Purpose: The aim of this study was to evaluate the prognostic factors of visual outcome after intravitreal anti-vascular endothelial growth factor injection in patients with myopic choroidal neovascularization (CNV).Methods: Forty eyes of 40 consecutive patients with myopic CNV who had received intravitreal ranibizumab or bevacizumab injections were retrospectively reviewed. Baseline visual acuity, presence of lacquer crack, dark rim, peripapillary choroidal atrophy size, and location of myopic CNV were evaluated using fluorescein angiography and indocyanine green angiography.Results: The logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) at 12 months after treatment was 0.23 6 0.28, and there was a significant improvement compared with the baseline BCVA (P = 0.001). After multiple linear regression analysis, baseline BCVA, presence of lacquer crack extending the fovea, and peripapillary choroidal atrophy size were the factors that significantly correlated with BCVA at 12 months (P = 0.001, P = 0.04, and P = 0.04). For mean change in BCVA over 12 months, there were also significant correlations with baseline BCVA, lacquer crack extension to the fovea, and peripapillary choroidal atrophy size (P = 0.001, P = 0.03, and P = 0.03). The mean number of anti-vascular endothelial growth factor injections was 2.8 6 2.0 over 12 months. Complete resolution of myopic CNV was noted in 22 eyes (55.0%) after initial first injection, and no additional treatment was required in 12 eyes (30%).Conclusion: Better baseline BCVA, lacquer crack extension to the fovea, and peripapillary atrophy were negative prognostic factors of visual acuity improvement, and there was quite a promising result of anti-vascular endothelial growth factor treatment in patients with myopic CNV.RETINA 32:949-955, 2012
Objective The aim of this study was to clarify the characteristic findings in myopic choroidal neovascularization (CNV) and the relationship with lacquer crack (LC). Methods In all, 66 consecutive myopic CNV patients treated with photodynamic therapy and/or intravitreal anti-vascular endothelial growth factor injection in one eye were reviewed. Data from fluorescein angiography (FA) and indocyanine green angiography (ICGA), obtained simultaneously using the Heidelberg retina angiograph 2 (HRA2), were analyzed. Results LCs were associated with a relatively large extent (Z3000 lm) of peripapillary choroidal atrophy and a dark rim, the proliferation of retinal pigment epithelial cells surrounding the neovascular membrane was accompanied by a small extent. Myopic CNV usually developed in the LC area surrounded by tiny crack fragments. In all, 35 patients with LCs received FA and ICGA at least twice during follow-up. LC progression was observed in nine (25.7%) treated eyes and six (23.1%) non-CNV fellow eyes. Crack fragments progressed in three distinct forms such as elongation, branching, or bridging pattern. Newly diagnosed myopic CNV was reported in 18 treated eyes and 3 fellow eyes. Progression of LCs and development of CNV occurred simultaneously in eight eyes. By multivariate Cox's regression, a statistically significant association was observed between recurrence of myopic CNV and the absence of a dark rim on ICGA. Conclusions The HRA2 instrument affords detailed high-resolution images of FA and ICGA. Notably, recurrence of myopic CNV developed in areas surrounded by new small crack fragments and LCs are considered to be important in the development of myopic CNV.
PurposeThe purpose of this study is to assess patient attitudes towards anti-glaucoma medication and their association with adherence, visual quality of life, and personality traits.Materials and MethodsOne hundred and forty-seven glaucoma patients were enrolled this study. The participants were divided into 'pharmacophobic' and 'pharmacophilic' groups according to their scores on the Modified Glaucoma Drug Attitude Inventory (MG-DAI). To establish a correlation with patient drug attitude, each group had their subjective drug adherence, visual quality of life, and personality traits examined. For personality traits, the Myers-Briggs Type Indicator (MBTI) was used to sub-classify each group.ResultsAmong the patients analyzed, 91 (72.80%) patients showed a 'pharmacophobic' attitude and 34 (27.20%) patients showed a 'pharmacophilic' attitude. The pharmacophobic group tended to have worse adherence than the pharmacophilic group. Personality dichotomies from the MBTI also showed different patterns for each group.ConclusionIn glaucoma patients, pharmacological adherence was influenced by their attitude towards drugs; an association might exist between drug attitude and underlying personality traits.
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