Idiopathic juxtafoveolar retinal telangiectasis in monozygotic twins

Monozygotic twins (aged 63 years old), with group-2A idiopathic juxtafoveolar retinal telangiectasia (JXT), underwent clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). Twin 1: Right fundus showed right-angled venules temporal to the fovea; FA demonstrated retino-retinal anastomosis and intraretinal leakage. Twin 2: Fundoscopy revealed right-angled venules in both eyes. OCT demonstrated foveal cysts in all eyes. This is the third set of monozygotic twins with group-2A JXT that has been reported in the literature, further supporting a genetic predisposition for JXT. The twin who smoked had more severe disease, suggesting that smoking is a risk factor for progression. OCT is useful in the detection and monitoring of these patients. Group-2A JXT is characterised by bilateral regions of retinal thickening temporal to the fovea with minimal exudation.1 Gass and Blodi described five stages of group-2A JXT.1 OCT clearly depicts the involvement of the intraretinal and subretinal spaces in this condition. Intraretinal cysts, lamellar hole, subretinal fibrosis and speckled intraretinal yellow-red hyper-reflectivity have been reported.2 <br/

Interleukin-8 promoter polymorphism -251A/T is a risk factor for age-related macular degeneration

Background/aims: To determine whether four expression-related cytokine polymorphisms are associated with age-related macular degeneration (AMD).Methods: DNA from 478 cases with AMD and 555 normal controls was genotyped for the pro-inflammatory IL1beta -511C/T, IL6 -174C/G, IL8 -251A/T and anti-inflammatory IL10 -1082G/A cytokine polymorphisms using the 5' nuclease TaqMan(R) assay for allelic discrimination. Associations with AMD were analysed using allelic frequencies.Results: The -251A allele of the IL8 promoter gene polymorphism was more prevalent in AMD patients than controls (p = 0.037, OR = 1.21, 95% CI = 1.01 to 1.44). Adjusting for age, sex, body mass index (BMI), current smoking and past smoking status did not alter the AMD association significantly (corrected p value = 0.043, OR = 1.23, 95% CI = 1.0 to 1.50).Conclusion: The pro-inflammatory homozygous IL8 -251AA genotype is an important risk factor for AMD. This may have implications for future therapy with biological agents that could target this cytokine

Intravitreal bevacizumab (Avastin) for the treatment of choroidal neovascularization in age-related macular degeneration: results from 118 cases

A retrospective review of 115 consecutive patients (118 eyes) based at Southampton Eye Unit, treated with intravitreal bevacizumab for CNV was performed. Lesions of all types irrespective of size or location that were either ineligible for photodynamic therapy (PDT) under the National Health Service (including minimally classic and occult CNV) or those not responding to PDT (classic or predominantly classic CNV with recurrent or persistent CNV activity) were included in the study (table 1). All patients underwent visual acuity testing (best corrected Snellen), slitlamp examination and fundus fluorescein angiography. Central macular thickness (CMT) was assessed using Stratus optical coherence tomography (Carl Zeiss Meditec, USA). After discussion about the off-label nature of treatment and the potential risks, informed consent was obtained from all patients. Intravitreal bevacizumab 1.25 mg was injected via the pars plana under sterile conditions; topical antibiotics were given for five days postoperatively. Patients were followed up at 2–4 weeks and then at 1-month intervals; Repeat injections were offered in the event of persistent lesion activity (indicated by persistent intraretinal/subretinal fluid or fibrovascular pigment epithelial detachment). All patients were monitored for any systemic and ocular adverse events. Blood pressure was measured before and 4–6 weeks after treatment. Snellen visual acuity was converted to a standard logarithm of the minimum angle of resolution scale and ETDRS letter score for statistical analysis.6 The Mann–Whitney test was used to compare the mean visual acuity and CMT, before and after treatment. <br/

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