Classification of retinal pigment epithelial detachments associated with drusen

Hartnett, M. Elizabeth; Weiter, John J.; Garsd, Armando; Jalkh, Alex E.

doi:10.1007/bf00166756

Cited by 204 publications

(119 citation statements)

References 18 publications

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“…However, besides CNV, there are retinal vascular forms of neovascular AMD that are also likely associated with abnormal VEGF expression, since improvement in visual acuity can occur after anti-VEGF therapies (Meyerle et al, 2007). The first described was the retinal vascular abnormality/anomalous complex (RVAC) (Hartnett et al, 1992;, in which retinal vessels grew into the deep outer retina and formed leaky angiomatous lesions (Fig. 19A).…”

Section: Classification Of Neovascular Amd: the Importance Of Rpe-ec mentioning

confidence: 99%

Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

598

527

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Collectively, angiogenic ocular conditions represent the leading cause of irreversible vision loss in developed countries. In the U.S., for example, retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration are the principal causes of blindness in the infant, working age and elderly populations, respectively. Evidence suggests that vascular endothelial growth factor (VEGF), a 40 kDa dimeric glycoprotein, promotes angiogenesis in each of these conditions, making it a highly significant therapeutic target. However, VEGF is pleiotropic, affecting a broad spectrum of endothelial, neuronal and glial behaviors, and confounding the validity of anti-VEGF strategies, particularly under chronic disease conditions. In fact, among other functions VEGF can influence cell proliferation, cell migration, proteolysis, cell survival and vessel permeability in a wide variety of biological contexts. This article will describe the roles played by VEGF in the pathogenesis of retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration. The potential disadvantages of inhibiting VEGF will be discussed, as will the rationales for targeting other VEGF-related modulators of angiogenesis.

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Section: Classification Of Neovascular Amd: the Importance Of Rpe-ec mentioning

confidence: 99%

Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

598

527

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“…The pathogenesis of this peculiar entity, which was first described in 1992 as a retinal angiomatous lesion associated with drusen, causing retinal pigment epithelium detachments (PEDs), 1 and in 1995 as an RCA causing PEDs, 2,3 still remains controversial. In 2001, Yannuzzi et al suggested that an angiomatous proliferation originating from the deep retinal layers extends posteriorly to anastomose with a sub-retinal pigment epithelium (RPE) neovascularization (type 1).…”

Section: Introductionmentioning

confidence: 99%

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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“…S erous pigment epithelium detachment (SPED) in age-related macular degeneration (AMD) has been associated with choroidal neovascularisation (CNV) with increased risk of visual loss, in from 24% to 67% of cases (Teeters & Bird 1973;Meredith et al 1979;Braunstein & Gass 1979;Klein et al 1980;Gass 1984;Casswell et al 1985;Poliner et al 1986;Elman et al 1986;Hartnett et al 1992).…”

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confidence: 99%

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

Parodi

Saviano

Bondel

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: Indocyanine green angiography has been reported to improve detection and delineation of occult choroidal neovascularisation in serous pigment epithelium detachment in age-related macular degeneration. The study aims to evaluate the visual acuity results of eyes affected by serous pigment epithelium detachment in age-related macular degeneration, having had indocyanine greendirected laser photocoagulation, and to correlate them to the pattern of serous pigment epithelium detachment on indocyanine green angiography. Methods: Thirty-four eyes of 31 patients affected by serous pigment epithelium detachment in age-related macular degeneration were prospectively considered. Each patient underwent an ophthalmological examination including fluorescein and indocyanine green angiography one day before, and 6 weeks, 3 months, 6 months, 9 months, 12 months and 24 months after krypton-laser treatment. The serous pigment epithelium detachment was classified in the late-phases angiograms as either hypofluorescent, isofluorescent or hyperfluorescent comparing the fluorescence of the serous pigment epithelium detachment with the choroidal background fluorescence. Results: The indocyanine green-guided laser treatment was associated with a temporary stabilization and a long-term progressive reduction of visual acuity: after 24 months visual acuity improved in 2.9%, stabilized in 26.5% and worsened in 70.5% of cases. Serous pigment epithelium detachment presenting a pretreatment hyperfluorescence had a final visual acuity of 0.06, with subfoveal choroidal neovascularisation development in 100% of cases, whereas serous pigment epithelium detachment presenting a pretreatment hypofluorescence and isofluorescence showed a final visual acuity of 0.12, with subfoveal choroidal neovascularisation development in 43.5% of eyes, with statistically significant difference. Conclusion: Overall visual acuity decreases with time after indocyanine greenguided laser treatment of choroidal neovascularisation in serous pigment epithelium detachment, and serous pigment epithelium detachment becoming hyperfluorescent in the late-phases of indocyanine green angiography has the worst functional outcome.Key words: indocyanine green angiography -hyperfluorescence -serous retinal pigment epithelial detachment.

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Classification of retinal pigment epithelial detachments associated with drusen

Cited by 204 publications

References 18 publications

Vascular endothelial growth factor in eye disease

Vascular endothelial growth factor in eye disease

Ranibizumab for retinal angiomatous proliferation in age-related macular degeneration

Hyperfluorescence associated with serous retinal pigment epithelial detachment on indocyanine green angiography

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