Aims: To assess the correlation between optical coherence tomography (OCT) and leakage on fundus fluorescein angiography (FFA) following photodynamic therapy (PDT) with verteporfin for choroidal neovascularisation (CN...Aims: To assess the correlation between optical coherence tomography (OCT) and leakage on fundus fluorescein angiography (FFA) following photodynamic therapy (PDT) with verteporfin for choroidal neovascularisation (CNV). Methods: Retrospective comparative observational case series of patients who were treated with PDT for CNV from one centre. All patients had 3 monthly FFA and OCT following initial PDT to assess if further treatment was required. A pair of FFA and OCT images from the same visit at a random follow up date were taken from each patient’ s series and assessed separately by different observers. The presence of pigment epithelial detachment,subretinal fluid,vitreomacular traction,intraretinal fluid,absence of foveal depression,and the retinal thickness on OCT were correlated with presence of leaks on FFA. Results: A total of 121 eyes of 121 patients were included. The presence of subretinal fluid,gross cystoid macular oedema,sponge-like retinal thickening and retinal thickness of more than 350 μ mon OCT correlated well with leak on FFA (p value < 0.01). The likelihood ratios were 3.0,5.7,2.7,and 3.6,respectively. The presence of a solitary foveal cyst did not correlate well with leaks on FFA. Conclusions: The presence of subretinal fluid,intraretinal fluid in the form of gross cystoid macular oedema,or sponge-like retinal thickening,or a retinal thickness more than 350 μ m correlates with leaks on FFA and so suggests the need for repeat PDT.展开更多
PURPOSE: To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT)-in patients with age-related macular degenerat...PURPOSE: To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT)-in patients with age-related macular degeneration (ARMD). DESIGN: Prospective observational case series. METHODS: setting: Institutional study. patient population: Fiftythree patients (62 eyes) with ARMD. observation procedure: Prospective observational case study. main outcome measures: Presence or absence of leakage on fluorescein angiography, presence of intraretinal or sub-retinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT. RESULTS: The macular thickness decreased significantly after PDT (P=.001). However, no significant changes in CNVthickness were measured after PDT (P=.567). Once the diagnosis of ARMD was established before treatment, OCT had a sensitivity of 96.77% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.65% ) and a moderate specificity (59.01% ) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 82.95% . CONCLUSIONS:OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with ARMD.展开更多
Purpose: To describe the OCT findings in two cases of idiopathic serous macula r detachments associated with Sildenafil (Viagra) use. Methods: Two patients wer e identified with idiopathic serous macular detachments a...Purpose: To describe the OCT findings in two cases of idiopathic serous macula r detachments associated with Sildenafil (Viagra) use. Methods: Two patients wer e identified with idiopathic serous macular detachments associated with Viagra u se. Each patient underwent rigorous historical questioning to rule out known cau ses of serous macular detachments and to determine contributing factors. A compr ehensive ocular examination was performed including dilated biomicroscopic exami nation of the macula and indirect ophthalmoscopic evaluation of the retinal peri phery. Additional evaluation included color fundus photography with FA and ICG,O CT analysis of the macula and B-scan ultrasonography. Systemicworkup included M RI of the brain and orbits, CT of the brain, orbits, chest and abdomen, blood ch emistries and electrophoresis, lumbar puncture with CSF analysis and chest radio graphs. Results: Both patients demonstrated idiopathic serous macular detachment associated with peri-macular vitelliform deposits. Although notable peripapill ary atrophy and RPE mottling were present, there was no evidence of heme, exudat e, or fibrosis to suggest a CNVM. FA showed no focal areas of leakage. Early and late frames of the ICG demonstrated engorged choroidal vessels without frank le akage. Extensive medical evaluation failed to reveal a systemic etiology. OCT fi ndings demonstrated large serous macular detachments that corresponded to the us e or discontinuation of Viagra. Discontinuation of Viagra coincided with complet e resolution of the serous macular detachment in one patient and improvement of the serous macular detachment in the other. When one patient resumed Viagra use, he experienced a recurrent serous macular detachment. Conclusions: We report th e OCT findings of two cases of idiopathic serous macular detachment associated w ith use of the potent vasodilator Sildenafil (Viagra).展开更多
文摘Aims: To assess the correlation between optical coherence tomography (OCT) and leakage on fundus fluorescein angiography (FFA) following photodynamic therapy (PDT) with verteporfin for choroidal neovascularisation (CNV). Methods: Retrospective comparative observational case series of patients who were treated with PDT for CNV from one centre. All patients had 3 monthly FFA and OCT following initial PDT to assess if further treatment was required. A pair of FFA and OCT images from the same visit at a random follow up date were taken from each patient’ s series and assessed separately by different observers. The presence of pigment epithelial detachment,subretinal fluid,vitreomacular traction,intraretinal fluid,absence of foveal depression,and the retinal thickness on OCT were correlated with presence of leaks on FFA. Results: A total of 121 eyes of 121 patients were included. The presence of subretinal fluid,gross cystoid macular oedema,sponge-like retinal thickening and retinal thickness of more than 350 μ mon OCT correlated well with leak on FFA (p value < 0.01). The likelihood ratios were 3.0,5.7,2.7,and 3.6,respectively. The presence of a solitary foveal cyst did not correlate well with leaks on FFA. Conclusions: The presence of subretinal fluid,intraretinal fluid in the form of gross cystoid macular oedema,or sponge-like retinal thickening,or a retinal thickness more than 350 μ m correlates with leaks on FFA and so suggests the need for repeat PDT.
文摘PURPOSE: To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT)-in patients with age-related macular degeneration (ARMD). DESIGN: Prospective observational case series. METHODS: setting: Institutional study. patient population: Fiftythree patients (62 eyes) with ARMD. observation procedure: Prospective observational case study. main outcome measures: Presence or absence of leakage on fluorescein angiography, presence of intraretinal or sub-retinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT. RESULTS: The macular thickness decreased significantly after PDT (P=.001). However, no significant changes in CNVthickness were measured after PDT (P=.567). Once the diagnosis of ARMD was established before treatment, OCT had a sensitivity of 96.77% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.65% ) and a moderate specificity (59.01% ) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 82.95% . CONCLUSIONS:OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with ARMD.
文摘Purpose: To describe the OCT findings in two cases of idiopathic serous macula r detachments associated with Sildenafil (Viagra) use. Methods: Two patients wer e identified with idiopathic serous macular detachments associated with Viagra u se. Each patient underwent rigorous historical questioning to rule out known cau ses of serous macular detachments and to determine contributing factors. A compr ehensive ocular examination was performed including dilated biomicroscopic exami nation of the macula and indirect ophthalmoscopic evaluation of the retinal peri phery. Additional evaluation included color fundus photography with FA and ICG,O CT analysis of the macula and B-scan ultrasonography. Systemicworkup included M RI of the brain and orbits, CT of the brain, orbits, chest and abdomen, blood ch emistries and electrophoresis, lumbar puncture with CSF analysis and chest radio graphs. Results: Both patients demonstrated idiopathic serous macular detachment associated with peri-macular vitelliform deposits. Although notable peripapill ary atrophy and RPE mottling were present, there was no evidence of heme, exudat e, or fibrosis to suggest a CNVM. FA showed no focal areas of leakage. Early and late frames of the ICG demonstrated engorged choroidal vessels without frank le akage. Extensive medical evaluation failed to reveal a systemic etiology. OCT fi ndings demonstrated large serous macular detachments that corresponded to the us e or discontinuation of Viagra. Discontinuation of Viagra coincided with complet e resolution of the serous macular detachment in one patient and improvement of the serous macular detachment in the other. When one patient resumed Viagra use, he experienced a recurrent serous macular detachment. Conclusions: We report th e OCT findings of two cases of idiopathic serous macular detachment associated w ith use of the potent vasodilator Sildenafil (Viagra).
