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Zaslavsky K, Park T, Lang Mcinnis R, Mandell M, Lee J, Lee C, Gilbert R, Derzko-Dzulynsky L. Outcomes in PIC-Related CNV: Pooled Analysis of Individual Participant Data. Ocul Immunol Inflamm 2023; 31:1825-1836. [PMID: 36179037 DOI: 10.1080/09273948.2022.2124176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Choroidal neovascularization (CNV) affects 64-75% of eyes with punctate inner choroidopathy (PIC). Although anti-VEGF agents are considered first-line therapy, there is controversy regarding other modalities, such as immunosuppression. We performed a systematic review of individual participant data (IPD) and generated a dataset of 278 eyes with PIC-related CNV from 45 studies. Forty-two percent presented with moderate visual loss (MVL) or worse. Four different treatment modalities (anti-VEGF, photodynamic therapy, local immunosuppression, and systemic immunosuppression) and most combinations among them were represented. Anti-VEGF injections decreased the likelihood of MVL (Odds Ratio 0.3, p = .027), an effect moderated by presenting visual acuity and patient age. Eyes receiving more than 3 injections were more likely to receive additional therapeutic modalities. Increasing number of modalities was associated with longer follow-up time and did not improve vision. The beneficial effect of anti-VEGF injections persisted when controlling for presenting visual acuity and follow-up time.
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Affiliation(s)
- Kirill Zaslavsky
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Park
- Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rachel Lang Mcinnis
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mark Mandell
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jihwan Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Rose Gilbert
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- National Institute for Health Research Moorfields Biomedical Research Centre, London, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Larissa Derzko-Dzulynsky
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Cicinelli MV, Ramtohul P, Marchese A, Bandello F, Bailey Freund K, Miserocchi E, Jampol LM. Latest advances in white spot syndromes: New findings and interpretations. Prog Retin Eye Res 2023; 97:101207. [PMID: 37574123 DOI: 10.1016/j.preteyeres.2023.101207] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
White spot syndromes (WSS) pose challenges in the field of ophthalmology, particularly in terms of accurate diagnosis and effective management. However, recent advancements in multimodal imaging (MMI) have significantly contributed to our understanding of WSS, allowing for improved characterization of these inflammatory chorioretinopathies. By employing various imaging modalities, including fundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence, optical coherence tomography (OCT), ultra-widefield imaging, and OCT angiography, researchers and clinicians have gained valuable insights into the underlying pathophysiological changes and clinical progression of WSS. Furthermore, MMI has unveiled novel and atypical variants within the spectrum of WSS, expanding our knowledge in this field. Notably, the identification of secondary forms of WSS occurring concurrently with unrelated chorioretinal disorders has suggested a potential autoimmune mechanism underlying these conditions. The introduction of MMI has also facilitated a more comprehensive evaluation of previously ill-defined entities, such as acute zonal occult outer retinopathy, leading to improved diagnostic criteria and enhanced recognition of distinct features. This review paper provides a comprehensive overview of the latest advances and interpretations in WSS. By integrating MMI into the diagnosis and management of these conditions, this review aims to enhance patient outcomes and provide valuable insights into the complexities surrounding WSS.
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Affiliation(s)
- Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Prithvi Ramtohul
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; NYU Grossman School of Medicine, New York, NY, USA
| | - Alessandro Marchese
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; NYU Grossman School of Medicine, New York, NY, USA
| | - Elisabetta Miserocchi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lee M Jampol
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Gan Y, He G, Zeng Y, Zhang X, Su Y, Mi L, Ji Y, Zhuang X, Wen F. SOLITARY PUNCTATE CHORIORETINITIS: A Unique Subtype of Punctate Inner Choroidopathy. Retina 2023; 43:1487-1495. [PMID: 37607393 PMCID: PMC10442130 DOI: 10.1097/iae.0000000000003828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
PURPOSE To describe a case series of a special subtype of punctate inner choroidopathy with solitary lesions in the macular area and named solitary punctate chorioretinitis. METHODS This retrospective observational study clinically evaluated 12 eyes from 12 patients diagnosed as punctate inner choroidopathy with solitary lesions. Demographic data and multimodal imaging features were analyzed for the included patients. RESULTS All the included patients were Chinese and of Han ethnicity. The median age of the included patients was 29.5 years (range: 25-40 years). Most patients (11/12, 91.67%) were myopic, with median refraction errors of -4.4 diopters (D) (range: -8.5 to 0 D). Solitary chorioretinitis lesions were yellow‒white and appeared hyperfluorescent during the entire phase of fundus fluorescein angiography without leakage (9/12, 75%) and hypofluorescent on indocyanine green angiography (11/11, 100%). On spectral domain optical coherence tomography, active inflammatory lesions appeared as isolated, heterogeneous, moderately reflective material at the outer retina (10/12, 83.33%) in the fovea or parafoveal region with disruption of the outer retinal layers. When the inflammatory lesions regressed, the moderately reflective materials in the outer retina were absorbed or regressed with outer retinal tissue loss. Additional sequelae of lesion regression included focal choroidal excavation and intraretinal cystoid space. Secondary choroidal neovascularization was noticed in 2 eyes (2/12, 16.67%). CONCLUSION Solitary punctate chorioretinitis is a rare and unique subtype of punctate inner choroidopathy. Solitary punctate chorioretinitis may also be an unrecognized etiology of some forms of focal choroidal excavation and idiopathic choroidal neovascularization.
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Affiliation(s)
- Yuhong Gan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Guiqin He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yunkao Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiongze Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yongyue Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lan Mi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuying Ji
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xuenan Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Feng Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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The role of near-infrared reflectance imaging in retinal disease: A systematic review. Surv Ophthalmol 2022; 68:313-331. [PMID: 36535488 DOI: 10.1016/j.survophthal.2022.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Near-infrared reflectance (NIR) retinal imaging aids in a better visualization of structures at the level of outer retina, retinal pigment epithelium, and choroid. It has multiple advantages, including easy acquisition in association with structural spectral domain optical coherence tomography, more comfort for patients, and enhanced contrast and spatial resolution. It helps in the diagnosis of chorioretinal diseases that present with minimal funduscopic findings and can be used to follow up many chorioretinal conditions. We describe the chorioretinal NIR imaging appearance and the clinical role of NIR imaging in ocular inflammatory disease, vascular and acquired disease, degenerative disease, tumors, associated systemic condition, toxic and traumatic disease, optic nerve head conditions, and physiological findings.
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Clinical Study of Intravitreal Injection of Anti-VEGF Drugs Combined with Triamcinolone Acetonide in the Treatment of Coats Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9911549. [PMID: 35756410 PMCID: PMC9232298 DOI: 10.1155/2022/9911549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the clinical study of intravitreal injection of anti-VEGF drugs combined with intravitreal injection of tretinoin for the treatment of Coats disease. Methods The medical records of 90 patients (120 eyes) with Coats disease admitted to our hospital from April 2010 to June 2021 were selected as retrospective study subjects and divided into control and treatment groups according to the numerical table method. There were 45 cases and 60 eyes in each group. Among them, intravitreal tretinoin drug was injected into the control group, and anti-VEGF drug was injected into the vitreous sclera of the treatment group on the basis of the control group. Results Before treatment, the differences in visual acuity changes between the two groups were not statistically significant (P > 0.05). After treatment, the light perception, manipulation, and indexes of both groups were significantly improved, and the treatment group was significantly better than the control group. This difference was statistically significant (P < 0.05) for statistical study comparison. The effective rate of 95.56% in the treatment group was significantly higher than that of 86.67% in the control group, and the complication rate was significantly lower than that of the control group, with statistically significant differences (P < 0.05). Conclusion Intravitreal injection of anti-VEGF drugs combined with tretinoin injection can significantly improve the clinical efficacy of patients with Coats disease and improve visual acuity and central retinal thickness, which has certain reference value for the clinical treatment of Coats disease.
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Gao R, Ma J, Zhang Z, Shang Q, Duan J. Spectral domain-optical coherence tomography retinal biomarkers in choroidal neovascularization of multifocal choroiditis, myopic choroidal neovascularization, and idiopathic choroidal neovascularization. Ann Med 2021; 53:1270-1278. [PMID: 34353190 PMCID: PMC8354171 DOI: 10.1080/07853890.2021.1961015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/20/2021] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To use optical coherence tomography (OCT) to compare retinal biomarkers of choroidal neovascularization (CNV) secondary to multifocal choroiditis (MFC), myopic choroidal neovascularization (mCNV), and idiopathic choroidal neovascularization (ICNV) and to provide a basis for its clinical diagnosis and treatment. METHODS In this retrospective case study, patients admitted to the Second Hospital of Hebei Medical University between January 2018 and January 2021 who were initially diagnosed with CNV secondary to MFC, mCNV, and ICNV were categorized into groups, by disease, for analysis. Spectral domain-OCT (SD-OCT) was used to describe and measure the morphological characteristics of CNV lesions in each group. The retinal biomarkers of CNV in MFC, mCNV, and ICNV were compared. RESULTS Sixty-eight patients (71 eyes) were included and all eyes were diagnosed with active type 2 CNV. The MFC group had higher refraction than the ICNV group (P2 < 0.05). The choroidal thickness (CT) and CNV diameter of the MFC group were significantly greater than those of the mCNV group (P1 < 0.05). The number of eyes with sub-retinal fluids (SRF) and a "pitchfork sign" was significantly greater in the MFC group than in the mCNV group (P1 < 0.05). There was a significant difference only in CT) values between the MFC and ICNV groups (P2 < 0.001), but not in the other observation indicators (P2 > 0.05). CONCLUSIONS OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV, which can allow the timely selection of treatment in some difficult cases. There were no differences between the MFC group and ICNV group except in refractive error, which indicates that some ICNV cases may be an early stage of a type of occult chorioretinitis. Long-term follow-up is needed for ICNV patients to confirm whether there is any potential inflammation.Key messagesSometimes, it is difficult to separate MFC with CNV from myopic CNV and ICNV in clinical.OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV.There were no differences between the MFC group and ICNV group except in refractive error.
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Affiliation(s)
- Rui Gao
- Ophthalmology Department, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei province, China
| | - Jingxue Ma
- Ophthalmology Department, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei province, China
| | - Zhengwei Zhang
- Ophthalmology Department, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi City, Jiangsu Province, China
| | - Qingli Shang
- Ophthalmology Department, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei province, China
| | - Jialiang Duan
- Ophthalmology Department, Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei province, China
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Gan Y, Zhang X, Su Y, Shen M, Peng Y, Wen F. OCTA versus dye angiography for the diagnosis and evaluation of neovascularisation in punctate inner choroidopathy. Br J Ophthalmol 2020; 106:547-552. [PMID: 33361443 DOI: 10.1136/bjophthalmol-2020-318191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To compare the sensitivity and specificity of identifying and evaluating the choroidal neovascularisation (CNV) in punctate inner choroidopathy (PIC) by optical coherence tomography angiography (OCTA) versus dye angiography. METHODS Consecutive patients diagnosed with PIC were enrolled in this study from June 2016 to December 2019. During the same visit, each patient underwent comprehensive ophthalmological and multimodal imaging examinations. The diagnostic accuracy of different modalities was evaluated. RESULTS The study included 160 affected eyes from 123 patients. Ninety-five eyes (59.38%) were identified with secondary CNV by multimodal imaging. The sensitivity and specificity for CNV detection with OCTA alone were 89.47% and 98.46%, respectively. OCTA also provided the morphology of CNV to determine the activity of CNV with a sensitivity of 86.67% and a specificity of 94.29%. CONCLUSIONS In this study, we investigated the utility of OCTA in the diagnosis and evaluation of patients with CNV secondary to PIC. Compared with dye angiography, OCTA show convincing diagnosis accuracy. Although OCTA has several limitations and is not sufficient to replace dye angiography in clinical practice, it can provide clinicians with a non-invasive way to monitor patients with CNV secondary to PIC and guide treatment decisions.
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Affiliation(s)
- Yuhong Gan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiongze Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yongyue Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mei Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yuting Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Feng Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Cheng LN, Lin YX, Liu L, Zhang XH, Xue YQ, Zhou SD, Liu ZL, Zhang H. Assessment of conbercept therapy for high myopia macular neovascularization by optical coherence tomography angiography. Sci Rep 2020; 10:16959. [PMID: 33046787 PMCID: PMC7550325 DOI: 10.1038/s41598-020-74073-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/31/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the efficacy and safety of the intravitreal injection of conbercept in the treatment of macular neovascularization (MNV) secondary to high myopia and to observe the application of optical coherence tomography angiography (OCTA) in the treatment follow-up. We reviewed the medical records of 20 patients (21 eyes) with MNV secondary to high myopia who were enrolled in the Department of Ophthalmology of the First Hospital of China Medical University between May 2018 and January 2020. Each patient received one or more intravitreal injections of conbercept (0.5 mg/0.05 mL). The treatment was conducted according to a 1 + PRN (pro re nata) regimen. The changes of best corrected visual acuity (BCVA), central macular thickness (CMT), and selected MNV and flow areas measured by OCTA were observed over a 6-month follow-up period. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 1.03 ± 0.61 before treatment and improved to 0.83 ± 0.59 (P = 0.007), 0.78 ± 0.62 (P = 0.001), 0.81 ± 0.73 (P = 0.027), and 0.79 ± 0.72 (P = 0.023) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. The mean CMT was 358.16 ± 206.11 μm before treatment and decreased to 295.38 ± 178.70 μm (P = 0.003), 288.34 ± 165.60 μm (P = 0.004), 284.36 ± 163.07 μm (P = 0.005), and 283.00 ± 160.32 μm (P = 0.004) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. Nineteen eyes (90.5%) had stable or improved vision at 6 months of follow-up. One month after conbercept injection, in OCTA images, the small-diameter blood vessels of the MNV decreased, the intertwined small blood vessels decreased or even disappeared, and the main or larger-diameter blood vessels were still present. The mean selected MNV and blood flow areas were 0.62 ± 0.81 and 0.22 ± 0.27 mm2, respectively, before treatment and decreased to 0.23 ± 0.33 and 0.07 ± 0.08 mm2 (P = 0.04 for both), respectively, 1 month after treatment. No drug-related systemic or ocular adverse effects were observed. Our results suggest that conbercept can effectively and safely improve BCVA and reduce CMT in patients with myopic MVN (mMNV). OCTA can be used to observe MNV area, blood flow area, and MNV morphological changes after treatment with conbercept, thus providing a reference for treatment follow-up.
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Affiliation(s)
- Lu-Na Cheng
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Yu-Xi Lin
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Lei Liu
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.,Department of Public Service, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Xu-He Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Yan-Qi Xue
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Sheng-Di Zhou
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Zhe-Li Liu
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Han Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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Xin X, Zhu Y, Xi R, Hao Y. Establishing a mouse model of choroidal neovascularization to study the therapeutic effect of levotinib and its mechanism. Saudi J Biol Sci 2020; 27:2491-2497. [PMID: 32884431 PMCID: PMC7451724 DOI: 10.1016/j.sjbs.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/13/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Objective To study the therapeutic effect and mechanism of levotinib on choroidal neovascularization (CNV) in mice. Methods 45 healthy C57BL/6 mice were selected and randomly divided into three groups: control group (group A), model group (group B) and levotinib group (group C). The model of CNV in mice was established. The fluorescence leakage of choroidal lesions in mice was observed by fundus fluorescein angiography. The morphological changes of retinal vessels in mice were observed by retinal slice preparation, the pathological changes of eyeball tissues in mice were observed by hematoxylin-eosin (HE) staining, the expression of vascular endothelial growth factor (VEGF) in mice retina was detected by real-time quantitative fluorescence PCR, and the protein expression of VEGF in mice retina was detected by Western blotting. Result On the 7th, 14th and 21st day after modeling, compared with group B, the fluorescence leakage area of group C mice was significantly reduced, and the difference was statistically significant (P < 0.05). The morphology of retinal vessels in group A was normal. In group B, the retinal vessels showed large areas of ischemia without perfusion and abundant neovascularization clusters and capillaries. Compared with group B, the morphology of retinal vessels in group C was significantly improved. Group A mice had normal eyeball structure, group B mice had visible spindle-like damage to the inner and outer retina, while group C mice had significantly less spindle-like damage than group B. Compared with group A, group B mice had significantly higher expression of retinal VEGF and the difference was statistically significant (P < 0.05), but compared with group B mice, the expression of VEGF in the retina of mice in group C was significantly decreased, and the difference was statistically significant (P < 0.05). Compared with group A, the expression of VEGF in retina of group B mice was significantly increased, and the difference was statistically significant (P < 0.05). Compared with group B, the expression of VEGF in retina of group C mice was significantly decreased, and the difference was statistically significant (P < 0.05). Conclusion Levatinib has obvious therapeutic effect on CNV, which may be achieved by inhibiting the high expression of VEGF in CNV.
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Affiliation(s)
- Xiaonan Xin
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yueyu Zhu
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Ruijie Xi
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yuhua Hao
- Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
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Wiryasaputra S, Wong JG. Focal Choroidal Excavation and Central Serous Chorioretinopathy Following Choroidal Neovascularization: A Longitudinal Case Study. JOURNAL OF VITREORETINAL DISEASES 2020; 4:157-162. [PMID: 37008379 PMCID: PMC9976248 DOI: 10.1177/2474126419888135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: This report describes the development of focal choroidal excavation (FCE) and recurrent central serous chorioretinopathy (CSCR) following the treatment of choroidal neovascularization (CNV) years earlier. Methods: A case report is presented. Results: A 30-year-old man previously treated for an active CNV returned several years later with subacute metamorphopsia. Optical coherence tomography and angiography demonstrated no recurrence of the CNV but instead found an FCE and associated CSCR in its place. Conclusion: Longitudinal follow-up with multimodal imaging demonstrated FCE with recurrent CSCR as possible sequelae of treated CNV.
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Affiliation(s)
- S. Wiryasaputra
- Sydney Eye Hospital, Sydney, Australia
- Singapore National Eye Centre, Singapore
| | - J. G. Wong
- Sydney Eye Hospital, Sydney, Australia
- Strathfield Retina Clinic, Sydney, Australia
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Cunningham ET, Pichi F, Dolz-Marco R, Freund KB, Zierhut M. Inflammatory Choroidal Neovascularization. Ocul Immunol Inflamm 2020; 28:2-6. [DOI: 10.1080/09273948.2019.1704153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Emmett T. Cunningham
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA
- The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA
| | - Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- The Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - K. Bailey Freund
- Vitreous-Retina-Macula Consultants of New York, New York, New York, USA
| | - Manfred Zierhut
- Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany
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Bilateral Multiple Focal Choroidal Excavations in a Patient with Paroxysmal Nocturnal Hemoglobinuria (PNH). Case Rep Ophthalmol Med 2020; 2019:7925737. [PMID: 31915557 PMCID: PMC6930727 DOI: 10.1155/2019/7925737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/15/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022] Open
Abstract
Focal choroidal excavation (FCE) is an unusual configuration characterized by focal thinning and pitting of the choroid in the absence of staphyloma or scleral ectasia. The etiology and clinical implications of FCE are currently unknown. We report a case of bilateral multiple FCEs in a patient with a long history of paroxysmal nocturnal hemoglobinuria (PNH). Focal choriocapillaris thinning and hyperreflectivity of the adjacent outer nuclear layer were revealed by spectral domain optical coherence tomography, which suggests the occlusion of the choriocapillaries and secondary degeneration of the above photoreceptors. We hypothesize that thrombophilia in the condition of PNH played an important role in the formation of FCE. Although there is no histopathological evidence to support the association between the choroid changes and PNH, this case may offer new clues as for the etiology of FCE.
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Hua R, Ning H. Using optical coherence tomography angiography to guide the treatment of pathological myopic patients with submacular hemorrhage. Photodiagnosis Photodyn Ther 2019; 28:105-109. [PMID: 31470121 DOI: 10.1016/j.pdpdt.2019.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
Abstract
The present study aimed to investigate whether optical coherence tomography angiography (OCTA) could be used to guide the treatment of pathological myopic patients with submacular hemorrhage. Two pathological myopia patients with submacular hemorrhage were examined. Initially, choroidal neovascularization (CNV) was not observed during fundus angiography in both patients. However, based on OCTA, the first patient was diagnosed with myopic lacquer crack-related macular hemorrhage, and the second with CNV secondary to punctate inner choroidopathy. The first patient was treated with traditional Chinese medicine administered orally, and the second with intravitreal injections of anti-vascular endothelial growth factor (VEGF). Lesions in both patients were resolved. Submacular hemorrhage in pathological myopia patients could be caused by numerous mechanisms. OCTA is useful in differentiating inflammatory CNV from inflammatory lesions, particularly if CNV is not detected using other multimodal imaging techniques.
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Affiliation(s)
- Rui Hua
- Ophthalmology, The First Affiliated Hospital of China Medical University, No. 155, Nanjingbei Street, Shenyang, 110001, China
| | - Hong Ning
- Ophthalmology, The First Affiliated Hospital of China Medical University, No. 155, Nanjingbei Street, Shenyang, 110001, China.
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