OCT imaging of choroidal neovascularisation and its role in the determination of patients' eligibility for surgery.

AIM: To evaluate the optical coherence tomographic characteristics of choroidal neovascularisation (CNV) in age related macular degeneration (AMD) and in idiopathic and inflammatory CNV. The use of this technique in the selection of patients for surgery is discussed. METHODS: Ocular coherence tomography (OCT), fluorescein, and indocyanine green angiography were performed in 23 patients affected by AMD complicated by well defined CNV and in 10 patients affected by inflammatory or idiopathic CNV. The neovascular membrane was surgically removed in five age related CNVs, two inflammatory choroidopathies, and two idiopathic CNVs. RESULTS: In inflammatory and idiopathic CNV, the OCT displayed a neovascularisation on the retinal pigment epithelium (RPE). In three cases the CNV was excised with an improvement of visual acuity equal to or greater than two Snellen lines; in a fourth case, the visual acuity after surgery was unchanged. In the cases of AMD the OCT fell into three different patterns: (A) CNV above the RPE (five cases); (B) focal, irregular thickening of the retinal pigment epithelial band (12 cases); (C) CNV above and below the RPE (six cases). The five pattern A CNV patients underwent the surgical excision of the neovascularisation. In four cases the visual acuity improved by two or more Snellen lines; in the fifth case the visual acuity remained unchanged. CONCLUSIONS: The authors suggest that the surgical removal of early age related CNV could be performed in those cases where the OCT shows a neovascular membrane on the RPE, as in idiopathic and inflammatory CNVs.

Diabetic maculopathy induced by vitreo-macular traction: evaluation by optical coherence tomography (OCT).

AIM: To evaluate the role and efficacy of optical coherence tomography (OCT) in the evaluation of diabetic maculopathy induced by vitreo-retinal traction. METHODS: 12 patients affected by diabetic maculopathy induced by vitreo-retinal traction were examined using biomicroscopy with a three-mirror contact lens, fluorescein angiography (FA) and OCT scanning in order to identify the presence of a vitreomacular traction. RESULTS: OCT revealed two patterns of maculopathy which were characterised by a thickening of the superior profile of the OCT tomogram or by the disappearance and inversion of the physiologic foveal depression respectively. CONCLUSIONS: OCT may be useful in the characterisation and monitoring of diabetic maculopathy induced by vitreo-retinal traction.

Optical coherence tomography (OCT) in idiopathic polypoidal choroidal vasculopathy (IPCV).

PURPOSE: Idiopathic polypoidal choroidal vasculopathy (IPCV) is a distinct clinical entity characterized by an edematous maculopathy and typical choroidal vascular change. The purpose of this study is to evaluate the use of optical coherence tomography (OCT) for diagnosing of this disease. METHODS: 4 patients affected by IPVC (mean age 71-84 years) underwent biomicroscopy with a three mirror conctact lens, fluorescein angiography (FA), indocyanine green angiography (ICGA) and OCT (Humphrey Zeiss) scan. RESULTS: in all 4 cases OCT tomograms acquired at the location of the typical choroidal abnormalities demonstrated by ICGA, revealed a characteristic hyper-reflectivity in the choroidal layers. CONCLUSION: ICGA is essential to diagnose IPVC, but OCT may be able to identify characteristic reflectivity patterns.

[Macular syndrome in choroidal cavernous hemangioma: the role of laser treatment]. / Syndrome maculaire au cours des hémangiomes caverneux choroïdiens: le rôle du traitement au laser.

On the basis of a series of case with natural history of choroidal cavernous hemangioma (21 cases with follow-up of up to 13 years) the authors suggest a classification of macular syndromes (types I, II and III) in choroidal cavernous hemangioma. They also suggest that partial barrage of the tumor can be sufficient to arrest or prevent further V.A. impairment.

[Subretinal neovascularization in childhood--a rare observation]. / Subretinale Gefässneubildungen im Kindesalter--einige seltene Beobachtungen.

The authors report on a number of cases of juvenile subretinal neovascularization. The causes identified were degeneration, parasites, trauma, and virus infections; there are also idiopathic cases.

[Papilledema in insulin-dependent patients]. / Das Papillenödem bei Insulin-abhängigen Patienten.

The acute edematous capillaropathy of epipapillary and peripapillary radial vascolarization is an uncommon complication of type I Diabetes. Fluorescein angiography allows a reliable diagnosis to be made, because it provides good vision of the papilla and of the peripapillary posterior pole. The authors underline the importance of differential diagnosis because of the different therapeutic approach.

[Laser treatment of diabetic maculopathy]. / Die Laserbehandlung der diabetischen Makulopathie.

The authors report on the techniques of laser treatment of diabetic maculopathy: focal direct laser coagulation of I.R.M.A. in exudative maculopathy; laser grid photocoagulation in edematous maculopathy.