Navegando por Palavras-chave "Neovascularização coroidal"
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- ItemAcesso aberto (Open Access)Degeneração macular relacionada à idade: modalidades terapêuticas(Conselho Brasileiro de Oftalmologia, 2001-11-01) Farah, Michel Eid [UNIFESP]; Oshima, Akiyoshi [UNIFESP]; Costa, Rogerio Alves [UNIFESP]; Sallum, Juliana Ferraz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)To describe the clinical and surgical therapeutic modalities in age-related macular degeneration (ARMD).
- ItemAcesso aberto (Open Access)Indocyanine green-mediated photothrombosis for choroidal neovascularization in angioid streaks(Conselho Brasileiro de Oftalmologia, 2008-06-01) Malerbi, Fernando Korn [UNIFESP]; Huang, Sheau Jiun [UNIFESP]; Aggio, Fabio Bom [UNIFESP]; Carvalho Jr., Edenilson [UNIFESP]; Bonomo, Pedro Paulo [UNIFESP]; Farah, Michel Eid [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To investigate the effect of indocyanine green-mediated photothrombosis on choroidal neovascularization secondary to angioid streaks. METHODS: Six eyes of 5 patients with an average age of 70 years were diagnosed to have subfoveal choroidal neovascularization secondary to angioid streaks. Therapy was indicated if choroidal neovascularization was considered to be active, according to evidence of fluorescein leakage on angiograms, as well as presence of intra- or subretinal fluid on optical coherence tomography. Patients received photothrombosis at baseline with retreatment as necessary at 3, 6 and 9 months follow-up. Fluorescein leakage was assessed at 3, 6 and 9 months, along with foveal thickness measured by optical coherence tomography. Indocyanine green angiography was performed initially and whenever retreatment was considered. Retreatment was performed whenever there was evidence of increased leakage on fluorescein angiograms at follow-up visits. RESULTS: The mean follow-up was 13.3 months. All eyes had at least 12 months follow-up. Two eyes underwent retreatment. Three eyes had visual acuity improvement and three eyes had stabilization. All patients showed less fluorescein leakage on final angiograms and reduced foveal thickness upon optical coherence tomography measurement. CONCLUSION: Photothrombosis is a feasible procedure for choroidal neovascularization secondary to angioid streaks. Lesion analysis showed anatomical improvement in most cases in this series. Further studies are warranted to evaluate long-term results of this treatment.
- ItemAcesso aberto (Open Access)Intermediate uveitis complicated by choroidal granuloma following subretinal neovascular membrane: case reports(Conselho Brasileiro de Oftalmologia, 2008-12-01) Garcia, Carlos Alexandre de Amorim; Segundo, Paulo de Souza; Garcia Filho, Carlos Alexandre de Amorim [UNIFESP]; Garcia, Ana Cláudia Medeiros de Amorim; Universidade Federal do Rio Grande do Norte Ophthalmology Department; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio Grande do NorteChoroidal neovascularization is a very rare complication in intermediate uveitis. A 27-year-old female patient diagnosed with intermediate uveitis two years ago. She presented with 20/200 visual acuity, snowballs, snowbanks, and macular cystoid edema in the right eye observed by fluorescein and optical coherence tomography (OCT). Photocoagulation was performed in the inferior peripheral retina in both eyes. The patient refused to undergo the prescribed clinical treatment. She returned twelve months later presenting with count fingers visual acuity, dry retina and subretinal macular pigmented granuloma observed on OCT. A 15-year-old female patient with decreased visual acuity of 20/400 in the right eye for eight days. She presented with bilateral vasculitis and papilitis, in the right eye, hemorrhage and extramacular subretinal neovascular membrane were observed on fluorescein and OCT. She was treated with 40 mg prednisone and intravitreous injection of 1.25 mg bevacizumab. Five months later she presented with 20/50 visual acuity, and extramacular granuloma observed on OCT. The formation of subretinal granuloma in intermediate uveitis is a possibility when complicated by subretinal neovascular membrane.
- ItemAcesso aberto (Open Access)Intravitreal ranibizumab and bevacizumab for the treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration(Conselho Brasileiro de Oftalmologia, 2009-10-01) Roller, Aaron Brock; Amaro, Miguel Hage [UNIFESP]; University of Iowa Department of Ophthalmology Hospitals and Clinics; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To investigate the efficacy of vascular endothelial growth factor-specific (VEGF) monoclonal antibodies in the treatment of choroidal neovascularization secondary to age-related macular degeneration (AMD) that does not extend beneath the foveal center (nonsubfoveal CNV). METHODS: The study design was a retrospective chart review of consecutive patients over a two-month period under active treatment with bevacizumab and/or ranibizumab for neovascular AMD. Patients with neovascularization within the macula that did not extend beneath the center of the foveal avascular zone, along with at least one large drusen (>125 µ) or many intermediate size (63-124 µ) drusen were included. Best corrected Snellen visual acuity and optical coherence tomography (OCT) analysis of the central macular thickness was recorded for each visit. Serial injections of bevacizumab and/or ranibizumab were administered until there was resolution of subretinal fluid clinically or by OCT. Data over the entire follow-up period were analyzed for overall visual acuity and OCT changes. All patients had follow-up since diagnosis of at least 6 months (mean=9.6 months). RESULTS: Of the thirteen included patients, eleven had reduction of retinal thickening in the area involved by the CNV. The remaining two patients did not have OCT data available but had no fluid or activity on clinical examination at last follow-up. One patient (8%) lost one line of vision; one (8%) remained stable, and eleven (84%) gained one or more lines of visual acuity. Three patients (23%) gained three or more lines. The average treatment outcome for all patients was a gain of 1.7 ± 1.3 lines of Snellen acuity. Both therapeutic agents were effective, with an average gain of 1.6 ± 0.6 lines for patients treated with bevacizumab, 1.5 ± 1.9 lines gained for patients treated with ranibizumab and 2.5 ± 0.7 lines gained in the two patients who received both agents over the course of their treatment. CONCLUSIONS: The use of intravitreal anti-VEGF agents for nonsubfoveal CNV in AMD is effective. Our results are comparable to published results from large-scale trials of anti-VEGF therapy for subfoveal CNV. Our data support the idea that bevacizumab or ranibizumab appear to be the treatment of choice for AMD patients with nonsubfoveal CNV.
- ItemAcesso aberto (Open Access)Ocular histoplasmosis-like syndrome: a report from a nonendemic area(Conselho Brasileiro de Oftalmologia, 2007-08-01) Amaro, Miguel Hage [UNIFESP]; Muccioli, Cristina [UNIFESP]; Abreu, Mariza Toledo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To report some cases of ocular histoplasmosis-like syndrome from a nonendemica area. DESIGN: Observational case series. METHODS: This is a prospective study of 16 eyes from 8 immunocompetent patients evaluated between January 2001 to September 2005. Six patients were female and 2 male aged between 20 to 44 years, average 28 years. All patients presented clinical features that resembled ocular histoplasmosis. All patients had a negative antibody test for histoplasmosis and negative medical and laboratory evaluation of toxoplasmosis, syphilis, and tuberculosis. All patients were submitted to a complete ocular examination including fluorescein angiography. One patient was submitted to indocyanine green angiography. RESULTS: Five patients presented the classical triad of clinical features that include peripapillary scarring, histo spots, choroidal neovascularization, one patient presentd enlargement of atrophic chorioretina scar, one patient presented multiple retinal pigment epithelial detachment, one, neovascularized retinal pigment epithelial detachment. Another patient presented only histo spots. CONCLUSION: These findings of ocular histoplasmosis-like syndrome in patients with negative antibody serum test from a nonendemica area suggest that other agents could cause these similar fundus findings of ocular histoplasmosis.
- ItemAcesso aberto (Open Access)Toxoplasmosis retinochoroiditis after photodynamic therapy and intravitreal triamcinolone for a supposed choroidal neovascularization: a case report(Conselho Brasileiro de Oftalmologia, 2007-02-01) Nóbrega, Mário Junqueira [UNIFESP]; Rosa, Evandro Luís; Universidade Federal de São Paulo (UNIFESP); Universidade da Região de Joinville; Hospital de Olhos Sadalla Amin GhanemThe purpose is to report a complication after photodynamic therapy (PDT) and intravitreal triamcinolone for a presumed choroidal neovascularization in age-related macular degeneration. Photodynamic therapy and intravitreal triamcinolone were used in an 84-year-old man with choroidal neovascularization in the left eye. Forty-five days after therapy, the patient returned with a severe necrotizing uveitis in the posterior pole and vitritis. Laboratory investigation disclosed a high anti-Toxoplasma IgG titer. Therapy with pyrimethamine, sulfadiazine and folinic acid resulted in total lesion healing although central vision was lost. Intravitreal triamcinolone may have had an influence on the exacerbation of retinochoroiditis in the posterior pole of the patient. Although rare, this complication may not be disregarded in the cases that require intraocular corticosteroids for treatment of several conditions, especially in patients who had previously suffered from toxoplasmosis infection.