Myopic choroidal neovascularization (MCNV) is one of the main reasons of vision loss in working population in Asia, which has brought economical and social-psychological burdens with high incidence in China, The precise pathogenesis of MCNV is unclear. Metamorphosia is the main reported symptom in these patients. The lesions were usually with smaller area, less leakage and relatively slow progression. Currently, intravitreal anti-vascular endothelial growth factor agents are now the established standard of care for MCNV, which was a major breakthrough in the treatment of MCNV achieving visual acuity improvement. Since the natural history, clinical features and therapy response of this disease is significant different from that in choroidal neovascularization secondary to age-related macular degeneration, the treatment dosing, frequency, retreatment criteria and the follow-up interval should been considerately. Facing the myopia boom in China, there is a need for the development of a precise definition and a more detailed classification for pathogenic myopia, optimize the outcome assessment and follow-up strategy, which should benefit to the further basically and clinical studies.
Waardenburg syndrome is a rare genetic disease of auditory pigmentation. The main symptom is sensorineural hearing loss. Pigment disorders and other developmental defects in skin, hair, iris, fundus and other parts are specifically divided into four different subtypes, each of which corresponds to different pathogenic genes, which encode transcription factors and signaling molecules that play a key role in the development process of neural crest cells into melanocytes. Because there are multiple subtypes of Waardenburg syndrome, different subtypes exhibit different symptoms, signs and ocular manifestations. Patients with Waardenburg syndrome are often first treated in ENT head and neck surgery due to hearing loss. Lack of theoretical knowledge related to Waardenburg syndrome by ophthalmologists may lead to misdiagnosis or missed diagnosis. Although there are currently limited treatments for the disease, with the continuous development of gene therapy and hearing management methods, the future treatment prospects will be broader.
Objective To evaluate the effectivness of photodynamic therapy (PDT) with chloroaluminum sulfonated phthalocyanine (CASPc) in B16F10 melanomas in a rabbit model. Methods B16F10 murine melanoma tumor fragments were implanted transclerally into the subchoroidal space of 38 immunosuppressed New Zealand albino rabbits and examined with indirect ophthalmoscopy and ultrasonography. When the tumors ranged from 2.0~3.8 mm in height, 30 rabbits were treated by PDT, with intravenous injection of CASPc 5 mg/kg, and irradiation at the wavelength of 675 nm of an argon-pumped dye laser after 24 hours. Light dose ranged from 20 J/cm2 to 70 J/cm2. The other 8 animals were treated with light only or photosensitizer only. The animals were followed up for 6~8 weeks. Results The 30 tumor-bearing rabbits were by PDT (laser and CASPc) regressed in 21 animals after treatment. At light doses under 40 J/cm2, tumor regrowth was observed in 9 animals after two weeks of treatment. In all of the 8 control animals, the tumor-bearing eyes were filled with tumor at the third week after implantation with laser doses of 70 J/cm2. Conclusion The study suggest that CASPc PDT may be effective in the treatment of B16F10 choroidal melanomas.(Chin J Ocul Fundus Dis，2004，20：67-132)
Choroidal neovascularization is the leading causes of central vision loss in wet age-related macular degeneration (wAMD) patients. Smoking not only aggravates the incidence and severity of the choroidal neovascularization of wAMD, but also affects the clinical treatment, making the prognosis worse. Nicotine, as an important harmful substance in tobacco, is an easily addictive and highly toxic alkaloid. Animal experiments and clinical studies have confirmed that nicotine can aggravate wAMD by mediating angiogenesis through nicotinic acetylcholine receptor, bone marrow blasts, inflammation, complement system, etc. Therefore, in order to early take appropriate intervention measures to prevent and delay the development, we should actively explore the exact pathogenesis by which nicotine aggravates the choroidal neovascularization.
The pathogensis of choroidal vascular changes in traumatic rtinopethy remains uncertain.We performed scanning electron micrmcopie (SEM) observation of methyl methalerylare vascular corrosion casts in a rabbi model with severe retinal contusion. Areas of filling defects in corrosion casts of the choriocapillaries, correspending to the areas of impact retinal lesions were noted in the traumatized eyes one to 28 days after trauma.No neovascularization was found in the eyes 56 days after trauma. The results confirm that obstruction and disappearance of involved choriocapillaries are the main changes of choroidal vasculatrue in severe blunt tram. The changes may be associated with continuous necrosis, of the photoreceptors 4 weeks after injury. （Chin J Ocul Fundus Dis,1993,9:5-7）
Objective To evaluate short-term effects of a single photodynamic therapy (PDT) treatment with visudyne (CIBA Vision Corp.) for choroidal neovascularization (CNV) in age-ralated macular degeneration (AMD). Methods Thirty cases (35 eyes) diagnosed as AMD patients with classic CNV were treated with PDT. The data of visual acuity testing, fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography （OCT) were used to evaluate the effects of a single treatment of PDT before and 1 week, 1 ,3 month after treatment. Results The visual acuity of 34 eyes were stable or improved in 3 months follow-up；and the visual acuity of 1 eye was decreased. Decrease or dispearance of fluorescein leakage from CNV was noted in 19 eyes. No serious complication occurred. Conclusion Single treatment of PDT for CNV in AMD can achieve short-term decrease or cessation of fluorescein leakage from CNV without loss of visual acuity. (Chin J Ocul Fundus Dis, 2002, 18: 171-174)
Objective To evaluate the efficacy and safety of photodynamic therapy (PDT) combined with intravitreal injection of bevacizumab for choroidal neovas cularization (CNV) caused by age-related macular degeneration (AMD). Methods A total of 21 eyes of 21 patients with AMD, which was diagnosed by examination of visual acuity, intraocular pressure, ocular fundus, fundus color photography, fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and optic coherence tomography(OCT), were underwent PDT combined with intravitreal injection of Bevacizumab. The patients, 15 males (15 eyes) and 6 females (6 eyes), aged from 56 to 78 years, with the average of 68.6 years. The best corrected visual acuity：counting fingers/10cm0.9, logMAR was 1.04 plusmn; 0.41.CNV located in below or side central fovea of macula. There was obvious leakage of fluorescein which examined by FFA and ICGA. The average of retinal thickness of macular foveal was （258.91 plusmn; 78.66）mu;m. The treatment method of PDT has to according to the way of PDT for TAP and Verteporfin PDT for VIP. Intravitreal infection with 1.5mg bevacizumab was performed after three days under surface anesthesia. Follow-up time was 1, 3, 6, 12 months after the treatment. Results At last visit, the best-corrected visual acuity：counting fingers/10 cm 1.5, logMAR was 1.04plusmn;0.41, and the differences are statistically significant compared with before. The BCVA improved four or more lines in 6 eyes (28.57%), improved two to four lines in 9 eyes (42.86%), stabilized (plusmn;1 line or no change) in 6 eyes (28.57%) and decreased in none. The average intraocular pressure was （15.20plusmn;2.41）mmHg after surgery, and the differences was not statistically significant compared with before（P＞0.05）. FFA and ICGA showed CNV complete closure in 13 eyes (61.90 %), partial closure in 8 eyes (38.10%). The average of retinal thickness of mac ular foveal was（127.38plusmn;20.14） mu;m (P＜0.01). Conclusion Combining treatment with PDT and intravitreal injection of Bevacizumab is safe and effective for CNV which caused by AMD. It has significant improvement in BCVA, leakage of CNV and retinal edema. (Chin J Ocul Fundus Dis,2008,24:164-167)