Abstract:
PURPOSE:To optimize the method of treating choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD). DESIGN:Experimental study and interventional case series. METHODS:The parameters associated with locating and then photocoagulating CNV feeder vessels were identified and optimized using published data and data derived from modeling the choroidal vasculature. Based on these optimized parameters, a prototype diagnostic/treatment system was designed that captures high-speed indocyanine green (ICG) angiogram images and facilitates analysis of the images by enhancing visualization of dye movement through CNV feeder vessels (FVs). The system also permits precise aiming and delivery of 810- nm wavelength photocoagulation laser energy to target FVs on a real-time ICG angiogram image of the choroidal vasculature. Target FVs are tracked by a joy-stick controlled laser aiming beam until an intravenously-injected high-concentration ICG dye bolus is observed to enter the target vessel, at which time the laser is fired. Proof of principle of the combined diagnosis/treatment system design for performing dye-enhanced photocoagulation (DEP) in the clinical setting and determination of the minimum DEP laser energy needed to close CNV FVs was made in 11 AMD patients requiring treatment of CNV, but for whom other treatment was not appropriate. RESULTS:Using ICG-DEP, CNV feeder vessels were closed with single pulse laser energy, delivering as little as 0.6 to 1.8 J of energy to the fundus, producing no visible change in the fundus. Successful FV closure was usually indicated immediately by presence of incarcerated ICG dye in the vessel adjacent to the burn site. The prototype system proved relatively easy to operate. After acquiring and interpreting diagnostic angiograms and repositioning a patient in front of the device, feeder vessel DEP and treatment evaluation required 15 to 20 minutes. CONCLUSIONS:Indocyanine green dye-enhanced photocoagulation of CNV feeder vessels, facilitated by use of a device that permits real-time visualization of the choroidal circulation while aiming the treatment laser beam, appears to minimize the amount of energy applied to the fundus and the volume of fundus tissue affected by treatment, compared with other treatment modalities. The combination diagnosis/treatment device should be useful in optimizing FV treatment and in refining and evaluating the efficacy of DEP in future clinical trials.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Flower RWdoi
10.1016/s0002-9394(02)01579-9subject
Has Abstractpub_date
2002-08-01 00:00:00pages
228-39issue
2eissn
0002-9394issn
1879-1891pii
S0002939402015799journal_volume
134pub_type
杂志文章abstract:PURPOSE:To report a 49-year-old woman with unilateral central retinal vein occlusion and ipsilateral cilioretinal artery occlusion who showed familial dysplasminogenemia associated with elevated lipoprotein(a). METHOD:Case report. RESULTS:Extensive hemostatic and coagulation studies for causes of thrombosis, as well ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(98)00163-9
更新日期:1998-08-01 00:00:00
abstract:PURPOSE:To describe the usage patterns of pharmacological treatments for neovascular age-related macular degeneration (AMD) in Medicare fee-for-service beneficiaries. DESIGN:Retrospective review of all Medicare fee-for-service Part B claims for neovascular AMD during 2008. METHODS:Medicare beneficiaries having underg...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2010.11.017
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:To assess the effect of Ahmed glaucoma valve implants on corneal endothelial cell density (ECD) in children with uveitic glaucoma. DESIGN:Cross-sectional study. METHODS:setting: Institutional. patientpopulation: Eighty eyes from 42 patients diagnosed with uveitis before the age of 16. Twenty-eight eyes had an...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2012.09.001
更新日期:2013-03-01 00:00:00
abstract::We applied vitreous surgical techniques in the treatment of hemorrhagic and fibrous complications of choroidal neovascular membranes by removing subretinal scars or hemorrhage, or both, in four patients. The surgical goals were achieved in all patients. Visual acuity improved in three patients. The major complication ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/0002-9394(88)90116-x
更新日期:1988-01-15 00:00:00
abstract:PURPOSE:To clinically validate and ascertain the repeatability of a short questionnaire for dry eye syndrome (DES), consisting of two questions pertaining to symptoms (dryness and irritation) and one question regarding previous history of clinically diagnosed DES. DESIGN:Clinical validation study with repeated assessm...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2006.02.038
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:To describe microscopic changes in the structure of human sclera immediately after enucleation (negative control group) and to compare them after being stored for three months in four different media: pure glycerin, absolute alcohol, benzalkonium chloride diluted in absolute alcohol (1:5000), and benzalkonium c...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2008.05.015
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:To report the clinical outcomes of penetrating keratoplasty (PK) after autologous cultivated limbal epithelial transplantation in eyes with limbal stem cell deficiency (LSCD) after ocular surface burns. DESIGN:Retrospective case series. METHODS:This study included 47 patients with unilateral LSCD treated by a...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2011.05.019
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:To determine the regional differences in the test-retest variability of topographic measurements of the optic nerve head obtained with a confocal scanning laser retina tomograph. METHODS:Three 10-degree topographic images centered on the optic disk of 20 individuals (20 eyes), five normal subjects, seven glauc...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)72656-x
更新日期:1995-10-01 00:00:00
abstract::A 70-year-old man had unilateral congestion of the right upper eyelid, which contained a nodular mass. A biopsy was performed, and histologic, immunocytochemical, and ultrastructural studies disclosed a pseudoneoplastic proliferation of endothelial cells and pericytes in a region containing clumps of bacteria. This co...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)72894-6
更新日期:1994-08-15 00:00:00
abstract:PURPOSE:To investigate the prevalence of peripheral pigmented retinal lesions and associated clinical findings in patients with Stargardt disease. DESIGN:Retrospective case series. METHODS:Records at a single academic institution were reviewed for patients with genetically confirmed Stargardt disease with peripheral ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2017.12.011
更新日期:2018-04-01 00:00:00
abstract::Eleven patients with intracranial malignant neoplasms underwent hyperosmotic opening of the blood-brain barrier by rapid mannitol infusion via the internal carotid or vertebral artery. Cyclophosphamide was administered intravenously preceding the mannitol infusion and methotrexate was infused after the mannitol via th...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/0002-9394(86)90536-2
更新日期:1986-11-15 00:00:00
abstract:PURPOSE:To assess the potential effect of intravitreal bevacizumab (IVB) (Avastin) on retinal function and anatomic recovery in eyes with choroidal neovascularization attributable to pathological myopia (mCNV). DESIGN:Retrospective case series. METHODS:setting: Institutional. patient population: Sixty-three eyes of 6...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2008.07.017
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:To analyze the effect of intensified topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple-DMEK) on the incidence of postoperative cystoid macular edema (CME). DESIGN:Single-center comparative clinical study with historical controls. METHODS: SETTING:...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2015.12.008
更新日期:2016-03-01 00:00:00
abstract:PURPOSE:To report a series of dislocations of the donor graft into the posterior segment associated with Descemet stripping endothelial keratoplasty (DSAEK) and to identify possible risk factors for dislocation and clinical outcomes. DESIGN:Retrospective case series. METHODS:Cases of donor graft dislocation into the ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajo.2011.09.006
更新日期:2012-04-01 00:00:00
abstract:PURPOSE:To investigate the rate of progressive visual field (VF) loss and associated factors for structural or functional progression in preperimetric open-angle glaucoma (OAG). DESIGN:Longitudinal, observational study. METHODS:We included 127 eyes of 127 preperimetric OAG patients who were treated with topical medic...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2014.10.010
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:To study the tomographic and pathomorphologic features of dome-shaped maculas with swept-source optical coherence tomography (OCT). DESIGN:Prospective, cross-sectional study. METHODS:The macular area of 51 highly myopic eyes (35 patients) with dome-shaped maculas was studied with swept-source OCT at 1050 nm. ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2012.08.007
更新日期:2013-02-01 00:00:00
abstract::We observed a 41-year-old man with congenital unilateral iris pigment epithelial hyperplasia associated with unilateral glaucoma, and considered the possible pathogenesis of this unique lesion and its relationship to the patient's glaucoma. ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)76809-6
更新日期:1978-08-01 00:00:00
abstract:PURPOSE:To characterize crystalline lens dimensions derived from in-vivo spectral-domain optical coherence tomography (SD-OCT) and identify associations between these parameters, ocular biometry and age. METHODS:In this retrospective study, lens thickness (LT), lens diameter (LD) and lens volume (LV) were measured int...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2020.12.021
更新日期:2020-12-29 00:00:00
abstract:PURPOSE:To evaluate the percentage and risk indicators leading to retinal redetachment in HIV (human immunodeficiency virus) patients with CMV (cytomegalovirus) retinitis related retinal detachments that were repaired with silicone oil, and then subsequently underwent oil removal. DESIGN:Retrospective, noncomparative ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2005.04.059
更新日期:2005-11-01 00:00:00
abstract:PURPOSE:Autosomal recessive congenital fibrosis of the extraocular muscles (CFEOM2) has been described in families from Saudi Arabia. Affected individuals have ptosis and exotropic ophthalmoplegia, and their disease has been mapped to chromosome 11q13. Here, we describe the phenotypic findings in a similarly affected Y...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(99)00467-5
更新日期:2000-05-01 00:00:00
abstract:PURPOSE:To evaluate a new computerized segmentation technique for the quantification of intraretinal and subretinal fluid in spectral-domain optical coherence tomography (SD OCT) images of the retina. DESIGN:Prospective, cross-sectional study. METHODS:Thirty-seven B-scan images of 37 patients with exudative age-relat...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2012.07.030
更新日期:2013-02-01 00:00:00
abstract::Three patients with geographic choroiditis developed subretinal neovascular membranes associated with subretinal hemorrhage and serous elevation of the retina. Proximity of the membrane to the foveal avascular zone prevented photocoagulation of the neovascular membrane in one patient. Central visual acuity remained 6/...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/0002-9394(79)90665-2
更新日期:1979-10-01 00:00:00
abstract:PURPOSE:To perform a quantitative trait locus (QTL) analysis and evaluate whether a locus between SIX1 and SIX6 is associated with retinal nerve fiber layer (RNFL) thickness in individuals of European descent. DESIGN:Observational, multicenter, cross-sectional study. METHODS:A total of 231 participants were recruited...
journal_title:American journal of ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajo.2015.04.001
更新日期:2015-07-01 00:00:00
abstract::A patient with X-chromosome-linked recessive Norrie's disease, characterized by retinal falciform fold, retinal detachment, repeated vitreous hemorrhage, and retrolental membrane formation, was observed from age 6 weeks. The patient showed the clinical progression from these early retinal and vitreous changes to the m...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)75079-2
更新日期:1980-07-01 00:00:00
abstract:PURPOSE:To evaluate corneal biomechanical properties across the glaucoma spectrum and study the relationship between these measurements and intraocular pressure measured by Goldmann applanation tonometry (GAT-IOP) and central corneal thickness (CCT). DESIGN:Prospective cross-sectional study. METHODS: SETTING:Tertiar...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/j.ajo.2011.10.032
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:To determine the safety of pars plana vitrectomy in eyes containing a treated posterior uveal melanoma. DESIGN:Interventional case series. METHODS:Retrospective case series of patients with posterior uveal melanoma who underwent pars plana vitrectomy. Complications, vitreous cytology, local tumor control, and...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(03)00244-7
更新日期:2003-09-01 00:00:00
abstract::A 33-year-old man had a sudden onset of night blindness 3 1/2 years after intestinal bypass surgery for morbid obesity. Ocular examination disclosed a probable Bitot's spot and electrophysiologic testing showed markedly impaired dark adaptation and subnormal electroretinography. After therapy with orally administered ...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/0002-9394(80)90164-6
更新日期:1980-06-01 00:00:00
abstract:PURPOSE:To determine the incidence of Graves' ophthalmopathy. METHODS:A population-based cohort of all Olmsted County, Minnesota, residents who had ophthalmopathy associated with autoimmune thyroid disease between Jan. 1, 1976, and Dec. 31, 1990, was identified through the medical diagnostic index of the Mayo Clinic a...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)72666-2
更新日期:1995-10-01 00:00:00
abstract:PURPOSE/METHODS:We observed a clinicopathologic correlation of a case of adenocarcinoma of the retinal pigment epithelium. RESULTS/CONCLUSIONS:The ultrasonographic findings of this tumor demonstrated a collar button profile with high internal reflectivity. The ultrasonographic characteristics in this case reflected th...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/s0002-9394(14)73887-5
更新日期:1995-02-01 00:00:00
abstract::We measured lower eyelid length in 288 healthy subjects to establish a norm and then in 95 patients with complaints of intractable photophobia, foreign-body sensation, chronic tearing, or chronic recurrent conjunctivitis. The difference in length was statistically significant (34.25 +/- 2.43 mm for healthy men vs 36.5...
journal_title:American journal of ophthalmology
pub_type: 杂志文章
doi:10.1016/0002-9394(83)90279-9
更新日期:1983-04-01 00:00:00