Biomedical subjects

P Avanza

Publications and source records attributed to P Avanza.

14 recordsLinked to original sources

PubMed1997

Hyperfluorescent plaque lesions in the late phases of indocyanine green angiography: a possible contraindication to the laser treatment of drusen.

PURPOSE: To highlight the possible role of indocyanine green angiography in predicting future exudative changes in eyes that are candidates for drusen laser treatment. METHODS: In a 56-year-old woman, fluorescein and indocyanine green angiography were performed before drusen laser treatment. RESULTS: The treated eye had a suspicious lesion at baseline indocyanine green angiography and a nonsuspicious fluoroangiographic pattern. Seven months after treatment, the patient developed choroidal neovascularization and pigment epithelial detachment in the treated eye. CONCLUSION: To decrease the risk of macular exudative changes that may be related to laser treatment, eyes that are candidates for drusen laser treatment should be examined before treatment, not only by fluorescein angiography, but also by indocyanine green angiography.

Angiography↗

PubMed1997

Laser photocoagulation of choroidal neovascularization in angioid streaks.

PURPOSE: To determine if laser photocoagulation of macular choroidal neovascularization in angioid streaks may be effective in preventing severe loss of vision. METHODS: Sixty-six consecutive eyes of 52 patients with extrafoveal, well-defined choroidal neovascularization secondary to angioid streaks who underwent direct laser photocoagulation were followed for 3-108 months (mean, 34.5 months; median, 20 months). RESULTS: Pretreatment mean visual acuity was 20/40 (range, 20/200-20/20), postlaser outcome was a visual acuity of 20/50 at 3 months, 20/50 at 6 months, 20/80 at 1 year, 20/80 at 2 years, 20/100 at 3 years, 20/125 at 4 years, 20/125 at 5 years, 20/100 at 6 years, and 20/80 at 7 years. During the first year after treatment there was a significant decrease in visual acuity (P < 0.01), but no significant change thereafter. Choroidal neovascularization recurred one or more times in 77% of the eyes, but by the final examination choroidal neovascularization had been eliminated completely in 31 eyes (47%). Fellow eyes with naturally progressed choroidal neovascularization were considered control eyes. Final visual acuity in treated eyes was definitely better than that in untreated eyes (P < 0.01). CONCLUSIONS: This is the largest series of eyes treated by laser photocoagulation for angioid streaks and choroidal neovascularization ever reported. Laser photocoagulation of choroidal neovascularization in angioid streaks may end the choroidal neovascularization and help stabilize visual acuity or slow down visual loss. Considering the very high frequency of recurrences (77% of the eyes studied), an intense clinical and fluorangiographic follow-up period is strongly recommended, mainly for the first 3 months after treatment.

Adult↗

PubMed1997

Indocyanine green angiography in angioid streaks.

PURPOSE: To define the indocyanine green angiographic aspects of angioid streaks, peau d'orange and choroidal new vessels. METHODS: Fifty-seven consecutive patients (112 eyes) with angioid streaks were evaluated by fluorescein angiography and indocyanine green angiography. RESULTS: Indocyanine green angiography showed angioid streaks in all eyes. We identified three different indocyanine green patterns of streaks (four groups): fluorescent (63%), hypofluorescent (8%), 'track-like' (19%) and mixed (10%). Angioid streaks were visualized better by indocyanine green angiography and red-free retinography than fluorescein angiography. Peau d'orange was seen better and found to be more widespread by indocyanine green angiography. Fluorescein angiography visualized choroidal neovascularization better, except for occult forms. CONCLUSIONS: Our findings show that angioid streaks have different indocyanine green angiography patterns. Considering that the hypofluorescent pattern was significantly observed in younger patients, indocyanine green angiography aspects might be correlated with different stages of the disease.

Adult↗

PubMed1996

Indocyanine green and fluorescein angiography of surgically excised macular choroidal neovascularizations: correlations with histopathologic and ultrastructural findings.

BACKGROUND: Informations are expected from the histopathological study of surgically excised choroidal neovascular membranes (CNMs), particularly in relation to the angiographic aspects of vascular architecture. METHODS: Fluorescein and indocyanine green (ICG) angiograms were studied together with the histopathological features of 12 surgically excised subfoveal CNMs in eyes affected by age-related macular degeneration (ARMD). RESULTS: Instead of the early and delayed diffuse hyperfluorescence secondary to CNMs observed on fluorescein angiography (seven were well defined, five scar evolved), ICG revealed (a) very early hypofluorescence of the membrane bulk over the fluorescence of the outer choroidal vascular bed and (b) late hyperfluorescence gradually increasing and partially defining the border of membranes. CNMs with well-defined hyperfluorescent aspects were characterized by fibrovascular bulk lined on one side by retinal pigment epithelium. Fibrosis reaction predominated over the vascular components in scar-evolved membranes. CONCLUSIONS: Fluorescein and ICG angiographic differences in the appearance of CNMs could depend on (a) the morphological structure and size of the CNM (b) its location within the chorioretinal layers and (c) different molecular characteristics of the dyes used.

Aged↗

PubMed1992

Best's multiple vitelliform degeneration.

Best's disease with multifocal lesions is rare. The authors describe four cases of multifocal vitelliform disease. The fluorescein angiographic features of macular and extramacular lesions are considered. Different stages of evolution may be present between central and extramacular lesions.

Adolescent↗

PubMed1992

[Juvenile serous macular detachment of the pigmented epithelium].

Juvenile macular detachment of the retinal pigmented epithelium is rarely seen clinically. Single or multiple detachments can occur and are due to the accumulation of liquid in the subretinal space. The natural history of the disease, which usually affects young people, has not yet been defined. We examined and followed 19 eyes of 15 patients affected by macular juvenile serous detachment of the retinal pigment epithelium, not associated with other retinal disturbances. The patients were followed for a mean period of 12 months (range 6-33 months). The mean age was 48 years (range 40-59 years): 7 patients were male and 8 female. Mean initial visual acuity was 8/10 (range 1/10-10/10) and mean final visual acuity was 9.2/10 (range 6/10-10/10). Detachment of the retinal pigmented epithelium was unchanged in 58% of cases, decreased or disappeared in 37% of cases and increased in 5% of cases. These results indicate that the natural course is usually good and photocoagulation is not necessary.

Adult↗

PubMed1990

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↗

PubMed1990

[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↗

PubMed1989

[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↗

PubMed1989

[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↗

PubMed1988

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↗

PubMedDate not supplied

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↗

PubMedDate not supplied

Laser photocoagulation of choroidal neovascularization in pathologic myopia: long-term results.

Direct laser photocoagulation of macular choroidal neovascularization (CNV) in pathologic myopia is still controversial. However, previous studies have reported encouraging results. One-hundred and thirty-three consecutively treated eyes were followed, in a prospective manner, for at least 12 months (108 of these were followed for 24 months, 84 for 36 months, 63 for 48 months, and 47 for 60 months) to evaluate the potential benefits and complications of laser treatment of extra-foveal macular CNV in pathologically myopic eyes. Pre-treatment mean visual acuity was 0.36. Post-treatment mean visual acuity was 0.33 at 1-year examination, 0.31 at 2 years, 0.32 at 3 years, 0.34 at 4 years, and 0.33 at 5 years. During the total follow-up period mean visual acuity did not change. Neovascular recurrences occurred in 58% of treated eyes by the end of the five-year follow-up. At final examination, complete destruction of CNV was achieved in 100 eyes (75%). These findings suggest that laser photocoagulation of macular choroidal neovascularization in pathologic myopia may be effective in preventing or limiting severe and irreversible loss of vision.

Adult↗

PubMedDate not supplied

Indocyanine green angiography (ICGA) in pathological myopia.

One hundred and fifty patients (300 eyes), mean age 49 +/- 15 years, with degenerative myopia underwent fluorescein and indocyanine green angiography (ICGA). Fluorescence of choroidal neovascularization (CNV) on ICGA was less evident than with fluorescein angiography (FA). FA revealed CNV in 98 eyes; ICGA showed CNV with different angiographic patterns in 82 eyes. ICGA permitted CNV diagnosis when retinal hemorrhages were present. ICGA allowed a more precise evaluation of lacquer cracks which appeared more numerous than the ones identified by FA. ICGA visualized the retrobulbar vasculature. This study shows that ICGA has a useful role for diagnosing and managing pathological myopia.

Adult↗