However, non-CNV fellow eyes without myopic CNV were also included in the analysis, and both the pattern of LC progression and the occurrence of myopic CNV were similar

However, non-CNV fellow eyes without myopic CNV were also included in the analysis, and both the pattern of LC progression and the occurrence of myopic CNV were similar. This study has some limitations, especially in that our data do not precisely reflect the natural course of LC development or recurrence of CNV. regression, a statistically significant association was observed between recurrence of myopic CNV and the absence of a dark rim on ICGA. Conclusions The HRA2 instrument PD-166285 affords detailed high-resolution images of FA and ICGA. Notably, PD-166285 recurrence of myopic CNV developed in areas surrounded by new small crack fragments and LCs are considered to be important in the development of myopic CNV. strong class=”kwd-title” Keywords: indocyanine green angiography, lacquer crack, myopic choroidal neovascularization Introduction Pathological myopia is the leading cause of severe visual loss in many countries.1, 2 High myopia is especially common in Asian populations, with rates of 9C21%,3, 4 compared with 2C4% in Caucasians.5, 6, 7 The pathogenesis of high myopia is associated with progressive and excessive elongation of the eyeball which predisposes to various degenerative changes involving the sclera, choroid, and retina.8, 9 Myopic choroidal neovascularization (CNV), the vision-threatening complication of myopia,10, 11 develops in 5C11% of patients with high myopia.8, 12, 13 Indocyanine green angiography (ICGA) can provide valuable information on choroidal vessels because of its longer wavelength fluorescence with limited diffusion within the choriocapillaries compared with fluorescein angiography (FA).14, 15, 16 Many characteristic findings of myopic CNV are observed using ICGA such as lacquer cracks (LCs), peripapillary choroidal atrophy, any dark rim, and late-phase hyperfluorescence. In particular, LCs are considered important in the development of the condition,13, 17, 18 but the associated mechanism remains unclear so far. The Heidelberg retina angiograph 2 (HRA2; Heidelberg Engineering, Heidelberg, Germany), a confocal scanning system, can yield detailed images and perform FA and ICGA simultaneously allowing comparison of images obtained at the same point of the retina. However, to the best of our knowledge, few reports on the use of this technique in the assessment of myopic CNV patients have appeared. The purpose of this study was to identify characteristic findings of myopic CNV, especially LC and to describe factors prognostic for recurrence of the condition. Materials and methods Subjects We retrospectively reviewed the medical PD-166285 records of 66 consecutive myopic CNV patients who received photodynamic therapy (PDT) and/or intravitreal ranibizumab or bevacizumab injection between 1 March 2005 and 31 May PD-166285 2008 at the Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. This study was conducted in accordance with the principles of the Declaration of Helsinki and carried out with the approval of our Institutional Review Board. Potential risks and benefits were discussed with all patients before they received treatment and each patient read and signed an informed consent form. Patients were included if they met all of the following criteria: (1) previous treatment with PDT and/or intravitreal anti-vascular endothelial growth factor (anti-VEGF) antibody (ranibizumab or bevacizumab) for myopic CNV in one eye, defined Rabbit Polyclonal to p90 RSK as the presence of active leakage from the CNV on FA, with a refractive error exceeding ?6.0 diopters (spherical equivalent) or an axial length of 26.5?mm; and (2) subfoveal, juxtafoveal, or extrafoveal myopic CNV. Exclusion criteria included (1) a history of laser photocoagulation, radiation, subtenon injection of triamcinolone acetonide, or vitreoretinal surgery on the study eye; (2) absence of FA and ICGA data at baseline; and (3) the presence of diabetic retinopathy, branch retinal vein occlusion, or other vascular diseases that might affect FA and ICGA. Examination Initial evaluation included refraction measurement, fundus photography, FA, ICGA, and optical coherence tomography (OCT). FA and ICGA were performed simultaneously using a confocal laser scanning system (HRA2). The presence and location of each LC were identified in the late phase of ICGA. The presence of LC and progression of LC with development of new CNV during follow-up period was also evaluated in the non-CNV fellow eyes. A dark rim was defined as a circular background hypofluorescence surrounding the neovascular membrane, and was detected in the early phase of ICGA. Late-phase ICGA hyperfluorescence was also noted. The extent of peripapillary choroidal atrophy was measured as the greatest linear dimension (GLD) of the hypofluorescent area around the disc, as seen in the late phase of ICGA. All measurements were taken by a.