Polypoidal choroidal vasculopathy is not an uncommon disease in Italy and should be suspected in patients presenting with extramacular lesions and no large drusen in the fellow eye.
Purpose: To describe clinical findings in patients with acute exudative polymorphous vitelliform maculopathy (AEPVM). Design: Retrospective, observational, multicenter case series review. Participants: Consecutive patients diagnosed with idiopathic AEPVM. Methods: Review of clinical charts, multimodal imaging, electrophysiologic findings, and genetic findings in previously unpublished patients and review of the literature. Main Outcome Measures: Clinical features of idiopathic AEPVM and differential diagnosis. Results: Eighteen patients (age range, 21e74 years) with typical features of AEPVM, including initial localized, serous detachments followed by the development of characteristic yellow-white deposits in the vitelliform space. Over time, this hyperautofluorescent material gravitated within the larger lesions, resulting in typical curvilinear deposits characteristic of later stages. Symptoms and clinical findings lasted from weeks to several years. Some patients showed previously undescribed features such as fluorescein-negative intraretinal cystic changes, choroidal neovascularization, serous retinal elevations mimicking retinal folds, increased choroidal thickness, lack of rapid visual recovery, and recurrence years after complete resolution of initial manifestations. Conclusions: Acute exudative polymorphous vitelliform maculopathy can present with a more variable natural course than previously described. Paraneoplastic retinopathy and autosomal recessive bestrophinopathy closely resemble AEPVM, necessitating medical and hereditary evaluation to exclude these clinical possibilities. This series of patients with AEPVM expands the clinical spectrum of the disorder, including demographics, clinical manifestations, imaging features, natural course, and visual prognosis.
Summary
Purpose: To evaluate macular volume in normal and glaucomatous eyes using Optical Coherence Tomography (OCT).
Methods: Fifty eyes of 30 patients (age: 49–68); 20 eyes normal, 15 eyes with early glaucoma and 15 eyes with advanced glaucoma have been studied with the commercially available OCT unit (OCT 2000) (Humphrey Zeiss, Dublin, CA, USA). All eyes were examined at a scan length of 3.44 mm vertically across the fovea. OCT macular retinal thickness maps were used to calculate macular volume.
Results: We observed significant differences between groups. Normals (7.35 ± 0.455 mm3) and early glaucoma (7.09 ± 0.475 mm3), each had significantly greater volume than subjects with advanced glaucoma (6.678 ± 0.455 mm3).
Conclusions: Volumetric analysis of macular thickness with OCT tomograms may be a useful method of documenting and monitoring patients with early glaucoma and advanced glaucoma. In our analysis, and according to the observations of other authors, OCT macular volumes correlates significantly with glaucoma status.
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