Pathogenesis of lesions in late age-related macular disease

Holz, Frank G.; Pauleikhoff, Daniel; Klein, Ronald; Bird, Alan C.

doi:10.1016/j.ajo.2003.11.026

Cited by 198 publications

(129 citation statements)

References 25 publications

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“…Type 1 and type 2 CNVs are due to a modification in the balance of growth factor secreted by RPE and a similar mechanism could account for type 3 neovascularization in AMD. 18 The results of this study show that at month 12, 86% of eyes lost less than 15 letters, and 10% of eyes gained 15 letters or more. These data may be compared with those obtained in other studies such as the MARINA study 19 for either minimally classic or occult type 1 CNV in AMD, or the PrONTO study in which the therapeutic scheme is globally similar to the one applied on our case series.…”

Section: Discussionmentioning

confidence: 76%

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Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Atmani

Voigt

Tien

et al. 2010

Eye

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Purpose To assess the 1-year functional outcome and to evaluate the morphological changes after intravitreal injections of ranibizumab in eyes affected with retinal angiomatous proliferation (RAP) due to age-related macular degeneration (AMD). Methods A prospective, non-randomized, interventional study was conducted on 26 consecutive patients with newly diagnosed RAP. All eyes were treatment naive and were randomized to receive intravitreal injections of ranibizumab for a 12-month period. After the first three monthly injections, re-treatment was performed in case of best-corrected visual acuity (BCVA) loss of at least five letters associated with fluid within the macula, central macular thickness (CMT) increase of at least 100 lm, and/or persistence of fluid within the macula as evaluated by optical coherence tomography, new onset macular haemorrhages, persistence of leakage from the lesions on fluorescein angiography. Results All patients completed the 12-month follow-up: 25 of the 29 treated eyes (86.2%) were stabilized, with a loss of less than 15 letters. Nineteen eyes (65.5%) maintained or improved their BCVA, and three eyes (10.3%) gained three lines or more. Overall, mean BCVA remained stable at the 12-month follow-up (À0.07 letters; P40.05). Mean CMT significantly decreased from 386 ± 147 to 216 ± 74 lm at the 12-month follow-up. No significant adverse events were observed during the study. The mean number of injections was 5.8±1.7 during the follow-up period. Conclusion The 1-year follow-up outcomes in our series suggest that ranibizumab is an effective treatment for RAP in AMD, allowing stabilization of BCVA and reduction of CMT.

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Section: Discussionmentioning

confidence: 76%

“…Its effect on PED is less obvious, probably because PED, which is frequently associated with this phenotype, is not only due to exudation but may be related to changes in resistance to water flow in the Bruch's membrane. 18 In our series the PED was detectable in 86% of eyes at baseline and in 66% of eyes at month 12.…”

Section: Discussionmentioning

confidence: 77%

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Atmani

Voigt

Tien

et al. 2010

Eye

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“…In particular, the development of exudative AMD is responsible for this situation. [1][2][3][4] Modern diagnostic procedures can distinguish among the subgroups of AMD. 5,6 Around 10% of all patients present with serous pigment epithelial detachment (PED).…”

Section: Introductionmentioning

confidence: 99%

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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Aims To investigate the therapeutic effects of different treatments on serous pigment epithelium detachment (PED) in age-related macular degeneration (AMD). Methods A total of 328 patients suffering from serous PED in AMD were retrospectively analysed. We treated only patients with documented visual deterioration: 86 patients with bevacizumab, 128 with ranibizumab, 60 with pegaptanib, and 54 with photodynamic therapy (PDT) combined with intravitreal triamcinolone acetonide (IVTA). Bestcorrected vision was determined in the logarithm of the minimal angle of resolution (logMAR). We also analysed morphological findings such as full foveal thickness by optical coherence tomography (OCT), manually calculated height of PED as measured by OCT, and fluorescence angiography. Results The mean follow-up was 42.4 weeks. The best-corrected visual acuity of 0.78 logMAR before treatment could be improved by about 0.066 logMAR after treatment. Retinal thickness decreased in all patients with PED, in the mean by about 64.06 lm, and the mean value of the manually calculated height decreased by about 0.98 units. All functional and morphological results proved to be significantly better after injection of ranibizumab and bevacizumab than after pegaptanib and the combined treatment with PDT and IVTA. In all, 41 (12.5%) of our patients developed a tear of the retinal pigment epithelium (RPE). Conclusion The therapeutic results were significantly better in patients treated with bevacizumab and ranibizumab than in those treated with pegaptanib or with a combination of PDT and IVTA. Even with treatment, tears of the RPE or only a partial flattening of the PED always indicated a worse prognosis in eyes with exudative AMD than in eyes with classic choroidal neovascularization.

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“…Retinal disease can impact any of several classes of retinal neurons. However, vision loss from the diseases that cause the most cases of acquired blindness in the world (2), age-related macular degeneration (AMD) and glaucoma, is primarily due to the progressive death of photoreceptors (3,4) and RGCs (5), respectively. Although adaptive optics (AO) ophthalmoscopy can image photoreceptors, their survival can be uncertain when pathology has altered the retina.…”

mentioning

confidence: 99%

Imaging individual neurons in the retinal ganglion cell layer of the living eye

Rossi

Granger

Sharma

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

178

151

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Although imaging of the living retina with adaptive optics scanning light ophthalmoscopy (AOSLO) provides microscopic access to individual cells, such as photoreceptors, retinal pigment epithelial cells, and blood cells in the retinal vasculature, other important cell classes, such as retinal ganglion cells, have proven much more challenging to image. The near transparency of inner retinal cells is advantageous for vision, as light must pass through them to reach the photoreceptors, but it has prevented them from being directly imaged in vivo. Here we show that the individual somas of neurons within the retinal ganglion cell (RGC) layer can be imaged with a modification of confocal AOSLO, in both monkeys and humans. Human images of RGC layer neurons did not match the quality of monkey images for several reasons, including safety concerns that limited the light levels permissible for human imaging. We also show that the same technique applied to the photoreceptor layer can resolve ambiguity about cone survival in age-related macular degeneration. The capability to noninvasively image RGC layer neurons in the living eye may one day allow for a better understanding of diseases, such as glaucoma, and accelerate the development of therapeutic strategies that aim to protect these cells. This method may also prove useful for imaging other structures, such as neurons in the brain.

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Pathogenesis of lesions in late age-related macular disease

Cited by 198 publications

References 25 publications

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Imaging individual neurons in the retinal ganglion cell layer of the living eye

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