Assuntos
Herpes Zoster Oftálmico/diagnóstico , Macula Lutea/patologia , Síndrome de Necrose Retiniana Aguda/diagnóstico , Tomografia de Coerência Óptica , Síndrome da Imunodeficiência Adquirida/complicações , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Humor Aquoso/virologia , DNA Viral/análise , Quimioterapia Combinada , Feminino , Angiofluoresceinografia , Foscarnet/uso terapêutico , Herpes Zoster Oftálmico/tratamento farmacológico , Herpes Zoster Oftálmico/virologia , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Síndrome de Necrose Retiniana Aguda/tratamento farmacológico , Síndrome de Necrose Retiniana Aguda/virologiaRESUMO
PURPOSE: To introduce a standardized macular photostress test using an automated perimeter as a method to quantify macular disease severity and as a tool to distinguish optic neuropathy from macular pathology. DESIGN: Prospective interventional pilot study. METHODS: Twenty-five bilaterally pseudophakic subjects aged range, 65 to 84: 15 patients with varying severity of non-neovascular age-related macular degeneration (AMD), five patients with no ocular disease, and five patients with moderate primary open-angle glaucoma (POAG). Previously reported normative values served as controls for this study. Patients underwent foveal threshold testing using the Humphrey Visual Field Perimeter Model 750 (Carl Zeiss Meditec, Inc, Dublin, California, USA). Baseline measurements were compared to threshold sensitivity after photostress at one minute and then two-minute intervals until sensitivity returned to baseline. Main outcome measures were baseline foveal threshold sensitivity, foveal threshold depression, and recovery following photostress. RESULTS: Automated macular photostress testing in macular disease (AMD) causes a decrease (P < .001) in baseline foveal sensitivity and a delay (P < .001) in recovery time to baseline sensitivity. Optic nerve pathology (POAG) does not affect (P = .343) the foveal response curve. CONCLUSIONS: The macular automated photostress (MAP) test is an inexpensive, noninvasive, and readily accessible adjunct for evaluating patients with macular disease. This standardized protocol is useful in objectively defining disease severity, may be used to follow response to treatment, and could aid in distinguishing optic neuropathy from macular pathology.
Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Degeneração Macular/diagnóstico , Doenças do Nervo Óptico/diagnóstico , Estimulação Luminosa , Testes de Campo Visual/métodos , Campos Visuais , Idoso , Idoso de 80 Anos ou mais , Humanos , Projetos Piloto , Estudos Prospectivos , Pseudofacia/complicações , Sensibilidade e Especificidade , Limiar SensorialRESUMO
PURPOSE: To report two cases of a retinal pigment epithelial tear after intravitreal injection of pegaptanib sodium. To our knowledge, this is the first report of this finding after intraocular antivascular endothelial growth factor therapy. DESIGN: Observational case reports. METHODS: Two patients presented with occult choroidal neovascularization and associated serous pigment epithelial detachment that was a result of age-related macular degeneration. Both patients were treated with an intravitreal injection of pegaptanib sodium. RESULTS: One patient developed a retinal pigment epithelium tear one week after the intravitreal injection. The second patient developed a retinal pigment epithelium tear eight weeks after treatment. CONCLUSIONS: Although these cases may represent natural history, there should be a high index of suspicion for retinal pigment epithelium tears in patients who report significant visual deterioration after intravitreal injection of pegaptanib sodium. Further studies are needed to determine whether angiographic subtypes of choroidal neovascular membranes are more susceptible to developing retinal pigment epithelium tears after treatment with antivascular endothelial growth factor agents.
Assuntos
Aptâmeros de Nucleotídeos/efeitos adversos , Epitélio Pigmentado Ocular/efeitos dos fármacos , Perfurações Retinianas/induzido quimicamente , Idoso , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/etiologia , Feminino , Angiofluoresceinografia , Humanos , Verde de Indocianina , Injeções , Degeneração Macular/complicações , Degeneração Macular/tratamento farmacológico , Masculino , Epitélio Pigmentado Ocular/patologia , Descolamento Retiniano/tratamento farmacológico , Descolamento Retiniano/etiologia , Perfurações Retinianas/diagnóstico , Tomografia de Coerência Óptica , Acuidade VisualRESUMO
PURPOSE: To describe a novel method for the evaluation of macular function with photostress testing and outline normative foveal threshold and recovery data for the adult population. METHODS: In this prospective study, 50 adult subjects (25 men and 25 women aged 30-49 years) with no ocular disease underwent foveal threshold testing using the Humphrey Visual Field Perimeter Model 750. Baseline values and recovery time after photostress were measured. Baseline measurements were compared with threshold sensitivity after photostress at 1, 2, 4, 6, and 10 minutes. RESULTS: Mean foveal sensitivities were reduced from 38.53 db to 32.36 db after photostress, representing an average sensitivity reduction of 16%. The mean recovery time to baseline sensitivity was 6.58 minutes. There was no significant difference between sexes, races, or smokers and nonsmokers. CONCLUSIONS: This standardized protocol for testing the foveal threshold response to photostress is an inexpensive and noninvasive adjunct for following macular disease and also distinguishing optic neuropathy from macular disease.