RESUMO
PURPOSE: To present electroretinogram findings in extensive macular atrophy with pseudodrusen (EMAP) and describe associated systemic factors. DESIGN: Retrospective case series. METHODS: Data on medical history, visual symptoms, multimodal imaging findings, and visual field were collected from the medical records of patients with extensive macular atrophy with pseudodrusen who attended a visual electrophysiology laboratory. Electrophysiological tests, including full-field electroretinogram, multifocal electroretinogram and photopic negative response, were performed. RESULTS: Eighteen patients (10 [56%] females, age 49-66 years) were included. Of these, 17 (94%) had a history of rheumatic fever in childhood and/or adolescence, 7 (39%) had cardiovascular disease, 4 (22%) had autoimmune disease, and 10 (56%) had inflammatory conditions. The primary visual complaints were nyctalopia (95%), followed by visual field loss (67%) and dyschromatopsia (67%). The key retinal findings included retinal pigmented epithelium atrophy in the macular region and subretinal drusenoid deposits. Regarding electrophysiological results, 100% of patients had abnormalities on multifocal electroretinogram, 94% displayed alterations in photopic negative response, and 78% showed changes in the full-field electroretinogram. CONCLUSIONS: In this cohort, electrophysiologic evaluation demonstrated diffuse retinal dysfunction affecting all layers of the retina in patients with EMAP. The disease is associated with immune-mediated systemic conditions, chiefly rheumatic fever.
Assuntos
Degeneração Macular , Drusas Retinianas , Febre Reumática , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Estudos Retrospectivos , Drusas Retinianas/diagnóstico , Drusas Retinianas/complicações , Febre Reumática/complicações , Eletrorretinografia , Degeneração Macular/complicações , Degeneração Macular/diagnóstico , Atrofia/complicações , Tomografia de Coerência Óptica/métodosRESUMO
OBJECTIVES: To clarify the clinical and angiographic characteristics of idiopathic polypoidal choroidal vasculopathy (IPCV) and its natural course. METHODS: Descriptive, prospective, consecutive case series of patients with presumed IPCV seen at Fort-de-France Hospital Center (French West Indies) between January and June 2006. All participants underwent complete eye examination and fluorescein and indocyanine green (ICG) angiography. The nature and location of the lesions were assessed in all eyes. Inclusion criteria were demonstration of characteristic lesions of IPCV on ICG angiography. RESULTS: Diagnosis of IPCV was made in 26 eyes of 14 patients, ten women and four men, all of Afro-Caribbean origin. The mean age was 77.4 years (range 60-92 years). Drusen were present in 13 eyes (50%), age-related macular degeneration (AMD) in one eye, and branch retinal vein occlusion in one eye. Twelve patients (85.7%) had bilateral involvement. Twelve eyes (46.2%) had visual acuity (VA) (Snellen) worse than 20/200, six eyes (23.1%) had VA between 20/200 and 20/100, and eight eyes (30.8%) had VA better than 20/100. On ICG angiography, lesions were predominantly located in the peripapillary area but also in the midperiphery, the macular and interpapillomacular areas, and the far periphery. CONCLUSION: Peripheral locations of IPCV and associations with drusen or AMD are not rare. The prognosis of the disease is poor in its natural course. Its etiology is unknown but genetic factors are probably involved. It is the main differential diagnosis for exudative AMD in black patients.
Assuntos
Doenças da Coroide/diagnóstico por imagem , Corioide/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Doenças da Coroide/complicações , Doenças da Coroide/etnologia , Doenças da Coroide/patologia , Dilatação Patológica/diagnóstico por imagem , Progressão da Doença , Etnicidade , Feminino , Fluoresceína , Angiofluoresceinografia , Humanos , Verde de Indocianina , Degeneração Macular/complicações , Degeneração Macular/diagnóstico por imagem , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Drusas Retinianas/complicações , Drusas Retinianas/diagnóstico por imagem , Oclusão da Veia Retiniana/complicações , Oclusão da Veia Retiniana/diagnóstico por imagem , Acuidade VisualRESUMO
The vitelliform macular lesion is usually observed in Best's disease and the adult type of foveomacular dystrophy. We describe a rare case of macular vitelliform lesion in association with basal laminar drusen. The patient has been followed at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo for the last four years. The differential diagnosis, clinical evolution, pathogenesis and treatment of this rare condition are discussed.
Assuntos
Degeneração Macular/patologia , Descolamento Retiniano/patologia , Drusas Retinianas/patologia , Idoso , Atrofia , Angiofluoresceinografia , Humanos , Degeneração Macular/complicações , Masculino , Descolamento Retiniano/complicações , Drusas Retinianas/complicaçõesRESUMO
Lesão viteliforme da mácula é mais observada nas distrofias de Best e foveomacular do adulto. No presente estudo, os autores relatam caso raro de descolamento viteliforme macular associado a drusas da lâmina basal, acompanhado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo há aproximadamente quatro anos, avaliado periodicamente com exames complementares. Os autores descrevem aspectos relevantes desta doença como etiopatogenia, evolução, diagnósticos diferenciais e tratamento.
Assuntos
Idoso , Humanos , Masculino , Degeneração Macular/patologia , Descolamento Retiniano/patologia , Drusas Retinianas/patologia , Atrofia , Angiofluoresceinografia , Degeneração Macular/complicações , Descolamento Retiniano/complicações , Drusas Retinianas/complicaçõesRESUMO
Se estudiaron 13 ojos de 9 pacientes con diagnóstico de degeneración macular relacionada con la edad (DMRE) y 11 ojos de 8 sujetos control de edades similares: a los que se les realizó exploración oftalmológica completa, como campimetría central, periférica y electrorretinograma (ERG). Las áreas de campimetría fueron medidas en mm² y en el ERG la amplitud en mV y la latencia en ms. Se realizaron mediante el programa de análisis estadístico Kwikstat, "Coeficientes de Correlación de Pearson" entre las campimetrías central y periférica, y a su vez entre éstas y el ERG de los pacientes del grupo control y del estudio; encontrando a pesar de ser escaso el número de pacientes y por lo tanto la correlación pobre, una mejor correlación en el grupo de estudio entre la campimetría central y periférica; y en el control entre flicker y campimetría periférica.