Intralesional Vessel Diameter Measured by Optical Coherence Tomography Angiography Could Improve the Differential Diagnosis of Small Melanocytic Choroidal Lesions.

In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify the predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our centre from 2016 to 2021. Clinical management involved active surveillance followed by brachytherapy if growth was detected. The lesions were classified into two groups according to whether they grew (small melanomas) or remained stable (choroidal nevi). Growth was detected in 19 (22.1%) lesions. All patients underwent OCTA at baseline. These images were compared to identify the possible predictors of growth. Significant between-group differences were observed in thickness (p = 0.00), greatest basal diameter (p = 0.00), number of risk factors (p = 0.00), symptoms (p = 0.001; relative risk [RR]: 4.3), orange pigment (p = 0.00; RR: 6.02), and ultrasonographic hollowness (Kappa sign); p = 0.000; RR: 5.3). The melanomas had significantly more vessels with a diameter ≥ 76.3 µm (p = 0.02; RR: 2.46). The time to growth in these lesions was significantly shorter (p = 0.05) than in lesions with smaller vessels. These findings show that vessel diameter quantified by OCTA can help differentiate between choroidal nevi and small melanomas, when considered together with clinical risk factors.

Retinal capillary hemangioma / Hemangioma capilar retiniano

This manuscript describes a case of a retinal capillary hemangioma which had been impairing our patient's vision for a number of years. We performed widefield retinal imaging which revealed the patient's vasoproliferative tumor, as well as fluorescein angiography, which displayed its intricate vascular network, depicting the characteristic vascular nature of this vasoproliferative tumor. This case also underlines the importance of ruling out other disease locations due to its association with von Hippel-Lindau syndrome

Este manuscrito describe un caso de hemangioma capilar retiniano que afectaba la visión de nuestra paciente durante varios años. Realizamos imágenes de retina de campo amplio que revelaron el tumor vasoproliferativo de la paciente, así como una angiografía fluoresceínica que mostró su intrincada red vascular, destapando la naturaleza vascular característica de este tumor vasoproliferativo. Este caso también acentúa la importancia de descartar otras localizaciones de la enfermedad por su asociación con el síndrome de von Hippel-Lindau

New frontiers and clinical implications in the pathophysiology of age-related macular degeneration / Nuevas fronteras e implicaciones clínicas en la fisiopatología de la degeneración macular asociada a la edad

Age-related macular degeneration (AMD) involves progressive degeneration of the central retina, termed the macula, which provides high-acuity vision needed to recognize faces, drive, etc. AMD is the leading cause of blindness in the aging population. A plethora of paradigm-shifting perspectives regarding AMD's multifaceted pathophysiology is emerging. This review will endeavor to gather novel insights and attempts to identify translational implications and new areas of research. The concept of aberrant inflammation being at the center of age-related diseases, particularly AMD, is being received with increasing credence. Retinal angiogenesis, at the forefront of the neovascular complications of AMD (nAMD), is now being understood as an imbalance between trophic factors released by retinal cells secretome. Additionally, mechanisms involving oxidative stress and inflammatory complement pathways have also been identified, along with genetic and other risk factors that play a key role in AMD's onset and progression. Associations have been drawn with AMD and other degenerative deposit diseases such as Alzheimer's disease, atherosclerosis, and glomerulonephritis, which are providing further insight into this maculopathy

La degeneración macular asociada a la edad (DMAE) está caracteriza por un proceso degenerativo progresivo de la retina central -denominada mácula- que es la responsable por la visión de definición. La DMAE es la principal causa de ceguera en la población de la 3.ª edad. Se postulan varias perspectivas de cambio de paradigma con respecto a la fisiopatología multifactorial de esta enfermedad. La presente revisión se centrará en recopilar nuevas ideas e intentos de identificar implicaciones traslacionales, además de nuevas áreas de investigación de la enfermedad. El concepto de inflamación aberrante, que aparece en el centro de las enfermedades asociadas a la edad, y en particular la DMAE, se presenta con creciente credibilidad. La angiogénesis retiniana que se encuentra en la vanguardia de las complicaciones neovasculares de la DMAE se entiende actualmente como un desequilibrio entre los factores tróficos liberados por el secretoma de las células de la retina. Además, también se han identificado mecanismos relacionados con el estrés oxidativo y las vías inflamatorias del complemento que, junto con factores genéticos y otros factores de riesgo, juegan un papel clave en la aparición y en la progresión de la enfermedad. Se han establecido asociaciones entre la DMAE y otras enfermedades degenerativas de depósitos, tales como la enfermedad de Alzheimer, la aterosclerosis y la glomerulonefritis, lo que proporciona información adicional sobre esta maculopatía

New frontiers and clinical implications in the pathophysiology of age-related macular degeneration.

Age-related macular degeneration (AMD) involves progressive degeneration of the central retina, termed the macula, which provides high-acuity vision needed to recognize faces, drive, etc. AMD is the leading cause of blindness in the aging population. A plethora of paradigm-shifting perspectives regarding AMD's multifaceted pathophysiology is emerging. This review will endeavor to gather novel insights and attempts to identify translational implications and new areas of research. The concept of aberrant inflammation being at the center of age-related diseases, particularly AMD, is being received with increasing credence. Retinal angiogenesis, at the forefront of the neovascular complications of AMD (nAMD), is now being understood as an imbalance between trophic factors released by retinal cells secretome. Additionally, mechanisms involving oxidative stress and inflammatory complement pathways have also been identified, along with genetic and other risk factors that play a key role in AMD's onset and progression. Associations have been drawn with AMD and other degenerative deposit diseases such as Alzheimer's disease, atherosclerosis, and glomerulonephritis, which are providing further insight into this maculopathy.