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Lawrence A. Yannuzzi - One of the best experts on this subject based on the ideXlab platform.

  • Annular Lesions and Catenary Forms in Chronic Central Serous Chorioretinopathy.
    American journal of ophthalmology, 2016
    Co-Authors: Kunal K. Dansingani, Chandrakumar Balaratnasingam, Sarah Mrejen, Maiko Inoue, K. Bailey Freund, James M. Klancnik, Lawrence A. Yannuzzi
    Abstract:

    Purpose To describe a series of patients exhibiting annular retinal pigment epithelial (RPE) lesions in the context of chronic central serous Chorioretinopathy. Design Retrospective comparative case series. Methods Consecutive patients with chronic central serous Chorioretinopathy were identified from the clinical practices of 3 retina specialists. A subset of patients exhibiting annular RPE lesions on fundus autofluorescence was included for chart review and examination of multimodal imaging (study group). Patients with alternative etiologies for neurosensory detachment or pigment epitheliopathy were excluded. A second consecutive cohort of patients, with acute central serous Chorioretinopathy, was also examined for the presence of annular lesions (comparative group). Results Sixty-seven patients with chronic central serous Chorioretinopathy were identified. Fourteen eyes of 12 patients exhibited annular lesions (study eyes). Mean visual acuity of study eyes was 20/27 (logMAR 0.13, SD 0.11). Annular lesions were composed of hyperautofluorescent stellate lesions arranged in an open or closed ring with intervening foci of punctate hypoautofluorescence. Optical coherence tomography showed RPE hyperplasia at the perimeters of annular lesions with loss of ellipsoid reflectivity and preserved RPE at the lesion center. Annular lesions were confined to the posterior poles and appeared to have developed at the margins of chronic neurosensory detachment. Forty-three eyes of 30 patients with acute central serous Chorioretinopathy comprised the comparative group and none of these eyes exhibited annular lesions. Conclusions Annular lesions occur in up to a fifth of patients with chronic central serous Chorioretinopathy but carry a relatively good visual prognosis. Curvilinear RPE figures and demarcation lines are seen in various retinal conditions but the characteristics of annular lesions described here suggest that they are specific to chronic central serous Chorioretinopathy.

  • central serous Chorioretinopathy treated with mineralocorticoid antagonists a one year pilot study
    Retina-the Journal of Retinal and Vitreous Diseases, 2016
    Co-Authors: Quraish Ghadiali, Jesse J Jung, Samir N Patel, Lawrence A. Yannuzzi
    Abstract:

    Purpose:To assess the treatment response to mineralocorticoid antagonists in a pilot study of patients diagnosed with central serous Chorioretinopathy using multimodal imaging.Methods:This retrospective observational case series included 23 eyes of 14 patients with central serous Chorioretinopathy t

  • Central serous Chorioretinopathy in patients with keratoconus.
    Retina (Philadelphia Pa.), 2008
    Co-Authors: Chiara M. Eandi, Lucian V. Del Priore, Enrico Bertelli, Michael D. Ober, Lawrence A. Yannuzzi
    Abstract:

    Purpose:To report the occurrence of central serous Chorioretinopathy in patients with keratoconus and discuss the possible connection between these two conditions.Methods:Observational case series.Results:The authors identified three subjects with keratoconus and central serous Chorioretinopathy. Al

  • Systemic findings associated with central serous Chorioretinopathy.
    American journal of ophthalmology, 1999
    Co-Authors: Michael Tittl, Richard F. Spaide, Doric Wong, Elisabetta Pilotto, Lawrence A. Yannuzzi, Yale L. Fisher, B Freund, David R. Guyer, Jason S. Slakter, John A. Sorenson
    Abstract:

    PURPOSE: To determine systemic factors associated with central serous Chorioretinopathy. METHODS: In a retrospective study, 230 consecutive patients with central serous Chorioretinopathy examined in a referral setting were compared with a historical gender-matched and age-matched control group of 230 patients with ocular findings who were examined in the same referral setting. RESULTS: The median age of the patients was 49.8 years, and of the control subjects, 50.0 years. The male-female ratio for both groups was 2.7:1. Patients with central serous Chorioretinopathy were more likely to use psychopharmacologic medications (odds ratio = 2.6; 95% confidence interval = 1.30 to 5.19; P = .0049) and corticosteroids (odds ratio = 3.17; 95% confidence interval = 1.30 to 7.70; P = .0067) and were more likely to have hypertension (odds ratio = 2.25; 95% confidence interval = 1.39 to 3.63; P = .0008) than were the control subjects. CONCLUSIONS: This study identified psychopharmacologic medication use, corticosteroid use, and hypertension as factors associated with central serous Chorioretinopathy. These findings reinforce the concept that stress and adaptations to stress play a role in this disorder. The findings of possible associations between central serous Chorioretinopathy and both hypertension and corticosteroid usage suggest that these modifiable factors may influence morbidity of central serous Chorioretinopathy.

  • fluorescein and icg angiography textbook and atlas
    1998
    Co-Authors: G Richard, Gisele Soubrane, Lawrence A. Yannuzzi
    Abstract:

    The Principles of Fluorescein Angiography Evaluating a Fluorescein Angiogram Fluorescein Angiography in the Healthy Eye Evaluating an Indocyanine Angiography Indocyanine Green Video Angiography Diseases of the Optic Nerve Head Disturbances of the Retinal Circulation Diabetic Retinopathy Vasular Disease - Miscellaneous Vitreoretinal Interface Abnormalities of the Macula Age-Related Macular Diseases Macular Diseases - Miscellaneous Hereditary Disorders Inflammatory Diseases of the Retina and Choroid Inflammatory Disease of Unknown Etiology Traumatic Chorioretinopathy Choroidal Diseases - Miscellaneous Retinal and Pigment Epithelial Hamartomas Neoplastic Diseases Radiotherapy - Radiation Chorioretinopathy Appendix Sources of Illustrations Index References

Antoine P Brézin - One of the best experts on this subject based on the ideXlab platform.

  • Birdshot Chorioretinopathy.
    Current opinion in ophthalmology, 2006
    Co-Authors: Dominique Monnet, Antoine P Brézin
    Abstract:

    Birdshot Chorioretinopathy is the disease with the strongest link to a human leukocyte antigen class I allele. Current research aims at understanding its immunogenetic mechanisms, focusing on the A29 allele, its subtypes, and on other loci of the human leukocyte antigen region. Research criteria can be applied to define birdshot Chorioretinopathy. Its heterogeneous presentations and its multiple consequences on visual function are being delineated. HLA-A*2902 is the most frequent subtype in Caucasians and in patients with birdshot Chorioretinopathy. The condition has also been observed, however, in a few HLA-A*2901 Caucasian patients, but remains absent or extremely rare in Asia where HLA-A*2901 is the most prevalent subtype. Birdshot Chorioretinopathy affects visual acuity, color vision, contrast sensitivity or visual field and pigmentation of birdshot spots could be a marker of disease severity. Electroretinography has been used to monitor the course of the disease; abnormalities may be due to altered outer retinal function or to inner retinal dysfunction. Various therapeutic regimens have been tested and most studies confirm that corticosteroids alone are not a sustainable treatment for patients with birdshot Chorioretinopathy. Progress has been made in understanding the spectrum of manifestations of birdshot Chorioretinopathy. The disease remains of unknown cause and many decisions regarding the management of patients are still empirical.

  • research criteria for the diagnosis of birdshot Chorioretinopathy results of an international consensus conference
    American Journal of Ophthalmology, 2006
    Co-Authors: Ralph D Levinson, Antoine P Brézin, A. Rothova, Massimo Accorinti, Gary N Holland
    Abstract:

    Purpose To present and evaluate research criteria for the diagnosis of birdshot Chorioretinopathy. Design Consensus statement. Methods Investigators who attended an international conference on birdshot Chorioretinopathy drafted diagnostic criteria, which were refined after comment by conference attendees. Sensitivity and specificity of the criteria were evaluated by review of 82 previously diagnosed cases and evaluation of 80 consecutive patients with other forms of uveitis. Results Criteria, including presence of “birdshot lesions” and mild intraocular inflammation in both eyes, are based on clinical findings in the absence of systemic disease; HLA-A29 is supportive of diagnosis, but not required. Diagnostic criteria were found to be 100% specific and 97.5% sensitive. Positive predictive value was 100%; negative predictive value was 97.6%. Conclusions Standardized criteria for the diagnosis of birdshot Chorioretinopathy will facilitate clinical research and the comparison of results from studies performed at different institutions by ensuring a homogeneous population of study patients.

Constantin J. Pournaras - One of the best experts on this subject based on the ideXlab platform.

  • Central serous Chorioretinopathy and glucocorticoids.
    Survey of ophthalmology, 2002
    Co-Authors: Evrydiki A. Bouzas, Panagiotis Karadimas, Constantin J. Pournaras
    Abstract:

    Central serous Chorioretinopathy is a relatively common retinal disease characterized by the accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. It typically affects young and middle-aged men with no previous medical and family history, and no systemic symptoms or signs. However, it has been noted that central serous Chorioretinopathy is associated with different conditions, characterized by exposure to increased levels of endogenous or exogenous glucocorticoids. In fact, central serous Chorioretinopathy has been described in patients with endogenous Cushing's syndrome. It is also prevalent in patients with type-A behavior, and following stressful events, and pregnancy probably represents a risk factor for central serous Chorioretinopathy; these conditions are characterized by endogenous hypercortisolism. In addition, many cases of central serous Chorioretinopathy have been described during or following treatment with glucocorticoids, administrated by any route, for various systemic or ocular conditions. Central serous Chorioretinopathy, when related to the exposure to exogenous glucocorticoids, has a less prominent male predilection, presents more often with a chronic or atypical form, and is frequently bilateral. Furthermore, treatment of central serous Chorioretinopathy with glucocorticoids was found to exacerbate the clinical picture. Based on these observations it could be suggested that glucocorticoids may be involved in the development of central serous Chorioretinopathy, even though the exact pathogenic mechanism remains unclear. Glucocorticoids should not be used in the treatment of central serous Chorioretinopathy and central serous Chorioretinopathy should be added to the list of ocular complications of glucocorticoids.

  • Central serous Chorioretinopathy complicating solar retinopathy treated with glucocorticoids.
    Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 1999
    Co-Authors: Evrydiki A. Bouzas, Philippe Moret, Constantin J. Pournaras
    Abstract:

    · Background: Solar retinopathy and central serous Chorioretinopathy are two well-defined clinical entities which affect the macular area. Their association has never been described. The relation of central serous Chorioretinopathy with the exposure to glucocorticoids has been recently suggested. · Case report: Central serous Chorioretinopathy developed in a patient who received corticosteroid therapy for solar retinopathy. · Conclusion: This case report provides additional evidence that central serous Chorioretinopathy may develop under the effect of glucocorticoids. Retinal damage resulting from a previous insult, such as solar retinopathy, may act as the permissive factor.

Emmett T. Cunningham - One of the best experts on this subject based on the ideXlab platform.

  • Central serous Chorioretinopathy after bone marrow transplantation.
    American journal of ophthalmology, 2001
    Co-Authors: Amani A. Fawzi, Emmett T. Cunningham
    Abstract:

    Abstract PURPOSE: To describe central serous Chorioretinopathy after bone marrow transplantation. METHODS: The medical records of the patient were reviewed retrospectively. RESULTS: A 46-year-old Filipino man developed multifocal central serous Chorioretinopathy affecting his left eye 4 months after bone marrow transplantation for acute myelogenous leukemia. Other co-existing medical problems at the time of presentation included systemic hypertension and graft-versus-host-disease (GVHD), for which the patient was using both systemic corticosteroids and cyclosporine. CONCLUSION: Central serous Chorioretinopathy is a rare cause of vision loss in patients after bone marrow transplantation. Previous descriptions of bone marrow transplantation-associated central serous Chorioretinopathy in patients with thrombotic microangiopathy, as well as the occurrence of both systemic hypertension and the use of systemic corticosteroids and cyclosporine in our patient with bone marrow transplantation-associated central serous Chorioretinopathy, support theories of choroidal vascular compromise in the pathogenesis of central serous Chorioretinopathy.

  • Central Serous Chorioretinopathy in Patients with Systemic Lupus Erythematosus
    Ophthalmology, 1996
    Co-Authors: Emmett T. Cunningham, Pierre R. Alfred, Alexander R. Irvine
    Abstract:

    Purpose: To describe three patients with systemic lupus erythematosus in whom ophthalmoscopic and fluorescein angiographic evidence of central serous Chorioretinopathy developed. Methods: The authors retrospectively reviewed the clinical and photographic records of three patients with systemic lupus erythematous in whom central serous Chorioretinopathy developed. Results: Ophthalmoscopic changes observed in these patients with systemic lupus erythematosus included discrete areas of clumping and mottling of the retinal pigment epithelium (RPE), focal RPE detachments, serous elevations of the neurosensory retina, and late subretinal fibrosis with scar formation. Fluorescein angiographic findings included transmission hypofluorescence and hyperfluorescence corresponding to focal RPE alterations, early punctate intense hyperfluorescence corresponding to RPE leaks with progressive filling of sub-RPE detachment spaces, and slow late filling of subretinal detachment spaces. Conclusion: Patients with systemic lupus erythematosus are at increased risk to have central serous Chorioretinopathy develop. The pathogenetic implications for an association between systemic lupus erythematosus and central serous Chorioretinopathy as well as the similarity to the Chorioretinopathy seen with accelerated hypertension, pregnancy, hemodialysis, organ transplantation, and exogenous and endogenous hypercortisolism are discussed. Focal choroidal vasculature compromise with secondary dysfunction of overlying RPE cells is the proposed common mechanism.

Tetsuju Sekiryu - One of the best experts on this subject based on the ideXlab platform.