The first three days seem to represent a relatively safe period during which surgery for macula-off retinal detachment may be postponed without compromising the patient's visual prognosis.
Photodynamic therapy combined with injection of intravitreal bevacizumab tends to be more effective compared to PDT monotherapy by reducing the post-PDT increase of vascular growth and inflammatory factors. Our short-term results are very promising. Further studies are necessary to show the long-term effect of PDT and anti-VEGF combination therapy.
Purpose To discuss the influence of AMD on critical flicker fusion frequency (CFF)
Methods CFF was measured centrally for red, green and blue signal and in 10° excentricity with a red signal. 33 patients with non exsudative AMD and a visual acuity (VA) of 20/100‐20/20, 12 patients with exsudative AMD (VA: 20/100‐20/25) and 45 age‐matched healthy eyes (VA: 20/32‐20/20) were included.
Results CFF decreased in eyes with non exsudative AMD (red 1,6Hz p=0,01, green 1,6 Hz p=0,04, blue 2,1 Hz p=0,01). The difference between central and peripher CFF increased (red‐red 10°, 1,0 Hz p=0,01). Differences between different colours were low and reached no significance. In eyes with exsudative AMD CFF showed lower values (red 2.2 Hz p=0.02, green 3.3 Hz p=0.001, blue 2,9 Hz p=0.02, but in spite of increased difference between central and peripher CFF had no statistical significance. (red‐red 10° , 1,3 Hz p=0,25). Eyes with exsudative AMD showed a 1.0 Hz (p=0.02) higher difference between CFF with a red and a green signal than healthy eyes. Sub‐group analysis of patients with non exsudative AMD and visual acuity better than 20/32 (n=20) and healthy eyes showed no difference. Patients with non exsudative (n=13) and eyes with exsudative AMD (n=7) and VA between 20/200 and 20/40 reached equal CFF values.
Conclusion CFF was decreased in non exsudative and exsudative AMD. The difference between central and peripher CFF increased in exsudative and nonexsudative AMD. Exsudative AMD has a stronger impact on a green than on a red signal. CFF is not able to distinguish between groups of equal visual acuity and therefore not applicable as a diagnostic test.
Intravitreal therapy with bevacizumab was safe and well tolerated. It is a therapeutic option in treating occult choroidal neovascularisations and minimal classic CNV. Six months after intravitreal administration of bevacizumab mean visual acuity was stabilised. Retinal thickness and leakage were more reduced after 1 month than after 3 and 6 months. According to our results, a monthly injection schedule could give more favourable results.
Purpose: Acute zonal occult outer retinopathy (AZOOR) is one of the "white dot syndromes" a clinically heterogeneous group of inflammatory chorioretinopathies. The etiology is not yet clear.
Methods: We present a 50 years female patient with a prior history of migraine. She experienced progressive visual loss and visual field defects in the last 3 years. Preceding each episode she experienced blue flickering photopsias.
Results: Visual acuity was 0,3 in the right eye and 0,6 in the left eye. Biomicroscopy showed a normal anterior segment, fundus exam revealed pigment epithelial atrophy more pronounced in the worse eye. Electrophysiology showed a marked reduction in the photopic ERG in the more affected eye. MRI demonstrated multiple white matter lesions including a corpus callosum location. Lumbar puncture showed oligoclonal bands. Further tests demonstrated hearing impairment.
Therapy was instituted during the three years course of the disease with steroids, immune suppressants and plasmapheresis with visual loss being progressive. New photopsia is currently present.
Conclusions: The etiology of AZOOR remains unclear. With our patient being one of the few described in the literature with concomitant multiple sclerosis, the question remains on whether there is an underlying common process of inflammatory autoimmune reactions. Whether treatment is possible, remains to be evaluated.
Purpose This retrospective study was designed to investigate the re‐injection interval, efficacy and safety of OZURDEX® in routine clinical practice.
Methods This analysis contains data from 87 patients from 10 sites in Germany who had received at least 2 OZURDEX® injections. Data was collected from the time of the patients’ first injection until 3 – 6 months following their latest OZURDEX® injection.
Results The mean time to OZURDEX® re‐injection between 1st and 2nd treatments was 141 days (5.03 months) in the overall population. Mean time intervals for the BRVO and CRVO sub‐populations were 153 days (5.46 months) and 127 days (4.52 months) respectively. In the overall population, a mean LogMAR BCVA improvement from 0.68 to 0.51 was recorded following the last OZURDEX® injection (mean time of 11.0 weeks post‐injection). For BRVO, mean improvement was from 0.54 to 0.43 (mean time of 10.5 weeks post injection) and for CRVO, 0.83 to 0.58 (mean time of 11.5 weeks post injection). Reductions in central retinal thickness were also observed. Intraocular pressure measurements over 25mmHg were reported in 19.5% of patients. No glaucoma surgeries were reported. 5 patients underwent cataract surgery during the course of the study (4 had known lens opacity at baseline and opacity status data from the 5th was missing).
Conclusion In this real life study, OZURDEX® was found to be safe and effective with repeat treatments. The mean re‐injection interval for RVO patients was 5.0 months.
Intravitreal therapy with Pegaptanib was safe and effective. The majority of patients showed a stabilisation in all the assessed parameters. In clinical practice unselective VEGF inhibition should be considered carefully for patients with high cardiovascular risk profile or thromboembolic events in the history.
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