Oscillatory photodynamic therapy for choroidal neovascularization and central serous retinopathy; a pilot study

To report the preliminary results of oscillatory photodynamic therapy [OPDT] for choroidal neovascularization [CNV] and central serous retinopathy [CSR]. This study included 7 eyes of 6 patients with CSR [2 eyes], idiopathic CNV [2 eyes], CNV due to age-related macular degeneration [AMD] [2 eyes], and peripapillary CNV secondary to presumed ocular histoplasmosis syndrome [1 eye]. Intravenous verteporfin [6 mg/m[2] body surface area] was infused over 10 minutes followed by oscillating laser [wavelength 689 nm] covering slightly beyond the entire lesion. An Area Centralis lens was applied and laser was delivered [600 mW/cm[2] fluence rate and 50 J/cm[2] dose]. Intravitreal bevacizumab and dexamethasone combination therapy was used with OPDT in 4 eyes with CNV; intravitreal dexamethasone and triamcinolone acetonide were injected in the other eye with CNV. Clinical examination, funduscopy, fluorescein angiography, and optical coherence tomography [OCT] were performed at baseline and after treatment. After mean follow-up of 7.1 +/- 5.1 months, visual acuity improved from 0.87 +/- 0.69 logMAR [20/160] to 0.60 +/- 0.65 logMAR [20/80] [P = 0.027]; central foveal thickness decreased from 322 +/- 62.1 to 240.7 +/- 34.8 microns as measured by OCT [P = 0.018]. Fluorescein angiography and OCT demonstrated cessation of vascular leakage, and resolution of hemorrhage and subretinal fluid in all eyes. No adverse events or recurrence were noted. OPDT was effective in treating CNV lesions and CSR. OPDT may be an improvement on standard PDT due to reduced side effects, thermal damage and scarring

Effect of squalamine on iris neovascularization in monkeys

The purpose of this study was to investigate the effect of squalamine, an antiangiogenic aminosterol, in an experimental model of iris neovascularization. Iris neovascularization was created in cynomolgus monkeys by occluding retinal veins with an argon laser and inducing persistent hypotony with a central corneal suture. Twenty-four eyes were treated in three groups. In group 1, 4 eyes were injected intravitreally with 3 mug/0.1 ml squalamine and four eyes with balanced saline solution [controls] immediately after vein occlusion [day 1]; injections were repeated every three days for three weeks. In group 2, 1 mg/kg squalamine was administered with intravenous infusion in dextrose 5% in four animals; 4 control animals received only dextrose. Infusions began on day 1 and were repeated every 3 days for 3 weeks. In group 3, after the development of iris neovascularization on day 7, 1 mg/kg squalamine was injected systematically in 4 animals; 4 animals received dextrose 5%. Monkeys were examined by slit-lamp biomicroscopy and underwent color photography and fluorescein angiography. The study concluded that intravitreally injected squalamine did not affect the development of iris revascularization; however, systemic squalamine injection inhibited the development of iris revascularization and caused a partial regression of new vessels in a primate model

Trans-scleral and intravitreal contact ND: YAG laser application: an experimental study

A contact Nd: YAG laser with a sapphire tip [convex surface 2 mm in diameter] was used to coagulate the retina and ciliary body through the sclera. The laser energy was successfully transmitted through the sclera producing retinal coagulation and destruction of the ciliary body. A 0.2 mm in diameter sapphire tip and Nd YAG laser was used to perform transvitreal retinal coagulation, retinotomy and retinochoriodal incision. Minimal hemorrhage occurred when retinochoroidotomy was done. Probe-tissue adhesion occurred but could easily be separated. Contact application of laser energy is a modern developed technology used primarily with a sapphire tip for cutting tissue [Daikuzono et at, 1985]. Because laser incisions are commonly accompanied by coagulation, bleeding from the tissue is reduced to a minimum with this technique. The initial successful application of contact laser delivery have been reported independently by us [Peyman et al., 1987] and Ando and associates 1986. To our knowledge, no long term results of contact Nd: YAG laser on ocular tissues has been reported thus far

Internal pars plana sclerotomy with the contact ND: YAG laser: an experimental study

Transvitreal pars plana sclerotomy using the contact Nd: YAG laser with a sapphire probe was performed on a group of rabbit eyes and compared with a similar procedure performed with a Ziegler knife. Although the intraocular pressure [IOP] was lowered in both groups of animals, the reduction was greater and more lasting in the group on which the Nd: YAG laser with sapphire probe was used. This technique may have application in cases with extensive peripheral anterior synechiae or where a vitrectomy as a combination procedure to clear ocular media is performed