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Francesco Bandello - One of the best experts on this subject based on the ideXlab platform.
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hyperreflective foci precede macular neovascularization formation in Angioid Streaks
Retinal Cases & Brief Reports, 2021Co-Authors: Alessandro Arrigo, Francesco Bandello, Alessio Antropoli, Lorenzo Bianco, Andrea Rosolia, Alessia Vuturo, Maurizio Battaglia ParodiAbstract:PURPOSE To describe the steps leading to the development and progression of macular neovascularization (MNV) in Angioid Streaks (AS). METHODS The study was designed as retrospective, longitudinal case-series. AS patients were investigated by means of multimodal imaging, including fundus autofluorescence and structural optical coherence tomography (OCT). Main outcome measures were hyperreflective foci (HF) and MNV progression steps. RESULTS Overall, 40 eyes (20 patients) affected by AS were evaluated. Over the follow-up, 5 eyes of 5 patients developed MNV. The mean follow-up was of 1.6 years. The mean number of anti-VEGF injections was 4.35±1.4. Mean BCVA was 0.53±0.38 LogMAR at the MNV onset, improving to 0.42±0.40 LogMAR at the end of the follow-up (p>0.05). Intraretinal HF onset and coalescence represented the first alterations occurring before the onset of the MNV. Anti-VEGF treatment was associated with exudation relapsing and remitting, with still present intraretinal hyperreflective foci and pigment accumulation. The longitudinal analysis of our cohort of eyes outlined the event timeline: 1.2 months to find concentrated HF, 4.5 months to observe pigment organization through the outer nuclear layer, and 1.5 years to detect MNV. CONCLUSIONS HF formation, concentration and migration represent early alterations occurring before the onset of the MNV in AS.
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The identification of activity of choroidal neovascularization complicating Angioid Streaks
Eye, 2021Co-Authors: Alessandro Marchese, Maria Vittoria Cicinelli, Chiara Giuffrè, Francesco Bandello, Alessandro Arrigo, Maurizio Battaglia ParodiAbstract:Objectives To inspect the inter-reader agreement of different diagnostic modalities in identifying choroidal neovascularization (CNV) activity secondary to Angioid Streaks (AS) and to analyze the prevalence of subretinal hyper-reflective material (SHRM) in active CNV. Methods Retrospective study of patients with AS with active CNV; optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) from each patient were collected. Agreement between two readers using different diagnostic modalities is presented as free-marginal kappa (k) and 95% confidence interval (CI). Results This study included 19 eyes of 12 patients with active CNV (5 naive and 14 previously treated). Agreement among readers on CNV activity was excellent for OCT ( k =0.88; 95% CI 0.71–1.00), good for FFA ( k = 0.70; 95% CI 0.46–0.94) and ICGA ( k = 0.58; 95% CI 0.31–0.84), and poor using OCTA ( k = 0.39; 95% CI 0.11–0.68). SHRM was the most common OCT finding associated with active CNV (100%); fuzzy borders were present in 53% of SHRM cases at baseline. Conclusions Identification of CNV activity in AS is challenging; OCT was the best modality to inspect active CNV. The identification of SHRM contributed to recognizing active CNV. Further studies are needed to assess the role of SHRM in anticipating prognosis and guiding treatment of CNV secondary to AS.
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intravitreal aflibercept for management of choroidal neovascularization secondary to Angioid Streaks the italian eylea strie study
European Journal of Ophthalmology, 2021Co-Authors: Maurizio Battaglia Parodi, Alessandro Marchese, Maria Vittoria Cicinelli, Chiara Giuffrè, Francesco Viola, Giovanni Staurenghi, Monica Varano, Francesco BandelloAbstract:PurposeTo investigate the effect and the safety of intravitreal aflibercept in patients affected by choroidal neovascularization secondary to Angioid Streaks with a long-term follow-up.MethodsMulti...
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identification of hyperreflective foci in Angioid Streaks
Eye, 2019Co-Authors: Francesco Romano, Alessandro Marchese, Maria Vittoria Cicinelli, Francesco Bandello, Stefano Mercuri, Alessandro Arrigo, Giorgia Carlotta Albertini, Maurizio Battaglia ParodiAbstract:To assess hyperreflective foci (HF) number in Angioid Streaks (AS) by means of spectral-domain optical coherence tomography (SD-OCT). Observational and cross-sectional study. Sixty-two eyes with AS and 62 controls underwent best-corrected visual acuity (BCVA), fundoscopy, and SD-OCT. HF were assessed on the horizontal scan of a six-line radial OCT, in the fovea (1500-μm diameter) and parafovea (500 μm external to the fovea), and sub-classified as retinal or choroidal, small or large. Eyes were distributed in one of four groups, as carrying foveal AS without choroidal neovascularization (CNV) (14 eyes), extra-foveal AS without CNV (14), active CNV (20), and inactive CNV (14). Primary outcome was HF assessment in AS. Secondary outcomes included their correlations with BCVA. AS-affected eyes had higher HF numbers. Our sub-analysis revealed that patients with active CNV had a larger number of retinal and choroidal HF than all the other groups, whereas retinal and choroidal foci were significantly increased in inactive CNV only with respect to controls. Interestingly, patients with foveal AS showed HF number increase in the choroid and fovea. BCVA deterioration positively correlated with the total HF number found in the fovea and the choroid. HF are significantly increased in patients with AS. Despite being especially evident in active CNV, the increasing number in eyes without CNV might suggest new pathogenetic aspects of the disease.
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OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF Angioid Streaks.
Retina (Philadelphia Pa.), 2018Co-Authors: Eleonora Corbelli, Alessandro Marchese, Adriano Carnevali, Maria Vittoria Cicinelli, Francesco Bandello, Lea Querques, Riccardo Sacconi, Giuseppe QuerquesAbstract:Purpose:To analyze the optical coherence tomography angiography features of eyes affected with Angioid Streaks (AS) and to evaluate their ability to predict choroidal neovascularization (CNV) activity.Methods:Angioid Streaks were individuated from a pool of consecutive patients. Eyes with and withou
Eric H. Souied - One of the best experts on this subject based on the ideXlab platform.
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intravitreal ranibizumab for choroidal neovascularization in Angioid Streaks four year follow up
Retina-the Journal of Retinal and Vitreous Diseases, 2016Co-Authors: Julien Tilleul, G. Mimoun, Giuseppe Querques, Nathalie Puche, Jennyfer Zerbib, Franck Lalloum, Mayer Srour, Eric H. SouiedAbstract:Purpose:To analyze retrospectively the efficacy of intravitreal ranibizumab injections for the management of choroidal neovascularization in patients with Angioid Streaks over a long term.Methods:In this “nonrandomized,” double-center, retrospective, interventional case series, a consecutive series
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Intravitreal ranibizumab for choroidal neovascularization in Angioid Streaks.
American journal of ophthalmology, 2010Co-Authors: G. Mimoun, Anita Leys, Gisèle Soubrane, Gabriel Coscas, Julien Tilleul, Eric H. SouiedAbstract:Purpose To analyze retrospectively the efficacy of intravitreal ranibizumab injections for the management of choroidal neovascularization (CNV) in patients with Angioid Streaks. Design Nonrandomized, double-center, retrospective, interventional case series. Methods A consecutive series of patients affected with CNV associated with Angioid Streaks were treated with intravitreal ranibizumab injections (0.5 mg/0.05 mL). Best-corrected visual acuity, fundus photography results, optical coherence tomography (OCT) results, and fluorescein angiography results were examined before and after treatment. The primary end point was the percentage of eyes with stable or improved visual acuity at the end of follow-up. Secondary end points were the percentage of eyes with stable or decreased macular thickness on optical coherence tomography and the percentage of eyes with persistent leakage on fluorescein angiography at the last follow-up examination. Results Thirty-five eyes of 27 patients were treated with repeated intravitreal ranibizumab injections (mean, 5.7 injections; range, 2 to 14 injections) for a mean of 24.1 months (range, 6 to 37 months). At the end of follow-up, visual acuity was stabilized or improved in 30 (85.7%) of 35 eyes. Macular thickness had stabilized or decreased in 18 (51.5%) of 35 eyes. At the last follow-up examination, on fluorescein angiography, no further leakage was observed in 23 (65.7%) of 35 eyes. Conclusions In this large series of Angioid Streaks-associated CNV, ranibizumab injections allowed stabilization of visual acuity. Ranibizumab seems to be a safe therapeutic option in CNV associated with Angioid Streaks.
Rosario Brancato - One of the best experts on this subject based on the ideXlab platform.
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Indocyanine green angiography in Angioid Streaks.
Acta ophthalmologica Scandinavica, 2009Co-Authors: Alfredo Pece, P. Avanza, U. Introini, Rosario BrancatoAbstract:Purpose: To define the indocyanine green angiographic aspects of Angioid Streaks, peau d'orange and choroidal new vessels. Methods: Fifty-seven consecutive patients (112 eyes) with Angioid Streaks were evaluated by fluorescein angiography and indocyanine green angiography. Results: Indocyanine green angiography showed Angioid Streaks in all eyes. We identified three different indocyanine green patterns of Streaks (four groups): fluorescent (63%), hypofluorescent (8%), ‘track-like’ (19%) and mixed (10%). Angioid Streaks were visualized better by indocyanine green angiography and red-free retinography than fluorescein angiography. Peau d'orange was seen better and found to be more widespread by indocyanine green angiography. Fluorescein angiography visualized choroidal neovascularization better, except for occult forms. Conclusions: Our findings show that Angioid Streaks have different indocyanine green angiography patterns. Considering that the hypofluorescent pattern was significantly observed in younger patients, indocyanine green angiography aspects might be correlated with different stages of the disease.
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Laser photocoagulation of choroidal neovascularization in Angioid Streaks.
Retina-the Journal of Retinal and Vitreous Diseases, 1997Co-Authors: Alfredo Peck, P. Avanza, Laura Galli, Rosario BrancatoAbstract:PurposeTo determine if laser photocoagulation of macular choroidal neovascularization in Angioid Streaks may be effective in preventing severe loss of vision.MethodsSixty-six consecutive eyes of 52 patients with extrafoveal, welldefined choroidal neovascularization secondary to Angioid Streaks who u
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echographic diagnosis of drusen of the optic nerve head in patients with Angioid Streaks
Ophthalmologica, 1994Co-Authors: Luisa Pierro, Rosario Brancato, M Minicucci, Alfredo PeceAbstract:A total of 58 patients (116 eyes) with Angioid Streaks, referred to this department over 2 years (1990–1992), underwent a thorough ophthalmic examination, retinal fluorescein angiography, dermatologic
Ioannis Ladas - One of the best experts on this subject based on the ideXlab platform.
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detection of nonexudative choroidal neovascularization secondary to Angioid Streaks using optical coherence tomography angiography
European Journal of Ophthalmology, 2017Co-Authors: Konstantinos Andreanos, Ilias Georgalas, Tryfon Rotsos, Chryssanthi Koutsandrea, Georgios Kymionis, Ioannis LadasAbstract:PurposeTo present a case of nonexudative choroidal neovascularization secondary to Angioid Streaks in a patient with pseudoxanthoma elasticum. The lesion was monitored over an 8-month period with t...
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REVIEW Angioid Streaks, clinical course, complications, and current therapeutic management
2013Co-Authors: Ilias Georgalas, Dimitris Papaconstantinou, Chrysanthi Koutsandrea, George Kalantzis, Dimitris Karagiannis, Gerasimos Georgopoulos, Ioannis LadasAbstract:Abstract: Angioid Streaks are visible irregular crack-like dehiscences in Bruch’s membrane that are associated with atrophic degeneration of the overlying retinal pigmented epithelium. Angioid Streaks may be associated with pseudoxanthoma elasticum, Paget’s disease, sickle-cell anemia, acromegaly, Ehlers–Danlos syndrome, and diabetes mellitus, but also appear in patients without any systemic disease. Patients with Angioid Streaks are generally asymptomatic, unless the lesions extend towards the foveola or develop complications such as traumatic Bruch’s membrane rupture or macular choroidal neovascularization (CNV). The visual prognosis in patients with CNV secondary to Angioid Streaks if untreated, is poor and most treatment modalities, until recently, have failed to limit the devastating impact of CNV in central vision. However, it is likely that treatment with antivascular endothelial growth factor, especially in treatment-naive eyes to yield favorable results in the future and this has to be investigated in future studies
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intravitreal ranibizumab treatment of macular choroidal neovascularization secondary to Angioid Streaks one year results of a prospective study
Retina-the Journal of Retinal and Vitreous Diseases, 2010Co-Authors: Ioannis Ladas, Ilias Georgalas, Athanasios I Kotsolis, Dimitrios S Ladas, Maria Niskopoulou, Dimitrios Papakonstantinou, Alexandros RouvasAbstract:PURPOSE The purpose of this study was to evaluate the efficacy of intravitreal ranibizumab in eyes with macular choroidal neovascularization secondary to Angioid Streaks. METHODS A prospective interventional case series was conducted on eyes with macular choroidal neovascularization, secondary to Angioid Streaks, treated by repeated injections of intravitreal ranibizumab (0.5 mg) and completing a follow-up time of 1 year. The outcome measures were best-corrected visual acuity, greatest lesion height as evaluated by optical coherence tomography, and lesion size as assessed by fluorescein angiography. RESULTS Over a 16-month period, we treated 15 consecutive eyes. The average number of injections was 7.1 +/- 0.5. Mean best-corrected visual acuity was improved from 20/100 to 20/50 (P = 0.006). Best-corrected visual acuity either improved or stabilized in 14 eyes (93.3%). At baseline, 3 of the 15 eyes (20%) had a best-corrected visual acuity of >or=20/50 compared with 10 eyes (66.7%) at the end of the first year. Fourteen eyes (93.3%) presented reduction in greatest lesion height and stabilization or reduction in lesion size. The mean greatest lesion height was decreased from 377.3 +/- 139.7 microm to 270.2 +/- 88.6 microm (P < 0.001). CONCLUSION Intravitreal ranibizumab is highly effective in improving or stabilizing vision and lesion morphology in patients with macular choroidal neovascularization secondary to Angioid Streaks.
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Angioid Streaks, clinical course, complications, and current therapeutic management.
Therapeutics and clinical risk management, 2009Co-Authors: Ilias Georgalas, Dimitris Papaconstantinou, Chrysanthi Koutsandrea, George Kalantzis, Dimitris Karagiannis, Gerasimos Georgopoulos, Ioannis LadasAbstract:Angioid Streaks are visible irregular crack-like dehiscences in Bruch’s membrane that are associated with atrophic degeneration of the overlying retinal pigmented epithelium. Angioid Streaks may be associated with pseudoxanthoma elasticum, Paget’s disease, sickle-cell anemia, acromegaly, Ehlers–Danlos syndrome, and diabetes mellitus, but also appear in patients without any systemic disease. Patients with Angioid Streaks are generally asymptomatic, unless the lesions extend towards the foveola or develop complications such as traumatic Bruch’s membrane rupture or macular choroidal neovascularization (CNV). The visual prognosis in patients with CNV secondary to Angioid Streaks if untreated, is poor and most treatment modalities, until recently, have failed to limit the devastating impact of CNV in central vision. However, it is likely that treatment with antivascular endothelial growth factor, especially in treatment-naive eyes to yield favorable results in the future and this has to be investigated in future studies.
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photodynamic therapy with verteporfin of choroidal neovascularization in Angioid Streaks conventional versus early retreatment
European Journal of Ophthalmology, 2005Co-Authors: Ioannis Ladas, Ilias Georgalas, Alexandros Rouvas, S Gotsis, D A Karagiannis, Michail MoschosAbstract:PURPOSE. To evaluate the effectiveness of conventional photodynamic therapy with verteporfin (PDT) in a series of patients with macular choroidal neovascularization (CNV) due to Angioid Streaks and to compare it to the effectiveness of early PDT retreatment. METHODS. This is a retrospective study of 24 eyes (22 consecutive patients) with subfoveal or juxtafoveal CNV secondary to Angioid Streaks treated with PDT from September 2000 through February 2003 and that completed at least the first year of follow-up. Until August 2001, retreatments were performed according to the conventional protocol for PDT every 3 months (Group 1, consisting of 11 eyes of 9 patients). After August 2001 (13 more eyes of 13 new patients), retreatments were performed earlier (every 8 weeks) when indicated (Group 2). The follow-up time ranged from 30 to 42 months and from 12 to 30 months in Groups 1 and 2. RESULTS. At the end of the follow-up, final best-corrected visualacuity decreased in 21 (87.5%), stabilized in 2 (8.3%), and improved in 1 (4.2%) of the total 24 eyes. In all, 19 of the 24 eyes (79.2%) had a final best-corrected visual acuity equal to or less than 20/400. There were not any statistically significant differences in final visual acuity between the two groups. CONCLUSIONS. In this large series of patients with macular CNV secondary to Angioid Streaks, the functional and the anatomic results of PDT were not satisfactory, even when retreatments were performed earlier than the conventional time of 3 months.
Gabriel Coscas - One of the best experts on this subject based on the ideXlab platform.
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Intravitreal ranibizumab for choroidal neovascularization in Angioid Streaks.
American journal of ophthalmology, 2010Co-Authors: G. Mimoun, Anita Leys, Gisèle Soubrane, Gabriel Coscas, Julien Tilleul, Eric H. SouiedAbstract:Purpose To analyze retrospectively the efficacy of intravitreal ranibizumab injections for the management of choroidal neovascularization (CNV) in patients with Angioid Streaks. Design Nonrandomized, double-center, retrospective, interventional case series. Methods A consecutive series of patients affected with CNV associated with Angioid Streaks were treated with intravitreal ranibizumab injections (0.5 mg/0.05 mL). Best-corrected visual acuity, fundus photography results, optical coherence tomography (OCT) results, and fluorescein angiography results were examined before and after treatment. The primary end point was the percentage of eyes with stable or improved visual acuity at the end of follow-up. Secondary end points were the percentage of eyes with stable or decreased macular thickness on optical coherence tomography and the percentage of eyes with persistent leakage on fluorescein angiography at the last follow-up examination. Results Thirty-five eyes of 27 patients were treated with repeated intravitreal ranibizumab injections (mean, 5.7 injections; range, 2 to 14 injections) for a mean of 24.1 months (range, 6 to 37 months). At the end of follow-up, visual acuity was stabilized or improved in 30 (85.7%) of 35 eyes. Macular thickness had stabilized or decreased in 18 (51.5%) of 35 eyes. At the last follow-up examination, on fluorescein angiography, no further leakage was observed in 23 (65.7%) of 35 eyes. Conclusions In this large series of Angioid Streaks-associated CNV, ranibizumab injections allowed stabilization of visual acuity. Ranibizumab seems to be a safe therapeutic option in CNV associated with Angioid Streaks.
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Indocyanine Green Videoangiography of Angioid Streaks
American journal of ophthalmology, 1995Co-Authors: M. Quaranta, Salomon Y. Cohen, Ralf Krott, Sterkers M, Gisèle Soubrane, Gabriel CoscasAbstract:Purpose The fluorescein angiographic features of Angioid Streaks are variable, and Angioid Streaks and their main complication, choroidal neovascularization, can sometimes be difficult to visualize in the presence of diffuse pigment migration, diffuse atrophy of the retinal pigment epithelium, or hemorrhage. The objective of the present investigation was to define the indocyanine green angiographic features of Angioid Streaks and to compare them with findings on fluorescein angiography. Methods For this prospective study, we recruited 22 consecutive patients, 21 of whom had Angioid Streaks and one who had typical peau d'orange appearance of the fundus. Complete ophthalmologic examination, fluorescein angiography, and indocyanine green videoangiography by the means of scanning laser ophthalmoscope were performed on all patients. Results In 21 patients with Angioid Streaks and in one patient with peau d'orange appearance of the fundus, indocyanine green videoangiography showed Angioid Streaks in the form of hyperfluorescent lines with numerous associated hyperfluorescent foci. The Angioid Streaks were more clearly visualized and were seen to be more numerous and larger by indocyanine green videoangiography than with red-free images or fluorescein angiography. Choroidal neovascularization was suspected in six eyes but could be precisely localized by fluorescein angiography in only three eyes. Indocyanine green angiography allowed precise localization of choroidal neovascularization in all six of these eyes. Conclusions These findings indicate that indocyanine green videoangiography provides different information than fluorescein angiography in the evaluation of Angioid Streaks and can more precisely localize their neovascular complications.
