Macular Degeneration: Ge J

Chen YX, Ge J, Yan M, Jin CJ, Zhang MX, Dong FT, Lu F, Zhang CF, Zhao JL. · Department of Ophthalmology, Peking Union Medical College Hospital, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China. · Zhonghua Yan Ke Za Zhi. · Pubmed #17605900 No free full text.

Abstract: OBJECTIVE: To determine the safety and efficacy of verteporfin (visudyne) photodynamic therapy in age-related macular degeneration patients with subfoveal predominant choroidal neovascularization in China. METHODS: Multicenter, open-label, non-controlled clinical study. The included patients are diagnosed AMD patients with predominant classic CNV. The included patients received verteporfin intravenously followed by 689 nm laser light administration 15 minutes after the infusion start. The patients were be followed up for 24 weeks (+/-12 days) after initial verteporfin PDT treatment. Clinical follow-up was done at the end of week 12 (+/-12 days) and week 24 (+/-12 days) after the initial treatment. Additional treatment was given after 12 weeks from initial treatment if leakage from CNV was observed on fundus fluorescein angiogram. The visual acuity with ETDRS visual chart and the retinal lesion changes were documented and compared with baseline. The adverse events both in the process of treatment and in the follow-up were recorded throughout the entire study period. RESULTS: Thirty-one patients (31 eyes) were included and completed the trial with vertepofin PDT treatment. During the 24 weeks of the trial, 38.7% of the treated eyes had a vision gain more than 5 letters, 83.9% of the treated eyes had less than 15 letters vision loss. At week 12 after the initial treatment, 12.9% of the treated eyes had no leakage; 61.3% of the treated eyes had leakages, but limited to the former lesion, 25.8% of the treated eyes had increased leakage. The results at week 24 after the initial treatment were similar to those at week 12. At week 24 after the initial treatment, there were only slight enlargements in the lesion size, area of retinal lesion, the lesion surrounding area, and greatest linear dimension (GLD) of the lesion, but no statistical significant difference was found between baseline and week 12 after initial treatment (P = 0.65, 0.31, 0.12, respectively). No obvious progress of the fibrosis was detected in most of the PDT treated eyes. Eleven cases of adverse events (AE) occurred in our trial and the incidence was 34.4%. Among the 11 patients with reported adverse event, 7 (21.9%) had mild adverse event; 3 (9.4%) had moderate adverse events; 1 (3.1%) had a serious adverse event. During the study period, no abnormal changes were found in most of the laboratory tests including serum and urine biochemistry, hematology and Electrocadiogram. CONCLUSIONS: The results of this trial showed positive efficacy of PDT with verteporfin in the treatment of predominantly subfoveal CNV secondary to AMD by reducing the risk of vision loss. The incidence of serious adverse events was only 3.1%. It is highly safe to use PDT with verteporfin in Chinese AMD patients with subfoveal predominant classical CNV.

Magnusson KP, Duan S, Sigurdsson H, Petursson H, Yang Z, Zhao Y, Bernstein PS, Ge J, Jonasson F, Stefansson E, Helgadottir G, Zabriskie NA, Jonsson T, Björnsson A, Thorlacius T, Jonsson PV, Thorleifsson G, Kong A, Stefansson H, Zhang K, Stefansson K, Gulcher JR. · DeCODE Genetics, Reykjavik, Iceland. · PLoS Med. · Pubmed #16300415 links to  free full text

Abstract: BACKGROUND: Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the developed world. The two forms of advanced AMD, geographic atrophy and neovascular AMD, represent different pathological processes in the macula that lead to loss of central vision. Soft drusen, characterized by deposits in the macula without visual loss, are considered to be a precursor of advanced AMD. Recently, it has been proposed that a common missense variant, Y402H, in the Complement Factor H (CFH) gene increases the risk for advanced AMD. However, its impact on soft drusen, GA, or neovascular AMD--or the relationship between them--is unclear. METHODS AND FINDINGS: We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA, and 100 with mixed neovascular AMD/GA), and 435 with early AMD (of whom 220 had soft drusen). A second cohort of 431 US patients from Utah, 322 with advanced AMD (244 neovascular AMD and 78 GA) and 109 early-AMD cases with soft drusen, were analyzed. We confirmed that the CFH Y402H variant shows significant association to advanced AMD, with odds ratio of 2.39 in Icelandic patients (p = 5.9 x 10(-12)) and odds ratio of 2.14 in US patients from Utah (p = 2.0 x 10(-9)) with advanced AMD. Furthermore, we show that the Y402H variant confers similar risk of soft drusen and both forms of advanced AMD (GA or neovascular AMD). CONCLUSION: Soft drusen occur prior to progression to advanced AMD and represent a histological feature shared by neovascular AMD and GA. Our results suggest that CFH is a major risk factor of soft drusen, and additional genetic factors and/or environmental factors may be required for progression to advanced AMD.

Jin C, Ge J, Zhou S, Chen H, Zhong X, Jiang R, Chen L, Chen L. · Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. · Yan Ke Xue Bao. · Pubmed #15499723 No free full text.

Abstract: PURPOSE: To evaluate short-term effects of single photodynamic therapy (PDT) for age-related macular degeneration (AMD) accompanied with choroidal neovascularization (CNV). METHODS: We analyzed retrospectively the effects of single PDT for 20 patients (20 eyes) with CNV caused by AMD. Corrected visual acuity, fluorescein angiography (FA) and optic coherence tomography (OCT) were examined before and after PDT. All patients were followed up at least 3 months. RESULTS: At the end of 3-month follow-up, 5 eyes had vision progress, 15 eyes had vision stable and no eye had vision deterioration. Fluorescein angiography one week post PDT showed cessation of fluorescein leakage in 8 eyes with predominant classic CNV, and reduction of fluorescein leakage in 12 eyes with minimal classic CNV or occult CNV without classic component. At the 3-month following PDT fluorescein angiography showed fluorescein leakage reappeared in 4 of 8 eyes with predominant classic CNV. Among 12 eyes with minimal classic CNV or occult CNV without classic component, 9 eyes showed decreased or unchanged fluorescein leakage, 3 eyes had a progression of fluorescein leakage. Optic coherence tomography showed obvious recovery of serous sensory retinal detachment after PDT. CONCLUSION: PDT may occlude or inhibit CNV caused by AMD in short-term. No obvious side effects were noticed.

Cheng B, Liu Y, Liu X, Ge J, Ling Y, Zheng X. · Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. · Zhonghua Yan Ke Za Zhi. · Pubmed #12133369 No free full text.

Abstract: OBJECTIVE: To investigate the effects of phacoemulsification on the macula following uncomplicated phacoemulsification by optical coherence tomography (OCT). METHODS: Eighty eyes of the senile cataract were chosen randomly. The uncomplicated phacoemulsification was performed. OCT was examined preoperatively and 1 week after the surgery. Preoperative visual acuity, the retinal thickness and phaco power were compared with those after surgery. RESULTS: In 80 eyes, the preoperative mean foveal thickness was (142.9 +/- 16.7) micrometer and the postoperative (157.9 +/- 36.7) micrometer, the difference being not significant (P > 0.05). Three eyes had macular edema 1 week after surgery. In 11 eyes with Tyndall sign (+ +), the mean postoperative foveal thickness was thicker than the mean preoperative value (P < 0.05). In lower phaco power group, the mean postoperative foveal thickness was (156.2 +/- 18.3) micrometer and the higher phaco power group was (172.6 +/- 32.9) microm (P < 0.05). The best corrected visual acuity after surgery had a negative correlation with the retinal thickness. CONCLUSIONS: The retinal thickening and macular edema can be found after uncomplicated phacoemulsification. The higher phaco power results in significant inflammation and thicker retina. The visual consequences were proportional to the degrees of macular thickening.