Biomedical subjects

Michael Stur

Publications and source records attributed to Michael Stur.

At least 19 recordsLinked to original sources

PubMed2006

Magnification-corrected photodynamic therapy.

BACKGROUND: To present a method for performing photodynamic therapy (PDT) with a constant predictable light fluence based on actual laser spot magnification. METHODS: A calibrated Gullstrand-type model eye with a scale of half circles in the centre of the artificial fundus was used for this study. The axial length of the model eye was set to different values ranging from 20 to 31 mm, and the actual laser spot magnification of four indirect condensing laser lenses were determined using a PDT laser unit. RESULTS: Equations for determining the actual laser spot magnification were calculated for each laser lens. The total change in laser spot magnification from hyperopia (axial length 20 mm) to myopia (axial length 31 mm) was -20% to +24.8% for Mainster Standard lens (Ocular Instruments Inc, Bellevue, Washington, USA), -15.7% to +27.7% for Mainster Wide Field lens (Ocular Instruments Inc), -16.3% to +33.1% for Volk Transequator lens (Volk Optical Inc, Mentor, Ohio, USA), and -19.2% to +24.4% for Volk PDT Laser lens (Volk Optical Inc). CONCLUSIONS: Axial length of the eye has a considerable effect on PDT laser spot magnification when an indirect laser lens is used. By calculating the actual laser spot magnification in conjunction with knowledge of the true greatest linear dimension of the neovascular lesion, the clinician may be able to deliver a constant predictable amount of light fluence to the fundus independent of the axial length of the PDT treating eye.

Choroidal Neovascularization↗

PubMed2006

Treatment frequency and visual outcome in subfoveal choroidal neovascularization related to pathologic myopia treated with photodynamic therapy.

BACKGROUND: The purpose of this study was to examine the influence of treatment frequency on visual acuity of patients with PDT treatment for subfoveal predominantly classic CNV related to pathological myopia. DESIGN: Retrospective case series. METHODS: Thirty-seven patients with subfoveal predominantly classic CNV caused by pathologic myopia and treated with PDT were included. All patients received a full ophthalmic examination, including best-corrected visual acuity, slit-lamp biomicroscopy, fundus photography and fluorescein angiography, before first treatment and every 3 months thereafter. Photodynamic therapy was performed according to standard protocol. Main outcome measurements were visual acuity and treatment frequency. RESULTS: The number of treatments received was 3.35+/-1.83 (average: 1-7). In 12 eyes (32.43%); the BCVA was stable or increased during the entire follow-up period. In eight eyes (21.62%), the BCVA decreased and did not return to the baseline values. A transient loss of visual acuity (over 3-9 months) with subsequent improvement in visual function was found in 68% (17 eyes). A gain of three or more lines compared with lowest BCVA was found in 56% (14 eyes). The number of treatments did not correlate with baseline BCVA, greatest linear dimension of CNV at baseline or with the change of BCVA from baseline. In cases with transient worsening of BCVA, the recovery of visual acuity correlated significantly with the number of treatments (r=-0.522, P<0.05; Spearman rank correlation) received. CONCLUSION: Visual acuity recovery correlates with the number of PDT re-treatments; in many cases, an improvement in visual function after temporary decrease of BCVA can be observed after re-treatment according to current treatment guidelines. The number of PDT treatments has no negative effect on the visual outcome in subfoveal CNVs caused by pathological myopia.

Adult↗

PubMed2006

Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study.

BACKGROUND: The study was carried out to confirm the effect of calcium dobesilate (CaD) compared to placebo (PLA) on the blood-retinal barrier (BRB) permeability in early diabetic retinopathy (DR). METHODS: Adults with type II diabetes and early diabetic retinopathy (below level 47 of ETDRS grading and PVPR between 20 and 50x10(-6)/ min, plasma-free fluorescein) were included in this double-blind placebo-controlled study. Treatment was 2 g daily for 24 months. The primary parameter, posterior vitreous penetration ratio (PVPR), was measured every 6 months by fluorophotometry. Secondary parameters were fundus photography, fluorescein angiography and safety assessments. Metabolic control was performed every 3 months. RESULTS: A total of 194 patients started the treatment (98 CaD, 96 PLA) and 137 completed the 24-month study (69 CaD, 68 PLA). Both treatment groups were comparable at baseline, with ETDRS level 10 in about 59% of patients. Mean PVPR change from baseline after 24 months was significantly (P=0.002) lower in the CaD group [-3.87 (SD 12.03)] than in the PLA group [+2.03 (SD 12.86)], corresponding to a 13.2% decrease in the CaD group and a 7.3% increase in the PLA group. PVPR evolution was also analysed by HbA1c classes (<7%, between 7 and 9%, > or =9%) and results confirmed the superiority of CaD independently of the diabetes control level. A highly significant difference [CaD: -3.38 (SD 13.44) versus PLA: +3.50 (SD 13.70)] was also obtained in a subgroup of patients without anti-hypertensive and/or lipid-lowering agents (P=0.002 at 24 months). A further analysis of the secondary parameters showed significant changes in favour of CaD in the evolution from baseline to the last visit of haemorrhages (P=0.029), DR level (P=0.0006) and microaneurysms (P=0.013). Regarding safety, only 2.5% (n=5 patients/ events) of all adverse events reported were assessed as possibly or probably related to the test drug, while all serious adverse events were reported as unlikely. There was no statistical difference between groups. CONCLUSION: Calcium dobesilate 2 g daily for 2 years shows a significantly better activity than placebo on prevention of BRB disruption, independently of diabetes control. Tolerance was very good.

Adult↗

PubMed2006

The effect of axial length on photodynamic therapy.

PURPOSE: To determine the effect of the axial length of the eye on photodynamic therapy (PDT) light fluence. DESIGN: Laboratory investigation. METHODS: A calibrated Gullstrand-type model eye was used for this study. The axial length of the model eye was set to different values ranging from 20 to 31 mm, and the light fluence rate for treating a spot of 4 mm was recorded and compared with a fluence rate of 600 mW/cm2 with four indirect condensing laser lenses. RESULTS: The axial length of the eye is inversely related to light fluence. From myopia to hyperopia, the total deviation from 600 mW/cm2 was -37.7% to +53.8% (Mainster Standard; Ocular Instruments Inc, Bellevue, Washington, USA), and -48.3% to +20.5% (Mainster Wide Field; Ocular Instruments Inc), -52.3% to +16.7% (Volk Transequator; Volk Optical Inc, Mentor, Ohio, USA), and -52.3% to +15.3% (Volk PDT Laser; Volk Optical Inc). CONCLUSIONS: Axial length of the eye has a considerable effect on PDT light fluence rate in this model. These findings may be important for optimizing PDT, particularly in eyes with high refractive errors.

Body Weights and Measures↗

PubMed2006

Photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration.

PURPOSE: To examine the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration (AMD). DESIGN: Retrospective, interventional case series. METHODS: Sixty eyes of 56 patients with neovascular AMD were treated with PDT with verteporfin followed by an intravitreal injection of 4 mg triamcinolone acetonide. The main outcome measures were visual acuity (VA), retreatment frequency with PDT (and triamcinolone), and frequency of side effects. RESULTS: Mean follow-up was 15.9 months (range 12 to 30 months, median 15 months). Twenty-three (38.3%) of 60 eyes had a stable result at 12 months' follow-up (that is, loss/gain <three lines) and 34 (56.7%) of 60 had a loss of 3 lines or more. Three patients (5%) had an improvement of 3 lines or more. Lesion type, patient age, and lesion size had no influence on the outcome, but baseline VA had a statistically significant effect (P = .006). The median number of PDT-intravitreal triamcinolone acetonide treatments was one. One-third (20 of 60) of all eyes had an increase in intraocular pressure (IOP) that required therapy. There were no cases of endophthalmitis, but 13 patients (21.6%) developed severe cataract that required surgery. CONCLUSIONS: The combination of PDT and intravitreal triamcinolone acetonide requires careful consideration as a treatment option for neovascular AMD. In our case series, this treatment combination did not prevent a considerable decrease in VA. The main benefit of this combination treatment was a low number of verteporfin treatments. Baseline VA was the main predictor of the final outcome.

Aged↗

PubMed2005

Digital area measurement of fundus landmarks.

PURPOSE: To present and validate an image analysis technique for the calculation of the true projection area of fundus landmarks from a digital fundus image. The authors present the description, technical details and results of the study. METHODS: Experimental study using a calibrated Gullstrand-type model eye with a scale of half circles in the centre of the artificial fundus. The axial length of the model eye was set to different values ranging from 21 mm to 29 mm, and the area of a half circle was calculated from digital fundus images with a magnification-calibrated image analysis program (UTHSCSA Image Tool). The calibration was based on Littmann's formula for correcting the magnification of fundus images. RESULTS: The maximum deviation of the calculated area size from the true fundus object area was -3.7% under myopic and +3.4% under hyperopic conditions. The 95% confidence interval for repeated area measurements was from +1.83 to -1.46%. CONCLUSIONS: The magnification-calibrated image analysis technique based on Littmann's formula is a non-invasive, accurate and reproducible tool for true area measurement of fundus landmarks.

Calibration↗

PubMed2005

The effect of digital measurement software on photodynamic therapy.

BACKGROUND: To investigate the effect of refraction-corrected digital measurement software on photodynamic therapy (PDT) treatment spot size. METHODS: Experimental study using a calibrated Gullstrand-type model eye. The axial length of the model eye was set to different values, ranging from 20 to 31 mm, and the PDT treatment spot sizes obtained from refraction-corrected digital measurement software and manual measurement with a fixed-magnification factor, as well as four different indirect contact laser lenses, were calculated and compared for a treatment spot with a diameter of 4 mm. RESULTS: The maximum deviation from the treating laser spot was +39.6% under myopic and +17.4% under hyperopic conditions when the refraction-corrected digital measurement software was used. The maximum deviation was +14.2% under myopic and +13.3% under hyperopic conditions when the manual measurement with the fixed-magnification factor was used. CONCLUSIONS: The use of refraction-corrected digital measurement software produces a larger deviation from treating laser spot than the use of manual measurement with a fixed-magnification factor. Therefore, refraction-corrected digital measurement software might not be suitable for calculating the recommended PDT treatment spot size in eyes with high refractive errors.

Choroidal Neovascularization↗

PubMed2005

Differences in reading performance of patients with Drusen maculopathy and subretinal fibrosis after CNV.

PURPOSE: To evaluate differences in reading performance and contrast sensitivity on patients with drusen maculopathy and subretinal fibrosis after CNV (choroidal neovascularisation). METHODS: 136 patients (60 with drusen (D), 76 with fibrosis (F)) were studied. Patients were classified according to type of maculopathy and best-corrected visual acuity into groups D1 and F1 (LogMAR 0.2-0.4), groups D2 and F2 (LogMAR>0.4-0.7), and group F3 (LogMAR>0.7-1.3). Reading acuity (in LogRAD) and speed were examined with the Radner Reading charts and compared to the reading speed measured with the long paragraphs of the Zuercher Reading Test. Contrast sensitivity was measured with Pelli-Robson charts. RESULTS: The patients' distance visual acuity was comparable between the drusen and fibrotic CNV groups (D1 versus F1, D2 versus F2). The reading acuity of the corresponding groups D1 and F1 was also comparable, but F2 patients showed a statistically lower reading acuity than D2 patients (P=0.03). All reading speed measurements of the groups F1 and F2 were significantly worse than those of the corresponding groups D1 and D2 (P-values: 0.0005-0.02). The correlation of reading speed between the Radner and Zuercher texts was very high (r=0.73-0.94). The contrast sensitivity was significantly lower in all groups compared with group D1 (P<0.001), but comparable for groups F1, F2, and F3. CONCLUSIONS: Despite comparable results in distance visual acuity, patients with subretinal fibrosis after CNV had a greater reduction in reading ability than the patients with drusen. The distance visual acuity measurements alone, therefore, underestimate the real-life conditions and impact of AMD.

Aged↗

PubMed2005

Ultrahigh resolution optical coherence tomography in macular dystrophy.

PURPOSE: To visualize and investigate intraretinal changes in macular dystrophies with ultrahigh resolution optical coherence tomography (UHR OCT). DESIGN: Prospective observational case series. METHODS: setting: Department of Ophthalmology and Center for Biomedical Engineering and Physics, Christian Doppler Laboratory, Medical University of Vienna, Vienna, Austria. patients: Thirteen patients (23 eyes) with adult-onset foveomacular vitelliform dystrophy (AOFVD) and 14 patients (27 eyes) with Stargardt's disease (SD) or fundus flavimaculatus (FF). OBSERVATIONS: Imaging using a compact, new generation UHR OCT system, achieving considerably improved visualization of intraretinal layers, especially the photoreceptor layer. main outcome measures: UHR OCT tomograms visualizing intraretinal differences in morphology of AOFVD and SD/FF as location and extension of deposits and loss of photoreceptors. Central foveal thickness defined as distance between internal limiting membrane and photoreceptors/retinal pigment epithelium interface. RESULTS: Patients with AOFVD had a mostly intact photoreceptor layer, a central foveal thickness of 142 +/- 23 microm as well as subretinal deposits. Patients with SD generally had a diffuse degenerative change with a visible reduction in thickness of all intraretinal layers, resulting in a corresponding reduction of central foveal thickness (94 +/- 38 microm) and central loss of photoreceptors (PRs). Comparative central foveal thickness of patients with AOFVD and SD/FF was significantly different (P < .001). Patients with FF had pigment epithelial deposits and paracentral focal photoreceptor loss. CONCLUSIONS: UHR OCT is a clinically feasible tool for examining intraretinal changes, in particular photoreceptor atrophy in macular dystrophies and, therefore, has the potential to be an adequate imaging system for monitoring the course of disease.

Adult↗

PubMed2005

Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study.

PURPOSE: To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD. DESIGN: Prospective, comparative, concurrent, nonrandomized, multicenter study. PARTICIPANTS: Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD. METHODS: After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD. MAIN OUTCOME MEASURES: A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%. RESULTS: Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% CI, 76%-95%). CONCLUSIONS: Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the intermediate stage of AMD.

Aged↗

PubMed2005

Intravitreal triamcinolone acetonide in patients with macular oedema due to central retinal vein occlusion.

PURPOSE: To evaluate treatment of macular oedema due to central retinal vein occlusion (CRVO) with intravitreal triamcinolone acetonide. METHODS: In a prospective case series, 13 patients with macular oedema due to non-ischaemic CRVO received an intravitreal injection of 4 mg triamcinolone acetonide. Examination included assessment of best corrected visual acuity (BCVA) for distance and reading, measurement of intraocular pressure (IOP), fluorescein angiography and high resolution imaging by optical coherence tomography, preoperatively and 1 week, 1 month, 3, 6 and 9 months postoperatively. RESULTS: Preoperative mean BCVA was 0.9 +/- 0.4 for distance vision and 1.0 +/- 0.3 for reading acuity, respectively. A significant improvement in distance VA (0.5 +/- 0.3, p < 0.001) and reading acuity (0.7 +/- 0.3, p = 0.03) was observed until 3 months and 6 months, respectively. Mean macular thickness was significantly reduced until 9 months postoperatively. CONCLUSION: Intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with macular oedema due to CRVO. However, the significant effect was not permanent and persisted for a maximum of 6 months.

Fluorescein Angiography↗

PubMed2005

Intravitreal triamcinolone acetonide in patients with macular oedema due to branch retinal vein occlusion: a pilot study.

PURPOSE: To evaluate treatment of macular oedema due to branch retinal vein occlusion (BRVO) with intravitreal triamcinolone acetonide. METHODS: In a prospective case series, nine patients with macular oedema due to BRVO received an intravitreal injection of 4 mg triamcinolone acetonide. Examination included best-corrected visual acuity (BCVA) for distance and reading, intraocular pressure (IOP) measurement, fluorescein angiography and high resolution imaging by optical coherence tomography, preoperatively and at 1 week, 1 month, 3 and 6 months postoperatively. RESULTS: Preoperative mean BCVAs were 1.3 +/- 0.8 for distance vision, and 1.1 +/- 0.3 for reading acuity, respectively. A significant improvement in reading acuity was observed until 1 month (0.7 +/- 0.4, p = 0.02). No significant reduction in mean macular thickness was observed. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide led to a significant improvement in mean VA in patients with macular oedema due to BRVO. However, the significant effect was not permanent and persisted for only 1 month.

Aged↗

PubMed2005

Assessment of central visual function in Stargardt's disease/fundus flavimaculatus with ultrahigh-resolution optical coherence tomography.

PURPOSE: To assess photoreceptor morphology in patients with Stargardt's disease and fundus flavimaculatus using ultrahigh-resolution optical coherence tomography (UHR-OCT) and correlate it with visual acuity (VA). METHODS: This was a prospective observational case series. Fourteen patients with Stargardt's disease (nine women, five men; average age, 39 years; range, 27-53) were examined. A clinically viable UHR-OCT system employing a new, compact titanium sapphire laser was used, enabling a 3-microm axial resolution in the retina. All patients received a full ophthalmic examination, including fluorescein angiography. Outcome was judged by central transverse photoreceptor loss, central foveal thickness, VA, central atrophy according to fluorescein angiography, and fundus autofluorescence. RESULTS: UHR-OCT was capable of visualizing and quantifying regions of central transverse photoreceptor (PR) loss. All Stargardt patients with central atrophy had a complete loss of the central photoreceptor layer in the foveal region (mean transverse photoreceptor loss, 4390 +/- 2270 microm; range, 530-9240 microm). Patients without clinically evident central atrophy had an intact photoreceptor layer centrally, but had small, focal parafoveal defects. A correlation was detected between VA and transverse PR loss (Spearman rho=-0.60, P=0.03), which was confirmed on logistic regression analysis (R2=0.49, P=0.0001). Central foveal thickness was reduced in patients with Stargardt's disease (85 +/- 40 microm; range, 58-280 microm). The correlation was statistically significant with VA (Spearman rho=0.43, P=0.04), but not with transverse PR loss (Spearman rho=-0.23, P >>0.05). Linear regression analysis showed a statistically significant association of central foveal thickness with VA (R2=0.51, P=0.0001), but not with transverse PR loss (P >>0.05). The extent of atrophy seen in fluorescein angiography correlated with VA and transverse PR loss (Spearman rho=-0.51, P=0.007; Spearman rho=0.77, P=0.0001). Similar correlations were found with the maximum transverse diameter of fundus autofluorescence (Spearman rho=-0.72, P=0.008; Spearman rho=0.77, P=0.003). CONCLUSIONS: Ultrahigh-resolution OCT demonstrates excellent visualization of intraretinal morphology and enables quantification of the photoreceptor layer. Thus, for the first time, an in vivo visualization and quantification of transverse, central photoreceptor loss and correlation with visual function is possible. Lower VA corresponds to a greater transverse photoreceptor loss, which also correlates with the extent of changes seen in fluorescein angiography and in fundus autofluorescence. Furthermore, reduced retinal thickness (i.e., atrophy of retinal layers) does not correlate with the transverse extent of PR loss. Thus, it seems that although there may be progressive atrophy of intraretinal layers, an intact photoreceptor layer leads to better VA. UHR-OCT may present a viable alternative to the assessment of central visual function, due to the easy, objective, and noninvasive data acquisition. Therefore, UHR-OCT could be of future use in judging patients' prognoses in Stargardt's disease.

Adult↗

PubMed2005

Choroidal hemodynamic changes during isometric exercise in patients with inactive central serous chorioretinopathy.

PURPOSE: Imaging studies suggest that the choroidal vasculature may be altered in central serous chorioretinopathy. Little is known, however, about the regulation of ocular blood flow in patients with central serous chorioretinopathy (CSC). The hypothesis for the present study was that choroidal blood flow changes during an increase in ocular perfusion pressure induced by isometric exercise may be altered in CSC. METHODS: An observer-masked, two-cohort study was performed in 14 nonsmoking patients with chronic-relapsing but inactive CSC and in 14 healthy nonsmoking volunteers. Both groups were matched for age and sex. Subfoveal choroidal blood flow (CBF) was assessed with laser Doppler flowmetry, and ocular perfusion pressure (OPP) was calculated from mean arterial pressure (MAP) and intraocular pressure (IOP). Changes of CBF during isometric exercise over a period of 6 minutes were measured. RESULTS: Whereas the increase of MAP, the pulse rate, and the OPP were comparable between the two study groups, subfoveal CBF increased significantly more in the group of patients with CSC (P < 0.001). IOP remained unchanged in both groups during isometric exercise. At an 85% increase in OPP, subfoveal CBF was approximately twice as high in the patients with CSC compared with the healthy control group. CONCLUSIONS: The data indicate an abnormal subfoveal CBF regulation in patients with relapsing CSC compared with age-matched, nonsmoking, healthy volunteers during isometric exercise.

Adult↗

PubMed2004

Incidence of patients presenting with exudative maculopathy and neovascular retinal disease in an urban population.

PURPOSE: To determine the incidence of exudative macular and neovascular retinal disease presenting within a defined urban population. STUDY DESIGN: prospective, observational, consecutive case series. PATIENTS AND METHODS: Patients referred to ten ophthalmic centers within a defined 10-week period with a newly diagnosed exudative macular and/or neovascular retinal disease were examined fundoscopically, angiographically and quantified according to age and underlying disease. RESULTS: A total of 527 eyes of 426 patients were referred. The most frequent disease was neovascular age-related macular degeneration (AMD, 199/527, 37.8%, 184 patients), followed by diabetic maculopathy and/or proliferative diabetic retinopathy (199/527, 37.8%, 128 patients) and venous occlusive disease (67/527, 12.7%, 67 patients). The majority of neovascular AMD consisted of occult without classic choroidal neovascularization (CNV, 115/ 199, 57.8%); predominantly classic CNV was seen more often than minimally classic CNV (43/199, 21.6% vs. 27/ 199, 13.6%). The overwhelming majority of the diabetic cases had diabetic macular edema (179/199, 89.9%); only 10.1% had vasoproliferative disease. All other causes of CNV, macular edema/exudation, and retinal neovascularization were observed in < 5% of all patients. CONCLUSION: The main causes of exudative maculopathy are CNV due to neovascular AMD and diabetic macular edema. Proliferative diabetic retinopathy is the main cause of retinal neovascularization. The number of patients with neovascular AMD presents a future challenge for ophthalmologists.

Aged↗

PubMed2004

Magnification-corrected indirect biomicroscopy of the optic nerve head.

BACKGROUND: Proper use of the new Super VitreoFundus and SuperPupil XL non-contact slit-lamp lenses for clinical disc biometry requires knowledge of their comparative magnification. METHODS: The optical performance of each fundus lens is described in terms of axial magnification, lens position, and the correction factor p (in degrees per millimeter) using a calibrated Gullstrand-type model eye adjusted for axial ametropia between -12.5 D and +12.6 D. RESULTS: The total change in axial magnification from myopia to hyperopia was -13.3% to +15.6% (Super VitreoFundus lens), and -13.9% to +14.1% (SuperPupil XL lens). When the fundus lens position was altered with respect to the model eye by +/-2 mm under myopic conditions the change in axial magnification was -5.1% to +7.7% (Super VitreoFundus lens), and -6.5% to +9.7% (SuperPupil XL lens). In the hyperopic condition the change was -3.8% to +5.8%, and -4.9% to +7.3%. Both fundus lenses exhibited a linear relationship between p and degree of ametropia of the model eye, while only the Super VitreoFundus lens displayed a constant relationship between p and ametropia of -5 D to +5 D. CONCLUSIONS: Using the fundus lens correction factor (p), the clinician may be able to estimate the dimensions of optic nerve head features with sufficient accuracy to allow clinical decisions to be made in the evaluation of patients with diagnosed or suspected glaucoma.

Fundus Oculi↗

PubMed2004

Photodynamic therapy with verteporfin in subfoveal choroidal neovascularization secondary to central serous chorioretinopathy.

OBJECTIVE: To examine the efficacy and safety of photodynamic therapy with verteporfin in the treatment of subfoveal choroidal neovascularization secondary to central serous chorioretinopathy (CSC). DESIGN: Prospective interventional, noncomparative case series. METHODS: After the diagnosis of a subfoveal choroidal neovascularization secondary to CSC, 26 eyes of 24 patients were treated with photodynamic therapy with verteporfin. Patients were then followed up every 2 to 3 months, with further treatments performed as deemed necessary through fluorescein angiography. The mean observation was 22.2 months (range, 6-36 months; median, 24 months). RESULTS: There was marked visual improvement, with patients gaining a mean of 1.6 lines after 1 year and a mean of 2.2 lines after 2 years. There was a statistically significant change in visual acuity from baseline to 12 and 24 months (mean difference, -0.16, P =.03; and mean difference, -0.22, P =.02; respectively; t test for both). There was no correlation between patients' age or greatest linear dimension of the lesions and the final outcome (P>.10 for all). No patient experienced any adverse effects. CONCLUSION: Photodynamic therapy with verteporfin resulted in a beneficial outcome in the treatment of subfoveal choroidal neovascularization secondary to CSC, without serious adverse effects in this case series.

Adult↗

PubMed2004

Effect of laser photocoagulation on the retinal vessel diameter in branch and macular vein occlusion.

OBJECTIVE: To investigate the response of retinal vessel diameters to photocoagulation treatment and their role for the success of laser treatment in patients with retinal vein occlusion. METHODS: The study included 14 patients with branch vein occlusion or macular vein occlusion. The ophthalmologic examination included best-corrected visual acuity, biomicroscopy, fundus photography, and fluorescein angiography. Retinal vessel diameters were quantified before and after laser photocoagulation using a retinal vessel analyzer. MAIN OUTCOME MEASURE: Retinal vessel diameters. RESULTS: In cases manifesting macular vein occlusions, no significant change of the vessel diameter in any vessel was observed during the follow-up period. In the group with branch vein occlusion, all vessels tended to constrict after the laser photocoagulation. The effect of laser treatment on retinal vessel diameters was significant for superotemporal (P =.045, analysis of variance [ANOVA]) and inferotemporal branch veins (P =.03, ANOVA). Vasoconstriction was more pronounced in the occluded branch veins (P =.009, ANOVA) compared with the nonaffected veins (P =.12; ANOVA). The change of visual acuity after 3 months was correlated with the change of vessel diameter 3 months after laser treatment for occluded venular branches (r = 0.78, P =.02, linear regression). There was no correlation between the number of laser burns and the change of vessel diameters in the affected veins in this period (r = 0.12, P =.75, linear regression). CONCLUSIONS: Our results show that retinal photocoagulation in patients with branch vein occlusion has a vasoconstrictive effect on occluded veins. The correlation between the change in visual acuity and the change in vessel diameter indicates that branch vein constriction after photocoagulation may be an early indicator of the success of laser treatment.

Aged↗