Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes

Grossniklaus, H. E.; Gass, Jörn‐Markus

doi:10.1016/s0002-9394(98)00145-7

Cited by 213 publications

(54 citation statements)

References 32 publications

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“…[32][33][34][35] Disease progression has been discussed in terms of individual differences in location and lateral extent of a neovascular lesion, and also in associated changes of the choriocapillaris, Bruch's membrane and retinal pigment epithelium. 36 Some of our cases had juxtafoveal or extrafoveal location of the CNV. However, that does not mean that the fovea was unaffected, since seven of 40 patients in our sample had poor visual acuity and a disrupted or no bowtie despite a juxta-or extrafoveal location of the membrane.…”

Section: Discussionmentioning

confidence: 65%

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Weber

Elsner

Miura

et al. 2006

Eye

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Purpose To investigate the relationship between visual acuity and foveal birefringence in patients with neovascular age-related macular degeneration. Methods In total, 40 patients with choroidal neovascularization underwent macular imaging with scanning laser polarimetry. Bowtie patterns, typically seen in birefringence images of the macula, were evaluated and classified into three categories: (1) regular bowtie present; (2) bowtie present, but disrupted; and (3) no bowtie present. The relation of the bowtie appearance to the best-corrected logMAR visual acuities was tested (ANOVA). Results Mean visual acuity was best for the group that had regular bowties (mean logMAR ¼ 0.34) and differed statistically significantly from the disrupted bowtie group and no bowtie group (P ¼ 0.01 and 0.0007). Ages for the three groups did not differ (P ¼ 0.31). Conclusions Appearance of a regular bowtie indicates a substantially intact Henle fibre layer with the potential for good visual function, despite the presence of underlying pathology. Conversely, disruption or absence of a bowtie may indicate severe damage to the photoreceptors, consistent with the finding of poorer visual acuity.

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Section: Discussionmentioning

confidence: 65%

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Weber

Elsner

Miura

et al. 2006

Eye

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“…Later histopathologic analyses of surgical and ocular specimens show strong correlations between the fundus and fluorescein angiographic appearances and the location of CNV, either above or below the RPE. This led to the classification of CNV lesions as type 1, beneath the RPE, type 2, above the RPE and beneath the neurosensory retina, or a combined form (Grossniklaus and Gass, 1998;Grossniklaus and Green, 2004). The reason why distinction between these types of CNV is important is that occult CNV can be associated with good vision until the transition to neurosensory retinal CNV occurs (Stevens et al, 1997).…”

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

627

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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“…Radiation therapy for CNV has a less favorable outcome with considerable side-effects (5). Submacular surgery for removal of CNV has a disappointing result in type I membrane (Sub RPE type), which is typical of age related macular degeneration (6). Macular translocation surgery for CNV is still evolving with variable results and of high-risk complications (5).…”

Section: Introductionmentioning

confidence: 99%

Preventive Versus Treatment Effect of Ag3340, a Potent Matrix Metalloproteinase Inhibitor in a Rat Model of Choroidal Neovascularization

Bradey

Cheng

Bartsch

et al. 2004

Journal of Ocular Pharmacology and Therapeutics

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Purpose: AG3340 (prinomastat) is a nonpeptidic, small-molecular-weight, synthetic matrix metalloproteinase inhibitor (MMPI) with selective inhibitory action of MMP-2, MMP-9, MMP-3, and MT-MMP1. We evaluated AG3340 injected intravitreally to treat choroidal neovascularization in a laser induced rat CNV model. Methods: In the pretreatment group, the drug was injected the same day after induction of choroidal neovascularization by diode laser. In the treatment group, the drug was injected 2 weeks after induction of choroidal neovascularization (CNV). Fluorescein and indocyanine green angiography were performed to evaluate CNV. ERG recordings and histology were performed to assess toxicity and the CNV lesions. Results: When used at the time of CNV induction, 62.8% of lesions in control versus 22.8% of the laser lesions in treated eyes developed CNV (p < 0.0001). The invading fibrovascular complex was thicker in the control eyes than that in the treated eyes. No signs of toxicity were detected. When used to treat established CNV, the percentage of leakage in treated and control eyes were 54.1% and 58.9% respectively (p > 0.05). Prinomastat was effective when given at the time of induction of CNV in the rat model. Administration of prinomastat 2 weeks after laser induction did not show efficacy. Conclusion: Prinomastat was active in the earliest stages of experimental CNV. It might be best used in combination with photodynamic therapy to inhibit recurrence of CNV from temporarily closed new vessels.

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Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes

Cited by 213 publications

References 32 publications

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Relationship between foveal birefringence and visual acuity in neovascular age-related macular degeneration

Vascular endothelial growth factor in eye disease

Preventive Versus Treatment Effect of Ag3340, a Potent Matrix Metalloproteinase Inhibitor in a Rat Model of Choroidal Neovascularization

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