating on intraoperative light-induced retinal injury.

We are presenting the state of knowledge concerning intraoperative light-induced retinal injury, considered to be a combination of photic retinopathy and retinal photocoagulation. It may arise from retinal light exposure to the operating microscope or to the fiberoptic endoilluminator. Ultraviolet and short-wavelength visible light are more dangerous than longer wavelength light. Many risk factors may facilitate the onset of this iatrogenic disease following surgery. Many aspects of the retinal damage are still poorly understood. Many mid light-induced retinal injuries probably remain undiagnosed in routine postoperative examination. Current appropriate light filters are not the definitive solution. Appropriate precautions should be taken during both anterior segment and vitreoretinal surgery.

Aged↗