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Evaluation of Retinal Pigment Epithelium and Choroidal Neovascularization in Rats Using Laser-Scanning Optical-Resolution Photoacoustic Microscopy
摘要： Purpose: To demonstrate the value of the laser-scanning optical-resolution (LSOR)-photoacoustic (PA) microscopy (PAM) system and the conventional multimodal imaging techniques in the evaluation of laser-induced retinal injury and choroidal neovascularization (CNV) in rats. Methods: Different degrees of retinal injury were induced using laser photocoagulation. We compared the LSOR-PAM system with conventional imaging techniques in evaluating retinal injury with or without CNV. Six additional rats, treated with an anti-VEGF antibody or immunoglobulin G immediately after photocoagulation, were imaged 7 and 14 days after injection, and CNV lesion areas were compared. Results: In the retinal injury model, fundus autofluorescence showed well-defined hyperreflection, while the lesion displayed abundant PA signals demonstrating nonuniform melanin distribution in retinal pigment epithelium (RPE). RPE was detected with higher contrast in the PAM B-scan image than optical coherence tomography (OCT). Additionally, the CNV lesion was present with multiple PA signal intensi- ties which distinctly characterized the location and area of CNV as found in fundus fluorescein angiography. Further- more, the decreased PA signals extending from the CNV le- sion were similar to those of the vascular bud in ex vivo im- aging, which was invisible in other in vivo images. When treated with anti-VEGF agents, statistically significant differ- ences can be demonstrated by PAM similar to other mo- dalities. Conclusions: LSOR-PAM can detect the melanin distribution of RPE in laser-induced retinal injury and CNV in rats. PAM imaging provides a potential new tool to evalu- ate the vitality and functionality of RPE in vivo as well as to monitor the development and treatment of CNV.
关键词： Age-related macular degeneration,Retinal pigment epithelium,Multimodal imaging,Photoacoustic microscopy,Choroidal neovascularization
更新于2025-09-12 10:27:22
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Microvasculature Changes of Myopic Choroidal Neovascularization and the Predictive Value of Feeder Vessel Disappearance after Ranibizumab Treatment Revealed Using Optical Coherence Tomography Angiography
摘要： Aim: To investigate vascular changes of myopic choroidal neovascularization (mCNV) after ranibizumab treatment using optical coherence tomography-angiography (OCTA). Methods: Consecutive subjects with a diagnosis of mCNV were included. Patients underwent intravitreal injection of ranibizumab treatment with a 6-month follow-up. All patients underwent a complete ophthalmological examination and OCTA evaluation. The 3 × 3 OCTA en face images were analyzed for the absence/presence of mCNV, CNV area, and CNV network morphology. In particular, the morphology of the mCNV was analyzed in order to detect the presence/absence of feeder vessels. Results: Eleven subjects were evaluated. At baseline, the mCNV was identified in all cases on OCTA. At 6 months, the mean mCNV area was not statically significantly reduced in comparison with baseline values (p > 0.05), while the morphologic analysis revealed a complete disappearance of the feeder vessel in 6 eyes. The subgroup analysis of these latter showed that the CNV area was significantly reduced, visual acuity had improved, and only one intravitreal injection was administrated over the entire follow-up period. Conclusions: OCTA allowed the detection of qualitative and quantitative vascular changes in mCNV. The disappearance of the feeder vessel was associated with better anatomical as well as functional outcomes at the last follow-up visit.
关键词： Myopic choroidal neovascularization,Pathologic myopia,Optical coherence tomography angiography
更新于2025-09-12 10:27:22
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Foveal choroidal neovascularization secondary to accidental laser exposure in a dermatologist
摘要： Rationale: Most laser-induced retinal injuries are caused by accidental laser discharge during the preparation of laser devices without protective goggles, laser injury during the cosmetic procedure in a dermatologist, is very rare, with no prior case reports. Patient concerns: A 55-year-old Asian male dermatologist visited our hospital with a 2-week history of visual disturbance in his right eye. He had experienced sudden central scotoma in the right eye while using a Q-switched Nd:YAG laser (1064 nm, 2 J/cm2, 6-mm spot size, 750 ps) 2 to 3 cm from the target without proper eye protection. He had applied a glass slide ?rmly onto the treatment area prior to commencing the procedure. The choroidal neovascularization (CNV) was detected via optical coherence tomography angiography (OCTA) 2 weeks after the laser injury. Diagnosis: Foveal CNV secondary to laser energy re?ected from the glass slide. Intervention: Intravitreal bevacizumab (1.25 mg/0.05 mL) injection was performed. Outcomes: Regression of CNV was observed. Lessons: Retinal injury can occur not only by direct laser beam exposure but also by way of a beam re?ected from a glass slide. Operators should always use laser safety eyewear during cosmetic procedures involving laser devices, so as to prevent the occurrence of ocular complications. Thorough short-term follow-up with OCTA is recommended for the prompt detection of CNV in cases of retinal laser injury.
关键词： fovea,case report,retina,laser,choroidal neovascularization
更新于2025-09-12 10:27:22
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Promiscuous Chemokine Antagonist (BKT130) Suppresses Laser-Induced Choroidal Neovascularization by Inhibition of Monocyte Recruitment
摘要： Background. Age-related macular degeneration (AMD), the most common cause of blindness in the developed world, usually affects individuals older than 60 years of age. The majority of visual loss in this disease is attributable to the development of choroidal neovascularization (CNV). Mononuclear phagocytes, including monocytes and their tissue descendants, macrophages, have long been implicated in the pathogenesis of neovascular AMD (nvAMD). Current therapies for nvAMD are based on targeting vascular endothelial growth factor (VEGF). This study is aimed at assessing if perturbation of chemokine signaling and mononuclear cell recruitment may serve as novel complementary therapeutic targets for nvAMD. Methods. A promiscuous chemokine antagonist (BKT130), aflibercept treatment, or combined BKT130+aflibercept treatment was tested in an in vivo laser-induced model of choroidal neovascularization (LI-CNV) and in an ex vivo choroidal sprouting assay (CSA). Quantification of CD11b+ cell in the CNV area was performed, and mRNA levels of genes implicated in CNV growth were measured in the retina and RPE-choroid. Results. BKT130 reduced the CNV area and recruitment of CD11b+ cells by 30-35%. No effect of BKT130 on macrophages’ proangiogenic phenotype was demonstrated ex vivo, but a lower VEGFA and CCR2 expression was found in the RPE-choroid and a lower expression of TNFα and NOS1 was found in both RPE-choroid and retinal tissues in the LI-CNV model under treatment with BKT130. Conclusions. Targeting monocyte recruitment via perturbation of chemokine signaling can reduce the size of experimental CNV and should be evaluated as a potential novel therapeutic modality for nvAMD.
关键词： Age-related macular degeneration,monocyte recruitment,VEGF,choroidal neovascularization,chemokine antagonist
更新于2025-09-11 14:15:04
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Initial Utilization of Aflibercept in Exudative Age-related Macular Degeneration
摘要： Purpose: Intravitreal aflibercept, a fusion protein with high affinity for vascular endothelial growth factor, offers an alternative treatment for exudative age-related macular degeneration. Preclinical studies and early and late phase clinical trials suggest that aflibercept’s high binding affinity may impart greater durability of activity and increased efficacy compared to ranibizumab or bevacizumab. Methods: A total of 266 eyes of 249 patients with exudative age-related macular degeneration who received aflibercept after treatment with bevacizumab and/or ranibizumab were included in a retrospective review. Mean central subfoveal thickness on spectral-domain optical coherence tomography and mean logarithm of the minimal angle of resolution (logMAR) visual acuity were calculated at 1, 3, 6, and 12 months after the first aflibercept injection. Subgroup analyses were performed in eyes receiving at least 5 bevacizumab and/or ranibizumab injections in the 6 months prior to aflibercept and in eyes receiving at least 10 injections in the 12 months prior to aflibercept. Results: Eyes received an average of 14.7 (range 1-43) ranibizumab and/or bevacizumab treatments prior to initiation of aflibercept therapy. The mean central subfoveal thickness decreased from 300 to 275 μm at 1 month (p<0.001) and was maintained at 6 months. Mean logMAR visual acuity improved from 0.60 (Snellen equivalent 20/80) to 0.54 (20/70, p = 0.01) at 1 month and was stable at 0.55 at 6 months (Snellen equivalent 20/70, p = 0.11, n = 251). In 82 eyes receiving at least 5 injections in the 6 months prior to aflibercept treatment (average of 18.1 injections total), the central subfoveal thickness improved from 296 to 279 μm at 1 month (p<0.0001) and was maintained at 6 months (p<0.0001). Visual acuity did not change (0.48 [20/61] at 1 month compared to baseline, 0.49 [20/62], p = 0.634, and at 6 months 0.51 [20/65], p = 0.601). In 50 eyes receiving at least 10 injections in the 12 months prior to aflibercept treatment (average of 21.8 injections total), the mean central subfoveal thickness decreased by 17 μm at 1 month (p = 0.0007) and was maintained at 6 months (p = 0.013). Again, visual acuity did not change (0.46 [20/56] at 1 month, baseline 0.44 [20/56], p = 0.547, and 0.50 [20/63] at 6 months, p = 0.2445). Conclusions: Aflibercept is a valuable treatment alternative in patients previously treated with bevacizumab and/or ranibizumab injections. Stability of visual acuity and anatomic improvement on spectral-domain optical coherence tomography were observed after initiation of aflibercept treatment in those previously treated with ranibizumab and/or bevacizumab injections every 4-6 weeks.
关键词： Ranibizumab,Age-related macular degeneration,Choroidal neovascularization,Aflibercept,Bevacizumab
更新于2025-09-10 09:29:36
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Comparison of Neovascular Lesion Area Measurements From Different Swept-Source OCT Angiographic Scan Patterns in Age-Related Macular Degeneration
摘要： PURPOSE. We compared area measurements for the same neovascular lesions imaged using swept source optical coherence tomography angiography (SS-OCTA) and enlarging scan patterns. METHODS. Patients with neovascular age-related macular degeneration were imaged using a 100-kHz SS-OCTA instrument (PLEX Elite 9000). The scanning protocols included the 3 3 3, 6 3 6, 9 3 9, and 12 3 12 mm ?elds of view. Two groups were studied. Group 1 included small lesions contained within the 3 3 3 mm scan, and Group 2 included larger lesions that were fully contained within the 6 3 6 mm scan. RESULTS. A total of 30 eyes of 26 patients were enrolled in Group 1 and 30 eyes of 25 patients were enrolled in Group 2. In Group 1, the automated mean lesion area measurements were 1.11 (SD ? 0.78), 1.14 (SD ? 0.80), and 1.27 (SD ? 0.82) mm2 for the 3 3 3, 6 3 6, and 12 3 12 mm scans, respectively (ANOVA P < 0.001; post hoc comparisons, P ? 0.184, 3 3 3 vs. 6 3 6 mm; P < 0.001 for the other two pairs). In Group 2, the automated mean lesion area measurements were 5.43 (SD ? 2.56), 5.53 (SD ? 2.48), and 5.49 (SD ? 2.65) mm2 for the 6 3 6, 9 3 9, and 12 3 12 mm scans, respectively (ANOVA P ? 0.435; post-hoc comparisons, P ? 0.062, 6 3 6 vs. 9 3 9 mm; P ? 0.553, 6 3 6 vs. 12 3 12 mm; P ? 0.654, 9 3 9 vs. 12 3 12 mm). CONCLUSIONS. The similarity in lesion area measurements across different scan patterns suggests that SS-OCTA imaging can be used to follow quantitatively the enlargement of choroidal neovascularization as the disease progresses.
关键词： neovascular AMD,optical coherence tomography angiography,swept-source OCTA,quantified measurement comparison,choroidal neovascularization
更新于2025-09-10 09:29:36
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Assessing the Anatomical and Functional Efficacy of Aflibercept on Wet ARMD: An OCT and Mferg Recording
摘要： Objective: To investigate the therapeutic efficacy of aflibercept on sub-foveal choroidal neovascularization due to Age-Related Macular Degeneration (ARMD). Methods: Fifteen patients (15 eyes) with sub-foveal choroidal neovascularization due to ARMD were treated with intravitreal aflibercept. The doses were monthly for the first three months, being repeated every three months after for one year, using 2 mg of intravitreal aflibercept. A total of six aflibercept injections were, finally, performed during the 12-month study. All patients underwent a complete ophthalmic examination, including the measurement of best-corrected visual acuity, fundus examination, intraocular pressure measurement, fluorescein angiography, optical coherence tomography (OCT) scan and multifocal electroretinography (mfERG) recording, at the baseline and at the first, second, third, sixth, ninth and 12th month after the first injection of aflibercept. Two masked examiners evaluated the visual acuity based on standard Snellen charts. Results: Fifteen patients (15 eyes), of mean age 69.2 ± 4.9 years old, with sub-foveal choroidal neovascularization due to ARMD were participated in this study. The mean BCVA was 0.12 ± 0.08, 0.20 ± 0.10, 0.25 ± 0.1, 0.28 ± 0.1, 0.34 ± 0.14, 0.36 ± 0.14 and 0.40 ± 0.14 decimal, at presentation, 1st, 2nd, 3rd, 6th, 9th and 12th month, respectively. Significant differences in amplitudes but not in latencies of three rings were observed over time. Significant reductions were noted among the central retinal thickness measurements before intravitreal aflibercept and at 1st, 2nd, 3rd, 6th, 9th and 12th month (465.0 ± 161.4, 374.9 ± 139.5, 323.3 ± 113.8, 290.3 ± 85, 263.3 ± 69, 243.0 ± 60.6 and 226.9 ± 63.5, respectively). Conclusion: This is the first time that anatomical and functional improvement of the macula in patients with sub-foveal choroidal neovascularization due to ARMD was shown objectively, based on OCT and mfERG recordings. In addition, the improvement of visual acuity was noted over time. Our study supports the fact that intravitreal use of aflibercept is safe and effective in treating sub-foveal choroidal neovascularization observed in patients with ARMD.
关键词： findings,electroretinography,Macular,Aflibercept,Anatomical,Sub-foveal,Multifocal,Optical coherence tomography,choroidal neovascularization,Function,Age-related macular degeneration
更新于2025-09-09 09:28:46
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An update on inflammatory choroidal neovascularization: epidemiology, multimodal imaging, and management
摘要： Inflammatory choroidal neovascular membranes are challenging to diagnose and manage. A number of uveitic entities may be complicated by the development of choroidal neovascularization leading to a decrease in central visual acuity. In conditions such as punctate inner choroidopathy, development of choroidal neovascularization is extremely common and must be suspected in all cases. On the other hand, in patients with conditions such as serpiginous choroiditis, and multifocal choroiditis, it may be difficult to differentiate between inflammatory choroiditis lesions and choroidal neovascularization. Multimodal imaging analysis, including the recently introduced technology of optical coherence tomography angiography, greatly aid in the diagnosis and management of inflammatory choroidal neovascularization. Management of these neovascular membranes consists of anti-vascular growth factor agents, with or without concomitant anti-inflammatory and/or corticosteroid therapy.
关键词： Posterior uveitis,angiography,Choroiditis,Uveitis,Fluorescein angiography,Optical coherence tomography angiography,EDI-OCT,Indocyanine green,Inflammatory choroidal neovascularization
更新于2025-09-09 09:28:46
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Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization Secondary to Candida Chorioretinitis
摘要： Purpose: To report a case of choroidal neovascularization (CNV) secondary to candida chorioretinitis initially treated with an intravitreal bevacizumab injection. Case summary: A 50-year-old female presented at our clinic with decreased vision and metamorphopsia in her left eye of 5 days duration. She received an anti-fungal treatment 2 months prior due to the presence of endogenous candida choroiditis in both eyes. Fluorescein angiography and optical coherence tomography (OCT) revealed juxtafoveal CNV in her left eye. Three monthly intravitreal injections of bevacizumab were administered as the initial loading dosage. Her visual symptoms improved and CNV regression was observed on OCT. No recurrence or complications were observed during the 6 month follow-up. Conclusions: Based on the present study results we suggest that intravitreal bevacizumab injection can be used to effectively treat CNV and improve visual symptoms during the treatment of juxtafoveal CNV associated with candida choroiditis.
关键词： Choroiditis,Intravitreal injection,Candida,Choroidal neovascularization,Bevacizumab
更新于2025-09-09 09:28:46
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Retinal metabolic and structural alterations in response to aflibercept treatment in neovascular age‐related macular degeneration
摘要： Purpose: Non-invasive retinal markers of disease activity could pave the way for individualized treatment in neovascular age-related macular degeneration (nAMD). We aimed to evaluate if retinal vascular oxygen saturation and calibres could predict the initial treatment response after a loading phase of intravitreal a?ibercept in nAMD. Method: A total of 149 eyes were included (nAMD, n = 76; dry AMD, n = 30; normal eyes n = 43). Of these, 57 treatment-na€?ve eyes with nAMD received three monthly injections with 2.0 mg a?ibercept and were subsequently strati?ed according to functional and structural response according to development in best-corrected visual acuity and macular retinal thickness. The retinal vascular oxygen saturation and calibres were measured prior to treatment and 1 month after the third injection. Results: Patients with nAMD and dry AMD had higher retinal arteriolar oxygen saturation as compared to normal eyes (94.3% versus 95.2% versus 92.6%, p = 0.04). Thirty-nine (68.4%) and 12 (21.1%) eyes with nAMD were functional and structural responders. After the loading phase, structural nonresponders developed a higher retinal arteriolar (95.3% versus 93.3%, p = 0.03) and venular (64.7% versus 59.4%, p = 0.02) oxygen saturation, and responders developed a lower retinal arteriolar calibre (118.0 versus 114.3 lm, p < 0.01). In a multiple logistic regression model, increasing retinal venular oxygen saturation associated with a negative structural treatment outcome (odds ratio 1.17 for each 1% increment after the loading phase, 95% con?dence interval 1.01–1.36, p = 0.03). Conclusion: Changes in the retinal venular oxygen saturation associate independently with initial treatment response in nAMD, but functional and structural retinal measurements prior to treatment could not predict the treatment response.
关键词： a?ibercept,retinal vascular calibre,disease activity,neovascular age-related macular degeneration,retinal oximetry,choroidal neovascularization
更新于2025-09-09 09:28:46