Macular Degeneration: Mackiewicz J

Dolar-Szczasny J, Mackiewicz J, Bindewald A, Holz FG, Zagórski Z. · Z Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #16417019 No free full text.

Abstract: PURPOSE: To present application of a confocal Scanning Laser Ophthalmoscope (cSLO) for fundus autofluorescence examination, as a new method of visualization of retinal pigment epithelium and its possible significance in the diagnosis of different retinal diseases. MATERIAL AND METHODS: Typical autofluorescence images in age-related macular degeneration (AMD), Stargardt disease, Best disease and pattern dystrophies are presented, based on the own experience and literature data. Autofluorescence images were obtained with a cSLO using an argon laser for generation of excitation light at 488 nm and a barrier filter >500 nm for the detection of the emitted signals. RESULTS: A variety of autofluorescence patterns, associated with the accumulation of lipofuscin in RPE cells, was found in the above entities. CONCLUSIONS: Presented method of fundus autofluorescence examination gives new possibilities in studying the pathogenetic mechanisms in various retinal diseases and may be useful in monitoring the follow-up and the effects of the treatment.

Dolar-Szczasny J, Mackiewicz J, Biziorek B, Zagórski Z. · Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #17725280 No free full text.

Abstract: PURPOSE: To identify patterns of fundus autofluorescence (AF) in patients with Stargardt dystrophy and fundus flavimaculatus. MATERIAL AND METHODS: 20 patients in age 7 to 47 years with Stargardt dystrophy and fundus flavimaculatus, were examined. Ophthalmic evaluation included nonstandarized Snellen visual acuity, complete ophthalmic examination, fluorescein angiography and color fundus photographs. The autofluorescence images were obtained using a confocal scanning laser ophthalmoscope HRA2. RESULTS: In 15 patients lack or decreased AF signal in a foveal region with punctate diffuse spots with increased and decreased AF signal extending far from the macular region were observed. In 4 patients apart from lack of the AF signal in the central area punctate spots were restricted to the macular region. In 1 patient AF image was copletely normal. CONCLUSIONS: Autofluorescence imaging allows for evaluation of the area with changes on the RPE level typical for this disease and is helpful, noninvasive examination for diagnostic process in such patients. A wide variation in clinical phenotype can occur in patients with Stargardt disease and fundus flavimaculatus. Obtained different phenotypes in autofluorescence imaging may correlate with different clinical types of this disease, described in the literature.

Mackiewicz J, Mańkowska A, Dolar-Szczasny J, Zubilewicz A, Oleszczuk A, Nowomiejska K, Rejdak R, Zagórski Z. · Katedry i I Kliniki Okulistyki Akademii Medycznej w Lublinie. · Klin Oczna. · Pubmed #17725273 No free full text.

Abstract: PURPOSE: To evaluate effects of intravitreal bevacizumab on visual acuity and angiographic lesions characteristics in patients with neovascular AMD and to report safety of such treatement. MATERIAL AND METHODS: 32 patients with confirmed choroidal neovascularisation (CNV) and AMD were treated. Patients received 2 intravitreal bevacizumabu (1.25 mg) iniections on 1-3 months basis. Control ophthalmic evaluations included visual acuity measurements with EDTRS charts, intraocular pressure measurements, complete ophthalmic examination in slit lamp, fluorescein angiography and blond pressure measurements. RESULTS: In 18 patients (56%) visual acuity improvement at a mean 3 lines on EDTRS charts was observed, in 9 patients (28%) visual acuity did not change and in 5 (16%) cases decreased visual acuity (about 1,5 lines in EDTRS charts) was noted. Mean follow-up period was 3 months after second injection. In most study eyes fluorescein angiography revealed a marked reduction in leakage from CNV. Apart from one case with endophthalmitis symptoms after second bevacizumab injection, we did not observed systemic or ocular adverse effects of the applied treatment. CONCLUSIONS: Short-term results suggest that intravitreal bevacizumab is relatively safe form of AMD treatement and is associated with improvement in visual acuity and reduction in angiographic leakage in most patients with neovascular AMD. Further evaluation of the long-term effectiveness of this treatment is warranted.

Maaijwee KJ, van Meurs JC, Kirchhof B, Mooij CM, Fischer JH, Mackiewicz J, Kobuch K, Joussen AM. · Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne, Germany. · Br J Ophthalmol. · Pubmed #16987900 No free full text.

Abstract: BACKGROUND: Translocation of a free autologous graft consisting of retinal pigment epithelium (RPE), Bruch's membrane, choriocapillaris and choroid in patients with exudative age-related macular degeneration is currently being evaluated in clinical practice. Angiographic studies in these patients suggest that their grafts become revascularised. AIM: To investigate the histological evidence of revascularisation of the graft in a porcine model. METHODS: In 11 pigs (11 eyes), an RPE-choroid graft was translocated from the mid-periphery to an intact or an intentionally damaged RPE and Bruch's membrane at the recipient site. The eyes were enucleated 1 week or 3 months after surgery. Tissue sections were evaluated using immunohistochemistry. RESULTS: Bridging vessels between recipient layer and graft were identified from 1 week to 3 months after surgery. This reconnection occurred regardless of whether the Bruch's membrane of the recipient site was left intact or intentionally damaged at the time of transplantation. The vasculature of the graft appeared open and perfused. Vessels with transcapillary pillars and conglomerates of small new vessels were present in the graft. CONCLUSIONS: This study showed histological evidence for revascularisation by angiogenesis of a free autologous RPE-choroid graft.