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Surgical removal of subretinal hemorrhage
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Recombinant tissue plasminogen activator (rtPA) has been used systemically in the management of acute myocardial infarction since 1984.1 Ophthalmic usage in postvitrectomy anterior chamber fibrin formation began in 1988.2 This has evolved into management of submacular hemorrhage, and a variety of options are currently being debated and refined. Current controversy centers around a safe dosage of intravitreal rtPA that avoids toxicity of the vehicle and around whether or not the retina imposes a barrier on the movement of intravitreal rtPA into the subretinal space. The transretinal treatment effect of intravitreal bevacizumab, another large molecule, in the treatment of wet macular degeneration was also a surprising finding. Still to be answered is whether the subretinal blood is liquefied or solid preoperatively. The answer to this question would clarify the need for, the timing of, and the dosage of rtPA.
Diagnosis: telling and hearing
Published in Rolf Ahlzén, Martyn Evans, Pekka Louhiala, Raimo Puustinen, Medical Humanities Companion, 2018
Communicating that diagnosis was important for the whole family. Another diagnosis had a similar effect. The rapid onset of severe ‘wet’ macular degeneration came as a complete surprise to my mother in 2000. At 86 she was enjoying relatively good health and living independently in a small retirement unit. She knitted all the time and was a member of a small group that produced a huge number of knitted items to be donated to the Salvation Army every three months. She cooked a lot and often brought scones, small cakes and her special fruitcake when she came to visit.
Chronic Hyperglycemia Impairs Vision, Hearing, and Sensory Function
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
Macular degeneration causes loss in the center of the field of vision. In dry macular degeneration, the center of the macula deteriorates. With wet macular degeneration, leaky blood vessels grow under the retina. The National Eye Institute of the National Institutes of Health has a website titled “What you should know about age-related macular degeneration.” It features “What is AMD?” AMD is a common eye condition and a leading cause of vision loss among people age 50 and older. It causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead.In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. As AMD progresses, a blurred area near the center of vision is a common symptom. Over time, the blurred area may grow larger or you may develop blank spots in your central vision. Objects also may not appear to be as bright as they used to be. AMD by itself does not lead to complete blindness, with no ability to see. However, the loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.
Ciliary neurotrophic factor (CNTF) delivery to retina: an overview of current research advancements
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2018
Maryam Ghasemi, Effat Alizadeh, Khatereh Saei Arezoumand, Behzad Fallahi Motlagh, Nosratollah Zarghami
AMD is a continuous degenerative disorder that results in loss of the central vision as an outcome of the abnormalities in macula of the retina. It does not initiate complete blindness because peripheral vision is unaffected in that disease [81]. Advanced AMD is classified into two types: dry macular degeneration and wet macular degeneration. There is no medication and surgery for dry macular degeneration, but wet AMD is curable with laser coagulation therapy, drug treatment and photodynamic therapy [82,83]. The clinical signs of AMD consist of drusen, hyperplasia of the retinal pigment epithelium (RPE), geographic atrophy and choroidal new vessels [84]. The first phase of AMD is considered with the presence of white or yellow lipid leaves in Bruch’s layer known as drusen, Then, the destruction of rod photoreceptors and RPE function happens in the high-level dry AMD patients that result in geographic atrophy [85]. In dry AMD, first step of treatment is the prevention of photoreceptors and RPE cells loss. CNTF is an effective neurotrophic factor that slows down the loss of photoreceptors. The CNTF implants that used in AMD patient slowed the visual loss rate at 12 months [86,87].
A Mini Review of Clinical and Research Applications of the Retinal Function Imager
Published in Current Eye Research, 2018
Liang Wang, Hong Jiang, Amiram Grinvald, Chaitra Jayadev, Jianhua Wang
While a significant decrease in average retinal venular velocity was not detected, the velocity was lower for narrow vessels in patients with more severe AMD.28 This formation of drusen and appearance of neovascularization appeared in nCPMs as white dots and a membrane, respectively (Figure 5).18 To predict the effectiveness of anti-vascular endothelial growth factor treatments on patients with more severe neurovascular “wet” macular degeneration, the retinal BFV was measured with the RFI within a week of injection. An increase in arteriolar BFV with other indications of improvement accurately predicted the patients with an increase in visual acuity.41,42 These studies indicate that AMD affects more than just the choroid and that the RFI may eventually apply for AMD diagnosis and treatment optimization.
Three new circulating microRNAs may be associated with wet age-related macular degeneration
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Ahmet Elbay, Çilem Ercan, Fahri Akbaş, Huri Bulut, Hakan Ozdemir
Wet macular degeneration develops as a result of the formation of abnormal blood vessels in the retina. The neovascularization may be located both under and over the RPE, it may lead to fluid leakage, and it is fragile. Vision loss may occur within days or weeks due to increased abnormal neovascularization (CNV) and subsequent fluid leakage from these abnormal vessels or bleeding. Its progression is much more rapid than dry AMD, and in most cases, legal blindness develops in the affected eye [3–5]. Thus, early identification of the clinical signs of wet AMD is indispensable for starting effective therapies such as anti-VGEF therapy. Delays in treatment exceeding 28 days are associated with progressive decreases in visual acuity [3].