Photodynamic therapy for polypoidal choroidal vasculopathy.

The first effective therapy for exudative macular degeneration (AMD) was Photodynamic Therapy (PDT). Diagnosis of the disease was to a large extent by fluorescein angiography (FA). Distinguishing between the leaky choroidal neovessels (CNV) associated with exudative AMD, and the polypoidal structures associated with Polypoidal Choroidal Vasculopathy (PCV) is not always easy using FA alone.

Reflectance imaging of the human retina at 810 nm does not suffice to optimize the parameters of hydrodynamic rebalancing laser treatment.

The hydrodynamic rebalancing laser (HRL) procedure is an ophthalmic therapy based on the administration of subthreshold infrared (810 nm) laser light to selected areas on the retina to treat various retina diseases. Heterogeneities of tissue response are observed, including undesired retinal damages. Variations of tissue absorbance were hypothesized to cause this uneven response.

Subretinal neovascular membranes complicating uveitis: frequency, treatments, and visual outcome.

Purpose: Retrospective evaluation in a uveitic population of subretinal neovascular membranes (SRNMs), their occurrence, visual impact, and outcome in differently treated subgroups of patients.

Methods: Medical records of patients were reviewed and cases with SRNM (n = 12) identified. Intraocular inflammation was classified according to vitreous examination records as high (2+ cells), low (1/2+ to 1+ cells), or inactive (0 cells).

Verteporfin therapy for subfoveal choroidal neovascularization in age-related macular degeneration: from clinical trials to clinical practice.

People with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) are at high risk of central vision loss. Until verteporfin therapy became available, there was no safe and effective treatment for a large majority of these people. The phase III clinical trials of verteporfin therapy showed that treatment could safely reduce the risk of vision loss in the majority of patients presenting with either predominantly classic CNV or with occult with no classic CNV, and in selected patients with minimally classic CNV.

Photodynamic therapy with verteporfin in ocular histoplasmosis: uncontrolled, open-label 2-year study.

Objective: To evaluate the safety, effect on visual function, and fluorescein angiographic appearance of subfoveal choroidal neovascularization (CNV) through 2 years after photodynamic therapy with verteporfin (Visudyne; Novartis AG, Basel, Switzerland) in patients with ocular histoplasmosis syndrome (OHS).

Design: Open-label, 3-center, uncontrolled clinical study.

Participants: Ocular histoplasmosis syndrome patients with subfoveal CNV (N = 26) with a greatest linear dimension no larger than 5400 microm with classic or occult CNV extending under the geometric center of the fovea, and best-corrected visual acuity letter score of approximately 20/40 to 20/200.

Acute severe visual acuity decrease after photodynamic therapy with verteporfin: case reports from randomized clinical trials-TAP and VIP report no. 3.

Purpose: To describe in detail occurrences of acute severe visual acuity decrease after photodynamic therapy (PDT) with verteporfin in the Treatment of Age-related macular degeneration with Photodynamic therapy (TAP) Investigation and the Verteporfin In Photodynamic therapy (VIP) Trial.

Design: Observational case series.

Methods: Retrospective review of all cases that developed acute severe visual acuity decrease after treatment.

[Visudyne photodynamic therapy and feeder vessel occlusion: rationale of a synergistic association and clinical options].

Purpose: Visudyne photodynamic therapy (PDT) has provided considerable improvement in patient care of subfoveal choroidal neovascularization (CNV). Patients tend to loose vision for a few months after the initial treatment, but the 4-year proven stability in vision most often provides an acceptable quality of life, sometimes with additional low vision rehabilitation. The initial visual acuity loss, borderline cost-effectiveness, and subgroups of patients not responding to PDT warrant improving the symptomatic treatment of subfoveal CNV.

On the selectivity of photodynamic therapy of choroidal neovascularization associated with age-related macular degeneration.

Purpose: This paper discusses the lack of complete selectivity in the photodynamic closure of choroidal neovasculature (CNV) associated with age-related macular degeneration. The arguments presented are supported by examples of clinical observations and may be useful for the design of the next generation of photosensitizers.

Results And Conclusion: Based on worldwide patient follow-up, it can be concluded that a substantial number of the more than 200000 treatments that have been dispensed so far could have resulted in stabilization of the disease for at least a number of years.

Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial--VIP report no. 3.

Purpose: To report 24-month vision and fluorescein angiographic outcomes from trials evaluating photodynamic therapy with verteporfin in patients with subfoveal choroidal neovascularization (CNV) caused by pathologic myopia.

Design And Setting: Multicenter, double-masked, placebo-controlled, randomized clinical trial at 28 ophthalmology practices in Europe and North America.

Participants: Patients with subfoveal choroidal neovascular lesions caused by pathologic myopia measuring no more than 5400 micro m and best-corrected visual acuity (approximate Snellen equivalent) of 20/100 or better.

Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin in the ocular histoplasmosis syndrome: one-year results of an uncontrolled, prospective case series.

Objective: To evaluate the safety and effect on visual acuity of photodynamic therapy with verteporfin (Visudyne, Novartis AG) in patients with subfoveal choroidal neovascularization (CNV) secondary to the ocular histoplasmosis syndrome (OHS).

Design: Open-label, three-center, noncomparative prospective case series.

Participants: OHS patients with subfoveal CNV lesions no larger than 5400 micro m in greatest linear dimension (GLD) with classic or occult CNV extending under the geometric center of the foveal avascular zone and best-corrected visual acuity letter score of 73 to 34 (approximate Snellen equivalent 20/40-20/200).

Early detection, diagnosis and management of choroidal neovascularization in age-related macular degeneration: the role of ophthalmologists.

Choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) is a serious condition which, if unrecognized and untreated, can result in the rapid deterioration of vision. Early detection and prompt referral to a retina specialist may potentially reduce the high risk of severe vision loss. The majority of AMD patients with CNV who present to an ophthalmologist will have been referred by either a primary care physician or an optometrist.

Implantable contact lens for moderate to high myopia: short-term follow-up of 2 models.

Purpose: To confirm the safety, efficacy, and predictability of the surgical correction of moderate to high myopia by the ICM V3 and ICM V4 implantable contact lenses (ICLs), with emphasis on vaulting, intraocular pressure (IOP), and pigment dispersion.

Setting: University Eye Hospital, Lausanne, Switzerland.

Methods: Thirty-two eyes had implantation of an ICL.

A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.

Objective: To evaluate short-term safety and the effects on visual acuity and fluorescein angiography of single or multiple sessions of photodynamic therapy with verteporfin for choroidal neovascularization (CNV) not related to age-related macular degeneration (AMD), including pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.

Design: A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial.

Setting: Four ophthalmic centers in Europe and North America providing retinal care.

Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration: results of retreatments in a phase 1 and 2 study.

Objectives: To evaluate safety and short-term visual acuity and fluorescein angiographic effects of photodynamic therapy (PDT) after retreatments with verteporfin for choroidal neovascularization (CNV) in age-related macular degeneration (AMD) that demonstrated fluorescein leakage after at least 1 course of PDT.

Design: Nonrandomized, multicenter, open-label phase 1 and 2 clinical trial using 2 different retreatment dosage regimens.

Setting: Four ophthalmic centers in Europe and North America providing retinal care.

Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration: results of a single treatment in a phase 1 and 2 study.

Objective: To evaluate the safety and short-term visual and fluorescein angiographic effects of a single photodynamic therapy treatment with verteporfin with the use of different dosage regimens in patients with choroidal neovascularization (CNV) from age-related macular degeneration.

Design: Nonrandomized, multicenter, open-label, clinical trial using 5 dosage regimens.

Setting: Four ophthalmic centers in North America and Europe providing retinal care.

A computer-based method to quantify the classic pattern of choroidal neovascularization in order to monitor photodynamic therapy.

Background: Photodynamic therapy (PDT) is a new treatment modality which relies on a nonthermal light exposure of choroidal neovascularization (CNV) which has accumulated a photosensitizer, to produce a photochemical thrombosis. The aim of the present study was to develop a more quantitative outcome parameter that can be used to optimize a number of treatment parameters which in PDT are larger than many other modalities.

Methods: Nine patients underwent up to four standardized fluorescein angiography (FA) examinations on a Zeiss 30 degrees retinograph using Kodak Trimax film.

Deep sclerectomy with collagen implant: medium term results.

Aims: To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI), a new non-penetrating filtration procedure.

Methods: Non-randomised prospective trial involving consecutive patients. 100 eyes of 100 patients with medically uncontrolled primary and secondary open angle glaucoma.

Comparison of deep sclerectomy with collagen implant and trabeculectomy in open-angle glaucoma.

Purpose: To assess the efficacy and postoperative complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure.

Setting: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland.

Methods: Forty-four eyes of 44 patients with medically uncontrolled open-angle glaucoma had DSCI and a matched control group of 44 patients, trabeculectomy.

Nd:Yag goniopuncture after deep sclerectomy with collagen implant.

Background And Objective: To study the need, the safety and the success rate of Nd:Yag goniopuncture in eyes that underwent deep sclerectomy with collagen implant.

Patients And Methods: The first 100 patients that underwent deep sclerectomy with collagen implant were prospectively followed. Deep sclerectomy with collagen implant is a non-penetrating filtering surgery which allows filtration of aqueous from the anterior chamber to the subconjunctival space through a remaining trabeculo-Descemet's membrane without opening the anterior chamber.

Change in capsulorhexis size with four foldable loop-haptic lenses over 6 months.

Purpose: To compare the change in continuous curvilinear capsulorhexis (CCC) size after implantation of four types of three-piece foldable intraocular lenses (IOLs) and determine whether initial CCC size and IOL characteristics play a role in the change.

Methods: This study comprised 133 eyes that had phacoemulsification and in-the-bag implantation of one of four types of foldable IOLs: Alcon AcrySof MA30BA (n = 36); lovision 127 (n = 29); Mentor ORC MemoryLens (n = 39); Allergan PhacoFlex II (n = 29). Photographs of the CCCs were taken with a digital retinograph 1 day and 6 months after surgery.

Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples.

Background: Conventional photocoagulation of subfoveal choroidal neovascularization (CNV) is often accompanied by visual loss due to thermal damage to adjacent retinal structures. Photodynamic therapy (PDT) allows vascular occlusion by selective photochemical destruction of vascular endothelial cells only. In a pilot study we evaluated the use of PDT in CNV.

Morphometric characteristics of traumatic choroidal ruptures associated with neovascularization.

Purpose: To define the morphometric characteristics of indirect choroidal ruptures associated with choroidal neovascularization (CNV).

Methods: A total of 79 eyes that had sustained traumatic indirect choroidal ruptures was studied retrospectively. Color pictures of the fundus and fluorescein angiograms were available in all cases, and patients were followed for at least 1 year.

[Exudative parafoveal astrocytic hamartoma associated with Bourneville tuberous sclerosis: spontaneous evolution].

The authors present an unusual case of exsudative parafoveolar astrocytic hamartome associated with tuberous sclerosis. The spontaneous regression of the serous retinal detachment and of the hard exsudates is described.