Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy
purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a po...
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| Veröffentlicht in: | American journal of ophthalmology 2009-07, Vol.148 (1), p.70-78.e1 |
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| creator | Cho, Minhee Barbazetto, Irene A Freund, K. Bailey |
| description | purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a poor anatomic response to anti–vascular endothelial growth factor (VEGF) therapy was related to polypoidal choroidal vasculopathy (PCV). observation procedure: Slit-lamp biomicroscopy, optical coherence tomography, fluorescein and indocyanine green angiography. main outcome measures: Snellen visual acuity (VA), anatomic response to therapy including presence or absence of retinal edema, hemorrhage, and lipid exudates. Results New or persistent PCV was identified in a cohort of patients demonstrating increasing macular exudation despite regular intravitreal ranibizumab (Lucentis; Genentech Inc, South San Francisco, California, USA) or bevacizumab (Avastin; Genentech Inc) injections for a minimum of 6 months. Treatment with verteporfin photodynamic therapy (PDT), PDT/anti-VEGF combination therapy, or continued anti-VEGF monotherapy resulted in complete resolution of exudation in 9 of 12 patients and partial resolution of exudation in the remaining 3 patients. Conclusion Treatment-refractory neovascular AMD may harbor vascular abnormalities such as PCV. Modifications in therapeutic protocols may be indicated in order to improve visual and anatomic outcomes in this population. |
| doi_str_mv | 10.1016/j.ajo.2009.02.012 |
| format | Article |
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Bailey</creator><creatorcontrib>Cho, Minhee ; Barbazetto, Irene A ; Freund, K. Bailey</creatorcontrib><description>purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a poor anatomic response to anti–vascular endothelial growth factor (VEGF) therapy was related to polypoidal choroidal vasculopathy (PCV). observation procedure: Slit-lamp biomicroscopy, optical coherence tomography, fluorescein and indocyanine green angiography. main outcome measures: Snellen visual acuity (VA), anatomic response to therapy including presence or absence of retinal edema, hemorrhage, and lipid exudates. Results New or persistent PCV was identified in a cohort of patients demonstrating increasing macular exudation despite regular intravitreal ranibizumab (Lucentis; Genentech Inc, South San Francisco, California, USA) or bevacizumab (Avastin; Genentech Inc) injections for a minimum of 6 months. Treatment with verteporfin photodynamic therapy (PDT), PDT/anti-VEGF combination therapy, or continued anti-VEGF monotherapy resulted in complete resolution of exudation in 9 of 12 patients and partial resolution of exudation in the remaining 3 patients. Conclusion Treatment-refractory neovascular AMD may harbor vascular abnormalities such as PCV. Modifications in therapeutic protocols may be indicated in order to improve visual and anatomic outcomes in this population.</description><identifier>ISSN: 0002-9394</identifier><identifier>EISSN: 1879-1891</identifier><identifier>DOI: 10.1016/j.ajo.2009.02.012</identifier><identifier>PMID: 19403115</identifier><identifier>CODEN: AJOPAA</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Angiogenesis Inhibitors - therapeutic use ; Biological and medical sciences ; Choroid - blood supply ; Choroidal Neovascularization - diagnosis ; Choroidal Neovascularization - drug therapy ; Choroidal Neovascularization - etiology ; Coloring Agents ; Combined Modality Therapy ; Drug Resistance ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Macular degeneration ; Macular Degeneration - diagnosis ; Macular Degeneration - drug therapy ; Macular Degeneration - etiology ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Miscellaneous ; Myopia ; Occult sciences ; Ophthalmology ; Patients ; Peripheral Vascular Diseases - complications ; Peripheral Vascular Diseases - diagnosis ; Peripheral Vascular Diseases - drug therapy ; Photochemotherapy ; Photodynamic therapy ; Photosensitizing Agents - therapeutic use ; Porphyrins - therapeutic use ; Retinopathies ; Retrospective Studies ; Studies ; Tomography ; Tomography, Optical Coherence ; Vascular endothelial growth factor ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual Acuity - physiology</subject><ispartof>American journal of ophthalmology, 2009-07, Vol.148 (1), p.70-78.e1</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jul 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-330885a81028ad343dc687951e9dcb1a61b62ef22216923f4e73efe191a4238b3</citedby><cites>FETCH-LOGICAL-c464t-330885a81028ad343dc687951e9dcb1a61b62ef22216923f4e73efe191a4238b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajo.2009.02.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21699153$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19403115$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cho, Minhee</creatorcontrib><creatorcontrib>Barbazetto, Irene A</creatorcontrib><creatorcontrib>Freund, K. Bailey</creatorcontrib><title>Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy</title><title>American journal of ophthalmology</title><addtitle>Am J Ophthalmol</addtitle><description>purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a poor anatomic response to anti–vascular endothelial growth factor (VEGF) therapy was related to polypoidal choroidal vasculopathy (PCV). observation procedure: Slit-lamp biomicroscopy, optical coherence tomography, fluorescein and indocyanine green angiography. main outcome measures: Snellen visual acuity (VA), anatomic response to therapy including presence or absence of retinal edema, hemorrhage, and lipid exudates. Results New or persistent PCV was identified in a cohort of patients demonstrating increasing macular exudation despite regular intravitreal ranibizumab (Lucentis; Genentech Inc, South San Francisco, California, USA) or bevacizumab (Avastin; Genentech Inc) injections for a minimum of 6 months. Treatment with verteporfin photodynamic therapy (PDT), PDT/anti-VEGF combination therapy, or continued anti-VEGF monotherapy resulted in complete resolution of exudation in 9 of 12 patients and partial resolution of exudation in the remaining 3 patients. Conclusion Treatment-refractory neovascular AMD may harbor vascular abnormalities such as PCV. Modifications in therapeutic protocols may be indicated in order to improve visual and anatomic outcomes in this population.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Choroid - blood supply</subject><subject>Choroidal Neovascularization - diagnosis</subject><subject>Choroidal Neovascularization - drug therapy</subject><subject>Choroidal Neovascularization - etiology</subject><subject>Coloring Agents</subject><subject>Combined Modality Therapy</subject><subject>Drug Resistance</subject><subject>Female</subject><subject>Fluorescein Angiography</subject><subject>Humans</subject><subject>Indocyanine Green</subject><subject>Macular degeneration</subject><subject>Macular Degeneration - diagnosis</subject><subject>Macular Degeneration - drug therapy</subject><subject>Macular Degeneration - etiology</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Myopia</subject><subject>Occult sciences</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Peripheral Vascular Diseases - complications</subject><subject>Peripheral Vascular Diseases - diagnosis</subject><subject>Peripheral Vascular Diseases - drug therapy</subject><subject>Photochemotherapy</subject><subject>Photodynamic therapy</subject><subject>Photosensitizing Agents - therapeutic use</subject><subject>Porphyrins - therapeutic use</subject><subject>Retinopathies</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Tomography</subject><subject>Tomography, Optical Coherence</subject><subject>Vascular endothelial growth factor</subject><subject>Vascular Endothelial Growth Factor A - antagonists & inhibitors</subject><subject>Visual Acuity - physiology</subject><issn>0002-9394</issn><issn>1879-1891</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kltv1DAQhSMEokvhB_CCIiF4S5ixHScWUqVquUrlIgq8Wl5n0nrJxoudVNp_j0NWVOoDT77oO-M5Z5xlTxFKBJSvtqXZ-pIBqBJYCcjuZStsalVgo_B-tgIAViiuxEn2KMZtOspa1A-zE1QCOGK1yrpv1AVjRx8O-WfyNybaqTchP7-iIlBvRmrzT2a5e0NXNFAwo_NDfknWD61JstHnX31_2HvXmj5fX_uw7H7-reX3Zrw-PM4edKaP9OS4nmY_3r39vv5QXHx5_3F9flFYIcVYcA5NU5kGgTWm5YK3ViY_FZJq7QaNxI1k1DHGUCrGO0E1p45QoRGMNxt-mr1c6u6D_z1RHPXORUt9bwbyU9Sy5koyUSXw-R1w66cwpN40SlEBCAEzhQtlg48xUKf3we2SaY2g5xHorU4j0PMINDCdRpA0z46Vp82O2lvFMfMEvDgCKSDTp_gH6-I_bramEpa41wtHKbAbR0FH62iw1LpAdtStd_9t4-yO2vZucOnBX3SgeOtWxyTQl_Nfmb8KKAAExfkfqSq3_Q</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Cho, Minhee</creator><creator>Barbazetto, Irene A</creator><creator>Freund, K. Bailey</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20090701</creationdate><title>Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy</title><author>Cho, Minhee ; Barbazetto, Irene A ; Freund, K. Bailey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-330885a81028ad343dc687951e9dcb1a61b62ef22216923f4e73efe191a4238b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Choroid - blood supply</topic><topic>Choroidal Neovascularization - diagnosis</topic><topic>Choroidal Neovascularization - drug therapy</topic><topic>Choroidal Neovascularization - etiology</topic><topic>Coloring Agents</topic><topic>Combined Modality Therapy</topic><topic>Drug Resistance</topic><topic>Female</topic><topic>Fluorescein Angiography</topic><topic>Humans</topic><topic>Indocyanine Green</topic><topic>Macular degeneration</topic><topic>Macular Degeneration - diagnosis</topic><topic>Macular Degeneration - drug therapy</topic><topic>Macular Degeneration - etiology</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Myopia</topic><topic>Occult sciences</topic><topic>Ophthalmology</topic><topic>Patients</topic><topic>Peripheral Vascular Diseases - complications</topic><topic>Peripheral Vascular Diseases - diagnosis</topic><topic>Peripheral Vascular Diseases - drug therapy</topic><topic>Photochemotherapy</topic><topic>Photodynamic therapy</topic><topic>Photosensitizing Agents - therapeutic use</topic><topic>Porphyrins - therapeutic use</topic><topic>Retinopathies</topic><topic>Retrospective Studies</topic><topic>Studies</topic><topic>Tomography</topic><topic>Tomography, Optical Coherence</topic><topic>Vascular endothelial growth factor</topic><topic>Vascular Endothelial Growth Factor A - antagonists & inhibitors</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cho, Minhee</creatorcontrib><creatorcontrib>Barbazetto, Irene A</creatorcontrib><creatorcontrib>Freund, K. Bailey</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cho, Minhee</au><au>Barbazetto, Irene A</au><au>Freund, K. Bailey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy</atitle><jtitle>American journal of ophthalmology</jtitle><addtitle>Am J Ophthalmol</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>148</volume><issue>1</issue><spage>70</spage><epage>78.e1</epage><pages>70-78.e1</pages><issn>0002-9394</issn><eissn>1879-1891</eissn><coden>AJOPAA</coden><abstract>purpose : To describe a neovascular pattern associated with treatment-refractory neovascular age-related macular degeneration (AMD). Design A retrospective observational case series. Methods setting: Clinical practice. patient population: Twelve eyes of 12 patients with neovascular AMD in which a poor anatomic response to anti–vascular endothelial growth factor (VEGF) therapy was related to polypoidal choroidal vasculopathy (PCV). observation procedure: Slit-lamp biomicroscopy, optical coherence tomography, fluorescein and indocyanine green angiography. main outcome measures: Snellen visual acuity (VA), anatomic response to therapy including presence or absence of retinal edema, hemorrhage, and lipid exudates. Results New or persistent PCV was identified in a cohort of patients demonstrating increasing macular exudation despite regular intravitreal ranibizumab (Lucentis; Genentech Inc, South San Francisco, California, USA) or bevacizumab (Avastin; Genentech Inc) injections for a minimum of 6 months. Treatment with verteporfin photodynamic therapy (PDT), PDT/anti-VEGF combination therapy, or continued anti-VEGF monotherapy resulted in complete resolution of exudation in 9 of 12 patients and partial resolution of exudation in the remaining 3 patients. Conclusion Treatment-refractory neovascular AMD may harbor vascular abnormalities such as PCV. Modifications in therapeutic protocols may be indicated in order to improve visual and anatomic outcomes in this population.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19403115</pmid><doi>10.1016/j.ajo.2009.02.012</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Angiogenesis Inhibitors - therapeutic use Biological and medical sciences Choroid - blood supply Choroidal Neovascularization - diagnosis Choroidal Neovascularization - drug therapy Choroidal Neovascularization - etiology Coloring Agents Combined Modality Therapy Drug Resistance Female Fluorescein Angiography Humans Indocyanine Green Macular degeneration Macular Degeneration - diagnosis Macular Degeneration - drug therapy Macular Degeneration - etiology Male Medical imaging Medical sciences Middle Aged Miscellaneous Myopia Occult sciences Ophthalmology Patients Peripheral Vascular Diseases - complications Peripheral Vascular Diseases - diagnosis Peripheral Vascular Diseases - drug therapy Photochemotherapy Photodynamic therapy Photosensitizing Agents - therapeutic use Porphyrins - therapeutic use Retinopathies Retrospective Studies Studies Tomography Tomography, Optical Coherence Vascular endothelial growth factor Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual Acuity - physiology |
| title | Refractory Neovascular Age-related Macular Degeneration Secondary to Polypoidal Choroidal Vasculopathy |
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