Macular Degeneration: Potter MJ

Potter MJ, Szabo SM. · Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Br J Ophthalmol. · Pubmed #17229805 No free full text.

Abstract: AIM: To determine the incidence of recurrence of choroidal neovascularisation (CNV) 18 months after cessation of photodynamic therapy (PDT) with verteporfin monotherapy in patients with age-related macular degeneration (AMD). METHODS: This was a prospective interventional cohort study. The sample consisted of 108 individuals with CNV secondary to AMD which was treated with PDT. Data on demographics, pre-PDT and post-PDT Early Treatment of Diabetic Retinopathy Study (ETDRS) acuity, pre-PDT lesion size and composition were collected for each participant. All participants returned for fundus photographs and ETDRS acuity measurements 18 months after their final PDT, which were compared with the same measurements from the final treatment session to determine recurrence status. Recurrences were classified primarily on the basis of haemorrhage and increased lesion size. RESULTS: Recurrences were observed in 36 of 108 (33%) eyes. 23 of 36 (64%) recurrences were clinically meaningful. Of the explanatory variables considered, only final PDT acuity was significantly different between those that recurred (45.5 ETDRS letters) and those that did not (38.4 letters; p = 0.03). CONCLUSION: CNV recurrences are common after PDT for AMD, occurring in 33% of eyes in this study. Visual acuity measured at the final PDT treatment visit may be a predictor of subsequent recurrence.

Bressler NM, Bressler SB, Haynes LA, Hao Y, Kaiser PK, Miller JW, Naor J, Potter MJ, Pournaras CJ, Reaves A, Rosenfeld PJ, Schmidt-Erfurth U, Slakter JS, Strong A, Vannier S. · No affiliation provided · Arch Ophthalmol. · Pubmed #16157822 No free full text.

This publication has no abstract.

Azab M, Boyer DS, Bressler NM, Bressler SB, Cihelkova I, Hao Y, Immonen I, Lim JI, Menchini U, Naor J, Potter MJ, Reaves A, Rosenfeld PJ, Slakter JS, Soucek P, Strong HA, Wenkstern A, Su XY, Yang YC, Anonymous00313. · No affiliation provided · Arch Ophthalmol. · Pubmed #15824216 No free full text.

Abstract: OBJECTIVE: To compare the treatment effect and safety of photodynamic therapy with verteporfin using a standard (SF) or reduced (RF) light fluence rate with that of placebo therapy in patients with subfoveal minimally classic choroidal neovascularization (CNV) with age-related macular degeneration. DESIGN: Phase 2, multicenter, double-masked, placebo-controlled, randomized clinical trial. SETTING: Nineteen ophthalmology practices in North America and Europe. PARTICIPANTS: Patients with initial best-corrected visual acuity of at least 20/250 and a lesion size of no greater than 6 Macular Photocoagulation Study (MPS) disc areas. METHODS: We randomly assigned 117 patients (1:1:1) to verteporfin infusion (6 mg/m(2)) and light application with an RF rate (300 mW/cm(2)) for 83 seconds (light dose of 25 J/cm(2)) or an SF rate (600 mW/cm(2)) for 83 seconds (light dose of 50 J/cm(2)) or to placebo infusion with RF or SF. Treatment was repeated every 3 months if the treating physician noted fluorescein leakage from CNV on angiography. Patients in whom a predominantly classic lesion developed could receive open-label standard verteporfin treatment. Best-corrected visual acuity was measured every 3 months, and angiographic changes were assessed by the Photograph Reading Center through the 3-month examination unless an ocular adverse event or conversion to a predominantly classic lesion was identified by an investigator. Safety was assessed throughout the study. All outcomes were on an intent-to-treat basis. RESULTS: One hundred three (88%) of 117 patients completed the 24-month examination. Twelve (30%) of 40 patients assigned to placebo received open-label standard verteporfin treatment after confirmation of presence of predominantly classic CNV. At month 12, a loss of at least 3 lines of visual acuity occurred in 5 (14%) of 36 eyes assigned to RF and 10 (28%) of 36 eyes assigned to SF, compared with 18 (47%) of 38 eyes assigned to placebo (RF, P = .002; SF, P = .08; RF + SF, P = .004). At month 24, this loss occurred in 9 (26%) of 34 eyes assigned to RF and 17 (53%) of 32 assigned to SF, compared with 23 (62%) of 37 eyes assigned to placebo (RF, P = .003; SF, P = .45; RF + SF, P = .03). Progression to predominantly classic CNV by 24 months was more common in the placebo group (11 [28%] of 39 patients compared with 2 [5%] of 38 in the RF group [P = .007] and 1 [3%] of 37 in the SF group [P = .002]). No unexpected ocular or systemic adverse events were identified. Treatment-related, usually transient visual disturbances were 13% with SF, 10% with placebo, and 5% with RF. CONCLUSIONS: Verteporfin therapy safely reduced the risks of losing at least 15 letters (> or =3 lines) of visual acuity and progression to predominantly classic CNV for at least 2 years in individuals with subfoveal minimally classic lesions due to age-related macular degeneration measuring 6 MPS disc areas or less. Based on the overall evidence available on verteporfin therapy for these lesions, the VIM Study Group would consider recommending verteporfin therapy for relatively small minimally classic lesions similar to those enrolled in the VIM Trial.

Blumenkranz MS, Bressler NM, Bressler SB, Donati G, Fish GE, Haynes LA, Lewis H, Miller JW, Monés JM, Potter MJ, Pournaras C, Reaves A, Rosenfeld PJ, Schachat AP, Schmidt-Erfurth U, Sickenburg M, Singerman LJ, Slakter JS, Strong A, Vannier S, Anonymous00194. · No affiliation provided · Arch Ophthalmol. · Pubmed #12365909 No free full text.

Abstract: OBJECTIVE: To report vision and safety outcomes from an extension of a 2-year investigation evaluating verteporfin photodynamic therapy in patients with age-related macular degeneration with subfoveal choroidal neovascularization (CNV). DESIGN AND SETTING: Open-label extension of selected patients from 2 multicenter, double-masked, placebo-controlled, randomized clinical trials, the Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Investigation, at 22 ophthalmology practices in Europe and North America. PARTICIPANTS: Patients enrolled in the TAP Investigation and followed up for at least 24 months in whom verteporfin therapy to CNV might reduce the risk of further vision loss. METHODS: Before receiving verteporfin therapy in the extension, eligible patients signed a written informed consent form accompanied by an oral consent process approved by local institutional review boards. Methods were similar to those described for 1- and 2-year results, with follow-up examinations beyond 2 years continuing at 3-month intervals with a few exceptions, including that extension patients with fluorescein leakage from CNV were to receive open-label verteporfin therapy irrespective of their original treatment assignment. RESULTS: Of 402 patients in the verteporfin group, 351 (87.3%) completed the month 24 examination; 320 (91.2%) of these enrolled in the extension study. The enrolled participants included 124 (78.0%) of the 159 verteporfin-treated patients with lesions composed of predominantly classic CNV at baseline, of whom 105 (84.7%) completed the month 36 examination. Verteporfin-treated patients with this lesion composition at baseline who participated in the extension study, with or without a month 36 examination, appeared more likely to have a younger age, better level of visual acuity, absence of fluorescein leakage from classic CNV, or no progression of classic CNV beyond the baseline boundaries of the lesion at the month 24 examination compared with those who did not enroll in the extension. For the 105 patients with a predominantly classic baseline lesion composition who completed the month 36 examination, an average of 1.3 treatments were given from the month 24 examination up to, but not including, the month 36 examination. A letter score loss in the study eye of at least 15 from baseline for these patients occurred in 39 (37.5%) at the month 24 examination compared with 44 (41.9%) of these patients at the month 36 examination. Visual acuity changed little from the month 24 examination (mean, -1.9 lines) to the month 36 examination (mean, -2.0 lines) for these eyes. Verteporfin-treated patients had little change in the mean visual acuity lost and few or no additional instances of infusion-related back pain or photosensitivity reactions from month 24 to month 36. Two patients originally assigned to placebo had acute severe vision decrease within 7 days after verteporfin treatment during the extension. One patient originally assigned to verteporfin had acute severe vision decrease after verteporfin treatment of the fellow eye during the extension. CONCLUSIONS: Vision outcomes for verteporfin-treated patients with predominantly classic lesions at baseline remained relatively stable from month 24 to month 36, although only approximately one third of the verteporfin-treated patients originally enrolled with this lesion composition had a month 36 examination. From these results, the TAP Study Group identified no safety concerns to preclude repeating photodynamic therapy with verteporfin. Additional treatment was judged likely to reduce the risk of further vision loss. Caution appears warranted in the absence of comparison with an untreated group during the extension and since not all patients in the TAP Investigation participated in the TAP Extension.

Szabo SM, Janssen PA, Khan K, Potter MJ, Lord SR. · Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada. · J Am Geriatr Soc. · Pubmed #18363677 No free full text.

Abstract: OBJECTIVES: To determine whether older women with exudative age-related macular degeneration (AMD) are at greater risk of falls. DESIGN: Cross-sectional study. SETTING: A hospital-based ophthalmology clinic in Vancouver, Canada. PARTICIPANTS: One hundred fifteen older (aged > or = 70) community-dwelling women with exudative AMD (AMD cohort) and two control groups: 54 community-dwelling women without exudative AMD drawn from the same community (non-AMD cohort) and 341 community-dwelling Australian women (Australian normative cohort). MEASUREMENTS: Participants were assessed for falls risk using the short-form Physiological Profile Assessment (PPA), which provides a fall risk index score and subcomponent measures of vision, proprioception, strength, reaction time, and postural sway. RESULTS: The mean fall risk index score in the AMD cohort (3.20) was significantly greater than that of the non-AMD cohort (1.21; P<.001), and fall risk scores increased with age to a greater extent in the AMD cohort. The higher fall risk scores in the AMD cohort resulted from significantly worse performance on each PPA test, not just the test of vision. The AMD cohort also performed worse than the Australian normative cohort in tests of vision, reaction time, and postural sway. CONCLUSION: Older women with AMD have impaired balance, slow visual reaction times, and poor vision, which in combination result in a significantly greater risk of falls than population norms. These deficits are clearly indicated in the physiological falls profile for the group. Strategies to enhance balance may be particularly beneficial to prevent falls in this group.

Potter MJ, Szabo SM, Li WW. · Department of Ophthalmology and Visual Sciences, University of British Columbia, Columbia, Canada. mpotter@ interchange.ubc.ca · Eye. · Pubmed #16946758 No free full text.

Abstract: PURPOSE: To determine if patients with occult with no classic and predominantly classic (PC) choroidal neovascular membranes have clinically equivalent visual outcomes after treatment with photodynamic therapy (PDT) with verteporfin. METHODS: This is a retrospective, observational cohort study. Two hundred and seventy-seven consecutive patients with occult or PC choroidal neovascularization secondary to age-related macular degeneration treated with PDT were included. The main outcome was the difference in mean change in Early Treatment of Diabetic Retinopathy Study (ETDRS) acuity lost from baseline in occult vs PC lesions, with the minimal clinically important difference (MCID) set at 7.5 letters. RESULTS: At baseline, 131 patients had occult and 146 had PC choroidal neovascularization. Twelve-month follow-up data were available for 94 occult and 110 PC participants. Occult patients lost an average of 8.7 letters (1.9 lines), and patients in the PC group an average of 10.0 ETDRS letters (two lines) over 12 months. The mean letters lost at 12 months was not significantly different between the groups, and the MCID was not detected (difference=1.3 letters; P=0.411; 95% confidence interval (-2.3, 5.6)). Patients with occult lesions required a mean of 2.99 treatments vs a mean of 2.96 treatments in the PC group (out of a possible 4; P=0.172). CONCLUSION: We were not able to detect a clinically important difference in mean change in visual acuity with PDT treatment between patients with occult and PC lesions.

Potter MJ, Szabo SM. · Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Graefes Arch Clin Exp Ophthalmol. · Pubmed #16341540 No free full text.

Abstract: BACKGROUND: Photodynamic therapy with verteporfin (PDT) has been demonstrated in randomized controlled trials to be a safe and effective therapy for choroidal neovascular membranes (CNV) secondary to age-related macular degeneration (AMD). Limited information is available on the prognosis with PDT for patients who fell outside the inclusion criteria for the clinical trials, however. The purpose of this study is to describe the clinical course of patients with CNV lesions in AMD treated with PDT, with baseline visual acuities sufficiently poor to warrant exclusion from previous randomized trials. METHODS: Retrospective case series. Ten consecutive patients with CNV secondary to exudative AMD treated with PDT with baseline visual acuity less than 34 ETDRS letters were followed for 1 year. The main outcome was median change in visual acuity on the ETDRS chart. RESULTS: The median change in acuity over 12 months was + 13 letters. All patients lost <3 lines of ETDRS acuity, and eight of ten patients (80%) gained at least one line of vision, over 12 months. CONCLUSIONS: In our series, patients with low visual acuity at baseline appeared to respond to PDT on both visual acuity and fluorescein angiographic measurements. PDT treatment may be considered for selected patients with these baseline characteristics.

Potter MJ, Szabo SM, Ho T. · Department of Ophthalmology and Visual Sciences, UBC VH Eye Care Centre, Vancouver, British Columbia, Canada. · Graefes Arch Clin Exp Ophthalmol. · Pubmed #16175378 No free full text.

Abstract: BACKGROUND: Combination photodynamic therapy with verteporfin (PDT) and intravitreal triamcinolone acetonide (IVT) is currently being investigated as a treatment for choroidal neovascularization (CNV) due to age-related macular degeneration. However, PDT with triamcinolone has never previously been described in the treatment of CNV secondary to pathologic myopia, or in a young person. We describe the case of a young girl treated with combination PDT and IVT for a myopic subfoveal CNV membrane. METHODS: This study was an interventional case report. The medical chart of a 13-year-old child treated with combination PDT with IVT was reviewed for changes in visual acuity on the ETDRS chart, CNV leakage on fluorescein angiography, and adverse events reported. RESULTS: ETDRS visual acuity improved from 20/80-2 to 20/25 in the right eye over 7 months following two treatments of a myopic CNV lesion with combination PDT and IVT. Following treatment, an inactive scar with no further leakage was visible on fluorescein angiography. An increase in intraocular pressure was associated with the second IVT treatment, and successfully treated with topical therapy. CONCLUSIONS: Combination PDT with IVT may be considered under appropriate circumstances to treat children with CNV.

Azab M, Benchaboune M, Blinder KJ, Bressler NM, Bressler SB, Gragoudas ES, Fish GE, Hao Y, Haynes L, Lim JI, Menchini U, Miller JW, Mones J, Potter MJ, Reaves A, Rosenfeld PJ, Strong A, Su XY, Slakter JS, Schmidt-Erfurth U, Sorenson JA, Anonymous00093, Anonymous00094. · No affiliation provided · Retina. · Pubmed #15076937 No free full text.

Abstract: PURPOSE: We sought to evaluate the detailed safety profile of photodynamic therapy with verteporfin in patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (ARMD) from the combined analysis of three multicenter, double-masked, placebo-controlled, randomized 24-month clinical trials of similar design (TAP Investigation Studies A and B and the VIP ARMD Trial), and to clarify the adverse reaction information in the current verteporfin product prescription information approved in the United States. METHODS: Nine hundred forty-eight patients were randomly assigned to verteporfin or placebo. Treatment was administered as described in previous reports. All general entry criteria were similar, so systemic safety results were combined for this analysis. Entry criteria for CNV lesion composition and visual acuity in the two TAP Investigation trials was different from those used in the VIP ARMD trial, so ocular safety results for the treated eye were not combined. RESULTS: The percentage of patients who experienced at least one ocular or nonocular adverse event, regardless of relationship to therapy, was similar between the verteporfin and placebo groups (92.3 and 89.1%, respectively, P = 0.114). The overall incidence of study eye adverse events was not significantly different between verteporfin and placebo. The only clinically relevant ocular adverse events reported with higher incidence after verteporfin compared with placebo were visual disturbances (22.1 versus 15.5% in TAP [P = 0.054] and 41.7 and 22.8% in VIP [P < 0.001]). Acute severe visual acuity decrease (defined as a visual acuity letter score decrease of at least 20, equivalent to at least four-line decrease, within 7 days of therapy) occurred in 3 patients treated with verteporfin in the TAP Investigation (0.7%) and 11 in the VIP ARMD trial (4.9%). Systemic adverse events with increased incidence after verteporfin compared with placebo, most of which were transient and mild or moderate, were injection site reactions (13.1 versus 5.6%; P < 0.001), photosensitivity reactions (2.4 versus 0.3%; P = 0.016), and infusion-related back pain (2.4 versus 0%; P = 0.004). No clinically relevant difference was observed between the verteporfin and placebo groups in any other adverse event. CONCLUSION: In 948 ARMD patients, verteporfin therapy had an overall safety profile similar to that for placebo, with a few exceptions. Visual disturbances, including acute severe visual acuity decrease, did not affect the net vision outcome benefits associated with treatment that has been reported previously. This detailed safety profile of verteporfin therapy clarifies the adverse reaction information in the current verteporfin product prescription information.

Arnold JJ, Blinder KJ, Bressler NM, Bressler SB, Burdan A, Haynes L, Lim JI, Miller JW, Potter MJ, Reaves A, Rosenfeld PJ, Sickenberg M, Slakter JS, Soubrane G, Strong HA, Stur M, Anonymous00242, Anonymous00243. · No affiliation provided · Am J Ophthalmol. · Pubmed #15059708 No free full text.

Abstract: PURPOSE: To describe in detail occurrences of acute severe visual acuity decrease after photodynamic therapy (PDT) with verteporfin in the Treatment of Age-related macular degeneration with Photodynamic therapy (TAP) Investigation and the Verteporfin In Photodynamic therapy (VIP) Trial. DESIGN: Observational case series. METHODS: Retrospective review of all cases that developed acute severe visual acuity decrease after treatment. RESULTS: Of 15 acute severe visual acuity decrease events originally identified in 14 eyes of 14 patients, one event in one patient was judged unlikely to have been an acute severe visual acuity decrease event on retrospective review of these events in preparation of this report. Eleven events occurred after the first treatment. At follow-up, 10 improved by at least 1 line in visual acuity from the level noted at the time of the event. Of the nine patients returning for the month 24 examination, visual acuity decreased at least 3 lines from baseline in six, including at least 6 lines in four, and remained within 1 line in three. Associated abnormal morphology included three with a serous macular detachment and abnormal choroidal hypofluorescence, four with macular hemorrhage, three with a greenish subfoveal hemorrhage, and four with no abnormality. Events appeared to be more likely when patients had a visual acuity of 20/50 or better. CONCLUSIONS: Acute severe visual acuity decrease after PDT with verteporfin was an uncommon event; the risk did not outweigh the benefits of therapy previously reported. When considering verteporfin therapy, patients should be warned of the possibility of this serious adverse event.

Blinder KJ, Bradley S, Bressler NM, Bressler SB, Donati G, Hao Y, Ma C, Menchini U, Miller J, Potter MJ, Pournaras C, Reaves A, Rosenfeld PJ, Strong HA, Stur M, Su XY, Virgili G, Anonymous00153, Anonymous00154. · · Am J Ophthalmol. · Pubmed #12967792 No free full text.

Abstract: PURPOSE: To determine whether differences in baseline lesion size and visual acuity might explain differing results found in three different lesion compositions (predominantly classic, minimally classic, and occult with no classic) among three placebo-controlled, randomized clinical trials evaluating photodynamic therapy with verteporfin (Visudyne, Novartis AG), also termed verteporfin therapy, in patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). METHODS: Exploratory analyses were conducted in patients with predominantly classic or minimally classic lesions at enrollment in the Treatment of AMD with Photodynamic Therapy (TAP) Investigation and in AMD patients with occult with no classic CNV in the Verteporfin In Photodynamic Therapy (VIP) Trial. Baseline characteristics of patients among these three lesion compositions were compared. In addition, multiple linear regression modeling was used to explore the effect of baseline lesion size, visual acuity, and lesion composition on mean change in visual acuity from baseline to 24 months. RESULTS: At baseline, the mean size of predominantly classic lesions (3.4 disk areas) was smaller than that of minimally classic (4.7 disk areas) and occult with no classic lesions (4.3 disk areas). In the multiple linear regression model of individual lesion compositions, there was a significant treatment-by-lesion-size interaction for minimally classic and occult with no classic lesions, but not for predominantly classic lesions. Interaction between treatment and baseline visual acuity was not significant for any lesion composition. Small verteporfin-treated lesions lost less vision than large verteporfin-treated lesions in each lesion composition. In the multiple linear regression model that included all lesion compositions, lesion size was a more significant predictive factor for the magnitude of treatment benefit than either lesion composition or visual acuity. Smaller (4.0 disk areas or less) minimally classic and occult with no classic lesions had similar visual acuity outcomes to those observed in predominantly classic lesions. CONCLUSIONS: Based on exploratory analyses, lesion size in the TAP Investigation and VIP Trial was an important predictor of the magnitude of treatment benefit with verteporfin therapy in occult with no classic and minimally classic lesion compositions. In patients with AMD, treating smaller rather than larger neovascular lesions, regardless of lesion composition, likely will result in a better level of visual acuity.

Cui JZ, Hinz BJ, Greve MD, Potter MJ, Hornan D, Samad A, To E, Matsubara JA. · Department of Ophthalmology, University of British Columbia, Vancouver, BC. · Can J Ophthalmol. · Pubmed #12608516 No free full text.

Abstract: BACKGROUND: Neovascularization is a serious consequence of several eye diseases, including age-related macular degeneration. Neovascularization is under the control of proangiogenic factors, such as vascular endothelial growth factor and fibroblast growth factor. Recent work in our laboratory has focused on other, novel angiogenic factors, such as neuropilin-1, and their potential role in neovascularization. The purpose of this study was to investigate the role of neuropilin-1 in choroidal neovascularization (CNV). METHODS: We examined the localization of neuropilin-1 by immunohistochemistry in nine choroidal neovascular membranes (CNVMs) surgically excised from four patients with age-related macular degeneration who had not undergone laser photocoagulation, four with idiopathic CNV and one with ocular histoplasmosis. We also stained the membranes for markers of endothelial and retinal pigment epithelial cells. Controls included omission of primary antibody, use of an irrelevant primary antibody, and neuropilin-1 staining of the posterior sclera, choroid and retina of four healthy donor eyes. RESULTS: Neuropilin-1 was present in eight of the nine CNVMs. It was localized mainly to the plasma membrane. The more vascular membranes and those consisting of a larger number of retinal pigment epithelial cells were associated with greater neuropilin-1 staining. Neuropilin-1 was not seen in the posterior segment of the four healthy eyes. INTERPRETATION: Neuropilin-1 appears to play an active role in CNV. Further study is needed to establish a causal relation.

Sahota B, Potter MJ. · Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada. · J Ophthalmic Nurs Technol. · Pubmed #11933323 No free full text.

Abstract: The results from the TAP Study have been found to be significant, but remember this is not a cure. There are no quick and easy solutions to this devastating disease, which can creep up so suddenly and without warning. Ophthalmologists may be able to stabilize the vision without allowing it to become worse, but the key words are "without allowing it to become worse." Unfortunately, to most patients, it is already worse. Nurses must address the patients' feelings and concerns first, before offering a physical solution that is only a temporary "band aid." After 10 years of working in the area of ophthalmology, specifically low vision, it has come to the authors' attention that a large percentage of patients suffering from AMD display depressive symptoms such as feelings of sadness, worthlessness, and hopelessness, and low self-esteem. Many appear to go through a grieving process. Keeping this is mind, the overall goal in nursing care should be to help patients with AMD use available resources so they have the potential to maintain a satisfying quality of life, physically and emotionally.

Cui JZ, Hornan D, Potter MJ, Greve MD, Hinz BJ, Samad A, Matsubara JA. · Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada. · Am J Ophthalmol. · Pubmed #11704049 No free full text.

Abstract: PURPOSE: The purpose of this study was to investigate the role of leptin in choroidal neovascularization. METHODS: We examined the localization of leptin by immunohistochemistry in nine choroidal neovascular membranes surgically excised from patients with age-related macular degeneration, idiopathic choroidal neovascularization, and ocular histoplasmosis. Controls included omission of primary antibody, use of an irrelevant primary antibody and leptin staining of posterior segment of four normal donor eyes. RESULTS: Leptin was present in eight membranes and appeared vesicular, within the cytoplasm. The more vascular membranes and those consisting of a larger number of retinal pigment epithelium cells were associated with greater leptin staining. Leptin was not seen in the posterior segment of the four normal eyes. CONCLUSION: We suggest that leptin plays an active role in choroidal neovascularization, although further experiments are necessary to establish a causal relationship.

Potter MJ, Lee AS, Moshaver A. · Department of Ophthalmology, University of British Columbia, Vancouver, Canada. · Retina. · Pubmed #11039441 No free full text.

This publication has no abstract.

Potter MJ, Chang TS, Lee AS, Rai S. · Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada. · Am J Ophthalmol. · Pubmed #10764875 No free full text.

Abstract: PURPOSE: To assess focal electroretinographic findings before and after retinal translocation surgery in a patient with age-related macular degeneration. METHOD: Case report. A 79-year-old man with a well-defined subfoveal choroidal neovascular membrane from age-related macular degeneration underwent preoperative and postoperative focal electroretinography. RESULTS: After retinal translocation surgery, best-corrected Snellen visual acuity improved from 9/200 to 20/60. A significant increase in mean foveal amplitude, from 0.08 microV to 0.16 microV (P = 0.008) was recorded. CONCLUSION: Age-related macular degenerative changes in visual acuity and foveal electroretinogram amplitude may be reversible after retinal translocation surgery.