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Macular edema anti-VEGF

Samaneh Sepahi, Seyed Ahmad Mohajeri, Seyedeh Maryam Hosseini, Elham Khodaverdi, Nasser Shoeibi, Maral Namdari, Sayyed Abolghasem Sajadi Tabassi
OBJECTIVE: Diabetic macular edema (DME) is one of the most important sight-threatening complications in patients with diabetes. Due to neuroprotective properties, crocin, as the main constituent in saffron, is thought to be useful in the treatment and prevention of diabetic maculopathy. The aim of this trial was to evaluate the effects of crocin as a supplement on reducing inflammation in patients with diabetic maculopathy. DESIGN: Double blind, placebo controlled, phase 2 randomized clinical trial...
March 14, 2018: American Journal of Ophthalmology
Tracy W Krick, Neil M Bressler
PURPOSE OF REVIEW: To present some recent clinically relevant results from Diabetic Retinopathy Clinical Research (DRCR) Network trials that may guide management of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). RECENT FINDINGS: Among eyes with DME and visual acuity 20/50 or worse, aflibercept, on average, had greater improvement in visual acuity over 2 years compared with bevacizumab or ranibizumab. Aflibercept is associated with higher rates of improvements in diabetic retinopathy severity among eyes with PDR and vision-impairing DME at baseline compared with bevacizumab or ranibizumab...
March 9, 2018: Current Opinion in Ophthalmology
Lee M Jampol, Adam R Glassman, Danni Liu, Lloyd Paul Aiello, Neil M Bressler, Elia J Duh, Susan Quaggin, John A Wells, Charles C Wykoff
PURPOSE: To assess systemic vascular endothelial growth factor (VEGF)-A levels after treatment with intravitreous aflibercept, bevacizumab, or ranibizumab. DESIGN: Comparative-effectiveness trial with participants randomly assigned to 2 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab after a re-treatment algorithm. PARTICIPANTS: Participants with available plasma samples (N = 436). METHODS: Plasma samples were collected before injections at baseline and 4-week, 52-week, and 104-week visits...
March 7, 2018: Ophthalmology
Roxane J Hillier, Elvis Ojaimi, David T Wong, Michael Y K Mak, Alan R Berger, Radha P Kohly, Peter J Kertes, Farzin Forooghian, Shelley R Boyd, Kenneth Eng, Filiberto Altomare, Louis R Giavedoni, Rosane Nisenbaum, Rajeev H Muni
Importance: Variability in response to anti-vascular endothelial growth factor (VEGF) treatment in diabetic macular edema (DME) remains a significant clinical challenge. Biomarkers could help anticipate responses to anti-VEGF therapy. Objectives: To investigate aqueous humor cytokine level changes in response to intravitreal ranibizumab therapy for the management of DME, and to determine the association between baseline aqueous levels and anatomic response. Design, Setting, and Participants: In this prospective multicenter cohort study, 49 participants with diabetes mellitus complicated by center-involving DME, with a central subfield thickness of 310 μm or greater on spectral-domain optical coherence tomography (SD-OCT), were recruited from December 22, 2011, to June 13, 2013 and statistical analysis were performed from March 1, 2017, to June 1, 2017...
March 8, 2018: JAMA Ophthalmology
Andrijana Kopić, Dubravka Biuk, Josip Barać, Maja Vinković, Tvrtka Benašić, Vlatko Kopić
Over the past decade, intravitreal injections of anti-VEGF agents have been widely used and intensively developed as a treatment option for many ophthalmological indications. Due to its availability and low cost, the most frequently used anti-VEGF agent is bevacizumab. This type of therapy is often indicated in patients with exudative age-related macular degeneration (ARMD) and diabetic macular edema (DME). If, in addition to these two conditions, patients have a diagnosis of primary open angle glaucoma (POAG), they also present with optic nerve head (ONH) retinal nerve fiber layer (RNFL) thinning...
September 2017: Acta Clinica Croatica
Ingrid U Scott, Paul C VanVeldhuisen, Michael S Ip, Barbara A Blodi, Neal L Oden, Michael Altaweel, Daniel M Berinstein
Importance: Comparisons of monthly vs treat-and-extend anti-vascular endothelial growth factor (anti-VEGF) regimens for macular edema from central retinal vein occlusion or hemiretinal vein occlusion is needed. Objective: To compare visual acuity letter score and central subfield thickness outcomes of participants in the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2) trial who then received either monthly injections or treat-and-extend (TAE) regimens of aflibercept or bevacizumab after a good response at month 6...
February 24, 2018: JAMA Ophthalmology
Kevin Miller, Jorge A Fortun
Diabetic retinopathy and diabetic macular edema comprise a major source of visual disability throughout the developed world. The etiology and pathogenesis of macular edema is intricate and multifactorial, in which the hyperglycemic state in diabetes induces a microangiopathy. Through several inflammatory and vasogenic mediators, including vascular endothelial growth factor (VEGF) upregulation and inflammatory cytokines and chemokines, pathologic changes are induced in the vascular endothelium triggering breakdown of the blood retinal barrier, causing extravasation of fluid into the extracellular space and manifesting clinically as macular edema, resulting in visual loss...
January 2018: Asia-Pacific Journal of Ophthalmology
Shruti Chandra, Jay Sheth, Giridhar Anantharaman, Mahesh Gopalakrishnan
Purpose: To report regression of neovascularization and reperfusion of ischemic areas of the retina on Wide-field Digital Fluorescein Angiography following anti-vascular endothelial growth factor injections in a patient with active Proliferative Diabetic Retinopathy. Observations: Case report of sixty-one-year-old male patient with proliferative diabetic retinopathy and diabetic macular edema documented on wide field digital fluorescein angiography. The patient was treated with three intravitreal injections of ranibizumab given at monthly intervals...
March 2018: American Journal of Ophthalmology Case Reports
Akira Hirata, Ken Hayashi, Kazuhisa Murata, Kei-Ichiro Nakamura
Purpose: The formation of macular hole after receiving anti-vascular endothelial growth factor (anti-VEGF) therapy is rare. We report a case of macular hole that occurred after intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD) in a patient, who underwent vitrectomy combined with choroidal neovascularization (CNV) removal. Observations: A 64-year-old female with AMD affecting her right eye received an intravitreal injection of an anti-VEGF agent...
March 2018: American Journal of Ophthalmology Case Reports
Aljoscha S Neubauer, Christos Haritoglou, Michael W Ulbig
BACKGROUND: In the treatment of center-involving diabetic macular edema, despite initial therapy with an anti-VEGF compound, an insufficient response may occur. Further therapy options include a switch of anti-VEGF products or to corticosteroid implants, such as Fluocinolone acetonide or Dexamethasone. OBJECTIVES: Firstly, to investigate systematically which evidence-based study data are available describing the efficacy of in-label treatments after primary anti-VEGF treatment, secondly, to investigate which costs go along for the healthcare provider...
February 16, 2018: Klinische Monatsblätter Für Augenheilkunde
Mioara-Laura Macovei, Maria-Alexandra Nica
The authors presented a clinical case of retinitis punctate albescens in a 26-year-old female patient, with a family history of typical retinitis pigmentosa (father) and bilateral cystoid macular edema treated with anti-VEGF (bevacizumab).
April 2017: Romanian Journal of Ophthalmology
Marco A Zarbin
Blockade of vascular endothelial growth factor (VEGF) signaling, whether via sequestration of free VEGF or via inhibition of the tyrosine kinases activated by VEGF, is associated with decreased nitric oxide (NO) and prostaglandin-I 2 (PG-I 2) production along with vascular endothelial cell death. Systemic administration of drugs that block VEGF signaling (eg, for cancer treatment) is associated with systemic complications such as hypertension and thrombosis. Evidence regarding the risk of systemic serious adverse events after intravitreal injection of anti-VEGF agents in patients with diabetic macular edema or neovascular age-related macular degeneration is inconsistent, in part because of study design limitations (eg, bias of ascertainment through strict enrollment criteria and/or inadequate power to identify the risk of low frequency events)...
February 1, 2018: Asia-Pacific Journal of Ophthalmology
Alexandros Rouvas, Irini Chatziralli, Angeliki Androu, Panagiota Mpougatsou, Dimitrios Alonistiotis, Maria Douvali, Stamatina A Kabanarou, Panagiotis Theodossiadis
PURPOSE: To compare the efficacy and safety of two intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, ranibizumab and aflibercept, for the treatment of vascularized pigment epithelium detachment (vPED) due to age-related macular degeneration (AMD) in a follow-up time of 12 months. METHODS: Participants in this study were 71 patients (71 eyes) with vPED due to AMD, who were treated with intravitreal 0.5 mg ranibizumab (n = 38) or 2.0 mg aflibercept (n = 33) and had at least 12-month follow-up...
February 5, 2018: International Ophthalmology
Agnese Fiori, Vincenzo Terlizzi, Heiner Kremer, Julian Gebauer, Hans-Peter Hammes, Martin C Harmsen, Karen Bieback
Diabetic retinopathy (DR) is a multifactorial microvascular disease induced by hyperglycemia and subsequent metabolic abnormalities. The resulting cell stress causes a sequela of events that ultimately can lead to severe vision impairment and blindness. The early stages are characterized by activation of glia and loss of pericytes, endothelial cells (EC) and neuronal cells. The integrity of the retinal microvasculature becomes affected, and, as a possible late response, macular edema may develop as a common reason for vision loss in patients with non-proliferative DR...
February 2, 2018: Immunobiology
Stefano Fogli, Marzia Del Re, Eleonora Rofi, Chiara Posarelli, Michele Figus, Romano Danesi
Clinical efficacy of intravitreal anti-VEGF drugs has been widely demonstrated in several angiogenesis-driven eye diseases including diabetic macular edema and the neovascular form of age-related macular degeneration. Pegaptanib, ranibizumab, and aflibercept have been approved for use in the eye, whereas bevacizumab is widely used by ophthalmologists to treat patients "off-label". These drugs are active in the nanomolar to picomolar range; however, caution is required when establishing the rank order of affinity and potency due to in vitro inter-experimental variation...
February 5, 2018: Eye
Magne Sand Sivertsen, Øystein Kalsnes Jørstad, Algirdas Grevys, Stian Foss, Morten Carstens Moe, Jan Terje Andersen
Macular edema due to neovascular age-related macular degeneration, diabetes or retinal vein occlusion can cause central vision loss. Intravitreal treatment with antibody-based biopharmaceutical compounds designed to neutralize vascular endothelial growth factor (VEGF) has proven to be an efficient strategy to ameliorate macular edema and restore visual acuity. At the same time, the use of anti-VEGF drugs places an economic burden on the health care system; the drugs are expensive, and repeated injections are usually required to maintain the therapeutic effect...
February 1, 2018: Scientific Reports
Tim J Enz, Livia Faes, Lucas M Bachmann, Michael A Thiel, Jeremy P Howell, Sophie C Boehni, Mario Bittner, Martin K Schmid
PURPOSE: To evaluate differences in postoperative central macular thickness, central macular volume, corrected distance visual acuity (CDVA), and number of intravitreal anti-vascular endothelial growth factor (VEGF) injections between conventional and femtosecond laser-assisted cataract surgery in wet age-related macular degeneration (AMD). SETTING: Tertiary referral center, Lucerne, Switzerland. DESIGN: Retrospective case series. METHODS: Consecutive patients with AMD and cataract were enrolled between January 2010 and December 2015...
January 17, 2018: Journal of Cataract and Refractive Surgery
Christoph Ehlken, Mandy Helms, Daniel Böhringer, Hansjürgen T Agostini, Andreas Stahl
Purpose: Real-life clinical outcomes of patients treated with anti-VEGF drugs for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or macular edema secondary to branch retinal vein occlusion (BRVO) are often inferior to results from randomized clinical trials. This observational cohort study investigates treatment adherence and real-life clinical outcomes within the first year of treatment. Patients and methods: A total of 708 treatment-naïve patients (466 nAMD, 134 DME, and 108 BRVO) were included...
2018: Clinical Ophthalmology
Daniel F Martin
PURPOSE: To present the evolution of intravitreal therapy for retinal diseases and its impact on clinical practice. DESIGN: Retrospective literature review and personal perspective. METHODS: Retrospective literature review and personal perspective. RESULTS: Pharmacotherapeutic advances in retinal disease have been remarkable over the last 25 years. Almost all of the new drugs developed have required intravitreal administration to be highly effective, leading to an exponential increase in the annual number of intravitreal injections given...
January 12, 2018: American Journal of Ophthalmology
Yoshito Koyanagi, Shigeo Yoshida, Yoshiyuki Kobayashi, Yuki Kubo, Takahito Nakama, Keijiro Ishikawa, Shintaro Nakao, Toshio Hisatomi, Yasuhiro Ikeda, Yuji Oshima, Tatsuro Ishibashi, Koh-Hei Sonoda
OBJECTIVE: To examine the relationship between early response to anti-vascular endothelial growth factor (VEGF) treatment and visual prognosis. METHODS: We retrospectively separated 20 patients with persistent diabetic macular edema (DME) into two responder status groups based on the reduction of central macular thickness (CMT) from baseline to month 3: a delayed responder group (DRG) (≤25% CMT reduction, n = 11) and an immediate responder group (IRG) (>25% CMT reduction, n = 14)...
January 9, 2018: Ophthalmologica. Journal International D'ophtalmologie
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