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Age-related differences in the prevalence of subtypes of Neovascular age-related macular degeneration in the first diagnosed eye
摘要： Purpose To evaluate age-related differences in the prevalence of subtypes of neovascular age-related macular degeneration (AMD) in the first diagnosed eye. Methods This retrospective, observational study included 1099 eyes of 1099 patients diagnosed with neovascular AMD. The neovascular AMD cases were classified into three subtypes: typical neovascular AMD, polypoidal choroidal vasculopathy (PCV), and type 3 neovascularization. The patients were divided into four groups, according to age: > 50 and < 60 years, ≥ 60 and < 70 years, ≥ 70 and < 80 years, and ≥ 80 years. Difference in the prevalence of three AMD subtypes was evaluated among the four age groups. Results In the age group > 50 and < 60 years, 34 (25.0%) and 102 patients (75.0%) were diagnosed with typical neovascular AMD and PCV, respectively. In the age group ≥ 60 and < 70 years, 90 (28.1%), 206 (64.4%), and 24 patients (7.5%) were diagnosed with typical neovascular AMD, PCV, and type 3 neovascularization, respectively. In the age group ≥ 70 and < 80 years, the corresponding numbers were 200 (41.9%), 197 (41.3%), and 80 (16.8%), respectively; in the age group ≥80 years, the corresponding values were 83 (50.0%), 39 (23.5%), and 44 (26.5%), respectively. A significant difference was observed in the prevalence of the subtypes of neovascular AMD among the four age groups (chi-square test, P < 0.001). Conclusion Subtype prevalence in newly diagnosed neovascular AMD differs significantly according to age. This result suggests that different pathophysiology may be involved in the development of different subtypes of neovascular AMD.
关键词： Retinal angiomatous proliferation,Polypoidal choroidal vasculopathy,Choroidal neovascularization,Type 3 neovascularization,Age-related macular degeneration
更新于2025-09-23 15:22:29
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Enhanced depth imaging optical coherence tomography of choroidal osteoma with secondary neovascular membranes: report of two cases
摘要： We report enhanced depth imaging optical coherence tomography (EDI-OCT) features based on clinical and imaging data from two newly diagnosed cases of choroidal osteoma presenting with recent visual loss secondary to choroidal neovascular membranes. The features described in the two cases, compression of the choriocapillaris and disorganization of the medium and large vessel layers, are consistent with those of previous reports. We noticed a sponge-like pattern previously reported, but it was subtle. Both lesions had multiple intralesional layers and a typical intrinsic transparency with visibility of the sclerochoroidal junction.
关键词： Choroid neoplasms,Choroidal neovascularization,Osteoma,Tomography, optical coherence
更新于2025-09-23 15:22:29
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Retinal vascular changes and aqueous humor cytokines changes after aflibercept intravitreal injection in treatment-na?ve myopic choroidal neovascularization
摘要： The aim of the study was to assess retinal vascular changes using optical coherence tomography angiography (OCTA) and aqueous humour changes of vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) levels in treatment-na?ve myopic choroidal neovascularization (mCNV) after aflibercept intravitreal injection. To explore the correlation between clinical and laboratory parameters. Fifteen eyes of 15 patients with treatment-na?ve mCNV underwent 2 intravitreal injections of aflibercept. Main outcome measures were best corrected visual acuity (BCVA), central retinal thickness (CRT) and external limiting membrane (ELM) visualization at OCT, lesion area and leakage at fluorescein angiography (FA), OCTA flow area and selected area at baseline and after the injections. Analysis of VEGF and PlGF in the aqueous humor was performed before each injection in cases and prior to cataract surgery on 10 patients as included as controls. Median BCVA increased from 0.6 to 0.3 logMAR (p < 0.001); CRT decreased from 387.5 to 267 micron (p < 0.001); FA area from 0.8 to 0.5 mm2 and OCTA area from 0.9 to 0.5 mm2 (p = 0.005). PIGF values changed from 1.8 to 1.4 pg/ml (p = 0.019) and VEGF values from 3.4 to 0.5 pg/ml (p = 0.008). A significant correlation was found after treatment between PIGF levels and BCVA (rho = 0.006) and VEGF levels and BCVA (rho = 0.018); between PlGF and CRT (rho = 0.020), PlGF and ELM visualization (rho = 0.002) and PlGF and FA leakage (rho < 0.001). Our results showed a significant reduction of mCNV area after aflibercept in both FA and OCTA measurements; an improvement of BCVA, and a reduction of VEGF and PIGF levels related to inactivity of the disease.
关键词： retinal vascular changes,OCTA,PlGF,myopic choroidal neovascularization,intravitreal injection,aflibercept,VEGF,aqueous humor cytokines
更新于2025-09-23 15:21:01
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Quantifying Disrupted Outer Retinal-Subretinal Layer in SD-OCT Images in Choroidal Neovascularization
摘要： We reported a fully automated method to identify and quantify the thickness of the outer retinal-subretinal (ORSR) layer from clinical spectral-domain optical coherence tomography (SD-OCT) scans of choroidal neovascularization (CNV) due to exudative age-related macular degeneration (eAMD). A total of 23 subjects with CNV met eligibility. Volumetric SD-OCT scans of 23 eyes were obtained (Zeiss Cirrus, 200 3 200 3 1024 voxels). In a subset of eyes, scans were repeated. The OCT volumes were analyzed using our standard parameters and using a 3-dimensional (3D) graph-search approach with an adaptive cost function. A retinal specialist graded the segmentation as generally accurate, local segmentation inaccuracies, or failure. Reproducibility on repeat scans was analyzed using root mean square coef?cient of variation (RMS CV) of the average ORSR thickness. Using a standard segmentation approach, 1/23 OCT segmentations was graded generally accurate and 22/23 were failure(s). With the adaptive method 21/23 segmentations were graded generally accurate; 2/23 were local segmentation inaccuracies and none was a failure. The intermethod quality of segmentation was signi?cantly different (P << 0.001). The average ORSR thickness measured on CNV patients (78.0 lm; 95% con?dence interval [CI], 72.5–83.4 lm) is signi?cantly larger (P << 0.001) than normal average ORSR layer thickness (51.5 6 3.3 lm). The RMS CV was 8.1%. We have developed a fully automated 3D method for segmenting the ORSR layer in SD-OCT of patients with CNV from eAMD. Our method can quantify the ORSR layer thickness in the presence of ?uid, which has the potential to augment management accuracy and ef?ciency of anti-VEGF treatment.
关键词： imaging,OCT,retina,choroidal neovascularization,AMD
更新于2025-09-23 15:21:01
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Essential contribution of macrophage Tie2 signal mediated autophagy in laser-induced choroidal neovascularization
摘要： Autophagy plays critical roles in various ocular diseases, including age-related macular degeneration (AMD). Tie2-expressing macrophages (TEMs) play crucial roles in angiogenesis. To investigate the role of TEMs and autophagy in the development of AMD, we employed macrophage-specific Tie2 knockout mice and used a laser-induced choroidal neovascularization (CNV). The results showed that TEMs can promote CNV formation by up-regulating the level of autophagy. These results were further verified by in vitro cell experiments that peritoneal macrophages from Tie2 knockout mice can inhibit the expression of autophagy-related factors and inhibit the expression of angiogenic factor of VEGF by activating AMPK signaling pathway. Our results suggest that TEMs and macrophage Tie2 signal mediated-autophagy play critical role in experimental CNV, and they may be novel preventive targets for AMD treatment.
关键词： Tie2-expressing macrophage (TEMs),Age-related macular degeneration,Choroidal neovascularization,Autophagy
更新于2025-09-23 15:19:57
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A Circulating MicroRNA Profile in a Laser-Induced Mouse Model of Choroidal Neovascularization
摘要： Choroidal neovascularization (CNV) is a pathological process in which aberrant blood vessels invade the subretinal space of the mammalian eye. It is a characteristic feature of the prevalent neovascular age-related macular degeneration (nAMD). Circulating microRNAs (cmiRNAs) are regarded as potentially valuable biomarkers for various age-related diseases, including nAMD. Here, we investigated cmiRNA expression in an established laser-induced CNV mouse model. Upon CNV induction in C57Bl/6 mice, blood-derived cmiRNAs were initially determined globally by RNA next generation sequencing, and the most strongly dysregulated cmiRNAs were independently replicated by quantitative reverse transcription PCR (RT-qPCR) in blood, retinal, and retinal pigment epithelium (RPE)/choroidal tissue. Our findings suggest that two miRNAs, mmu-mir-486a-5p and mmur-mir-92a-3p, are consistently dysregulated during CNV formation. Furthermore, in functional in vitro assays, a significant impact of mmu-mir-486a-5p and mmu-mir-92a-3p on murine microglial cell viability was observed, while mmu-mir-92a-3p also showed an impact on microglial mobility. Taken together, we report a robust dysregulation of two miRNAs in blood and RPE/choroid after laser-induced initiation of CNV lesions in mice, highlighting their potential role in pathology and eventual therapy of CNV-associated complications.
关键词： cmiRNA regulation,biomarker,laser-induced choroidal,neovascularization,age-related macular degeneration
更新于2025-09-23 15:19:57
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Comparison of choroidal neovascularization secondary to white dot syndromes and age-related macular degeneration by using optical coherence tomography angiography
摘要： Purpose: To characterize and compare choroidal neovascularization (CNV) secondary to white dot syndromes (WDS) and age-related macular degeneration (AMD) using optical coherence tomography angiography (OCT-A). Methods: This is a cross-sectional study in which we imaged patients with CNV secondary to WDS and AMD with either the Zeiss Angioplex OCT-A or Optovue AngioVue OCT-A. Relevant demographic and clinical characteristics were collected and analyzed. CNV area and vessel density (VD) were measured by three independent graders, and linear regression analysis was subsequently performed. Results: Three patients with multifocal choroiditis and panuveitis, one patient each with birdshot chorioretinopathy, presumed ocular histoplasmosis syndrome, and persistent placoid maculopathy, and eleven patients with AMD with sufficient image quality were included. CNV associated with WDS was significantly smaller than that secondary to AMD (0.56±0.32 vs 2.79±1.80 mm2, β=-2.22, P=0.01), while no difference in VD was detected (0.46±0.09 vs 0.44±0.09, β=0.02, P=0.71). Conclusion: CNV networks secondary to WDS appear to be smaller than those secondary to AMD but have similar VD. OCT-A is a powerful tool to investigate properties of CNV from various etiologies. Larger studies are needed for further characterization and understanding of CNV pathogenesis in inflammatory conditions.
关键词： uveitis,age-related macular degeneration,inflammation,choroidal neovascularization,white dot syndromes,optical coherence tomography angiography,choroidal neovascular membrane
更新于2025-09-19 17:15:36
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Treatment of neovascular age-related macular degeneration with anti-VEGF agents: retrospective analysis of 5-year outcomes
摘要： Purpose: To evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD) with anti-VEGF agents. Materials and methods: We retrospectively analyzed all patients with nAMD who initiated anti-VEGF treatment before October 2009. We collected data regarding visual and anatomical outcomes. Results: A total of 278 patients met the selection criteria. The mean number of intravitreal injections was 5.7 in the first year and 3.7 in the fifth year. A positive mean visual acuity variation of +3.7 Early Treatment Diabetic Retinopathy Study letters occurred in the first year, but no significant differences relative to baseline were observed thereafter. The majority of patients (71%) maintained stable visual acuity throughout follow-up. At 5 years, mean central macular thickness remained substantially inferior to baseline (-96.6 μm), and 56% of patients maintained dry retinas. Conclusion: Anti-VEGF therapy leads to long-term visual stabilization in the great majority of patients.
关键词： visual acuity,vascular endothelial growth factor,choroidal neovascularization,age-related macular degeneration
更新于2025-09-19 17:15:36
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Statement of the BVA, the DOG, and the RG on treatment of choroidal neovascularization in diseases other than neovascular age-related macular degeneration; Stellungnahme des BVA, der DOG und der RG zur Therapie chorioidaler Neovaskularisationen bei anderen Erkrankungen als der neovaskul?ren altersabh?ngigen Makuladegeneration (Englische Version);
摘要： Choroidal neovascularizations (CNV) occur not only in age-related macular degeneration (AMD), but also in numerous other macular and retinal disorders of varying etiology and, if left untreated, can cause irreversible visual loss. The diagnosis of CNV as well as the indication for treatment should be made in the same way as in neovascular AMD: On initial diagnosis: best-corrected visual acuity, fundus examination, optical coherence tomography (OCT), and fluorescein angiography. At follow-up: best-correct visual acuity, fundus examination, OCT, and, depending on findings, fluorescein angiography. Active CNV should be treated with intravitreal operative medication (IVOM) using vascular endothelial growth factor (VEGF) inhibitors if patients have visual acuity of at least 0.05 or if there is sufficient reason to assume that visual acuity could increase to over 0.05 under treatment. Underlying disorders can include, e.g., high myopia, angioid streaks, central serous chorioretinopathy, active and inactive uveitis of varying etiology, including retinochoroiditis, chorioretinitis, and choroiditis, eye injuries, retinal dystrophies, e.g., best disease and pattern dystrophies, idiopathic CNV, subretinal masses (osteomas, hamartomas, nevi). If CNV is not present as a complication in the above-mentioned disorders, IVOM with VEGF inhibitors should not be performed. Ranibizumab and aflibercept are approved in Germany for the treatment of CNV secondary to pathologic myopia. Ranibizumab has been approved in Germany since 12/2016 for the treatment of CNV in disorders other than neovascular AMD and pathologic myopia irrespective of the underlying disease. The other VEGF inhibitors, aflibercept and bevacizumab, can be used off-label. Due to its overall significantly poorer treatment results, photodynamic therapy (PDT) should only be used in exceptional cases and extrafoveal localization. After one initial intravitreal administration of VEGF inhibitors, further CNV activity should be monitored monthly for the first 6 months (see point 2). In the case of persisting or recurrent activity, repeated IVOM should be performed. Depending on disease course, the follow-up interval might be extended 6 months after the last IVOM. In individual justified cases (e.g., patients requiring frequent re-injections), a different treatment regimen (e.g., treat and extend) can be considered in the further course. If visual acuity drops below 0.05 on anti-VEGF treatment, or no further positive treatment outcome is expected (e.g., in the presence of atrophy and/or fibrosis), treatment should be discontinued, unless there is a clear possibility that visual acuity could increase again to over 0.05 under treatment. If no improvement is seen under therapy with a certain VEGF inhibitor, or if deterioration occurs, one can consider switching to an alternative VEGF inhibitor.
关键词： Choroidal neovascularization,Myopia,Retinal dystrophies,Ranibizumab,VEGF inhibitors,Uveitis,Idiopathic CNV,Central serous chorioretinopathy,Angioid streaks,Photodynamic therapy,Subretinal tumors,Aflibercept,Bevacizumab,Eye injuries
更新于2025-09-19 17:15:36
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Choroidal neovascularization after an alexandrite laser burn
摘要： Lasers used for hair removal operate between 700 and 1000 nm to be absorbed by hair follicle melanin and destroyed by thermal injury. Due to the high concentration of melanin in the retinal pigment epithelium, the retina is particularly susceptible to laser-related accidents. The use of alexandrite laser for esthetic purposes has been growing in recent years as well as its use by unqualified personnel, which can result in eye-level accidents. We describe an alexandrite laser accident suffered by a beautician that resulted in choroidal neovascularization.
关键词： Retinal injury,Laser burn,Choroidal neovascularization,Alexandrite laser
更新于2025-09-19 17:13:59