Refractory neovascular age-related macular degeneration secondary to polypoidal choroidal vasculopathy
| Autor: | K. Bailey Freund, Irene Barbazetto, Minhee Cho |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Indocyanine Green
Male Vascular Endothelial Growth Factor A medicine.medical_specialty Porphyrins genetic structures Combination therapy Bevacizumab Population Drug Resistance Visual Acuity Angiogenesis Inhibitors chemistry.chemical_compound Macular Degeneration Ophthalmology medicine Humans Fluorescein Angiography education Coloring Agents Aged Retrospective Studies Aged 80 and over Peripheral Vascular Diseases education.field_of_study Photosensitizing Agents medicine.diagnostic_test business.industry Choroid Verteporfin Macular degeneration Middle Aged medicine.disease Fluorescein angiography Combined Modality Therapy eye diseases Choroidal Neovascularization chemistry Photochemotherapy Female sense organs business Indocyanine green Tomography Optical Coherence Retinopathy medicine.drug |
| Zdroj: | American journal of ophthalmology. 148(1) |
| ISSN: | 1879-1891 |
| Popis: | purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a poor anatomic response to anti–vascular endothelial growth factor (VEGF) therapy was related to polypoidal choroidal vasculopathy (PCV). observation procedure: Slit-lamp biomicroscopy, optical coherence tomography, fluorescein and indocyanine green angiography. main outcome measures: Snellen visual acuity (VA), anatomic response to therapy including presence or absence of retinal edema, hemorrhage, and lipid exudates. Results New or persistent PCV was identified in a cohort of patients demonstrating increasing macular exudation despite regular intravitreal ranibizumab (Lucentis; Genentech Inc, South San Francisco, California, USA) or bevacizumab (Avastin; Genentech Inc) injections for a minimum of 6 months. Treatment with verteporfin photodynamic therapy (PDT), PDT/anti-VEGF combination therapy, or continued anti-VEGF monotherapy resulted in complete resolution of exudation in 9 of 12 patients and partial resolution of exudation in the remaining 3 patients. Conclusion Treatment-refractory neovascular AMD may harbor vascular abnormalities such as PCV. Modifications in therapeutic protocols may be indicated in order to improve visual and anatomic outcomes in this population. |
| Databáze: | OpenAIRE |
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