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Results for “Choroidal Neovascularization”

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At least 199 records · Page 11Linked to original sources

PubMed2003

Investigation of laser-induced choroidal neovascularization in the rat.

PURPOSE: Choroidal neovascularization plays an important role in pathogenesis of age-related macular degeneration. Induction of neovascularization by laser photocoagulation in the rat fundus is an established animal model in which the effects of new therapeutic approaches are assessed. The purpose of this study was to compare different detection methods of laser-induced neovascularization in the rat. METHODS: Laser spots were applied to the fundus of Long-Evans rats. Ten days after, four different methods were used to detect laser-induced neovascularization: (1) high-resolution angiography with fluorescein isothiocyanate-dextran, (2) immunohistochemical visualization of platelet endothelial cell adhesion molecule (PECAM)-1, (3) visualization of intravascular lumens by peroxidase perfusion in the living rat with subsequent histologic analysis, and (4) histochemical representation of alkaline phosphatase in endothelial cells. RESULTS: At the rim of the laser scars vessel-forming endothelial cells with intravasal dextran and peroxidase were present. Cross-sections demonstrated that these vessels originated from the retina. The center of the scars contained homogenous endothelial cells of choroidal origin, which was confirmed by immunohistochemistry and electron microscopy. In laser-treated eyes without FITC-dextran perfusion, scars showed unspecific fluorescence, making differentiation from specific FITC-dextran-associated fluorescence difficult. CONCLUSIONS: In the rat model of laser-induced neovascularization, newly developed endothelial cells originate from the retina and the choroid. Whereas ring-like surrounding vessels come from the retina, flat endothelial cells in deeper layers are of choroidal origin or may originate from circulating endothelial precursor cells. Dextran angiography has to be regarded critically for visualizing the choriocapillaris and CNV in laser scars. PECAM-1 immunohistochemistry is best for detection and quantification of neovascularization in laser scars.

Alkaline Phosphatase↗

PubMed2002

Photodynamic therapy for the treatment of choroidal neovascularization secondary to rubella retinopathy.

PURPOSE: To describe a patient for whom photodynamic therapy was used to treat subfoveal choroidal neovascularization secondary to rubella retinopathy. DESIGN: Interventional case report. METHODS: A 36-year-old man with subfoveal choroidal neovascularization secondary to rubella retinopathy was treated with photodynamic therapy using verteporfin. Outcome was followed up with subsequent fundus examinations, fluorescein angiography, and evaluations of best-corrected visual acuity. RESULTS: Two treatments of photodynamic therapy using verteporfin resulted in involution of the neovascular membrane, resolution of subretinal hemorrhage, and improvement in best-corrected visual acuity from 20/200 to 20/60 2 months after the second treatment. Owing to recurrence of active choroidal neovascularization, the patient required two more treatments of photodynamic therapy in the next 6 months, after which his best-corrected visual acuity was restored to 20/60. CONCLUSION: Photodynamic therapy may be an effective treatment for subfoveal choroidal neovascularization secondary to rubella retinopathy.

Adult↗

PubMed1996

Choroidal neovascular membrane after laser-induced chorioretinal anastomosis.

PURPOSE: To treat a patient who had a choroidal neovascular membrane after laser-induced chorioretinal anastomosis for nonischemic central retinal vein occlusion. METHODS: A 70-year-old man underwent successful formation of a chorioretinal anastomosis for nonischemic central retinal vein occlusion. He subsequently developed a choroidal neovascular membrane at the site of the chorioretinal anastomosis. RESULTS: The choroidal neovascular membrane at the site of the chorioretinal anastomosis was treated successfully with argon laser photocoagulation. The anastomosis remained functional. CONCLUSION: We recommend that patients who have undergone laser-induced chorioretinal anastomosis for nonischemic central retinal vein occlusion be followed up closely for choroidal neovascular membrane formation.

Aged↗

PubMed1997

ICG videoangiography of occult choroidal neovascularization in age-related macular degeneration.

Digital indocyanine green videoangiography has recently been reported to improve the imaging of occult choroidal neovascularization. In this study, 44 eyes with occult choroidal neovascularization in age-related macular degeneration were studied with fluorescein and indocyanine green videoangiography. On indocyanine green videoangiographic examination, 6 of the 44 eyes (13.6%) with occult choroidal neovascularization had vascularized pigment epithelial detachment and 27 (61.4%) had vascularized retinal pigment epithelium. In the remaining 11 (25%) eyes which had previous laser photocoagulation, indocyanine green videoangiography confirmed the presence of recurrence while fluorescein revealed no demonstrable neovascularization. The findings in our study indicate that patients with occult choroidal neovascularization have manifestations that are more clearly demonstrated with indocyanine green videoangiography and improved imaging of these abnormal vessels could potentially increase the number of patients eligible for photocoagulation treatment.

Adult↗

PubMed1998

Presumed macular choroidal watershed vascular filling, choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration.

PURPOSE: To investigate the possible association of presumed macular choroidal watershed vascular filling (PMWF), choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration. METHODS: In a retrospective study, we evaluated 74 randomly selected indocyanine green videoangiograms of 74 patients with age-related macular degeneration. We also reviewed the charts of 20 randomly selected, age-matched control patients without age-related macular degeneration, initially referred for uniocular conditions, and subsequently performed indocyanine green videoangiography on their normal fellow eyes. We evaluated these videoangiograms for the presence of PMWF, manifesting as characteristic early choroidal hypofluorescence and its relation to choroidal neovascularization when present. Additionally, the incidence of hypertension, coronary artery disease, peripheral vascular disease, and diabetes mellitus was determined. RESULTS: Forty-one (55.4%) of 74 patients with age-related macular degeneration vs three (15.0%) of 20 normal control patients exhibited PMWF on indocyanine green videoangiography (P = .0014). Of the 61 patients with age-related macular degeneration and choroidal neovascularization, 36 (59.0%) exhibited PMWF on videoangiography. Associated choroidal neovascularization arose from the PMWF zone in 33 (91.7%) of these cases. Hypertension was observed in 24 (58.5%) of 41 patients with age-related macular degeneration and PMWF vs nine (27.3%) of 33 patients with age-related macular degeneration who did not exhibit PMWF (P = .007). CONCLUSIONS: An increased incidence of PMWF occurs in patients with age-related macular degeneration with a possible predisposition for the development of associated choroidal neovascularization. Additionally, PMWF may be accentuated by associated hypertensive choroidal microvascular insult.

Aged↗

PubMed1988

Retinal revascularization following laser photocoagulation treatment for choroidal neovascular membranes.

Retinal revascularization developed within the treatment scar in 7% of patients who had laser photocoagulation treatment for a choroidal neovascular membrane. This revascularization could be mistaken for recurrent choroidal neovascularization because it initially proliferated into a glomerularlike structure and showed dye leakage on angiography. Unlike choroidal neovascularization, these vessels, however, filled entirely from the retinal circulation and stereoscopic angiograms showed them to be located in the inner retina. In the 20 patients who were followed up, the retinal revascularization first appeared approximately four weeks after treatment and persisted for an average of ten weeks. It was associated with dense laser scarring, retinal capillary obliteration, and internal limiting membrane wrinkling, suggesting that heavy initial laser treatment was a predisposing factor for its development. It is important to differentiate retinal revascularization, which has an excellent prognosis and does not require re-treatment, from recurrent choroidal neovascularization, which usually must be treated promptly to avoid loss in visual acuity.

Adult↗

PubMed1990

Treatment of foveal pigment epithelial detachments with contiguous extrafoveal choroidal neovascular membranes.

Fourteen eyes of 14 patients who had subfoveal retinal pigment epithelial detachments and extrafoveal contiguous choroidal neovascular membranes associated with age-related macular degeneration underwent laser photo-coagulation treatment directed solely to their choroidal neovascular membrane. In eight of 14 eyes (57%), photocoagulation treatment resulted in closure of the choroidal neovascular membrane with subsequent collapse of the pigment epithelial detachment. Six of the eight eyes also had visual improvement. In six of 14 eyes (43%), the neovascular membrane eventually progressed into the fovea with resultant visual loss. The results of our study suggest that photocoagulation of extrafoveal choroidal neovascular membranes associated with foveal detachments of the retinal pigment epithelium may preserve and even improve visual function in affected patients.

Aged↗

PubMed2000

In vivo gene transfer into choroidal neovascularization by the HVJ liposome method.

PURPOSE: To evaluate the efficacy of the HVJ liposome method for gene transfer in rats with experimentally induced choroidal neovascularization. METHODS: Plasmid DNA containing the LacZ reporter gene, or fluorescein isothiocyanate (FITC)-labeled double-stranded phosphorothioate oligodeoxynucleotides (S-ODNs), was encapsulated in liposomes. The liposomes were coated with the envelope of inactivated hemagglutinating virus of Japan (HVJ). Intense laser burns were applied to the posterior pole of the retina of pigmented rats to induce choroidal neovascularization. Following photocoagulation, HVJ liposome suspension was injected into the vitreous. On days 3, 7, 14, and 28 after injection, the eyes were removed and fixed. The eyes injected with LacZ gene were reacted with X-gal, frozen, and cut into thin sections. The sections were examined for the expression of the LacZ gene by light microscopy. The enucleated eyes injected with double-stranded S-ODNs were frozen, cut into thin sections, and examined a confocal scanning laser microscope for FITC labeling. Eyes without injection of HVJ liposomes served as controls. RESULTS: Expression of LacZ genes (beta-galactosidase activity), or localization of FITC labeling, was observed mainly in the laser-induced choroidal neovascular tissue from 3 to 28 days after the intravitreal injection of HVJ liposome. CONCLUSIONS: We conclude that the HVJ liposome method achieved effective gene transfer into choroidal neovascular tissue. Thus, this method can be used as a nonviral gene therapy system for the treatment of choroidal neovascularization in vivo.

Animals↗

PubMed2001

Initial experience of inferior limited macular translocation for subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration.

PURPOSE: To report our initial experience of inferior limited macular translocation in patients with subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration. METHODS: We conducted a retrospective study of 23 eyes of 22 patients with choroidal neovascularization involving the foveal center secondary to pathologic myopia (11 eyes), ocular histoplasmosis syndrome (four eyes), angioid streaks (four eyes), idiopathic neovascularization (three eyes), and multifocal choroiditis (one eye), in which the fovea was moved inferiorly by means of limited macular translocation surgery. The mean preoperative best-corrected visual acuity was 20/150, and in five of 23 eyes (21.7%) the visual acuity was 20/80 or better. The major outcome measures were preoperative and postoperative visual acuity, postoperative foveal displacement, and complications related to the surgery. RESULTS: The mean postoperative follow-up was 10.82 months (range, 6 to 18 months). Postoperative best-corrected visual acuity improved by 2 or more Snellen lines of visual acuity in 11 of 23 eyes (47.82%), remained within 1 line in seven of 23 eyes (30.43%), and worsened 2 or more lines of vision in five of 23 eyes (21.74%). The mean postoperative best-corrected visual acuity was 20/100, and in 12 of the 23 eyes (52.17%) the visual acuity achieved was 20/80 or better. Retinal detachment was the most frequent complication and occurred in six eyes (26%). CONCLUSIONS: Our initial experience with limited macular translocation shows that this treatment modality offers the potential to improve visual function in some eyes with subfoveal choroidal neovascularization secondary to myopia, ocular histoplasmosis syndrome, angioid streaks, idiopathic neovascularization, and multifocal choroiditis. Although longer and more complete follow-up is needed, the results of this initial series warrant further studies to define the precise role of macular translocation in the management of these conditions.

Adult↗

PubMedDate not supplied

Choroidal neovascularization occurring concurrently in myopic eyes of monozygotic twins.

PURPOSE: To present young monozygotic twins both of whom developed choroidal neovascularization at the same time. CASE/OBSERVATIONS: Monozygotic twins, 22-year-old women, who lived in the same house, developed choroidal neovascularization in the left eye at the same time. The degree of myopia was higher in the left eye (-7.75 and -8.5 dpt in spherical equivalent) than in the right eye (-6.75 and -4.5 dpt) of both patients. The choroidal neovascularization regressed in a different time course and the visual acuity returned to normal in both patients. CONCLUSION: This pair of monozygotic twins suggests that both genetic and environmental factors underlie the development of choroidal neovascularization in myopic eyes.

Adult↗

PubMed1996

Recurrence of a choroidal neovascular membrane in a patient with punctate inner choroidopathy treated with daily doses of thalidomide.

PURPOSE: To determine whether thalidomide therapy can prevent a recurrence of a choroidal neovascular membrane in a patient with punctate inner choroidopathy. METHODS: Case report. In a 38-year-old woman with bilateral punctate inner choroidopathy, thalidomide therapy was initiated three days after laser photocoagulation of a choroidal neovascular membrane. RESULTS: The patient had a recurrence of the choroidal neovascular membrane eight months after the start of thalidomide therapy. CONCLUSIONS: The failure of thalidomide to prevent a recurrence of a choroidal neovascular membrane in this patient suggests that this medication may have only a limited benefit in preventing recurrences of choroidal neovascular membranes.

Adult↗

PubMed1994

Choroidal neovascularization in black patients.

OBJECTIVE: To characterize choroidal neovascularization (CNV) in black patients examined at a retinal disease referral center. DESIGN: Retrospective review of the medical records of all patients diagnosed as having CNV to identify black patients with CNV. SETTING: Single tertiary retinal referral center that included four ophthalmologists. PATIENTS: All patients diagnosed as having CNV between April 1990 and October 1992. MAIN OUTCOME MEASURES: Prevalence, demographic information, fundus photographic and fluorescein angiographic characteristics, natural history, and response to laser photocoagulation of CNV in black patients. RESULTS: Black patients comprise 15% of all patients seen at this center. Of 1725 patients identified as having CNV who were seen at the center during a 2.5-year period, only 25 were black (1.4%). In these patients, CNV was associated with a variety of retinal diseases, the most frequent being age-related macular degeneration. The average age of the study group was 54 years, women outnumbered men 2:1, and 13 of the patients developed bilateral lesions. Twelve of the 38 lesions were extrafoveal on presentation, and five of these were peripapillary. In the laser-treated eyes, recurrence of CNV was frequent and associated with visual loss. CONCLUSIONS: Choroidal neovascularization seems to be rare in blacks among a retinal disease referral center population. The overall presentation, natural history, and response to laser treatment seems to be similar to that of white patients. No feature of CNV in black patients was identified that would suggest that results of randomized clinical trials of laser photocoagulation for CNV are not valid for these patients.

Baltimore↗

PubMed2005

Low power vs standard power transpupillary thermotherapy in patients with age-related macular degeneration and subfoveal choroidal neovascularization ineligible for photodynamic therapy.

AIM: To assess the effect of standard power vs low power transpupillary thermotherapy (TTT) in patients with active subfoveal choroidal neovascularization secondary to age-related macular degeneration ineligible for photodynamic therapy (PDT) by original treatment of age-related macular degeneration with photodynamic therapy (TAP) study group recommendations. METHODS: Retrospective review of 79 patients with active predominantly occult subfoveal choroidal neovascularization or predominantly classic subfoveal choroidal neovascularization but Snellen visual acuity <20/200. All patients were treated with TTT administered via a Mainster wide field fundus contact lens with a retinal power/diameter coefficient of 248 mW/mm in the standard power (n=27) and 181 mW/mm in the low power group (n=52). The primary outcome was stabilization (<1 Snellen line change) or improvement (two or more Snellen lines) in visual acuity. Clinical and fluorescein angiographic resolution of overlying exudation was documented. RESULTS: At 24 month follow-up, 17 patients (63%) in the standard power and 36 patients (69%) in the low power group achieved stable or improved vision. Improved vision (mean three lines) was observed in 22% of the standard power and 23% of the low power group. Overlying exudation was reduced clinically with minimal or no leakage on fluorescein angiogram in 85% of standard power and 90% of low power group. Subgroup analysis in the low power group demonstrated a visual benefit in patients with subfoveal lesions, which had any classic component. CONCLUSIONS: Low power TTT is as effective as standard power in stabilizing or improving vision and reducing overlying exudation in patients with active subfoveal choroidal neovascularization ineligible for PDT.

Aged↗

PubMed1995

Indocyanine green angiography and choroidal neovascularization obscured by hemorrhage.

BACKGROUND AND OBJECTIVE: To determine the use of indocyanine green (ICG) angiography in detecting choroidal neovascularization obscured by hemorrhage. STUDY/DESIGN: Indocyanine green angiography was performed on 20 consecutive patients who were suspected to have choroidal neovascular membranes (CNVs) that were obscured by subretinal or intraretinal hemorrhage on fluorescein angiography. The etiology of choroidal neovascularization was age-related macular degeneration. RESULTS: In all patients, ICG angiography was able to detect some choroidal neovascularization. The entire extent of the CNV was identified in 12 (60%) of these patients after ICG angiography was performed. In the remaining eight eyes (40%), the CNV still was obscured partially by a thick layer of hemorrhage. Difficulty in detection was due to thick subretinal hemorrhage, lipid exudate, and pigment. CONCLUSION: The authors conclude that ICG angiography is superior to fluorescein angiography in showing the presence and extent of CNVs associated with age-related macular degeneration that are almost entirely obscured by hemorrhage.

Choroid↗

PubMed2001

Macular translocation for subfoveal choroidal neovascularization in angioid streaks.

PURPOSE: To report a case of visual improvement after macular translocation performed for a subfoveal choroidal neovascular membrane in a patient with pseudoxanthoma elasticum and angioid streaks. METHODS: The fovea was translocated inferiorly by scleral imbrication, intentional retinal detachment with a small posterior retinotomy, and partial fluid-air exchange. The choroidal neovascular membrane was photocoagulated 1 week later. RESULTS: The visual acuity of the patient improved from 20/125 to 20/40. The center of the foveal avascular zone was moved inferiorly 844 microm. The choroidal neovascular membrane was extrafoveal after translocation and was treated with laser photocoagulation. CONCLUSION: Macular translocation may be considered in the management of subfoveal choroidal neovascular membrane in patients with pseudoxanthoma elasticum and angioid streaks.

Adult↗

PubMedDate not supplied

Expression of connective tissue growth factor and its potential role in choroidal neovascularization.

BACKGROUND: To determine the expression of connective tissue growth factor (CTGF) in choroidal neovascularization. METHODS: Surgically excised choroidal neovascular membranes (CNVMs) were obtained at vitrectomy from eight eyes with age-related macular degeneration, five eyes with high myopia, and two eyes with angioid streaks. Light microscopic immunohistochemical analysis was performed to detect CTGF, transforming growth factor beta 1 (TGF-beta1), vascular endothelial growth factor (VEGF), pancytokeratin, and smooth muscle actin (SMA). RESULTS: CNVMs were classified by fibrotic status as cellular CNVM, moderate fibrous CNVM, and extensive fibrous CNVM. CTGF expression was found in vascular cells, stromal cells, and retinal pigment epithelium (RPE) cells. For the stromal cells, fibroblastlike cells were most strongly positive for CTGF. CTGF immunoreactivity in the stroma was stronger in the fibrous CNVMs than in the cellular CNVMs. Immunohistochemical analysis of serial sections revealed colocalization of CTGF with TGF-beta1 and VEGF; colocalization of CTGF with pancytokeratin and SMA was also found. CONCLUSION: Our findings suggest that transdifferentiated RPE cells and vascular cells possess remarkable CTGF expression in CNVMs. This expression of CTGF may stimulate fibroblasts to produce extracellular matrix and may promote angiogenesis in vascular cells. Colocalized TGF-beta1 and VEGF may also contribute the upregulation of CTGF.

Aged↗

PubMed1996

Clinicopathologic features of indocyanine green angiography-imaged, surgically excised choroidal neovascular membranes.

OBJECTIVE: The authors describe the clinicopathologic features of surgically excised choroidal neovascular membranes imaged by indocyanine green angiography (ICG). DESIGN: Fifteen eyes from 15 patients with surgically excised subfoveal choroidal neovascular membranes underwent preoperative and postoperative ICG angiography. All excised membranes were examined by light microscopy for overall configuration and the presence of cellular and extracellular constituents. One membrane was examined by transmission electron microscopy. RESULTS: Fourteen patients had age-related macular degeneration and one had ocular histoplasmosis syndrome. Constituents in more than 50% of membranes included retinal pigment epithelium (15/15), vascular endothelium (14/15), inflammatory cells (10/15), and basal laminar deposit (8/15). Basil laminar deposit was present only in membranes of patients with age-related macular degeneration. Eleven membranes were located primarily under the retinal pigment epithelium and four were located primarily under the neurosensory retina. There appeared to be no correlation between the ICG appearance and the histopathologic configuration of the membranes. CONCLUSION: Surgically excised ICG-imaged membranes correspond to subretinal pigment epithelium and subneurosensory retinal choroidal neovascularization.

Adult↗

PubMed1989

Choroidal neovascularization and central serous chorioretinopathy.

Three forms of choroidal neovascularization may occur associated with central serous chorioretinopathy (CSC). Two have previously been reported and are briefly reviewed. The author presents a third, previously unreported pattern of choroidal neovascularization complicating untreated recurrent CSC.

Adult↗