ABSTRACT
To evaluate the results of Verteporfin photodynamic therapy [PDT] in vasoproliferative tumors [VPT] of the retina and retinal capillary hemangiomas [RCH]. In a retrospective case series, 6 tumors in 5 eyes with VPT, and 3 RCH in 3 eyes underwent PDT which was performed using intravenous Verteporfin. Eyes were evaluated for tumor regression, final bestcorrected visual acuity [BCVA], and final retinal status. Patients were followed for a mean period of 7.1 +/- 3.9 months. Mean number of PDT sessions for each tumor was 1.33 [range 1-2]. Overall, mean BCVA improved from 1.7 +/- 1.06 to 0.88 +/- 0.8 logMAR [P=0.017]. Tumor thickness decreased from 3.53 +/- 0.83 to 1.73 +/- 0.73 mm [P<0.001]. Subgroup analysis revealed improvement in BCVA and tumor thickness in the VPT group [P=0.04]. However, in the RCH group, there was no statistically significant improvement in BCVA [P=0.43] despite significant reduction in tumor thickness [P=0.024]. A favorable outcome characterized by improved or unchanged visual acuity was achieved and the tumor regressed in all eyes. Subretinal fluid was absorbed in all eyes except for one eye with preoperative proliferative vitreoretinopathy. Vasoproliferative tumors and retinal capillary hemangiomas can be treated effectively by Verteporfin PDT and a favorable outcome can be expected
ABSTRACT
In spite of several treatment methods which are being used to treat exudative age-related macular degeneration [ARMD] like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors [VEGF], no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy [TTT] with subtenon triamcinolone acetonide [TA] injection in treatment of choroidal neovascularization [CNV] in patients with ARMD. In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration [ARMD] were studied. All CNVs [including 20 predominantly classic and 43 predominantly occult lesions] were treated with diode laser [810nm]. In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months [ranging from 5.5 to 16 months]. The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months [4.5 to 23 months]. Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV; and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination collected data were analyzed by one-sample and paired - sample T test, using SPSS software. At the end of the study in first group, visual acuity remained stable [0 to +/- one line] in 14 out of 20 [70%] of eyes, improved [> one line] in 2 of 20 [10%] eyes and showed a decline [> one line worsening] in 4/20 [20%] eyes. In second group thirty one eyes [72.1%] had stable vision [ +/- 1 line], 4 eyes [9.32%] had better vision more than 1 line and 8 eyes [18.6%] had more than 1 line decrease in vision. All CNVs were closed in last follow up. No statistically significant difference was found between two groups in clinical and functional with 20 mg and 40 mg injection of subtenon TA. Combined TTT and subtenon injection of TA in eyes with exudative ARMD can be an effective method to stabilize visual acuity of these patients
Subject(s)
Humans , Triamcinolone Acetonide , Triamcinolone Acetonide/administration & dosage , Hyperthermia, Induced , Pupil , Macular Degeneration , Lasers, Semiconductor , Visual AcuityABSTRACT
To determine globe and patient survival in children with retinoblastoma at a major referral center in Iran. Hospital records of 156 eyes of 105 patients with retinoblastoma referred to the Ocular Oncology Center at Rasoul Akram Hospital, Tehran, Iran from 2001 to 2007 were reviewed. Demographic data, family history, presenting symptoms, duration of symptoms, ocular findings and treatment modalities were evaluated. Main outcome measures included patient survival with the event of death, and globe survival with the event of enucleation. Mean age at the time of diagnosis was 28.5 +/- 23.0 [range 3-120] months. Mean follow-up was 30.9 +/- 29.0 [range 3-72] months. Male to female ratio was 47/58. Five patients had positive family history. Involvement was unilateral in 52% and bilateral in 48% of patients. Enucleation was performed as primary treatment in 76 eyes [48.7%] and as secondary treatment for recurrence in 11 eyes [7.1%]. Sixty nine eyes [44.2%] were salvaged by different globe preserving modalities. Kaplan-Meier 5-year survival estimate for globe preservation according to the International Classification of Retinoblastoma [ICRB] was 100% for group A, 93.5% for group B, 86.7% for group C, 57.1% for group D and 0% for group E. Kaplan-Meier estimates for 5-year patient survival was 100% for ICRB groups A and B, 92.3% for group C, 73.3% for group D and 79.9% for group E. Five year patient survival rate was better in ICRB groups A to D than in group E [P=0.004]. Advances in treatment, early diagnosis and prompt referral have improved the prognosis of patients with retinoblastoma in terms of globe and patient survival
ABSTRACT
To describe the association between optic disc traction and non-arthritic anterior ischemic optic neuropathy [NAION].eighty three eyes of 83 patients with NAION were evaluated by optical coherence tomography [OCT] for detecting vitreous adhesion to the optic never head with separation form adjacent retina [partial posterior vitreous detachment]. Those who were negative for such adhesion underwent ultrasonography to detect complete PVD. Fifty male and 33 female subjects with mean age of 51.9 +/- 10yr were studied. Partial PVD with optic never head adhesion was found in 54 patients [65.1%] using OCT. Ultrasonography found complete PVD in all eyes with optically empty spaces in OCT. Vitreous traction on optic never head from PVD may play a causative role in some cases of NAION. This traction may impair vascular supply and axoplasmic flow leading to signs and symptoms of NAION