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AIM: To report the use of intravitreal bevacizumab associated with cataract surgery to prevent the re-activation of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).METHODS: Twelve eyes from 12 patients who had been previously treated for wet AMD and presented cataracts were operated on by clear cornea phacoemulsification with intraocular lens implantation, and an intravitreal injection of 1.25mg (0.05mL) bevacizumab was performed by the end of the procedure. The results were evaluated in terms of visual acuity improvement and reactivation of CNV, as determined by the appearance of fluid in optical coherence tomography (OCT). RESULTS: Best-corrected visual acuity(BCVA) significantly improved after surgery (P<0.01 and P=0.049 for BCVA after CNV closure and BCVA after cataract development respectively, Student's t test for paired data). Mean follow-up after cataract surgery was 11.8 months (SD 6.1, range 3 to 22 months). CNV reactivation or appearance of new CNV lesions was not observed in any case during follow-up. CONCLUSION: Intravitreal bevacizumab immediately after cataract surgery may prevent CNV reactivation in patients previously treated from CNV secondary to AMD.
ABSTRACT
AIM: To report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age related macular degeneration (AMD).METHODS: The present study was retrospective about non-randomized interventional case series. Fifty-one consecutive eyes with subfoveal (all types) CNV associated with AMD were treated by PDT and intravitreal (19.4±2.1)mg per 0.1mL TA at the Alicante Institute of Ophthalmology. The appearance of macular choriocapillaris and retinal pigment epithelium (RPE) atrophy was considered at two years follow-up. Thirty consecutive eyes treated by PDT alone, matched for age, sex, and type and size of CNV were considered as control group. RESULTS: Twenty-one of 47 eyes in the study group (45%) and 7 of 30 eyes in the control group (23%) developed macular RPE and choriocapillaris atrophy in the treated area at month 24 (P =0.04, Chi-square test). The greatest diameter of the atrophic areas averaged (5 044±1 666)μm in the study groupvs(4 345±1 550)μm in the control group. Mean final best corrected visual acuity (logarithm of minimal angle of resolution) was (0.87±033) in the cases with RPE atrophyvs(0.66±0.26) in the cases with no RPE atrophy in the study group (P=011, Mann-Whitney U test). CONCLUSION: The association of high doses of intravitreal TA and PDT may increase the risk for RPE and choriocapillaris atrophy.
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AIM: To report two cases whose decreased visual acuity was the first symptom of leukaemia and optical coherence tomography (OCT) allowed identification and localization of the retinal lesions.METHODS: Retrospective, interventional, case reports. RESULTS: One case of lymphoblastic acute leukaemia and chronic lymphoid leukaemia were diagnosed following decreased visual acuity. OCT showed macular serous detachment in the first case. The second case presented hypo fluorescent retinal infiltrates which appeared as hyper reflective lesions by OCT. Retinal changes disappeared and visual acuity was recovered following complete remission of the neoplasm.CONCLUSION: OCT is a valuable, non invasive diagnostic tool permitting detection, localization and follow-up of ocular dissemination of neoplasms.
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AIM: To report the demographic characteristics of a sample of population affected by exudative age-related macular degeneration (AMD) in the region of Castilla-Leon (North-Central Spain), and to compare them with a group of population of the same age and from the same geographic area.METHODS: In this observational, prospective study, AMD patients attending a regional reference clinic for photodynamic therapy were interviewed. The patients reported their medical history for high blood pressure, hyperlipemia and smoking habit. Iris color was examined and classified as fight (green, blue and grey) or dark (hazel, brown, black).RESULTS: A total of 343 patients were interviewed. Mean age at onset was 74.9 years (range 55 to 93), Among whom 64.5% were female and 35.5% male. Iris color was rated as light in 45.1% of the patients. Arterial hypertension (AH) was present in 50% of the cases and 15.3% were on treatment for hypercholesterolemia, and 30.2% of the patients were smokers or had quit smoking (80.9% of males).CONCLUSION: The frequency of light colored iris is higher among patients with exudative AMD. In our series, other risk factors for exudative AMD were smoking habit in males, not being on treatment for hypercholesterolemia and being female.
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· AIM: To determine the influence of topical anaesthetic drops, age and central corneal thickness (CCT) in the determination of intraocular pressure (IOP) by non contact tonometry (NCT). · METHODS: Ninety-three eyes from 47 patients were examined for CCT and lOP by NCT before and after the instillation of topical anaesthetic drops.· RESULTS: Average age was 66.4 (SD 16, range 34 to 88years-of-age). Thirty one patients were female and 16 were male. Average basal IOP was 16.0 mmHg (SD 4.0, range 8.5to 26.1). IOP pressure one minute after topical anesthesia instillation was 15.0 mmHg (SD 3.8, range 7.7 to 26.7), and 14.9 mm Hg (SD 3.9, range 7.6 to 26.3) five minutes after the instillation. The differences were statistically significant for the 0 to 1 minute lapse (P=0.0007) and for the 0 to 5minute lapse (P=0.0003), but not for the 1 to 5 minute lapse (P=0.27) (Student's t test for paired data). Average CCT before topical anaesthetic drops was 565.4 microns. Simple linear regression analysis demonstrated absence of significant variation between age and IOP changes and between CCT and IOP changes,· CONCLUSION: Our study confirms that the instillation of topical anaesthetics causes a reduction in IOP, which is progressive during the first 5 minutes after instillation. This IOP reduction does not seem to be associated with basal CCT or age.