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Biomedical subjects

L A Yannuzzi

Publications and source records attributed to L A Yannuzzi.

121 records · Page 7Linked to original sources
PubMedDate not supplied

Risk factors for choroidal neovascularization in young patients: a case-control study.

A pair-matched, case-control design was used to study exposure to Histoplasma capsulatum and other environmental factors, and to determine various host characteristics including human leukocyte antigen (HLA) typings in 94 young patients with macular choroidal neovascularization (CNV) and in 94 controls with other eye diseases. Patients with two types of retinal patterns were studied: Type I, or those with CNV with one or no chorioretinal atrophic spots in the posterior pole or periphery (n = 51), and Type II, or those with CNV and 2 or more chorioretinal atrophic spots (n = 43). Our purpose was to explore whether these two variants of idiopathic CNV have different and distinguishable epidemiologies which may or may not be related to prior exposure to Histoplasma. We found that histoplasmin skin tests were negative in all but two Type I cases. The combination of the HLA-B7 and HLA-DR2 markers (but not either marker alone) was significantly increased in Type I cases. Among Type II cases, HLA-B7, HLA-DR2, HLA-DQ1, a positive histoplasmin skin test, myopic refractive error, prior residence in a histoplasmosis endemic area, occupations involving exposure to animals, and hypertension were all significantly increased. Histoplasmin skin test responses were positive in 18 Type II cases (45%). In the multivariate analysis, only DR2 and the combined presence of DQ1 and a positive histoplasmin skin test remained predictive of Type II disease. Our findings suggest that histoplasmin sensitivity is associated with some, but not all, cases of Type II disease. However, histoplasmin sensitivity appears to have no relationship to Type I disease. HLA factors may play a role in both disease types, possibly by producing a modified immune response to Histoplasma and/or other unidentified agents.

Adolescent↗
PubMedDate not supplied

Fluorescein angiography of the fundus: a schematic approach to interpretation.

Fluorescein angiographic patterns reveal a wide variety of anatomical, pathological and physiological information which, correctly interpreted, contributes to the differential diagnosis of fundus diseases and to the evaluation of appropriate therapeutic approaches. A schema for interpretation of the fluorescein angiogram is presented, following a logical progression from the initial determination of abnormal hypofluorescence of hyperfluorescence to the evaluation of the specific locations and features of the patterns, and their relationships to various disorders.

Choroid Neoplasms↗
PubMedDate not supplied

Chorioretinal, iris, and ciliary body infiltration by juvenile xanthogranuloma masquerading as uveitis.

Juvenile xanthogranuloma is a benign cutaneous disorder which occasionally involves the eye, orbit, and ocular adnexa in children. Iris and ciliary body manifestations are commonly seen, but retinal and choroidal lesions are exceedingly rare. We report a unique case of retinal, choroidal, iris, and ciliary body infiltration in a 12-year-old patient diagnosed by excisional biopsy of the iris. The diagnosis was confirmed by routine histology and oil-red-o staining. Immunohistochemistry revealed predominantly macrophages, monocytes, and T-helper lymphocytes. Unusual features of this case include the late age at diagnosis, posterior pole involvement, and lack of cutaneous lesions. The presence of cellular adhesion molecules and T lymphocytes implicate a lymphocyte-driven inflammatory process. Apolipoprotein A was the predominant apolipoprotein present within the foamy histiocytes. We also present a critical review of the literature.

Child↗
PubMedDate not supplied

Curvilinear pigmentary lesions in a rod-cone dystrophy.

PURPOSE: To report a peculiar curvilinear pigmentary lesion in the peripheral fundus in a rod-cone dystrophy. METHODS: Observational case report. Fundus examination of a 57-year-old woman who was known to have a generalized rod-cone dystrophy since she was 8 years old. RESULTS: The peripheral fundus examination revealed a curvilinear lesion which resembles a well-known finding associated with a presumed ocular histoplasmosis syndrome or multifocal choroiditis. CONCLUSIONS: The differential diagnosis of a peculiar curvilinear pigmentary lesion in the peripheral fundus may be expanded to include a generalized rod-cone dystrophy.

Choroiditis↗
PubMedDate not supplied

Late effect of external eye irradiation on choroidal circulation.

PURPOSE: To report two cases of atypical late onset radiation chorioretinopathy occurring 15 and 25 years post exposure and the indocyanine green (ICG) angiographic findings in these patients. METHODS: Clinical examination and imaging including fluorescein and ICG angiography were performed. RESULT: Fundus examination of the first patient revealed microangiopathy with intraretinal hemorrhages, lipid exudation, telangiectatic and aneurysmal capillary changes. Indocyanine green angiography showed an apparent chorioretinal anastomosis and delayed perfusion of the choriocapillaris. Fundus examination of the second patient revealed a pigment epithelial detachment and retinal pigment epithelial changes. Indocyanine green angiography showed atypical, tortuous, dilated, choroidal vessels as well as areas of hypoperfusion. Both patients had multiple dot-like hyperfluorescent spots in the midphase of the ICG angiogram. CONCLUSIONS: External radiation exposure may lead to both retinal and choroidal alterations which may be independent events and which may manifest after a long period of quiescence. Furthermore, ICG angiography appears to be a useful diagnostic tool to study the alterations of the choroid following external eye irradiation.

Brachytherapy↗
PubMedDate not supplied

Laser treatment of diffuse retinal pigment epitheliopathy.

The Authors report laser treatment of 18 eyes (14 patients) with a variant of central serous chorioretinopathy associated with widespread decompensation of the retinal pigment epithelium (RPE) in the macula, diffuse retinal pigment epitheliopathy (DRPE). All eighteen eyes with DRPE were treated with Krypton red laser photocoagulation in a grid pattern to leaking RPE in areas of neurosensory retinal detachment. All eyes showed anatomic improvement with resolution of the serous macular detachment and lipid exudation. The visual acuity was stabilized in 15 eyes (83%) at 6 months' follow-up, but only 3 eyes (17%) demonstrated improved visual acuity in the same time interval. At eighteen months, 2 of 15 eyes (13%) retained improved visual acuity, 11 eyes (74%) remained unchanged, and 2 eyes (13%) had visual loss. In this series of patients with DRPE, grid laser photocoagulation treatment was uniformly successful in producing an anatomic improvement in the exudative manifestations of the macula and in preventing or slowing progression of vision loss.

Aged↗
PubMedDate not supplied

Indocyanine green videoangiography: current status.

Indocyanine-green (ICG) angiography has experienced a rejuvenated interest in the past few years because of improvements in technological systems. After three years of experience with evolving digital technology, we have reviewed our experience to provide an update on potential applications in a variety of choroidopathies. Based on 3,000 cases studied with ICG angiography, we evaluated the diagnostic value of the procedure in choroidal abnormalities including ischemic, tumor, idiopathic, inflammatory, and neovascularized diseases. ICG angiography is still of limited clinical value in ischemic diseases because of a relatively poor imaging potential for the choriocapillaris. The procedure has not yet provided information which is of significant value in the evaluation and management of choroidal tumors. Valuable information has been provided on the fundamental pathogenesis of certain idiopathic diseases. Preliminary experience in inflammatory diseases is very promising. A genuine advance in imaging of "occult"-choroidal neovascularization has been provided by the diagnostic technique. Improved delineation of these vessels offers opportunities for ICG-guided laser treatment.

Choroid Diseases↗