Chorioretinal anastomosis and photodynamic therapy:a two-year follow-up study

Silva, Rufino; Cachulo, Maria da Luz; Figueira, João; Abreu, J. R. Faria de; Cunha-Vaz, Josè

doi:10.1007/s00417-006-0532-y

Cited by 26 publications

(24 citation statements)

References 21 publications

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“…The prevalence of RAP is higher than expected [14,15,16,17] and this may contribute to a higher rate of CNV development. In fact, patients with RAP are believed to have a much higher risk of developing bilateral lesions than patients with other forms of neovascularization – 100% at 3 years [15,16,18]. The fact that no eyes developed polypoidal choroidal vasculopathy is of relevance and may be due to the fact that every patient included had clear evidence of a large central scar in the non-study eye due to CNV.…”

Section: Discussionmentioning

confidence: 99%

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Early Markers of Choroidal Neovascularization in the Fellow Eye of Patients with Unilateral Exudative Age-Related Macular Degeneration

et al. 2010

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Objective: To identify morphological and/or functional early markers of choroidal neovascularization (CNV) development in fellow eyes of patients with exudative age-related macular degeneration (AMD). Design: This is a single-center, prospective, observational, longitudinal 2-year study. Patients: Patients were enrolled with the diagnosis of neovascular AMD in 1 eye and early age-related maculopathy (ARM) in the fellow eye. Intervention or Methods: All patients completed the baseline assessment and were followed up for up to 24 months with repeated ophthalmic and imaging assessments performed at 6-month intervals. Main OutcomeMeasures: Each patient underwent a detailed ocular and medical history, a complete ophthalmologic examination with color fundus photography, fluorescein angiography, indocyanine green angiography (ICG), optical coherence tomography (OCT), fundus autofluorescence (FAF) imaging and retinal leakage analysis (RLA). Results: Sixty-two patients were enrolled in the study. Large or intermediate drusen were present in 100% of the study eyes and hyperpigmentation in 46% (24 eyes). Fifty-two patients completed the 2-year study follow-up. Large soft drusen (>125 µm) were observed in 15 out of 17 eyes (88%) that converted and developed CNV during the study and in 25 out of 35 eyes (71.4%) that did not develop CNV. Among the 17 eyes that developed CNV, 9 (53%) showed abnormal findings before conversion, on ICG. No particular FAF pattern was found to be correlated with conversion to wet AMD. OCT was able to document the presence of intra- or subretinal fluid at the time of conversion in all 17 eyes that developed CNV during the study. Alterations of the blood-retinal barrier were identified by RLA before conversion in 76% of the eyes that converted and 23% of the eyes that did not convert during the study. Conclusions: Characterization of early ARM phenotypes is challenging. By combining different imaging modalities of the macula and correlating this information, we were able to determine the presence of functional macular alterations in the fellow eye of patients with this disease before development of CNV.

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Section: Discussionmentioning

confidence: 99%

“…Hot spots are observed frequently in RAP, polypoidal choroidal vasculopathy and focal occult CNV [14]. Plaques are larger than 1 disk diameter in size and may be associated with non-active areas of neovascularization [18,19]. ICG may demonstrate neovascular connections between the choroid and retina, in the form of anastomoses.…”

Section: Discussionmentioning

confidence: 99%

Early Markers of Choroidal Neovascularization in the Fellow Eye of Patients with Unilateral Exudative Age-Related Macular Degeneration

et al. 2010

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“…Moreover, the fellow eye is at high risk of developing RAP (Gross et al 2005). Various treatments for RAP, such as conventional laser photocoagulation (Slakter et al 2000;Johnson & Glaser 2006), photodynamic therapy (PDT) (Boscia et al 2004;Panagiotidis et al 2006;Silva et al 2007), surgical therapy (Borrillo et al 2003;Sakimoto et al 2005;Shiragami et al 2007) or combined therapies (Boscia et al 2005;Nakata et al 2006), have been discouraging or showed limited success with recurrent exudation. Recent studies showed that combined therapy of intravitreal triamcinolone and PDT effectively reduced angiographic leakage and had a positive effect on visual acuity (Freund et al 2006;van de Moere et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Kramann

Schöpfer

Lorenz

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To determine the efficacy of intravitreal injections of ranibizumab in the treatment of retinal angiomatous proliferation (RAP) in neovascular agerelated macular degeneration. Methods: Retrospective, consecutive case series of 26 eyes (26 patients) treated with intravitreal injections of 0.5 mg ranibizumab for RAP. Patients received intravitreal injections at monthly intervals during upload phase for a 3-month period. Results: Mean visual acuity before treatment was 0.75 ± 0.38logMAR (mean ± SD, n = 26). In the upload phase, mean visual acuity improved 4 weeks after the initial injection to 0.6 ± 0.37logMAR (n = 26) and to 0.53 ± 0.34logMAR (n = 26) 4 weeks after the third monthly intravitreal injection of ranibizumab. The mean optical coherence tomography (OCT) central foveal thickness reduced from 345 ± 55 lm at baseline to 215 ± 87 lm at 3 months. In the maintenance phase, mean visual acuity after 6 months was 0.66 ± 0.38logMAR (n = 12) and 0.7 ± 0.37logMAR after 9 months (n = 6). The mean OCT central foveal thickness was 259 ± 59 lm (n = 13) at 6 months and 280 ± 127 lm (n = 6) at nine-month follow-up. Conclusion: Intravitreal ranibizumab resulted in an improvement of visual acuity 4 weeks after the first injection but was more pronounced after 3 months. A reduction in leakage and OCT central foveal thickness was seen 3 months after the commencement of treatment.

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“…The therapy strategies used in the past were numerous and included conventional laser photocoagulation [11,12], photodynamic therapy [13][14][15], surgery [16][17][18][19] or combinations [16,20], all with more or less discouraging outcomes.…”

Section: Introductionmentioning

confidence: 99%

Late Stage III Retinal Angiomatous Proliferation with Retino-Choroidal Anastomosis do not Respond Well to Treatment with Ranibizumab (Lucentis®)

Matthé¹,

Sandner²,

Maaß³

2017

Int J Neurorehabilitation Eng

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Background: Retinal Angiomatous Proliferations (RAP) is a subgroup of exsudative or "wet" Age-related Macular Degeneration (wAMD) with devastating reduction of visual acuity in later stages. Intravitreal Ranibizumab provides a good therapy, but is considered to be not as effective in this class of neovascularization compared to choroidal neovascularization (CNV). We investigated the efficacy of Ranibizumab in late stage III RAP with retino-choroidal anastomosis compared to the outcome of CNV lesions.

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Chorioretinal anastomosis and photodynamic therapy:a two-year follow-up study

Abstract: AMD eyes with chorioretinal anastomosis can benefit from PDT with Verteporfin at two years. However, during the second year significant additional VA loss occurs mainly due to recurrence. New modalities of treatment are necessary to achieve VA improvement in CRA eyes.

Cited by 26 publications

References 21 publications

Early Markers of Choroidal Neovascularization in the Fellow Eye of Patients with Unilateral Exudative Age-Related Macular Degeneration

Early Markers of Choroidal Neovascularization in the Fellow Eye of Patients with Unilateral Exudative Age-Related Macular Degeneration

Intravitreal ranibizumab treatment of retinal angiomatous proliferation

Late Stage III Retinal Angiomatous Proliferation with Retino-Choroidal Anastomosis do not Respond Well to Treatment with Ranibizumab (Lucentis®)

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