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H Niederberger

Publications and source records attributed to H Niederberger.

9 recordsLinked to original sources
PubMed2006

Photodynamic therapy in the treatment of chronic central serous chorioretinopathy.

BACKGROUND: Central serous chorioretinopathy (CSC) is usually a benign disorder which resolves spontaneously, and requires no treatment. Nevertheless, in cases of chronic or recurrent detachment of the neurosensory retina a durable decrease of the visual acuity may be measured due to lesion of the photoreceptors. To avoid this evolution we performed a pilot study to assess the effect of photodynamic therapy (PDT) in patients with CSC without clinical normalization 6 months after the begin of the symptoms. PATIENTS AND METHODS: We report on 14 eyes in 13 patients presenting a chronic CSC without leaking point accessible for focal laser photocoagulation. The diagnosis was confirmed by fluorescein angiography (FA), and optical coherence tomography (OCT). PDT with verteporfin was performed according to the protocol used for treating choroidal neovascularization in age-related macular degeneration. RESULTS: One month after PDT, leakage on FA and detachment of the neurosensory retina on OCT had disappeared, and visual acuity had improved in all patients. CONCLUSIONS: The mechanism of action of PDT in chronic CSC is still hypothetical. PDT should decrease the passage of fluid towards the retina by affecting the choroidal blood flow, and allow a better resorption of the subretinal fluid. PDT could be an alternative to treat patients with chronic CSC.

Adult↗
PubMed2005

Simultaneous fluorescein and indocyanine green angiography for exudative macular degeneration.

BACKGROUND: The present study investigates how often a simultaneous fluorescein and indocyanine green (ICG) angiography had therapeutic consequences and if it is useful as a clinical routine diagnostic tool. PATIENTS AND METHODS: 502 consecutive simultaneous angiographies in eyes with exudative macular degeneration were retrospectively studied. RESULTS: A classic extra- or juxtafoveolar choroidal neovascularisation (CNV) was found in 3.5 % of the eyes. A subfoveal predominantly classic CNV was present in 19 % of the angiographies. ICG angiography showed a vascular network in 3 % of the eyes with occult CNV in fluorescein angiography. A neovascularisation supplied by retinal vessels (retinal angiomatous proliferation) was found in 9 % and a polypoidal choroidal vasculopathy (PCV) in 6 %. Other plaques or hot spots were visible in 4 %. In 11 eyes with progressive exudation from PCV and threatening of the fovea, laser treatment was successfully performed. CONCLUSIONS: Combined angiography identifies treatable PCV. Advantages of a combined procedure (easier logistics, no missing of treatable cases) and arguments for a two step procedure with ICG angiography only in selected cases (lower costs, lower rate of adverse reactions) must be weighed against each other.

Adult↗
PubMed2000

[Simultaneous ICG- and fluorescein-angiography for fundus examination].

BACKGROUND: An indocyanine-green (ICG) angiography is rarely used as the only diagnostic procedure. Almost always it is performed additionally to a fluorescein angiography. The use of simultaneous ICG and fluorescein (SIF) angiography therefore makes sense. Several examples for the application of SIF-angiography are presented. MATERIALS AND METHODS: SIF-angiography was performed using a 2-wavelength scanning laser ophthalmoscope (SLO). Images were digitally recorded in real time with a graphics workstation. The following cases will be presented: choroidal neovascularization in age-related macular degeneration, choroidal hemangioma, inflammatory fundus disease (APMPPE) and idiopathic polypoidal choroidal vasculopathy. RESULTS: ICG and fluorescein angiography can be simultaneously recorded with the 2-wavelenghth SLO. The quality of the combined pictures is comparable to single-channel recordings of separate ICG and fluorescein images. We show results of the above mentioned cases. CONCLUSIONS: SIF angiography is time efficient and allows precise comparison and analysis of the transit of both dyes through retinal and choroidal circulation. The topographic relation of pathologic findings in ICG angiograms with the critical retinal vascular landmarks is facilitated.

Adult↗
PubMed1999

Indocyanine green versus fluorescein angiography in the differential diagnosis of arteritic and nonarteritic anterior ischemic optic neuropathy.

PURPOSE: We evaluated in a prospective study the usefulness of indocyanine green (ICG) versus fluorescein angiography in the differential diagnosis between arteritic and nonarteritic anterior ischemic optic neuropathy (AION). METHODS: Simultaneous ICG and fluorescein angiography was performed on 22 eyes with AION. Appearance of both dyes in the choroid and in the retina, laminar flow, venous filling, and complete filling of the choroid were measured independently. Massive delayed choroidal filling corresponding to occluded posterior ciliary arteries was especially assessed, as it is almost always diagnostic of arteritic AION. We considered the choroidal filling as massive delayed if it was still incomplete after the venous filling. RESULTS: We diagnosed 5 arteritic AIONs, confirmed by biopsy, and 17 nonarteritic AIONs. In both types of angiography, 3 of 5 patients with arteritic AION showed massive delayed complete choroidal filling times (44.2, 45.8, and 70 seconds), and patients with nonarteritic AION had normal complete choroidal filling times. Dye appearance at the different angiographic times was similar for fluorescein and ICG angiography (P = 0.95-0.96). CONCLUSION: Fluorescein angiography alone is sufficient to reveal massive delayed choroidal filling time in arteritic AION. For our purpose, ICG angiography provides no additional information.

Aged↗
PubMed1998

[Digital internet-based ophthalmologic image databank].

OBJECTIVE: To manage an ophthalmological image database easily and rationally. MATERIALS AND METHODS: Fundus, macro and simultaneously recorded Fluorescein and ICG angiography images were digitized and archived using personal computers and UNIX workstations. Image data were written to CD-recordables. The CD-s with image information were stored in a jukebox-server. On demand image information was converted to dynamic hypertext markup language (html) with a WWW-server. Information stored on the servers could be observed with browser programs running on client computers connected to local area network. The communication with ophthalmologist working outside our hospital was realized by electronic mail. RESULTS: Different platforms (PC, Mac, workstations, etc.) and operating systems (Windows 3.x, 95, NT, MacOS, UNIX, etc.) can be used as clients. The communication with the system is accomplished by standard internet programs (Internet Explorer, Netscape Navigator, etc.). Thanks to the intuitive graphical user interface, no special computer knowledge is required to retrieve the stored data. CONCLUSION: Our digital image database has many advantages over a conventional image archive: it is round the clock available, images can be stored and copied without loss of quality, digital images can be easily integrated in other applications, it can be used without special computer knowledge, it is expandable and compatible with all contemporary computer platforms.

Computer Communication Networks↗
PubMed1997

Low dose radiation for subfoveal choroidal neovascularization in age-related macular degeneration. A pilot study: radiotherapy for age-related macular degeneration.

The aim of our pilot study was to test the effect of low dose radiation on classic and occult subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). The posterior pole of the afflicted eye of 12 patients was irradiated with 5 Gray (Gy), and that of 34 patients with 8 Gy. The radiotherapy was done by a linear accelerator (6 MV X-rays) during 4 consecutive days with daily doses of 1.25 Gy and 2 Gy respectively. At the time of treatment, and 6 weeks, 6 months and 1 year after, a simultaneous fluorescein and ICG angiography of both eyes were carried out, and the distance visual acuity was measured. In none of the cases were we able to note a reduction in the subfoveal membrane's size. With regards to the visual acuity, the evolution was slightly better than the spontaneous courses described in existing literature. Further prospective randomized studies with higher dose radiation are necessary in order to determine the significance of radiotherapy in the treatment of this pathology.

Aged↗
PubMed1996

[Observations of choroid pulsation].

BACKGROUND: While performing indocyanine-green (ICG) videoangiograms with the Rodenstock scanning laser ophthalmoscope (SLO), we got more and more aware of visible choroidal pulsation mainly during the inflow of ICG into the eye. We wanted to learn more about the frequency and the different forms of this phenomenon. MATERIAL AND METHODS: We examined 187 consecutive ICG angiographies retrospectively, which were performed with a Rodenstock SLO and stored by videotape. Most patients suffered from age-related macular degeneration and had a mean age of about 70 years. We defined 4 groups of different pulsatile dye inflow in the choroid, namely (group 1) the diffuse form, involving the whole macular region; (group 2) the local form, involving an area smaller than the fovea. In group 3 (mixed form) we found the pulsatile inflow diffuse initially, later on remained a local pulsation. In group 4 (special form) we noticed a localized pulsation of a longer duration (10-15 seconds) and of a special type, namely back and forth movements of dye in one or a few choroidal veins. In addition, we examined the presence of pulsation in the central retinal vein. RESULTS: In 173 of 187 angiograms we could examine the choroidal inflow in the macular region. We found in 94 of these 173 angiograms (or in 54%) choroidal pulsation. 84% of all cases were in group 1, 2 and 3. This probably physiological pulsation occurred mostly in the first few seconds after the inflow of the dye. After about 5 seconds it was normally not visible any more. In our group 4 we collected 16 out of 94 angiograms (or 17%). We could not find a correlation between the presence of a pulsation in the central vein and in the choroid. CONCLUSIONS: Choroidal pulsatile inflow of ICG is a frequent (most probably physiological) phenomenon. The localized pulsation found in several older patients with back and forth movements of dye in one or a few veins may be abnormal; it reflects phasic pressure changes in choroidal veins of low flow. We do not know yet if this phenomenon is of any diagnostic value. However, more studies of these interesting dynamic processes seem to be warranted.

Adult↗
PubMed1996

[Simultaneous digital indocyanine green and fluorescein angiography].

BACKGROUND: The simultaneous recording of indocyanine green and fluorescein angiography is since more than twenty years possible. The real-time digital recording of angiograms is about since 10 years possible. Because of the poor temporal resolution due to technical limitations, both of the above methods were only seldom used routinely. Graphics workstations can digitize and store multiple video sources real-time with full video framerate. Comparing to conventional videoangiography, the quality can be improved significantly. MATERIALS AND METHODS: Simultaneous ICG and Fluorescein (SIF) angiography images of a two-channel Scanning Laser Ophthalmoscope were digitized and stored real-time at a rate of 28-50 images/sec using a graphics workstation. The digitized image sequence could be replayed as a motion picture and/or single images of the recorded sequence could be analyzed separately. RESULTS: The simultaneous digital recording of angiograms is easier, than using two video tape recorders. It was possible to enhance the quality of the stored images using standard digital image processing procedures. Morphological measurements and densitometry were done with software developed for the UNIX workstation, or with personal computers using standard software packages. CONCLUSION: Simultaneous digital ICG and fluorescein angiography has several advantages over conventional video-angiographies: the image quality is better, data retrieval is easier, it is easier to perform than conventional video angiography, image can be accessed through a computer network, it is easy to perform morphological and densitometrical measurements, etc.

Angiography↗