The Evaluation of Photodynamic Therapy for Idiopathic Subfoveal Choroidal Neovascularization with Imaging Studies

PURPOSE: To evaluate the effect of photodynamic therapy (PDT) for idiopathic subfoveal choroidal neovascularization with various imaging studies. METHODS: We retrospectively reviewed the medical records and imaging studies of 17 patients (17 eyes) who were diagnosed with idiopathic subfoveal choroidal neovascularization and treated with PDT between December 2000 and May 2003. Slit lamp examination, fluorescein angiography (FAG), indocyanine green angiography (ICGA), and optical coherence tomography (OCT) were conducted before and after PDT. RESULTS: After PDT, the mean visual acuity was improved from 0.23 (20/80) to 0.48 (20/40). On FAG, the mean size of neovascular lesion (the longest length of lesion) was slightly decreased from 2038 +/- 592 micrometer to 1872 +/- 622 micrometer after PDT. However, the change was not significant. Fluorescein dye leakage decreased or disappeared, but staining of the lesion was noted. On OCT, the macular edema disappeared, but the hyperreflective area remained after PDT. CONCLUSIONS: PDT was effective in the treatment of idiopathic choroidal neovascularization. The factors representing the therapeutic effect of PDT were visual improvement, decreased leakage on FAG, and decreased macular edema on OCT, and these three factors were significantly related to each other.

Peripapillary Atrophy in Primary Open-Angle Glaucoma and Normal-Tension Glaucoma

PURPOSE: To study the relation between the progression of glaucoma and the expression of zone beta in primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG). METHODS: One hundred thirty eyes with POAG and 62 with NTG were enrolled in this study. We classified them based on the expression of zone beta and compared their optic nerve head parameters. We looked for changes in optic nerve head parameters depending on the expression of zone beta in patients who received HRT at least 1 year previously, and whose maximal intraocular pressure (IOP) during the follow-up periods was controlled under 21 mmHg. RESULTS: In the POAG patients, the group with zone beta had significantly larger cup-to-disc (C/D) ratio, and significantly smaller neural rim area and volume, than the group without zone beta. In the NTG patients optic nerve head parameters did not show statistically significant difference. Compared with the previous values, C/D ratio, neural rim area and volume showed significant progression in POAG with zone beta, but did not show significant change in POAG without zone beta and in NTG. CONCLUSIONS: In POAG, the expression of zone beta was associated with more severe optic nerve damage and faster progression than in patients without zone beta. In NTG, the expression of zone beta was not associated with significant changes in the optic nerve shape or the progression of glaucoma.

Clinical Results of Hydroxyapatite Orbital Implantations using Autologous Sclera as a Wrapping Material

PURPOSE: To evaluate the clinical result of hydroxyapatite implantation using autologous sclera as wrapping material. METHODS: From December 2001 to February 2003, we performed 20 cases of hydroxyapatite implantation with autologous sclera as wrapping material. Eyes were enucleated for severe phthisis because evisceration could not provide adequate space for hydroxyapatite implantation or secondary hydroxyapatite implantation after prior evisceration. Postoperative complications were evaluated at postoperative 1 week, 2 weeks, 3 weeks - 1 month, 2 months, 3 months, and every 2 or 3 months thereafter. RESULTS: The mean follow up period was 12.1 +/- 4.52 months (4~18 months). During the follow up period, conjunctival erosions developed in 2 cases, which were controlled by conservative management only. No such postoperative complications as implant exposure, orbital infection, extrusion, inflammatory reaction occured. CONCLUSIONS: Autologous sclera is the suitable wrapping material of hydroxyapatite implant when enucleation is needed in primary surgery for severe phthisis, or for secondary hydroxyapatite implantation after prior evisceration surgery.