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Macular edema anti-VEGF

Pedro Romero-Aroca, Marc Baget-Bernaldiz, Alicia Pareja-Rios, Maribel Lopez-Galvez, Raul Navarro-Gil, Raquel Verges
Diabetic macular edema (DME) can cause blindness in diabetic patients suffering from diabetic retinopathy (DR). DM parameters controls (glycemia, arterial tension, and lipids) are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF) is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease...
2016: Journal of Diabetes Research
Yuji Itoh, Daniel Petkovsek, Peter K Kaiser, Rishi P Singh, Justis P Ehlers
BACKGROUND AND OBJECTIVE: To assess the relationship between spectral-domain optical coherence tomography (SD-OCT) features and functional outcomes for diabetic macular edema (DME) undergoing treatment with intravitreal bevacizumab (Avastin; Genentech, South San Francisco, CA). PATIENTS AND METHODS: Institutional review board-approved, retrospective, consecutive case series of eyes receiving intravitreal bevacizumab (1.25 mg) for DME. SD-OCT features were evaluated and correlated with functional response to anti-vascular endothelial growth factor (VEGF) therapy...
October 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Toke Bek, Christina Mørup Jørgensen
Purpose: The advent of vascular endothelial VEGF antagonists has increased the therapeutic options for diabetic maculopathy considerably. However, there is a need to identify patients who respond favorably to the treatment from those in whom the treatment is less effective. The purpose of the present study was to test the hypothesis that the oxygen saturation in retinal vessels together with other risk factors can predict the effect of anti-VEGF treatment on diabetic maculopathy. Methods: In 73 eyes from 53 patients with center-involving diabetic macular edema, multiple linear regression was used to evaluate the predictive value of oxygen saturation in larger retinal vessels together with age, diabetes duration, diabetes type, hemoglobin A1c (HbA1c), mean arterial blood pressure (MAP), body mass index (BMI), previous retinal photocoagulation, visual acuity (VA), and central retinal thickness (CRT) before treatment as explanatory variables for VA and CRT after three monthly injections of anti-VEGF medication...
October 1, 2016: Investigative Ophthalmology & Visual Science
Jörg T Regula, Peter Lundh von Leithner, Richard Foxton, Veluchamy A Barathi, Chui Ming Gemmy Cheung, Sai Bo Bo Tun, Yeo Sia Wey, Daiju Iwata, Miroslav Dostalek, Jörg Moelleken, Kay G Stubenrauch, Everson Nogoceke, Gabriella Widmer, Pamela Strassburger, Michael J Koss, Christian Klein, David T Shima, Guido Hartmann
Anti-angiogenic therapies using biological molecules that neutralize vascular endothelial growth factor-A (VEGF-A) have revolutionized treatment of retinal vascular diseases including age-related macular degeneration (AMD). This study reports preclinical assessment of a strategy to enhance anti-VEGF-A monotherapy efficacy by targeting both VEGF-A and angiopoietin-2 (ANG-2), a factor strongly upregulated in vitreous fluids of patients with retinal vascular disease and exerting some of its activities in concert with VEGF-A...
October 14, 2016: EMBO Molecular Medicine
Yuichiro Ogura, Fumio Shiraga, Hiroko Terasaki, Masahito Ohji, Susumu Ishida, Taiji Sakamoto, Akito Hirakata, Tatsuro Ishibashi
PURPOSE: To elucidate the current clinical practice patterns of diabetic macular edema (DME) management by retinal specialists in Japan in the era of anti-vascular endothelial growth factor (VEGF) therapy. METHODS: Forty-six retinal specialists were administered a survey regarding the pathology and clinical practice of DME. RESULTS: Nearly, half of the specialists (45.2 %) think that the main biochemical factor involved in DME development is the vascular permeability-potentiating action of VEGF-A...
October 8, 2016: Japanese Journal of Ophthalmology
Therese Granström, Henrietta Forsman, Anna Lindholm Olinder, Dimitrios Gkretsis, Jan W Eriksson, Elisabet Granstam, Janeth Leksell
AIMS: To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12months in a real world setting. METHODS: In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68years) with type 1 and type 2 diabetes diagnosed with DME were included...
September 21, 2016: Diabetes Research and Clinical Practice
Dordi Austeng, Tora Sund Morken, Stine Bolme, Turid Follestad, Vidar Halsteinli
BACKGROUND: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) now improve or stabilize visual acuity in a number of previously untreatable eye diseases, of which the main are age-related macular degeneration, retinal vein occlusion and diabetic macular edema. Most patients require multiple injections over lengthy periods of time and the prevalence of treatable conditions is increasing. Anti-VEGF IVI normally administered by physicians, therefore represent a considerable workload on ophthalmologic clinics and will continue to do so in the near future...
October 1, 2016: BMC Ophthalmology
Lee M Jampol, Adam R Glassman, Neil M Bressler, John A Wells, Allison R Ayala
Importance: Post hoc analyses from the Diabetic Retinopathy Clinical Research Network randomized clinical trial comparing aflibercept, bevacizumab, and ranibizumab for diabetic macular edema (DME) might influence interpretation of study results. Objective: To provide additional outcomes comparing 3 anti-vascular endothelial growth factor (VEGF) agents for DME. Design, Setting, and Participants: Post hoc analyses performed from May 3, 2016, to June 21, 2016, of a randomized clinical trial performed from August 22, 2012, to September 23, 2015, of 660 participants comparing 3 anti-VEGF treatments in eyes with center-involved DME causing vision impairment...
October 6, 2016: JAMA Ophthalmology
Alexandre Sellam, Agnes Glacet-Bernard, Florence Coscas, Alexandra Miere, Gabriel Coscas, Eric H Souied
PURPOSE: To evaluate changes of vascular flow of patients treated with intravitreal injections of anti-vascular endothelial growth factor for macular edema secondary to retinal vein occlusion (RVO) with optical coherence tomography angiography (OCTA). METHODS: Patients with RVO with macular edema and treated with intravitreal injections of anti-vascular endothelial growth factors were retrospectively evaluated. The following examinations were performed before and after treatment: best-corrected visual acuity, spectral domain optical coherence tomography, fluorescein angiography, and OCTA (Optovue, Inc)...
September 28, 2016: Retina
Peter A Campochiaro, Lloyd Paul Aiello, Philip J Rosenfeld
The association of retinal hypoxia with retinal neovascularization has been recognized for decades, causing Michaelson to postulate in 1948 that a factor secreted by hypoxic retina was involved. The isolation of vascular endothelial growth factor (VEGF), characterization of its angiogenic activity, and demonstration that its expression was increased in hypoxic tissue made it a prime candidate. Intraocular levels of VEGF are elevated in patients with retinal or iris neovascularization, and VEGF-specific antagonists markedly suppress retinal neovascularization in mice and primates with ischemic retinopathy...
October 2016: Ophthalmology
Stephen G Schwartz, Ingrid U Scott, Michael W Stewart, Harry W Flynn
Diabetic macular edema (DME) remains an important cause of visual loss. Although anti-vascular endothelial growth factor (VEGF) agents are generally used as first-line treatments for patients with center-involving DME, there is an important role for corticosteroids as well. Corticosteroids may be especially useful in pseudophakic patients poorly responsive to anti-VEGF therapies, in patients wishing to reduce the number of required injections, and in pregnant patients. Intravitreal triamcinolone acetonide has been used for many years but is not approved for this indication...
2016: Clinical Ophthalmology
Chirag P Shah, Jeffrey S Heier
BACKGROUND AND OBJECTIVE: To evaluate the short-term anatomic and visual outcomes after aflibercept (Eylea; Regeneron, Tarrytown, NY) in eyes with diabetic macular edema (DME) previously treated with ranibizumab (Lucentis; Genentech, South San Francisco, CA) and/or bevacizumab (Avastin; Genentech, South San Francisco, CA). PATIENTS AND METHODS: A single-center, retrospective, noncomparative study of 30 eyes in 23 patients with DME treated with prior ranibizumab and/or bevacizumab before switching to aflibercept...
September 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Asaf Achiron, Ayana Kydyrbaeva, Vitaly Man, Oded Lagstein, Zvia Burgansky, Oren Blumenfeld, Asaf Bar, Elisha Bartov
PURPOSE: Assessing changes in foveal photoreceptor microstructure (FPM) following intravitreal anti-VEGF treatment may serve as a prognostic marker in patients with macular edema (ME). METHODS: Sixteen eyes belonging to newly diagnosed patients with ME were included in this prospective longitudinal study. FPM integrity was evaluated at baseline and at the end of a series of anti-VEGF injections. RESULTS: Treatment led to a significant improvement in mean visual acuity (VA) and central macular thickness...
September 15, 2016: Ophthalmic Research
Michael W Stewart
Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement...
August 25, 2016: World Journal of Diabetes
Pukhraj Rishi, Neha Raka, Ekta Rishi
BACKGROUND: To study potential ischemic effects of intravitreal Bevacizumab (IVB) on unaffected retina in treatment-naive eyes with macular edema secondary to branch retinal vein occlusion (BRVO) and contralateral eyes secondary to systemic absorption. METHODS AND FINDINGS: Prospective, interventional series included 27 treatment-naive eyes with BRVO and macular edema. EXCLUSION CRITERIA: Eyes with diabetic retinopathy, glaucoma, vasculitides, papilledema or systemic neurologic condition...
2016: PloS One
M R Moreno, T S Tabitha, J Nirmal, K Radhakrishnan, C H Yee, S Lim, S Venkatraman, R Agrawal
The anti-vascular endothelial growth factor (VEGF) agents such as ranibizumab (Lucentis®) and aflibercept (EyLea®) are currently used as monthly or bimonthly intravitreal injections to treat potentially blinding retinal diseases such as wet age-related macular degeneration (AMD) or diabetic macular edema (DME). Because of the complications associated with repeated intra-vitreal injections, there is considerable interest in developing a sustained delivery system. The purpose of this study was to examine the stability of both therapeutic proteins under physiological conditions as well as when incorporated into drug delivery systems (DDS)...
September 8, 2016: European Journal of Pharmaceutics and Biopharmaceutics
Junyeop Lee, Byung Gil Moon, Ah Ran Cho, Young Hee Yoon
PURPOSE: To investigate the structural integrity of the superficial capillary plexuses (SCPs) and deep capillary plexuses (DCPs) using optical coherence tomography (OCT) angiography (OCTA) in patients with diabetic macular edema (DME) and its association with the response to anti-vascular endothelial growth factor (VEGF) treatment. DESIGN: Retrospective, case-control study. PARTICIPANTS: We included 51 DME eyes with a poor response to anti-VEGF agents and 32 age-matched DME eyes with a good response to anti-VEGF treatment, along with 20 fellow eyes without DME from the cases and controls...
September 6, 2016: Ophthalmology
Teruyo Kida, Josef Flammer, Hidehiro Oku, Seita Morishita, Masanori Fukumoto, Hiroyuki Suzuki, Katarzyna Konieczka, Tsunehiko Ikeda
BACKGROUND: Branch retinal vein occlusion (BRVO) commonly occurs at the arteriovenous crossing in the unilateral eye, and cardiovascular diseases can be risk factors of BRVO. However, the pathomechanism leading to BRVO is not yet clear. In addition to mechanical compression, the vein might locally constrict due to an altered biochemical environment, such as an increase in the concentration of endothelin-1 (ET-1). We evaluated changes in ET-1 following injection of intravitreal bevacizumab (IVB), which is the anti-vascular endothelial growth factor (VEGF) agent with the longest serum half-life, to determine the effect on BRVO-related macular edema...
2016: EPMA Journal
Audrey Giocanti-Auregan, Ramin Tadayoni, Typhaine Grenet, Franck Fajnkuchen, Sylvia Nghiem-Buffet, Corinne Delahaye-Mazza, Gabriel Quentel, Salomon Y Cohen
BACKGROUND: To estimate the need for bilateral intravitreal anti-VEGF injections in patients treated for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion, choroidal neovascularization (CNV) in high myopia, and other causes of CNV. METHODS: All consecutive patients treated with intravitreal anti-VEGF injection over a 1-month period were included in a prospective multicenter survey. The reason for intravitreal anti-VEGF injection and the involvement of the fellow eye in the pathology requiring a treatment with intravitreal anti-VEGF were recorded...
2016: BMC Ophthalmology
Henrik Vorum, Thorbjørn Kruse Olesen, Jette Zinck, Morten Hedegaard
OBJECTIVE: This study evaluates real-world evidence regarding the frequency of anti-vascular endothelial growth factor (VEGF) injections during the first year of therapy of treatment-naïve patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME) and retinal vein occlusion (RVO) from the Danish National Patient Registry. There was a switch in anti-VEGF treatment for naïve nAMD patients during the study period, following the introduction of aflibercept, which was expected to reduce the injection frequency relative to ranibizumab due to a perception of prolonged treatment duration of aflibercept...
August 5, 2016: Current Medical Research and Opinion
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