Macular Degeneration: Ladewig M

Jaissle GB, Ziemssen F, Petermeier K, Szurman P, Ladewig M, Gelisken F, Völker M, Holz FG, Bartz-Schmidt KU. · Abt. I, Universitätsaugenklinik Tübingen, Schleichstrasse 12, 72076 Tübingen. · Ophthalmologe. · Pubmed #16763863 No free full text.

Abstract: Application of VEGF inhibitors represents a treatment option for macular edema secondary to retinal vein occlusion that targets the disease at the causal molecular level. First reports on intravitreal injections of bevacizumab show promising morphological and functional effects and demonstrate that bevacizumab is a potent antiedematous agent in this context. A significant reduction of the central retinal thickness followed by a rapid improvement of visual acuity may be achieved within days. In a pilot study with a review period of 3 months, we found a significant improvement of one or more lines in 93% and four or more lines in 27% of eyes. This was associated with a concomitant significant reduction in central retinal thickness, which, however, was not sustained by a single injection (64% reduction after 1 month and 28% after 3 months). No relevant adverse events were noted. The duration of action after intravitreal bevacizumab administration is currently unknown. Reinjections will be necessary to maintain a lasting beneficial effect. Prospective, controlled long-term studies are mandatory to develop standardized treatment protocols that allow a safe and effective application of this off-label therapy.

Ladewig M, Kraus H, Foerster MH, Kellner U. · Department of Ophthalmology, Universitäts-Klinikum Benjamin Franklin, Freie Universität Berlin, Berlin, Germany. · Arch Ophthalmol. · Pubmed #14609911 No free full text.

Abstract: OBJECTIVES: To determine the clinical and functional findings in patients with late-onset cone dystrophy (LOCD) (after the age of 50 years), which is rare; and to compare them with those of patients with age-related macular degeneration (AMD). METHODS: Eleven LOCD patients underwent ophthalmologic and electroretinographic examinations. Full-field electroretinograms were recorded according to the International Society for Clinical Electrophysiology of Vision standard. The results were compared with those of a group of 20 AMD patients and a group of 23 age-related control subjects. RESULTS: There was no difference between LOCD and AMD patients regarding the severity of visual acuity loss, color vision deficiencies, and central visual field defects. Alterations of the posterior pole were present in all LOCD and AMD patients. In contrast to the AMD group, all LOCD patients did not show drusen and 6 of the 11 LOCD patients displayed temporal optic disc pallor. The electroretinogram revealed the major functional difference, with severe reduction of cone-mediated responses and moderate reduction of rod-mediated responses in LOCD patients. Unexpectedly, the 30-Hz flicker amplitude was reduced in AMD patients compared with healthy controls. CONCLUSIONS: Late-onset cone dystrophy and AMD have several features in common. In elderly patients with progressive visual loss and without drusen, LOCD should be considered. The electroretinographic results in a small group of AMD patients indicate a generalized cone dysfunction.