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Choroidal neovascularisation (CNV) is a common visionthreatening complication of myopia and pathological myopia. Despite significant advances in understanding the epidemiology, pathogenesis and natural history of myopic CNV, there is no standard definition of myopic CNV and its relationship to axial length and other myopic degenerative changes. Several treatments are available to ophthalmologists, but with the advent of new therapies there is a need for further consensus and clinical management recommendations. Verteporfin photodynamic therapy has been an established treatment for subfoveal myopic CNV for many years, but this treatment does not restore visual acuity and is associated with long-term chorioretinal atrophy. More recently, clinical trials investigating the efficacy and safety of anti-vascular endothelial growth factor agents in patients with myopic CNV have demonstrated substantial visual acuity gains and quality of life increases compared with photodynamic therapy. These enhanced outcomes provide updated evidence-based clinical management guidelines of myopic CNV, and increase the need for a generally accepted definition for myopic CNV. This review critically summarises the latest myopic CNV literature in the context of clinical experience and recommends a myopic CNV treatment algorithm. [ABSTRACT FROM AUTHOR] more...

Background To compare the long-term efficacy of ranibizumab versus bevacizumab for myopic choroidal neovascularization (CNV). Methods This was a retrospective, multicenter, comparative, non-randomized study of 64 consecutive patients with myopic CNV treated with ranibizumab (22 patients) or bevacizumab (42 patients). Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography were evaluated before and after treatment. All the patients were followed for at least 12 months. Results BCVA (logarithm of the minimal angle of resolution) improved from 0.63 ± 0.30 to 0.43 ± 0.27, 0.41 ± 0.37, 0.40 ± 0.39, 0.39 ± 0.43, and 0.39 ± 0.42 at 1, 2, 3, 6, and 12 months after treatment in the ranibizumab group, and from 0.67 ± 0.28 to 0.52 ± 0.31, 0.49 ± 0.31, 0.47 ± 0.31, 0.42 ± 0.32, and 0.46 ± 0.43 in the bevacizumab group (all P < 0.05 compared with baseline BCVA in each group). CFT decreased by 20.21%, 19.58%, and 22.43% from the baseline 304 ± 76 μm at 3, 6, and 12 months after treatment in the former group, and by 15.20%, 15.67%, and 15.56% from the baseline 297 ± 62 μm in the latter group (all P < 0.05 compared with baseline CFT in each group). BCVA improvement and CFT reduction did not statistically differ when compared at the same periods from treatment between 2 groups. Neither ocular nor systemic safety problems appeared during follow up. Conclusions This study showed a similar functional and anatomical improvement after treatment of ranibizumab and bevacizumab for myopic CNV over a 12-month follow-up period. [ABSTRACT FROM AUTHOR] more...

Background: To compare the expression of chemokines in the aqueous humor and chemokine receptors in intraocular lymphocytes from Behçet and non-Behçet uveitis patients. Methods: A total of 95 uveitis patients were included in this study. We studied 39 Behçet and 56 non-Behçet uveitis patients. Flow cytometric analysis was performed using lymphocytes from the aqueous humor and the peripheral blood during the active phase of intraocular inflammation. We compared the expression of CXCR1, CXCR3, and CCR5 in CD4+ and CD8+ T lymphocytes and the concentration of intraocular CXCL8, CXCL10 and CCL5 in Behçet and non-Behçet patients. Results: The CD4+ cell population was higher in the aqueous humor of non-Behçet patients, whereas the CD8+ cell population was higher in the aqueous humor of Behçet patients. The expressions of CXCR1 and CCR5 were not significantly different between the two groups, whereas the intraocular expression of CXCR3 was higher in the CD4+ cells of non-Behçet and in the CD8+ cells of Behçet uveitis patients. Intraocular CXCL8 and CXCL10 levels were higher in Behçet than they were in non-Behçet patients. CCL5 levels were not different between the groups. Conclusions: This suggests that the expression of chemokines and chemokine receptors in intraocular lymphocytes is different in Behçet compared to non-Behçet uveitis patients, which might be related to the differential phenotypes of intraocular lymphocytes among different uveitis etiologies. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] more...

Purpose: The aim of this study was to investigate the suppressing effects of systemically administered ursodeoxycholic acid (UDCA) and tauroursodeoxycholic acid (TUDCA) on choroidal neovascularization (CNV) in a laser-treated rat model. Methods: CNV was induced by argon laser photocoagulation in the right eye of each animal. UDCA 500 mg/kg, TUDCA 100 mg/kg, or vehicle was intraperitoneally injected at 24 h before and daily after laser treatment. Fourteen days after laser treatment, fluorescein angiography was performed to evaluate leakage from CNV and eyes were enucleated for histologic evaluation. Vascular endothelial growth factor (VEGF) levels in the retina were measured using enzyme-linked immunosorbent assay at 3 days after laser treatment and were compared between the UDCA, TUDCA, and control groups. Results: The proportion of CNV lesions showing clinically significant fluorescein leakage was lower in the UDCA and TUDCA groups (42%, P = 0.0124; and 46%, P = 0.0292) than in the control group (67%). CNV lesion dimensions including CNV area and CNV/choroid thickness ratio were also significantly reduced in the UDCA and TUDCA groups (7,664 ± 630 μm2, P < 0.001 and 8,558 ± 570 μm2, P < 0.001; 2.35 ± 0.16, P = 0.026 and 2.27 ± 0.15, P = 0.003) compared with the control group (12,147 ± 661 μm2 and 3.10 ± 0.27). The VEGF level in the retina after laser treatment was lower in the TUDCA group than that in the control group (9.0 ± 2.7 pg/mg vs. 29.4 ± 8.2 pg/mg, P = 0.032), whereas the UDCA group showed no difference. Conclusions: The systemic administration of UDCA and TUDCA suppressed laser-induced CNV formation in rats, which might be associated with anti-inflammatory action. The result indicates that UDCA and TUDCA are potential candidate drugs for the treatment of many CNV-related retinal diseases, including age-related macular degeneration. [ABSTRACT FROM AUTHOR] more...

Introduction: Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane.Case Presentation: A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis(R)) five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes.Conclusion: Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions. [ABSTRACT FROM AUTHOR] more...

Background: The removal of high-abundance proteins from plasma is an efficient approach to investigating flowthrough proteins for biomarker discovery studies. Most depletion methods are based on multiple immunoaffinity methods available commercially including LC columns and spin columns. Despite its usefulness, high-abundance depletion has an intrinsic problem, the sponge effect, which should be assessed during depletion experiments. Concurrently, the yield of depletion of high-abundance proteins must be monitored during the use of the depletion column. To date, there is no reasonable technique for measuring the recovery of flow-through proteins after depletion and assessing the capacity for capture of high-abundance proteins. Results: In this study, we developed a method of measuring recovery yields of a multiple affinity removal system column easily and rapidly using enhanced green fluorescence protein as an indicator of flow-through proteins. Also, we monitored the capture efficiency through depletion of a high-abundance protein, albumin labeled with fluorescein isothiocyanate. Conclusion: This simple method can be applied easily to common high-abundance protein depletion methods, effectively reducing experimental variations in biomarker discovery studies. [ABSTRACT FROM AUTHOR] more...

To determine whether retinal microcirculatory changes occur after vitrectomy in eyes with diffuse diabetic macular edema (DME), and whether changes in blood flow are associated with visual outcome and the resolution of macular edema. Thirty-three eyes of 30 consecutive diabetic patients who underwent pars plana vitrectomy for diffuse DME, and 16 eyes of 16 diabetic patients without macular edema, were included. Mean macular blood flows were measured using a Heidelberg Retinal Flowmeter, and central macular thicknesses (CMTs) were determined by optical coherence tomography. Visual outcomes, CMTs, and macular blood flow were evaluated before and 1, 4, 12 weeks after vitrectomy, and compared between eyes with resolved macular edema and those with persistent macular edema. Mean preoperative macular blood flow in eyes with diffuse DME was higher than in controls (606.5±357.9 AU vs 407.1±265.9 AU, P=0.021). Mean macular blood flow (422.6±247.5 AU) at 12 weeks after vitrectomy was significantly lower than preoperative blood flow ( P=0.002), and similar to that of controls ( P=0.47). In 22 of the 33 (66.7%) DME eyes, macular edema was resolved at 12 weeks after vitrectomy. The mean ratio of macular blood flow at 12 weeks postoperatively versus the preoperative level was significantly lower in eyes with resolved macular edema than in eyes with persistent macular edema (0.65 vs 1.08, P<0.001). Increased macular blood flow in diabetic macular edema was normalized after vitrectomy in eyes with resolved macular edema. Changes of macular blood flow may be associated with the resolution of macular edema in diabetic eyes. [ABSTRACT FROM AUTHOR] more...

AbstractAims:To investigate the degree of implicit time delay in aretinopathic hexagons according to the grading of diabetic retinopathy and factors that affect the mfERG responses of aretinopathic areas. Methods:MfERG was recorded using the RETIscan system (Roland consult, Brandenbrug, Germany) in 40 eyes of 20 nondiabetic controls, 32 eyes of 16 diabetic patients without retinopathy, and 96 eyes of 48 diabetic patients with nonproliferative diabetic retinopathy (NPDR). Hexagons are divided into retinopathic and aretinopathic hexagons, which were selected using fundus photographs and fluorescence angiography. Relative amplitude and implicit time delay were compared between patient groups and controls. Results:The mean implicit time delay in aretinopathic hexagons was significantly different between each subject group and correlated with the retinopathy severity of the whole retina, as well as in retinopathic hexagons. In all three NPDR groups, implicit time was significantly more delayed in retinopathic hexagons compared to aretinopathic hexagons. Relative amplitude was significantly decreased only in the severe NPDR group in both retinopathic and aretinopathic hexagons. The duration of diabetes and glycemic control status did not correlate with the local mfERG responses. Conclusions:Local mfERG showed considerable implicit time delays in clinically normal retinal areas that correlated significantly with the severity of diabetic retinopathy of the whole retina.Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] more...