記述言語：英語   出版者・発行元：SPRINGER JAPAN KK  

To evaluate the results of a 3-year follow-up of intravitreal pegaptanib sodium injection as maintenance therapy for the treatment of neovascular age-related macular degeneration (AMD) in Japanese patients.
In this prospective, uncontrolled interventional study, 20 eyes of 19 patients with treatment-na < ve AMD who had received 3 consecutive monthly injections of 0.5 mg/0.05 mL ranibizumab as the induction treatment and had shown clinical/anatomical improvement were enrolled. An intravitreal injection of 0.3 mg/0.09 mL pegaptanib sodium was administered as the maintenance therapy every 6 weeks. Booster treatments using ranibizumab were allowed if clinical deterioration was judged to be present. The primary outcome measures were the best-corrected visual acuity (BCVA) and the central foveal thickness (CFT) as evaluated using spectral-domain optical coherence tomography.
Sixteen of the 20 eyes (80 %) were assessed at the 3-year follow-up. The mean logMAR BCVA improved significantly from 0.56 +/- A 0.31 before the induction treatment to 0.24 +/- A 0.25 at baseline (P < 0.001) and was well maintained at 156 weeks (0.25 +/- A 0.28, P = 0.938). Moreover, the mean CFT also decreased significantly from 346 +/- A 111 mu m before the induction treatment to 232 +/- A 54 mu m at baseline (P < 0.001) and was well preserved at 156 weeks (210 +/- A 59 mu m, P = 0.278). Thirteen eyes (81.3 %) received an unscheduled booster treatment, and no severe systemic or ocular side effects occurred during follow-up.
Intravitreal pegaptanib sodium injection as the maintenance therapy was effective in stabilizing the vision of patients with AMD in whom induction treatment led to improved BCVA, as evaluated at the 3-year follow-up.

DOI： 10.1007/s10384-015-0374-4

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記述言語：英語   出版者・発行元：Dove Medical Press Ltd  

Purpose: To evaluate the anatomic and functional effect of microincision vitrectomy surgery (MIVS) with internal limiting membrane (ILM) peeling for macular edema secondary to branch retinal vein occlusion (BRVO). Methods: The medical records of 101 eyes of 101 patients who had undergone MIVS with ILM peeling for macular edema secondary to BRVO were studied. Patients were classified into ischemic and non-ischemic BRVO based on angiograph. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT), determined by spectral domain optical coherence tomography, were evaluated at baseline and at 1, 3, 6, and 12 months postoperatively. Results: Preoperative mean logarithm of the minimum angle of resolution (logMAR) BCVA ± standard deviation (SD) was 0.52±0.43 and mean CFT ± SD was 489.4±224.9 μm. Postoperative mean BCVA ± SD values were 0.41±0.35, 0.35±0.41, 0.29±0.36, and 0.25±0.41, and mean CFT values were 370.1±148.9, 327.5±157.5, 310.9±154.9, and 274.4±135.3 μm at 1, 3, 6, 12 months, respectively. The mean BCVA was significantly improved at 3, 6, and 12 months postoperatively (all P,0.05), and the mean CFT was significantly decreased at all postoperative follow-up time points (all P,0.05). At the 12-month postoperative evaluation, BCVA had improved by 0.2 logMAR units in 50 eyes (60.0%) with ischemic BRVO and in nine eyes (50.0%) with non-ischemic BRVO. Six eyes (6.0%) experienced recurrence or persistence of macular edema at 12 months postoperatively. Conclusion: MIVS with ILM peeling for macular edema secondary to BRVO is effective in improving visual acuity and foveal morphology with low recurrence of macular edema.

DOI： 10.2147/OPTH.S75659

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Purpose: To report a case of fundus albipunctatus who developed choroidal neovascularization and who received vitreal injection of anti-VEGF agents. Case: A 74-year-old male presented with blurring and metamorphopsia in the left eye since 11 days before. Findings: Corrected visual acuity was 1.2 right and 0.9 left. Both eyes showed numerous white dots in the posterior fundus area. The left macula showed choroidal neovascularization with subretinal hemorrhage and retinal detachment. He was diagnosed as fundus albipunctatus with choroidal neovascularization. The left eye received 4 sessions of intravitreal injection of ranibi-zumab. Recurrence was treated by 3 sessions of aflibercept. Subretinal hemorrhage and white dots disappeared with visual acuity of 0.6 for 12 months until present. Conclusion: Choroidal neovascularization in a case of fundus albipunctatus subsided after multiple sessions of intravitreal injection of ranibizumab and aflibercept.

DOI： 10.11477/mf.1410211418

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記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

Objective: To study the anatomic and visual outcomes of a surgical procedure in which tissue plasminogen activator and air are injected subretinally to displace massive submacular hemorrhages secondary to age-related macular degeneration.
Design: Prospective, consecutive, interventional case series.
Participants: Thirteen consecutive patients (13 eyes) with massive submacular hemorrhages secondary to age-related macular degeneration.
Intervention: The surgical procedure consisted of a 25-gauge vitrectomy and submacular injection of tissue plasminogen activator (25 mu g) and 0.4 ml air with a microneedle having an outer diameter of 50 mu m. The procedure was followed by having the patient remain in the prone position overnight.
Main Outcome Measures: Mean visual acuity change from baseline, mean central lesion thickness change from baseline, fluorescein angiography findings, and surgical complications.
Results: Total subfoveal blood displacement was achieved in all 13 eyes (100%). Central lesion thickness decreased from a mean baseline value of 867 mm to a mean value of 379 mu m at 1 month after surgery. There was visual improvement in 11 eyes, no visual improvement in 1 eye, and poorer vision in 1 eye. The mean change in Early Treatment Diabetic Retinopathy Study letter score from baseline was 19.4 letters at 1 month (P = 0.006) and 23.3 letters at 3 months (P = 0.001). There was intraoperative macular hole formation.
Conclusions: Submacular air injection with a microneedle facilitates displacement of clots dissolved with tissue plasminogen activator with fewcomplications and results in earlier visual improvement. (C) 2015 by the American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2014.07.027

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Objective: To study the anatomic and visual outcomes of a surgical procedure in which tissue plasminogen activator and air are injected subretinally to displace massive submacular hemorrhages secondary to age-related macular degeneration. Design: Prospective, consecutive, interventional case series. Participants: Thirteen consecutive patients (13 eyes) with massive submacular hemorrhages secondary to age-related macular degeneration. Intervention: The surgical procedure consisted of a 25-gauge vitrectomy and submacular injection of tissue plasminogen activator (25 μg) and 0.4 ml air with a microneedle having an outer diameter of 50 μm. The procedure was followed by having the patient remain in the prone position overnight. Main Outcome Measures: Mean visual acuity change from baseline, mean central lesion thickness change from baseline, fluorescein angiography findings, and surgical complications. Results: Total subfoveal blood displacement was achieved in all 13 eyes (100%). Central lesion thickness decreased from a mean baseline value of 867 μm to a mean value of 379 μm at 1 month after surgery. There was visual improvement in 11 eyes, no visual improvement in 1 eye, and poorer vision in 1 eye. The mean change in Early Treatment Diabetic Retinopathy Study letter score from baseline was 19.4 letters at 1 month (P = 0.006) and 23.3 letters at 3 months (P = 0.001). There was intraoperative macular hole formation. Conclusions: Submacular air injection with a microneedle facilitates displacement of clots dissolved with tissue plasminogen activator with few complications and results in earlier visual improvement. © 2014 American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2014.07.027

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