脈絡膜新生血管、脈絡膜血管新生

WordNet

a highly vascular membrane in the eye between the retina and the sclera; a dark pigmentation minimizes the scattering of light inside the eye (同)choroid coat

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/21 22:56:48」(JST)

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Choroidal neovascularization (CNV) is the creation of new blood vessels in the choroid layer of the eye. This is a common sign of the degenerative maculopathy wet AMD (age-related macular degeneration).^[1]

Causes

CNV can occur rapidly in individuals with defects in Bruch's membrane, the innermost layer of the choroid. It is also associated with excessive amounts of Vascular endothelial growth factor (VEGF). As well as in wet AMD, CNV can also occur frequently with the rare genetic disease pseudoxanthoma elasticum and rarely with the more common optic disc drusen. CNV has also been associated with extreme myopia or malignant myopic degeneration, where in choroidal neovascularization occurs primarily in the presence of cracks within the retinal (specifically) macular tissue known as lacquer cracks.

Symptoms

CNV can create a sudden deterioration of central vision, noticeable within a few weeks. Other symptoms which can occur include metamorphopsia, and colour disturbances. Hemorrhaging of the new blood vessels can accelerate the onset of symptoms of CNV.

Signs

CNV can be detected by using a type of perimetry called preferential hyperacuity perimetry.^[2] On the basis of fluorescein angiography, CNV may be described as classic or occult.

Treatment

Standard of care in retinology today are intravitreal injections of anti-VEGF drugs to control neovascularization and reduce the area of fluid below the retinal pigment epithelium. These drugs are commonly known as Avastin and Lucentis, and although their effectiveness has been shown to significantly improve visual prognosis with CNV, the recurrence rate for these neovascular areas remains high. Individuals with CNV should be aware that they are at a much greater risk (25%) of developing CNV in fellow eye, this according to the American Academy of Ophthalmology and further supported by clinical reports.

In 'wet' (also known as 'neovascular') Age-Related Macular Degeneration, CNV is treated with photodynamic therapy coupled with a photosensitive drug such as verteporfin (Visudyne). The drug is given intravenously. It is then activated in the eye by a laser light. The drug destroys the new blood vessels, and prevents any new vessels forming by forming thrombi.^[3]
Anti-VEGF drugs, such as pegaptanib (Macugen) and ranibizumab (Lucentis), are also used to treat CNV. Anti-VEGFs bind to and inactivate Vascular endothelial growth factor.^[4]

References

^ Spalton DJ, Hitchings RA, Hunter PA (2005). Atlas of Clinical Ophthalmology (3rd Edition ed.).
^ "Elsevier". Ophsource.org. Retrieved 2012-12-14.
^ Donati, Guy (2007). "Emerging Therapies for Neovascular Age-Related Macular Degeneration: State of the Art". Ophthalmologica 221 (6): 366–377. doi:10.1159/000107495. PMID 17947822. |accessdate= requires |url= (help)
^ Takeda, AL; Colquitt, J; Clegg, AJ; Jones, J (Sep 2007). "Pegaptanib and ranibizumab for neovascular age-related macular degeneration: a systematic review.". The British journal of ophthalmology 91 (9): 1177–82. doi:10.1136/bjo.2007.118562. PMC 1954893. PMID 17475698. Retrieved 15 December 2012.

UpToDate Contents

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1. 加齢黄斑変性：臨床像、病因、および診断 age related macular degeneration clinical presentation etiology and diagnosis
2. 網膜静脈閉塞：治療 retinal vein occlusion treatment
3. 加齢黄斑変性：治療および予防 age related macular degeneration treatment and prevention
4. イールズ病 eales disease
5. 特発性頭蓋内圧亢進症（偽脳腫瘍）：臨床的特徴および診断 idiopathic intracranial hypertension pseudotumor cerebri clinical features and diagnosis

English Journal

Anti Vascular Endothelial Growth Factor therapies in Ophthalmology: Current Use, Controversies and the Future.

Kwong TQ1, Mohamed M.Author information 1Department of Ophthalmology, Eastbourne District General Hospital, Eastbourne, East Sussex, BN21 2UD.AbstractUse of anti-Vascular endothelial growth factor (VEGF) therapies was restricted to systemic administration for certain cancers until 2005 when localised intra-ocular administration was introduced for the treatment of ocular disorders. In the UK, the current licenced and NICE approved indications are for the treatment of neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DMO), macular oedema secondary to a retinal vein occlusion (RVO) and choroidal neovascularisation in Pathological Myopia. These diagnoses alone account for two thirds of the main causes of legally registrable visual impairment and blindness. Some idea of the magnitude of impact of these landmark therapies can be gauged from reports of blindness registration, which have halved between 2000 and 2010 in Denmark, the bulk of which are attributable to these agents.
British journal of clinical pharmacology.Br J Clin Pharmacol.2014 Mar 6. doi: 10.1111/bcp.12371. [Epub ahead of print]
Use of anti-Vascular endothelial growth factor (VEGF) therapies was restricted to systemic administration for certain cancers until 2005 when localised intra-ocular administration was introduced for the treatment of ocular disorders. In the UK, the current licenced and NICE approved indications are
PMID 24602183

Choroidal Thickness in Idiopathic Subfoveal Choroidal Neovascularization.

Cao XS1, Peng XY, You QS, Zhang YP, Jonas JB.Author information 1Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.AbstractPurpose: To evaluate choroidal thickness in patients with idiopathic choroidal neovascularization. Methods: The observational case series study included patients who were consecutively diagnosed with idiopathic unilateral choroidal neovascularization as demonstrated by ophthalmoscopy, fluorescein angiography and enhanced depth imaging optical coherence tomography (EDI-OCT). Using EDI-OCT, choroidal thickness was measured at the fovea and at locations in a distance of 500, 1,000 and 1,500 μm temporal and nasal to the fovea. Results: Mean subfoveal choroidal thickness was significantly (p = 0.002) thicker in the study group than in the control group (357 ± 99 vs. 316 ± 83 μm). In a parallel manner, the differences between the study group and the control group in choroidal thickness were significant for all other measurement points, except for the examination at 1,500 μm nasal to the fovea (p = 0.09). The results remained unchanged after adjusting for axial length and age. Conclusions: Idiopathic unilateral choroidal neovascularization is associated with a thickening of the choroid. © 2014 S. Karger AG, Basel.
Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.Ophthalmologica.2014 Mar 5. [Epub ahead of print]
Purpose: To evaluate choroidal thickness in patients with idiopathic choroidal neovascularization. Methods: The observational case series study included patients who were consecutively diagnosed with idiopathic unilateral choroidal neovascularization as demonstrated by ophthalmoscopy, fluorescein an
PMID 24603209

RTP801 Gene Expression Is Differentially Upregulated in Retinopathy and Is Silenced by PF-04523655, a 19-Mer siRNA Directed Against RTP801.

Rittenhouse KD1, Johnson TR, Vicini P, Hirakawa B, Kalabat D, Yang AH, Huang W, Basile AS.Author information 1Ophthalmology External Research Unit, External R&D Innovations, Pfizer, Inc., San Diego, California.AbstractPURPOSE: The intraocular pharmacodynamics of PF-04523655, a small-interfering RNA (siRNA) directed against RTP801, was characterized using rat models of retinopathy.
Investigative ophthalmology & visual science.Invest Ophthalmol Vis Sci.2014 Mar 4;55(3):1232-40. doi: 10.1167/iovs.13-13449.
PURPOSE: The intraocular pharmacodynamics of PF-04523655, a small-interfering RNA (siRNA) directed against RTP801, was characterized using rat models of retinopathy.METHODS: Rat models of streptozotocin-induced diabetes and wet AMD were used to determine the onset, extent, and duration of siRNA inhi
PMID 24458146

Japanese Journal

CLINICAL INVESTIGATION : Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab

Cohen Salomon Y.,Nghiem-Buffet Sylvia,Grenet Typhaine [他]
Japanese journal of ophthalmology : the official international journal of the Japanese Ophthalmological Society 59(1), 36-42, 2015-01
NAID 40020328380

カリジノゲナーゼの血管新生抑制作用

中村信介,鶴間一寛,嶋澤雅光,原英彰,ナカムラシンスケ,ツルマカズヒロ,シマザワマサミツ,ハラヒデアキ,Shinsuke NAKAMURA,Kazuhiro TSURUMA,Masamitsu SHIMAZAWA,Hideaki HARA
岐阜薬科大学紀要　 = The annual proceedings of Gifu Pharmaceutical University 63, 22-32, 2014-06-30
… Irreversible vision loss and blindness due to abnormal retinal neovascularization has been increasing. … Recently, it has been reported thatkallidinogenase improved choroidal and retinal circulation, and prevented the retinal vascular hyperpermeability by the peripheralroute. …
NAID 120005564611