Titre du document / Document title

Deep retinal vascular anomalous complexes in advanced age-related macular degeneration

Auteur(s) / Author(s)

HARTNETT M. E. ^{(1 2 3)} ; WEITER J. J. ^{(1 2)} ; STAURENGHI G. ⁽⁴⁾ ; ELSNER A. E. ^{(1 2)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Harvard University, Boston, ETATS-UNIS
⁽²⁾ Schepens Eye Research Institute, Boston, ETATS-UNIS
⁽³⁾ State University of New York at Buffalo, Erie County Medical Center, Buffalo, ETATS-UNIS
⁽⁴⁾ Eye Clinic, Institute of Biomedical Science, University of Milan, San Paolo Hospital, Milano, ITALIE

Résumé / Abstract

Purpose: The authors describe the clinical characteristics of a group of patients with age-related macular degeneration (AMD), deep retinal vascular anomalous complexes (RVACs), advanced Bruch membrane changes, and severe visual loss. Based on clinical evaluation and imaging studies, the authors hypothesize the cause of such retinal vascular formations. Patients and Methods: The authors quantified an initial case series of 6 patients and expanded it to 11 patients (14 eyes) with AMD and RVACs diagnosed by fluorescein angiography or slit-lamp examination. Associated pigment epithelial detachments (PEDs) of 13 eyes are described. In addition to the clinical and fluorescein angiography descriptions, infrared imaging and indocyanine green angiography were used to characterize more recently described RVACs and fellow eyes. Results: Each study eye had a clearly defined anastomosis connecting the retinal circulation to a vascular complex in the deep retina. The RVACs associated with PEDs assumed a more central location than did typical choroidal neovascularization associated with PEDs. In seven eyes with RVACs, there were clinically recognizable retinovascular findings: intraretinal hemorrhages, telangiectasia, or microaneurysms. Legal blindness occurred in 9 of 11 patients. Conclusion: These results indicate that retinovascular changes can be associated with nondisciform AMD. The authors speculate that neurodegenerative changes and hypoxia may lead to such changes, the RVAC being a more advanced finding. Closure of an RVAC with photocoagulation is difficult, perhaps because of its higher blood flow. The visual outcome is poor, not only because of the advanced state of the underlying AMD, but also because of the exudative nature of the RVAC.

Revue / Journal Title

Ophthalmology   ISSN 0161-6420   CODEN OPHTDG 

Source / Source

1996, vol. 103, n^o12, pp. 2042-2053 (41 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1976) (Revue)

Mots-clés anglais / English Keywords

Degeneration ; Macula ; Age ; Anomaly ; Blood vessel ; Retina ; Angiography ; Fluorescein ; Slitlamp ; Human ; Eye disease ; Retinopathy ; Maculopathy ; Cardiovascular disease ; Vascular disease ; Radiodiagnosis ;

Mots-clés français / French Keywords

Dégénérescence ; Macula ; Age ; Anomalie ; Vaisseau sanguin ; Rétine ; Angiographie ; Fluorescéine ; Lampe fente ; Homme ; Oeil pathologie ; Rétinopathie ; Maculopathie ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Radiodiagnostic ;

Mots-clés espagnols / Spanish Keywords

Degeneración ; Mácula ; Edad ; Anomalía ; Vaso sanguíneo ; Retina ; Angiografía ; Fluoresceína ; Lámpara hendidura ; Hombre ; Ojo patología ; Retinopatía ; Maculopatía ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Radiodiagnóstico ;

Localisation / Location

INIST-CNRS, Cote INIST : 18914, 35400006143466.0080