Idiopathic polypoidal choroidal vasculopathy in Thai patients with clinical and angiographic choroidal neovascularization

Chavakij Bhoomibunchoo,1 Yosanan Yospaiboon,1 Somanus Thoongsuwan,2 Duangnate Rojanaporn,3 Nawat Watanachai,4 Pichai Jirarattanasopa,5 Nattapon Wongcumchang,6 Atchara Amphornphruet,7 Sritatath Vongkulsiri,8 Eakkachai Arayangkoon9 1Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 2Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 3Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 4Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 5Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla, 6Department of Ophthalmology, Faculty of Medicine, Thammasat University, Pathum Thani, 7Department of Ophthalmology, Rajavithi Hospital, Bangkok, 8Department of Ophthalmology, Phramongkutklao Hospital, Bangkok, 9Department of Ophthalmology, Mettapracharak Hospital, Nakhon Pathom, Thailand Objective: This study aimed to study the prevalence and characteristics of idiopathic polypoidal choroidal vasculopathy (IPCV) in Thai patients with clinical and angiographic choroidal neovascularization (CNV).Patients and methods: A consecutive case study of 140 patients presenting with CNV was conducted in nine large referral eye centers throughout Thailand. The demographic data, fundus photographs, fundus fluorescein angiography and indocyanine green angiography of the patients were analyzed.Results: Of 129 patients with clinical and angiographic CNV, IPCV was diagnosed in 100 patients (77.52%), idiopathic CNVs in 16 patients (12.40%) and age-related macular degeneration (AMD) in 12 patients (9.30%). Of the 107 eyes with IPCV, 90 eyes (84.11%) had both branching venous networks (BVNs) and polypoidal lesions. Most IPCV patients (93%) had unilateral involvement and were at a younger age than AMD patients. In all, 79 eyes (73.83%) had lesions found in the macular area, 14 eyes (13.08%) in the temporal to vascular arcades, ten eyes (9.35%) in the peripapillary area and four eyes (3.74%) in both macular and peripapillary areas. The clinical manifestations of IPCV at presentation were categorized into two patterns. There were 95 eyes (88.79%) of a hemorrhagic pattern and 12 eyes (11.21%) of an exudative pattern.Conclusion: IPCV is the most common macular disease in Thai patients with CNV. Most IPCVs have both BVNs and polypoidal lesions located in the macular area and present with a hemorrhagic pattern. Keywords: idiopathic polypoidal choroidal vasculopathy, prevalence, choroidal neovascularization, age-related macular degeneratio

NSC114085

The ability of all 11 variable opacity (Opa) proteins encoded by Neisseria gonorrhoeae MS11 to interact directly with the five CD66 antigens was determined. Transfected HeLa cell lines expressing individual CD66 antigens were infected with recombinant N. gonorrhoeae and Escherichia coli strains expressing defined Opas. Based upon the ability of these bacteria to bind and invade and to isolate specifically CD66 antigens from detergent-soluble extracts of the corresponding cell lines, distinct specificity groups of Opa interaction with CD66 were seen. Defining these specificity groups allowed us to assign a specific function for CD66a in the Opa-mediated interaction of gonococci with two different target cell types, which are both known to co-express multiple CD66 antigens. The competence of individual Opas to interact with CD66a was strictly correlated with their ability to induce an oxidative response by polymorphonuclear neutrophils. The same Opa specificity was observed for the level of gonococcal binding to primary endothelial cells after stimulation with TNFalpha, which was shown to increase the expression of CD66a rather than CD66e. As CD66e alone is expressed on other target tissues of gonococcal pathogenicity, Opa variation probably contributes to the cell tropism displayed by gonococci

Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology

NASCI-ESCR POSITION PAPER in the use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiolog