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Macular edema anti-VEGF

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https://www.readbyqxmd.com/read/28427072/anti-vascular-endothelial-growth-factor-injections-the-new-standard-of-care-in-proliferative-diabetic-retinopathy
#1
Xintong Li, Marco A Zarbin, Neelakshi Bhagat
For decades, panretinal photocoagulation (PRP) has been the standard of care for the treatment of proliferative diabetic retinopathy (PDR). The relatively recent advent of anti-vascular endothelial growth factor (VEGF) formulations for intravitreal injection has provided a fresh perspective on PDR treatment, especially in eyes with concurrent diabetic macular edema (DME). The anti-VEGF agent ranibizumab has demonstrated a potentially protective effect on eyes with DME in terms of progression to PDR in the RIDE/RISE trials, as has aflibercept in the VIVID/VISTA trials...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427071/is-laser-still-important-in-diabetic-macular-edema-as-primary-or-deferral-therapy
#2
Maurizio Battaglia Parodi, Francesco Bandello
Laser treatment was used in the past to reduce the visual loss due to diabetic macular edema. The recent advent of anti-vascular endothelial growth factor (anti-VEGF) has completely revolutionized the management of diabetic retinopathy, with a significant improvement in the overall prognosis. Nevertheless, macular laser can still be applied in selected cases characterized by retinal thickness ≤400 microns, high visual acuity, extrafoveal location, and contraindications to the intravitreal approach with anti-VEGF and steroids...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427070/practical-lessons-from-protocol-t-for-the-management-of-diabetic-macular-edema
#3
Lekha Mukkamala, Neelakshi Bhagat, Marco Zarbin
PURPOSE: To review the results of Diabetic Retinopathy Clinical Research Network Protocol T, as applied to clinical practice. METHODS: Review of major publications reporting the results of Protocol T, a randomized single-masked (in year-1 only), multicenter clinical trial comparing aflibercept, bevacizumab, and ranibizumab as treatment option for center-involving diabetic macular edema (DME). The main outcome measures were change in visual acuity (VA), central subfield thickness (CST) on optical coherence tomography, cost effectiveness, burden of care, and safety...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427068/intravitreal-steroids-in-diabetic-macular-edema
#4
Rosangela Lattanzio, Maria Vittoria Cicinelli, Francesco Bandello
Over the past decade, great strides have been made in the management of diabetic macular edema (DME). Therapeutic alternatives now include focal/grid laser photocoagulation, vitreo-retinal surgery, and intraocular injection of anti-angiogenic and steroid molecules. Intravitreal administration of steroids represents a fundamental alternative for recalcitrant and naive eyes with DME, especially in those cases when anti-vascular endothelial growth factor (VEGF) agents are contraindicated or a treatment regimen with fewer intravitreal injections is required...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427067/intravitreal-aflibercept-in-diabetic-macular-edema-long-term-outcomes
#5
Ugo Introini, Giuseppe Casalino
For decades, macular laser photocoagulation has been the standard of care in the treatment of diabetic macular edema (DME). With the relatively recent advent of anti-vascular endothelial growth factor (VEGF) agents, DME treatment has entered a new era. VEGF is a well-known pro-angiogenic and pro-permeability factor involved in the pathogenesis of DME. VEGF blockade has proven remarkably effective at reducing DME and improving visual acuity (VA) in eyes with center involved DME causing VA loss in several randomized controlled trials (RCTs)...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427057/long-term-anatomical-and-functional-outcomes-in-patients-with-ischemic-central-retinal-vein-occlusion-treated-with-anti-vascular-endothelial-growth-factor-agents
#6
Irini Chatziralli, George Theodossiadis, Efstratios Parikakis, Panagiotis G Mitropoulos, Panagiotis Theodossiadis
PURPOSE: To evaluate the anatomical and functional outcomes in patients with ischemic central retinal vein occlusion (CRVO) treated with intravitreal anti-vascular endothelial growth factor (VEGF) agents. METHODS: This retrospective study included 15 treatment-naive patients with ischemic CRVO and macular edema who were treated with intravitreal ranibizumab or aflibercept. The main outcomes were the evolution of retinal ischemia over time, as well as the change in best corrected visual acuity (BCVA) and in central subfield thickness (CST) at month 24...
April 21, 2017: Ophthalmic Research
https://www.readbyqxmd.com/read/28419394/use-of-corticosteroids-in-the-treatment-of-patients-with-diabetic-macular-edema-who-have-a-suboptimal-response-to-anti-vegf-recommendations-of-an-expert-panel
#7
Carl D Regillo, David G Callanan, Diana V Do, Howard F Fine, Nancy M Holekamp, Baruch D Kuppermann, Michael A Singer, Rishi P Singh
BACKGROUND AND OBJECTIVE: Guidance on the use of corticosteroids in the treatment of diabetic macular edema (DME) is lacking. This study aimed to develop a clinically recommended treatment paradigm for DME with emphasis on the role of corticosteroids. PATIENTS AND METHODS: An expert panel of nine retinal specialists in the United States developed consensus recommendations for DME treatment through a modified Delphi process. RESULTS: The panelists typically use intravitreal injections of vascular endothelial growth factor (VEGF) antagonists as first-line treatment of DME and switch patients with an inadequate response to anti-VEGF therapy (failure of best-corrected visual acuity to improve to 20/40 or better because of edema after three to six monthly injections, or a less-than-50% reduction in excess macular thickness after three to four monthly injections) to intravitreal corticosteroid treatment...
April 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28402713/optical-biometry-derived-axial-length-measurements-following-intravitreal-anti-vascular-endothelial-growth-factor-treatment-for-macular-edema
#8
George D Kymionis, Athanassios Giarmoukakis, Ioanna K Apostolidi, Styliani V Blazaki, Konstantinos I Tsoulnaras, Joanna Moschandrea, Sofia Panagopoulou, Miltiadis K Tsilimbaris
PURPOSE: To evaluate axial length (AL) alterations in patients with macular disease over the course of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment. METHODS: In this prospective, comparative study, 33 patients with macular edema underwent unilaterally intravitreal anti-VEGF therapy and were followed for two months; the contralateral eyes were considered as controls. Central retinal thickness (CRT) was measured with spectral-domain optical coherence tomography and AL with an IOL-Master optical biometer...
April 12, 2017: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/28392675/clinical-utility-of-intravitreal-fluocinolone-acetonide-iluvien-%C3%A2-implant-in-the-management-of-patients-with-chronic-diabetic-macular-edema-a-review-of-the-current-literature
#9
REVIEW
Habiba Saedon, Astha Anand, Yit C Yang
The first-line therapy for patients with center-involving diabetic macular edema (DME) is with intravitreal anti-vascular endothelial growth factor (VEGF) agents, with or without adjunctive macular laser treatment. However, a significant proportion of patients have persistent and recurrent edema despite repeated anti-VEGF injections. The fluocinolone acetonide (FA) 190 μg intravitreal implant has been shown in pivotal clinical trials to be efficacious for the treatment of DME and has been approved in many countries for use in patients who have not responded to first-line therapy...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28377846/a-quantitative-approach-to-predict-differential-effects-of-anti-vegf-treatment-on-diffuse-and-focal-leakage-in-patients-with-diabetic-macular-edema-a-pilot-study
#10
Michael J Allingham, Dibyendu Mukherjee, Erin B Lally, Hossein Rabbani, Priyatham S Mettu, Scott W Cousins, Sina Farsiu
PURPOSE: We use semiautomated segmentation of fluorescein angiography (FA) to determine whether anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME) differentially affects microaneurysm (MA)-associated leakage, termed focal leakage, versus non-MA-associated leakage, termed diffuse leakage. METHODS: We performed a retrospective study of 29 subjects treated with at least three consecutive injections of anti-VEGF agents for DME (mean 4...
March 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28373914/effect-of-intravitreal-aflibercept-on-recalcitrant-diabetic-macular-edema
#11
Kendra A Klein, Tina S Cleary, Elias Reichel
BACKGROUND: Despite anti-VEGF therapy, some patients develop chronic diabetic macular edema. The objective of this study was to evaluate anatomic and visual outcomes of switching patients with chronic DME from intravitreal bevacizumab or ranibizumab to intravitreal aflibercept injection. METHODS: In this retrospective observational case series, 11 eyes with recalcitrant diabetic macular edema (DME) were evaluated 6 months prior to and 6 months following initial intravitreal aflibercept injection (IAI)...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28366074/intravitreal-bevacizumab-and-dexamethasone-implant-for-treatment-of-chronic-diabetic-macular-edema
#12
Emre Güler, Yüksel Totan, Fatma Betül Güragaç
OBJECTIVE: To evaluate anatomical and functional outcomes of intraviteal bevacizumab (IVB) in patients with chronic diabetic macular edema (DME), and the effectivity and safety of dexamethasone implant in those unresponsive to regular IVB treatment. METHODS: Thirty-five eyes of 35 patients (16 male and 19 female) with chronic DME (central foveal thickness (CFT)  > 275 μm, duration  > 6 months) received three injections of 2.5 mg IVB with six-week intervals...
June 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28351046/retinal-vein-occlusions
#13
Jost B Jonas, Jordi Monés, Agnès Glacet-Bernard, Gabriel Coscas
Retinal vein occlusions (RVOs) have been defined as retinal vascular disorders characterized by dilatation of retinal veins with retinal and subretinal hemorrhages, macular edema, and a varying degree of retinal ischemia. Retinal angiography, either as fluorescein and indocyanine green (ICG) angiography or in the form of optical coherence tomography (OCT)-based angiography, is essential for the diagnosis and assessment of the prognosis of RVOs. It allows the differentiation of diverse types of RVOs, such as perfused or nonperfused, as well as the detection of different modalities in the natural history of RVOs...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351042/intracellular-edema
#14
Raja Narayanan, Baruch D Kuppermann
The macula is predisposed to edema in various retinal conditions, even when the insult is remote from the macula. The various factors that may predispose the macula to edema include high metabolic activity, radial arrangement of the Henle's layer, lack of inner layers at the fovea, and lack of blood supply at the fovea. The edema is most pronounced in the outer plexiform layer (Henle's layer). Alteration in the blood-retinal barrier and ischemia cause disturbances in vascular permeability as well as with the function of Müller cells...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28348885/switch-to-aflibercept-in-diabetic-macular-edema-patients-unresponsive-to-previous-anti-vegf-therapy
#15
Filipe Mira, Manuel Paulo, Filipe Henriques, João Figueira
Purpose. The aim was to evaluate the efficacy of aflibercept in patients with diabetic macular edema (DME) unresponsive to prior anti-VEGF therapy. Methods. Retrospective review of DME unresponsive to previous anti-VEGF switched to aflibercept with 3 months of follow-up. Changes in best correct visual acuity (BCVA), central retinal thickness (CRT), and frequency of injections were analyzed. The percentage of subjects who had ≥20/40 (logMAR equivalent 0.3) and ≤20/200 (logMAR equivalent 1) was evaluated...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28348882/combination-of-anti-vegf-and-laser-photocoagulation-for-diabetic-macular-edema-a-review
#16
REVIEW
Laura N Distefano, Jose Garcia-Arumi, Vicente Martinez-Castillo, Anna Boixadera
Diabetic macular edema (DME) is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept), better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28336283/-early-efficacy-of-dexamethasone-implant-ozurdex-%C3%A2-in-diabetic-macular-edema-real-life-study
#17
V Sarda, F Fajnkuchen, S Nghiem-Buffet, T Grenet, G Chaine, A Giocanti-Auregan
PURPOSE: To assess early efficacy of dexamethasone intravitreal implant 0.7mg (OZURDEX(®)) at the time of peak efficacy (2 months after injection) in patients with decreased visual acuity secondary to diabetic macular edema (DME). MATERIALS AND METHODS: Retrospective monocentric study. Inclusion criteria were best-corrected visual acuity (BCVA)≤70 letters (20/40) due to DME and central retinal thickness (CRT)≥300 microns (Cirrus 2, Carl Zeiss Meditec, Inc, Dublin)...
March 20, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28324452/a-review-of-ranibizumab-for-the-treatment-of-diabetic-retinopathy
#18
REVIEW
Michael W Stewart
INTRODUCTION: Laser photocoagulation has been the standard treatment for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) for several decades. The discovery of vascular endothelial growth factor (VEGF) and the subsequent determination of its critical role in the development DME and PDR has led to the development of VEGF inhibitory drugs. Ranibizumab was the first anti-VEGF drug approved for the treatment of both DME and diabetic retinopathy in eyes with DME. METHODS: Medline searches with the keywords "ranibizumab," "diabetic macular edema," and "proliferative diabetic retinopathy" were performed to identify pertinent pre-clinical studies and clinical trials...
March 21, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28316837/combination-of-navigated-macular-laser-photocoagulation-and-anti-vegf-therapy-precise-treatment-for-macular-edema-under-dry-retinal-conditions
#19
Ernest V Boiko, Dmitrii S Maltsev
Purpose. To compare the controllability of navigated macular laser photocoagulation (MLP) in dry versus edematous retina and validate that pretreatment diagnostic images can be used as basis for navigated MLP after the macular edema (ME) has been resolved. Materials and Methods. Group 1 was divided into subgroup 1 (dry retina MLP) and subgroup 2 (MLP in ME) for comparisons of laser-burn diameters. In group 2, the areas and locations of ME before an intravitreal injection of anti-VEGF (IVAV) were compared with those of recurrent ME...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28316835/clinical-characteristics-of-patients-with-newly-diagnosed-diabetic-macular-edema-in-turkey-a-real-life-registry-study-turk-dem
#20
Bora Eldem, Sengul Ozdek, Ali Osman Saatci, Emin Ozmert, Esat Ulay, Gulsah Nomak
Purpose. To evaluate the clinical and diagnostic characteristics of patients with newly diagnosed diabetic macular edema (DME) in Turkey in a real-life setting. Methods. A total of 945 consecutive patients (mean (SD) age: 61.3 (9.9) years, 55.2% male) with newly diagnosed DME were included. Data on patient demographics, comorbidities, ocular history, ophthalmic examination findings including type of DME, central macular thickness (CMT) via time domain (TD) and spectral domain (SD) optical coherence tomography (OCT), and planned treatments were recorded...
2017: Journal of Ophthalmology
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