29 results on '"Goldstein, Michaella"'
Search Results
2. MICROPERIMETRY IN BEST VITELLIFORM MACULAR DYSTROPHY.
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PARODI, MAURIZIO BATTAGLIA, CASTELLINO, NICCOLÒ, IACONO, PIERLUIGI, CHOWERS, ITAY, EMPESLIDIS, THEODOROS, GOLDSTEIN, MICHAELLA, and BANDELLO, FRANCESCO
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- 2018
3. SWITCHING TREATMENT FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION FROM BEVACIZUMAB TO RANIBIZUMAB.
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MOISSEIEV, ELAD, KATZ, GABRIEL, MOISSEIEV, JOSEPH, LOEWENSTEIN, ANAT, GOLDSTEIN, MICHAELLA, LOMNICKY, YOSEF, ABEND, YITZHAK, TREISTER, GIORA, GOLDENBERG, DAFNA, and LEVKOVITCH-VERBIN, HANA
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- 2015
4. Long-term outcomes of triamcinolone acetonide–assisted anterior vitrectomy during complicated cataract surgery with vitreous loss.
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Bar-Sela, Shai M., Fleissig, Efrat, Yatziv, Yossi, Varssano, David, Regenbogen, Michael, Loewenstein, Anat, and Goldstein, Michaella
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- 2014
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5. DIAMETERS OF RETINAL BLOOD VESSELS IN A HEALTHY COHORT AS MEASURED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.
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Goldenberg, Dafna, Shahar, Jonathan, Loewenstein, Anat, and Goldstein, Michaella
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- 2013
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6. SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY CLASSIFICATION OF ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY.
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Goldenberg, Dafna, Habot-Wilner, Zohar, Loewenstein, Anat, and Goldstein, Michaella
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- 2012
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7. HEIDELBERG SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHIC FINDINGS IN RETINAL ARTERY MACROANEURYSM.
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Goldenberg, Dafna, Soiberman, Uri, Loewenstein, Anat, and Goldstein, Michaella
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- 2012
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8. CLINICAL CHARACTERISTICS OF ENDOPHTHALMITIS AFTER AN INJECTION OF INTRAVITREAL ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR.
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Mezad-Koursh, Daphna, Goldstein, Michaella, Heilwail, Gad, Zayit-Soudry, Shiri, Loewenstein, Anat, and Barak, Adiel
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- 2010
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9. VARIABILITY AMONG RETINA SPECIALISTS IN EVALUATING FLUORESCEIN ANGIOGRAMS OF PATIENTS WITH NEOVASCULAR AGERELATED MACULAR DEGENERATION.
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Zayit-Soudry, Shiri, Alfasi, Meirav, Goldstein, Michaella, Moisseiev, Joseph, Axer-Siegel, Ruth, Pollack, Ayala, Yassur, Yuval, and Loewenstein, Anat
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- 2007
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10. BILATERAL EFFECT OF UNILATERAL DEXAMETHASONE INTRAVITREAL IMPLANT IN A CASE OF NONINFECTIOUS UVEITIC MACULAR EDEMA AND VITRITIS.
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Habot-Wilner, Zohar, Sorkin, Nir, Goldenberg, Dafna, and Goldstein, Michaella
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UVEITIS ,DEXAMETHASONE ,VISUAL acuity - Abstract
The article presents a case study of a 26-year-old woman who was injected with dexamethasone drug delivery system (DEX-DDS) for treatment of macular edema and vitritis in her eyes which improved visual acuity.
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- 2015
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11. CAT-SCRATCH DISEASE ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION.
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Waisbourd, Michael, Goldstein, Michaella, Giladi, Michael, Shulman, Shiri, and Loewenstein, Anat
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TREATMENT of eye diseases ,RETINAL diseases ,CAT-scratch disease ,ARTERIAL occlusions ,OPTIC disc abnormalities ,ANTIBIOTICS ,AGE factors in vision disorders ,DIAGNOSIS - Abstract
The article presents case studies on branch retinal artery occlusion (BRAO) as sign of cat-scratch disease by which a man, age 25 who complain with decrease vision and BRAO and a woman, age 27 with bilateral decreased vision. The man and the woman had improved with systemic antibiotics. The man had normal optic disk after 4 weeks treatment while the woman had complete BRAO result after 5 weeks. The article concludes that diagnosis of BRAO must consider cat-scratch disease in young patients.
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- 2010
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12. Authors' Reply.
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Loewenstein, Anat, Hourvitz, Daphne, Goldstein, Michaella, Ashkenazi, Isaac, Avni, Isaac, and Lazar, Moshe
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- 1995
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13. Reply.
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Gomel N, Goldstein M, Fung AT, Iovino C, Tatti F, Peiretti E, Habot-Wilner Z, Loewenstein A, Iglicki M, and Zur D
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- 2024
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14. POLYPOIDAL LESIONS ASSOCIATED WITH CHOROIDAL NEVI.
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Gomel N, Goldstein M, Fung AT, Iovino C, Tatti F, Peiretti E, Habot-Wilner Z, Loewenstein A, Iglicki M, and Zur D
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- Humans, Middle Aged, Aged, Retrospective Studies, Endothelial Growth Factors, Choroid pathology, Tomography, Optical Coherence methods, Fluorescein Angiography methods, Intravitreal Injections, Choroid Diseases drug therapy, Choroid Neoplasms pathology, Nevus, Polyps drug therapy
- Abstract
Purpose: To investigate eyes with polypoidal lesions associated with choroidal nevi, their multimodal imaging characteristics, and long clinical follow-up., Methods: Multicenter, retrospective case series study of patients with polypoidal lesions overlying choroidal nevi. Demographic and clinical information were recorded. Multimodal imaging including color fundus photography, optical coherence tomography, optical coherence tomography angiography, fundus fluorescein angiography, indocyanine angiography, and A- and B-scan ultrasonography were analyzed for nevus and polypoidal lesion characteristics., Results: Fourteen eyes (14 patients; mean age: 70.3 ± 6.7 years) with polypoidal lesions overlying choroidal nevi were included. The mean follow-up duration was 50.0 ± 27.9 months (range 12-108). All nevi were pigmented on color fundus photography, flat on ultrasonography with a mean basal diameter of 3.8 ± 0.4 mm. In all but one eye, optical coherence tomography showed a shallow irregular pigment epithelium detachment overlying the nevus. A total of 11/14 eyes (78.6%) had exudative activity, 9 eyes received intravitreal anti-vascular endothelial growth factor injections, and one eye required intravitreal anti-vascular endothelial growth factor combined with photodynamic therapy. Mean visual acuity was 20/32 at baseline and 20/50 at final visit., Conclusion: We present the largest known cohort of eyes with polypoidal lesions associated with choroidal nevi with up to 9 years follow-up. The exudative degree of the polypoidal lesion in this condition is variable and treatment decisions should be taken on an individual basis. We hypothesize that choroidal ischemia because of altered choroidal vasculature rather than Haller layer hyperpermeability plays a role in the formation of polypoidal lesions overlying nevi.
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- 2024
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15. IMPACT OF COVID-19 PANDEMIC LOCKDOWNS ON VISUAL ACUITY OF PATIENTS WITH NEOVASCULAR AMD: A Large Cohort.
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Shor R, Segal O, Mimouni M, Greenbaum E, Zur D, Trivizki O, Schwartz S, Loewenstein A, Goldstein M, and Rabina G
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- Aged, 80 and over, Angiogenesis Inhibitors therapeutic use, Communicable Disease Control, Humans, Intravitreal Injections, Pandemics, Ranibizumab therapeutic use, Retrospective Studies, Treatment Outcome, Vascular Endothelial Growth Factor A, Visual Acuity, COVID-19 epidemiology, Wet Macular Degeneration drug therapy
- Abstract
Purpose: Evaluating the impact of delayed care, secondary to coronavirus disease 2019 (COVID-19) pandemic lockdowns, on visual acuity in previously treated neovascular age-related macular degeneration (nAMD) patients., Methods: This was a multicenter, retrospective, study of patients with nAMD previously treated with anti-VEGF injections who were followed up during 2019 (pre-COVID-19) and compared with patients with nAMD during 2020 (COVID-19)., Results: A total of 1,192 patients with nAMD with a mean age of 81.5 years met the inclusion criteria. Of these, 850 patients were assessed in 2019 (pre-COVID-19) and 630 patients were assessed in 2020 (COVID-19). Three hundred eight patients were assessed through both 2019 and 2020 and thus were included in both cohorts. There was no significant difference between 2020 and 2019 in baseline and change in best-corrected visual acuity (BCVA; P = 0.342 and P = 0.911, respectively). The mean number of anti-VEGF injections was significantly lower (5.55 vs. 6.13, P < 0.01), with constant lower ratio of injections per patient in the COVID-19 period. Baseline BCVA (0.859, P < 0.01), number of injections (-0.006, P = 0.01), and age (0.003, P < 0.01) were predictors of final BCVA., Conclusion: In patients with nAMD, delayed care secondary to COVID-19 pandemic lockdowns has no statistically significant impact on BCVA. Best-corrected visual acuity, older age, and lower number of yearly anti-VEGF injections are predictors for decrease BCVA.
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- 2022
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16. ACQUIRED VITELLIFORM LESIONS: A Novel Finding in Eyes with Peripapillary Pachychoroid Syndrome.
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Barequet D, Iglicki M, Meshi A, Loewenstein A, Goldstein M, and Zur D
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- Aged, Female, Fluorescein Angiography, Humans, Male, Retrospective Studies, Tomography, Optical Coherence methods, Choroid pathology, Choroid Diseases diagnosis
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Purpose: To describe a novel finding of acquired vitelliform lesions in eyes with peripapillary pachychoroid syndrome., Methods: A retrospective, multicenter, observational case series including seven patients with peripapillary pachychoroid syndrome and concomitant acquired vitelliform lesions. Medical records and multimodal imaging findings were comprehensively reviewed., Results: Six of seven patients were men, with a mean age of 72.6 years. Mean baseline best-corrected visual acuity was 0.11 ± 0.07 (Snellen equivalent 20/25), and all patients presented with baseline best-corrected visual acuity of 20/30 or better. Mean follow-up time was 24.4 months (range 1-54 months). At last follow-up, best-corrected visual acuity was stable in 13/14 eyes, and deteriorated in one eye because of subfoveal atrophy.Fundus examination revealed peripapillary retinal pigment epithelium alterations and pigment migration in all eyes. Fundus autofluorescence showed mottled hyperautofluorescence and hypoautofluorescence in the peripapillary region, and hypoautofluorescent lesions corresponding to the pigmentary changes. Optical coherence tomography showed nasal choroidal thickening and pachyvessels with overlying retinal pigment epithelium irregularity. All eyes presented with peripapillary intraretinal fluid. Subretinal fluid was present in five eyes of three patients. Acquired vitelliform lesions were present in 11 eyes., Conclusion: The novel association between peripapillary pachychoroid syndrome and acquired vitelliform lesions is characterized by the classic findings of both entities, and visual prognosis is accordingly good.
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- 2022
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17. UNDERDIAGNOSED OPTIC DISK PIT MACULOPATHY: Spectral Domain Optical Coherence Tomography Features For Accurate Diagnosis.
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Iglicki M, Busch C, Loewenstein A, Fung AT, Invernizzi A, Mariussi M, Arias R, Gabrielle PH, Cebeci Z, Okada M, Nawrocki J, Michalewska Z, Goldstein M, Barak A, and Zur D
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- Adolescent, Adult, Aged, Aged, 80 and over, Eye Abnormalities complications, Female, Humans, Macular Degeneration etiology, Male, Middle Aged, Optic Disk pathology, Reproducibility of Results, Retrospective Studies, Young Adult, Eye Abnormalities pathology, Macula Lutea pathology, Macular Degeneration diagnosis, Optic Disk abnormalities, Tomography, Optical Coherence methods
- Abstract
Purpose: To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to describe structural features on spectral domain optical coherence tomography in misdiagnosed and all other consecutive cases of ODPM., Methods: Multicenter international retrospective cohort study., Participants: 59 eyes from 59 patients with ODPM., Main Outcome Measures: 1) Proportion of patients with ODPM initially misdiagnosed, inaccurate diagnosis and treatment. 2) Morphologic features on spectral domain optical coherence tomography: other causes of subretinal and/or intraretinal fluid, inner/outer retinoschisis, communication with optic disk pit, and retinal pigment epithelium alterations. 3) Visual and anatomical outcomes 6 months after proper treatment., Results: Fifteen patients (25.4%) with ODPM were correctly diagnosed initially and those were significantly younger than misdiagnosed cases (age 33.8 ± 15.2 vs. 58.7 ± 15.8 years, P < 0.0001). Forty of forty-four misdiagnosed eyes (90.9%) were treated for their presumed diagnosis before referral. Eyes with initial misdiagnosis had significantly more outer retinoschisis at baseline (88.4 vs. 40.0%, P = 0.0002) and more retinal pigment epithelium alterations (90.0 vs. 27.3%, P < 0.0001) 6 months after proper treatment., Conclusion: Optic disk pit maculopathy is an underdiagnosed entity and can mimic other causes for subretinal fluid. Awareness and identification of pertinent spectral domain optical coherence tomography features can help avoid inappropriate and delayed treatment.
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- 2019
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18. ACCURACY AND PRECISION OF INTRAVITREAL INJECTIONS OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS IN REAL LIFE: What Is Actually in the Syringe?
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Loewenstein I, Goldstein M, Moisseiev J, and Moisseiev E
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- Follow-Up Studies, Humans, Intravitreal Injections instrumentation, Reproducibility of Results, Retrospective Studies, Vascular Endothelial Growth Factor A antagonists & inhibitors, Angiogenesis Inhibitors administration & dosage, Retinal Diseases drug therapy, Syringes
- Abstract
Purpose: To evaluate the accuracy and precision of anti-vascular endothelial growth factor volume delivery by intravitreal injections in the clinical setup., Methods: Volume output was measured in 669 intravitreal injections administered to patients, calculated from the difference in syringe weight before and after expelling the drug. Three groups were included: prefilled bevacizumab 1.0 mL syringe (Group 1, n = 432), pre-filled ranibizumab in a small-volume syringe with low dead-space plunger design (Group 2, n = 125), and aflibercept drawn and injected using a 1.0-mL syringe (Group 3, n = 112). Accuracy was analyzed by mean absolute percentage error, and precision by coefficient of variation., Results: Volume outputs in all 3 groups were significantly different from the target of 50 μL (P < 0.0001 for all), and mean absolute percentage error values were 12.25% ± 5.92% in Group 1, 13.60% ± 8.75% in Group 2, and 24.69% ± 14.84% in Group 3. No difference was found between groups 1 and 2, but both were significantly more accurate than Group 3 (P < 0.0001 for both)., Conclusion: The current practices used for intravitreal injections are highly variable, with overdelivery of the anti-vascular endothelial growth factor drugs measured in most cases, but underdelivery in 16.3% of injections. Use of a prefilled syringe was associated with improved accuracy, and low dead-space plunger design may improve precision.
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- 2019
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19. DEXAMETHASONE IMPLANT FOR DIABETIC MACULAR EDEMA IN NAIVE COMPARED WITH REFRACTORY EYES: The International Retina Group Real-Life 24-Month Multicenter Study. The IRGREL-DEX Study.
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Iglicki M, Busch C, Zur D, Okada M, Mariussi M, Chhablani JK, Cebeci Z, Fraser-Bell S, Chaikitmongkol V, Couturier A, Giancipoli E, Lupidi M, Rodríguez-Valdés PJ, Rehak M, Fung AT, Goldstein M, and Loewenstein A
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- Aged, Diabetic Retinopathy complications, Diabetic Retinopathy physiopathology, Drug Implants, Endothelial Growth Factors antagonists & inhibitors, Female, Follow-Up Studies, Glucocorticoids administration & dosage, Humans, Intraocular Pressure physiology, Intravitreal Injections, Macular Edema etiology, Macular Edema physiopathology, Male, Retrospective Studies, Time Factors, Tomography, Optical Coherence, Treatment Outcome, Angiogenesis Inhibitors therapeutic use, Dexamethasone administration & dosage, Diabetic Retinopathy drug therapy, Drug Resistance, Macula Lutea pathology, Macular Edema drug therapy, Visual Acuity
- Abstract
Purpose: To investigate efficacy and safety of repeated dexamethasone (DEX) implants over 24 months, in diabetic macular edema (DME) eyes that were treatment naive compared with eyes refractory to anti-vascular endothelial growth factor treatment, in a real-life environment., Methods: This multicenter international retrospective study assessed best-corrected visual acuity and central subfield thickness (CST) of naive and refractory eyes to anti-vascular endothelial growth factor injections treated with dexamethasone implants. Safety data (intraocular pressure rise and cataract surgery) were recorded., Results: A total of 130 eyes from 125 patients were included. Baseline best-corrected visual acuity and CST were similar for naive (n = 71) and refractory eyes (n = 59). Both groups improved significantly in vision after 24 months (P < 0.001). However, naive eyes gained statistically significantly more vision than refractory eyes (+11.3 ± 10.0 vs. 7.3 ± 2.7 letters, P = 0.01) and were more likely to gain ≥10 letters (OR 3.31, 95% CI 1.19-9.24, P = 0.02). At 6, 12, and 24 months, CST was significantly decreased compared with baseline in both naive and refractory eyes; however, CST was higher in refractory eyes than in naive eyes (CST 279 ± 61 vs. 313 ± 125 μm, P = 0.10)., Conclusion: Over a follow-up of 24 months, vision improved in diabetic macular edema eyes after treatment with dexamethasone implants, both in eyes that were treatment naive and eyes refractory to anti-vascular endothelial growth factor treatment; however, improvement was greater in naive eyes.
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- 2019
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20. CHANGES IN CHOROIDAL THICKNESS IN CLINICALLY SIGNIFICANT PSEUDOPHAKIC CYSTOID MACULAR EDEMA.
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Fleissig E, Cohen S, Iglicki M, Goldstein M, and Zur D
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Choroid pathology, Macular Edema pathology, Pseudophakia pathology
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Purpose: To investigate choroidal thickness in eyes with clinically significant pseudophakic cystoid macular edema (PCME) during the acute phase and following resolution of the edema, using enhanced depth imaging spectral domain optical coherence tomography (EDI-OCT)., Methods: This is a retrospective, observational clinical study. Patients' records were reviewed for cases of clinically significant PCME after uneventful phacoemulsification surgery. Choroidal thickness was measured at time of PCME diagnosis in both eyes and after CME resolution in the affected eye using enhanced depth imaging spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering). Measurements were taken subfoveal and 1.5 mm nasal, temporal, inferior, and superior from the center of the fovea. Statistical analysis was performed using paired t-test and Pearson correlation., Results: Mean subfoveal choroidal thickness in 34 eyes with PCME measured 258 ± 83 μm at baseline and decreased to 215 ± 79 μm after CME resolution (P < 0.001). Mean subfoveal choroidal thickness measured at baseline in fellow eyes was significantly lower (194 ± 77 μm) compared to acute PCME (P < 0.001) and after CME resolution (P = 0.011)., Conclusion: Choroidal thickness is increased in eyes with PCME and decreases following edema resolution. These findings may strengthen the hypothesis of an inflammatory pathogenesis in PCME.
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- 2018
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21. MICROPERIMETRY IN BEST VITELLIFORM MACULAR DYSTROPHY.
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Battaglia Parodi M, Castellino N, Iacono P, Chowers I, Empeslidis T, Goldstein M, and Bandello F
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- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Fixation, Ocular physiology, Humans, Male, Middle Aged, Prospective Studies, Scotoma pathology, Visual Acuity physiology, Vitelliform Macular Dystrophy pathology, Vitelliform Macular Dystrophy physiopathology, Young Adult, Visual Field Tests methods, Vitelliform Macular Dystrophy diagnosis
- Abstract
Purpose: To investigate retinal sensitivity in eyes with all the clinical stages of Best vitelliform macular dystrophy (VMD)., Methods: Thirty-two patients affected by VMD in subclinical, vitelliform, pseudohypopyon, vitelliruptive, and atrophic stages were enrolled in this prospective cross-sectional study. Patients underwent a complete ophthalmologic examination, including determination of best-corrected visual acuity (BCVA), staging of the disease (Gass's classification), and microperimetry by means of the macular integrity assessment microperimeter. The primary outcome measure was to describe the alterations in the retinal sensitivity of eyes affected by VMD in different stages. Secondary outcome measures included correlations between retinal sensitivity and best-corrected visual acuity and the correlation between the VMD stage and the specific microperimetry pattern., Results: Mean retinal sensitivity was reduced in all the VMD stages. Nevertheless, vitelliform, pseudohypopyon, and vitelliruptive stages turned out to be very similar, especially within 10°. Fixation was classified as stable in 27 eyes (44.2%), relatively unstable in 16 eyes (26.2%), and unstable in 18 eyes (29.5%). Fixation stability correlated both with the disease stage and best-corrected visual acuity., Conclusion: VMD is characterized by complex microperimetric abnormalities, involving the whole macular area. Microperimetry may contribute to the global clinical assessment of patients affected by VMD and could be used in future therapeutic approaches.
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- 2018
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22. SWITCHING TREATMENT FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION FROM BEVACIZUMAB TO RANIBIZUMAB: Who is Likely to Benefit From the Switch?
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Moisseiev E, Katz G, Moisseiev J, Loewenstein A, Goldstein M, Lomnicky Y, Abend Y, Treister G, Goldenberg D, and Levkovitch-Verbin H
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- Aged, Aged, 80 and over, Female, Humans, Intravitreal Injections, Male, Middle Aged, Retina pathology, Retrospective Studies, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A antagonists & inhibitors, Visual Acuity physiology, Wet Macular Degeneration diagnosis, Wet Macular Degeneration physiopathology, Angiogenesis Inhibitors therapeutic use, Bevacizumab therapeutic use, Drug Substitution, Ranibizumab therapeutic use, Wet Macular Degeneration drug therapy
- Abstract
Purpose: To evaluate the safety and efficacy of switching from bevacizumab to ranibizumab in patients with neovascular age-related macular degeneration., Methods: Retrospective study of patients with neovascular age-related macular degeneration initially treated with bevacizumab and switched to ranibizumab. Visual acuity and central retinal thickness (CRT) were retrieved at four time points: before the last three bevacizumab injections, at the switch, after the first three ranibizumab injections, and at the end of follow-up., Results: One hundred and fourteen eyes of 110 patients were included. Switching from bevacizumab to ranibizumab did not achieve a significant change in visual acuity, and a significant reduction in CRT was achieved after the first three injections but was not maintained by the end of follow-up. Eyes that lost ≥0.1 logMAR before the switch were more likely to improve in visual acuity (P = 0.013), and eyes with ≥10% increase in CRT before the switch were more likely to improve anatomically (P = 0.0003). In 47.3% of the eyes, the CRT was reduced by ≥10% after the first 3 ranibizumab injections, and the reduction was maintained with additional injections., Conclusion: Switching to ranibizumab should be considered in patients with visual acuity decrease or CRT increase, despite monthly bevacizumab injections. The response should be evaluated after the first three injections to guide future treatment.
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- 2015
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23. Diameters of retinal blood vessels in a healthy cohort as measured by spectral domain optical coherence tomography.
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Goldenberg D, Shahar J, Loewenstein A, and Goldstein M
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- Adult, Cohort Studies, Female, Humans, Male, Organ Size, Prospective Studies, Visual Acuity physiology, Retinal Artery anatomy & histology, Retinal Vein anatomy & histology, Tomography, Optical Coherence methods
- Abstract
Purpose: To describe a method for measuring the diameters of large retinal blood vessels by means of spectral domain optical coherence tomography., Methods: Prospective cohort study of 29 healthy subjects (58 eyes) who underwent a spectral domain optical coherence tomography examination. Two cubes of horizontal scans were placed at the superior and inferior borders of the disk to include the large temporal retinal vessels. Vessels diameters were measured, and an artery-to-vein ratio was calculated at 10 measurement points (480-1440 μm superiorly and inferiorly from the optic disk border)., Results: The mean age of the study subjects was 41.45 ± 15.53 years. Patients had no ocular or systemic pathologies. The mean diameter of the retinal artery was 135.73 ± 15.64 μm and of the vein 151.32 ± 15.22 μm at the measurement point of 480 μm, with a gradual decrease to 123.01 ± 13.43 μm and 137.69 ± 13.84 μm, respectively, at 1440 μm. The artery-to-vein ratio was ≈ 0.9 at all points of measurement., Conclusion: This is a new noninvasive method for retinal blood vessels diameter measurement using the spectral domain optical coherence tomography imaging modality. This method may aid in evaluation of retinal and systemic vascular diseases.
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- 2013
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24. Spectral domain optical coherence tomography classification of acute posterior multifocal placoid pigment epitheliopathy.
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Goldenberg D, Habot-Wilner Z, Loewenstein A, and Goldstein M
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- Adolescent, Adult, Female, Fluorescein Angiography, Follow-Up Studies, Fundus Oculi, Humans, Male, Prospective Studies, Retinal Diseases diagnosis, Visual Acuity physiology, Young Adult, Retinal Diseases classification, Retinal Pigment Epithelium pathology, Tomography, Optical Coherence
- Abstract
Purpose: To study the retinal morphologic changes occurring in acute posterior multifocal placoid pigment epitheliopathy using spectral domain optical coherence tomography., Methods: Prospective observational case series of 12 eyes (6 consecutive patients) diagnosed with acute posterior multifocal placoid pigment epitheliopathy. All patients underwent complete ophthalmologic examination, fundus photography, fluorescein angiography, and spectral domain optical coherence tomography at the initial visit. During follow-up, ophthalmologic examination and spectral domain optical coherence tomography scans were performed. The scans were directed to the lesions observed on the clinical examination and fluorescein angiography., Results: Spectral domain optical coherence tomography classification containing four distinct stages for acute posterior multifocal placoid pigment epitheliopathy is proposed. Stage 1 demonstrates a dome-shaped elevation with disruption of the photoreceptor junction that flattens shortly after. Stage 2, occurring 2 weeks later, demonstrates distinct separation between the photoreceptor junction and the retinal pigment epithelium (RPE). Stage 3, visible 6 weeks post disease initiation, demonstrates accentuated RPE hyperreflectivity and union of the RPE and photoreceptor junction. Stage 4, the resolution phase, starts at 3 months demonstrating reformation of 2 distinct visible layers of photoreceptors and RPE., Conclusion: The morphologic retinal findings in acute posterior multifocal placoid pigment epitheliopathy visible by the spectral domain optical coherence tomography occur in the outer retina, mainly the photoreceptors and RPE. Most findings reached nearly complete resolution and were correlated with improvement in visual acuity.
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- 2012
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25. Heidelberg spectral-domain optical coherence tomographic findings in retinal artery macroaneurysm.
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Goldenberg D, Soiberman U, Loewenstein A, and Goldstein M
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- Adult, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Humans, Male, Middle Aged, Papilledema diagnosis, Retinal Hemorrhage diagnosis, Retrospective Studies, Subretinal Fluid, Visual Acuity, Aneurysm diagnosis, Retinal Artery pathology, Retinal Diseases diagnosis, Tomography, Optical Coherence
- Abstract
Purpose: To describe the morphologic variables of macroaneurysms, to assess their diameter in comparison to their upstream/downstream vessel diameter as visualized on spectral-domain optical coherence tomography, and to describe morphologic changes in the retina adjacent to macroaneurysm., Methods: A retrospective case series of adult patients who were clinically diagnosed with retinal macroaneurysms and who underwent Heidelberg spectral-domain optical coherence tomography (OCT) between June 2009 and October 2010., Results: A total of 12 patients (age range, 31-95 years, 2 men) in whom macroaneurysms were demonstrated by spectral-domain OCT (12 eyes). All the macroaneurysms had a typical OCT appearance, and a diameter of 285.33 ± 76.98 μm. The diameter of the upstream/downstream vessel was 117.5 ± 17.13 μm (P = 0.0001 vs. the mean macroaneurysm diameter). Other related OCT findings were superficial retinal hemorrhage, intraretinal lipids, and intraretinal edema prominently involving the outer retinal layers., Conclusion: Spectral-domain OCT is an effective tool for detecting retinal macroaneurysms. It also provides important supplementary clinical information that may be helpful in planning the management of macroaneurysm, without the need for ancillary tests.
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- 2012
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26. Clinical characteristics of endophthalmitis after an injection of intravitreal antivascular endothelial growth factor.
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Mezad-Koursh D, Goldstein M, Heilwail G, Zayit-Soudry S, Loewenstein A, and Barak A
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- Acute Disease, Aged, Aged, 80 and over, Anti-Bacterial Agents administration & dosage, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal, Humanized, Bacteria isolation & purification, Bevacizumab, Endophthalmitis microbiology, Endophthalmitis therapy, Eye Infections, Bacterial microbiology, Eye Infections, Bacterial therapy, Female, Humans, Male, Middle Aged, Ranibizumab, Retrospective Studies, Visual Acuity physiology, Vitrectomy, Vitreous Body microbiology, Angiogenesis Inhibitors administration & dosage, Endophthalmitis diagnosis, Eye Infections, Bacterial diagnosis, Injections adverse effects, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
Purpose: The purpose of this study was to describe the clinical characteristics and management of patients with bacterial endophthalmitis after an intravitreal antivascular endothelial growth factor injection., Methods: This is a retrospective chart review of all patients admitted with suspected endophthalmitis from 2006 to 2008., Results: Endophthalmitis was verified by positive Gram stain and culture in nine eyes. The mean preinjection visual acuity of the 9 eyes was 0.02 +/- 0.021 diopters (decimal visual acuity scale) and dropped to 0.01667 +/- 0.02449 diopters in the eyes with endophthalmitis. All nine patients presented with reduced visual acuity, of whom seven also had ocular pain. Initial treatment was administered without delay and consisted of vitreous tap and intravitreal antibiotics injection in five cases and pars plana vitrectomy with intravitreal antibiotics injection in the other four cases. Vitreous tap failed in one case. Seven patients underwent a second procedure and two underwent a third procedure. The mean posttreatment visual acuity in all 9 eyes improved significantly (0.19 +/- 0.24, P = 0.0071). Five patients had major complications (e.g., retinal detachment, phacolytic glaucoma, and recurrent endophthalmitis)., Conclusion: Acute endophthalmitis following anti-VEGF injection appears within days and can result in severe loss of vision if not treated promptly. In our series the clinical and prognostic characteristics were considerably different between culture positive endophthalmitis cases and culture negative cases.
- Published
- 2010
- Full Text
- View/download PDF
27. Variability among retina specialists in evaluating fluorescein angiograms of patients with neovascular age-related macular degeneration.
- Author
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Zayit-Soudry S, Alfasi M, Goldstein M, Moisseiev J, Axer-Siegel R, Pollack A, Yassur Y, and Loewenstein A
- Subjects
- Choroidal Neovascularization drug therapy, Choroidal Neovascularization etiology, Female, Humans, Macular Degeneration complications, Macular Degeneration drug therapy, Male, Photochemotherapy, Reproducibility of Results, Retrospective Studies, Signal Processing, Computer-Assisted, Choroidal Neovascularization classification, Fluorescein Angiography classification, Macular Degeneration classification, Medicine, Retina, Specialization
- Abstract
Purpose: To determine the rate of agreement among five retina specialists in classifying various angiographic features of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD), as evaluated on printed digital fluorescein angiogram (FA) frames, as well as determination of eligibility for photodynamic treatment (PDT) according to established guidelines., Methods: Ninety-two digital FAs demonstrating subfoveal CNV secondary to AMD were evaluated independently by five retina specialists. The pattern of classic component could be classified as no classic component, minimally classic, predominantly classic, or classic only. Each grader was asked to determine eligibility of each case to PDT according to established treatment guidelines, national health insurance guidelines, and one's own personal judgment., Results: The kappa coefficient of concordance calculated for all five observers regarding CNV localization was 0.285, indicating fair overall agreement, and was 0.295, indicating fair agreement, regarding classification of leakage pattern. The kappa coefficient of agreement calculated for all five graders regarding eligibility for treatment according to established international guidelines, national health insurance, and each grader's own personal judgment was 0.163, 0.33, and 0.164, respectively, indicating slight to fair overall agreement., Conclusion: Considerable variability may exist among retina specialists interpreting FAs and should be considered in the assessment of treatment guidelines.
- Published
- 2007
- Full Text
- View/download PDF
28. Diagnostic and therapeutic challenges.
- Author
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McDonald HR, Goldstein M, Loewenstein A, Pieramici DJ, and Khawly JA
- Subjects
- Adult, Blood, Capillary Permeability, Fluorescein Angiography, Humans, Male, Visual Acuity, Laser Coagulation, Retinal Diseases diagnosis, Retinal Diseases surgery, Retinal Vessels pathology
- Published
- 2005
- Full Text
- View/download PDF
29. Visual outcome in eyes with asymptomatic optic disc edema.
- Author
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Almog Y and Goldstein M
- Subjects
- Aged, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Optic Neuropathy, Ischemic diagnosis, Optic Neuropathy, Ischemic physiopathology, Papilledema diagnosis, Prospective Studies, Remission, Spontaneous, Risk Factors, Papilledema physiopathology, Visual Acuity physiology
- Abstract
Background: Asymptomatic optic disc edema may last for months before conversion to anterior ischemic optic neuropathy (AION). Alternatively, the optic disc edema may resolve with preservation of normal vision. The conversion rate of asymptomatic optic disc edema to AION has not been prospectively studied. We prospectively followed patients with asymptomatic disc edema to determine this conversion rate., Methods: The cohort was followed from 1991 to 2000 at a single ophthalmology clinic in Israel. There were 23 patients aged 47-74 years with asymptomatic disc edema and no signs of optic nerve dysfunction in whom the disc edema had been incidentally discovered on routine fundus examination performed for diabetes, hypertension, or follow-up after AION in the fellow eye., Results: In 9 (36%) eyes, optic disc edema progressed to overt AION with a mean latency of 16.8 weeks (range 2-80 weeks). In 16 (64%) eyes, optic disc edema resolved without loss of vision with a mean latency of 15.5 weeks (range 4-44 weeks). The conversion rate to AION was 40% in patients who had had AION in the fellow eye, 31% in patients with diabetes, 43% in patients with diabetic retinopathy, and 0% in four amiodarone-treated patients., Conclusion: Asymptomatic disc edema generally resolves with no visual loss, but one third of patients progress to full-blown AION. Diabetes mellitus is common in patients with asymptomatic optic disc edema. Perhaps patients diagnosed as having diabetic papillopathy actually have an impending AION that does not progress to overt disease.
- Published
- 2003
- Full Text
- View/download PDF
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