scholarly journals A Brief History of Anti-VEGF for the Treatment of Ocular Angiogenesis

2012 ◽  
Vol 181 (2) ◽  
pp. 376-379 ◽  
Author(s):  
Leo A. Kim ◽  
Patricia A. D'Amore

2021 ◽  
pp. 112067212110248
Author(s):  
Ankush Kawali ◽  
Sanjay Srinivasan ◽  
Padmamalini Mahendradas ◽  
Rohit Shetty

Introduction: Treating chronic macular edema (CME) post endophthalmitis is a challenge. Use of steroids may reactivate the infection and repeated intravitreal therapy with anti-vascular growth factor inhibitors (Anti-VEGF) puts the patient again at the risk of exacerbation of inflammation or endophthalmitis. We describe a case of CME post traumatic endophthalmitis successfully treated with topical interferon therapy. Case description: A 34-year-old Asian Indian lady with a history of cat bite to her right eye and treated elsewhere as traumatic endophthalmitis with recurrent macular edema, presented to us 1 year after the injury. She had received anti-VEGF injection for same. Her medical history was non-contributory except for close contact with her cat. Therapeutic trials with oral doxycycline followed by oral albendazole with steroids, as well as repeated anti-VEGF therapy failed to prevent recurrence of CME. Patient’s steroid responsiveness and reluctance for injections, made us to opt for a novel topical Interferon therapy. Macular edema resolved in 2 months. Interruption of interferon therapy due to COVID-lock down resulted in recurrence of the CME, which again responded well to interferon monotherapy. Conclusion: Topical interferon may have a role in the treatment of inflammatory macular edema and can serve as a, safer, economical and non-invasive treatment option compared to intravitreal steroids and anti-VEGFs.



2020 ◽  
Vol 4 (6) ◽  
pp. 525-529
Author(s):  
Kenneth C. Fan ◽  
Mark A. McAllister ◽  
Nicolas A. Yannuzzi ◽  
Nimesh A. Patel ◽  
Supalert Prakhunhungsit ◽  
...  

Purpose: This case report describes a unique case of a young patient with retinopathy of prematurity (ROP), a unilateral Coats-like response, and X-linked retinoschisis (XLRS). Methods: A 9-year-old boy with a history of regressed ROP presented with a unilateral Coats-like response, subretinal exudation, and XLRS. Examination and imaging findings demonstrated a highly unique combination of bilateral retinoschisis and a dramatic unilateral Coats-like response with a large schisis cavity. Results: Treatment with laser photocoagulation and anti-VEGF therapy led to resolution of the subretinal exudative changes. Conclusions: This is the first published description to our knowledge of a patient with a Coats-like response, XLRS, and a history of regressed ROP with resolution after treatment.



2019 ◽  
Vol 104 (8) ◽  
pp. 1064-1069
Author(s):  
Vincent Daien ◽  
Vuong Nguyen ◽  
Rohan W Essex ◽  
Robin Guymer ◽  
Jennifer J Arnold ◽  
...  

BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.



2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Vikas Tah ◽  
Harry O. Orlans ◽  
Jonathan Hyer ◽  
Edward Casswell ◽  
Nizar Din ◽  
...  

Ocular angiogenesis and macular oedema are major causes of sight loss across the world. Aberrant neovascularisation, which may arise secondary to numerous disease processes, can result in reduced vision as a result of oedema, haemorrhage, and scarring. The development of antivascular endothelial growth factor (anti-VEGF) agents has revolutionised the treatment of retinal vasogenic conditions. These drugs are now commonly employed for the treatment of a plethora of ocular pathologies including choroidal neovascularisation, diabetic macular oedema, and retinal vein occlusion to name a few. In this paper, we will explore the current use of anti-VEGF in a variety of retinal diseases and the impact that these medications have had on visual outcome for patients.



2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Kenichi Kimoto ◽  
Toshiaki Kubota

We review articles describing intravitreal injection of anti-VEGF drug trials, while discussing the mechanisms of the action of anti-VEGF antibodies, and also evaluating their outcomes. Intraocular injections of anti-VEGF drug are considered to be an effective treatment for macular edema after retinal vein occlusion, however, recurrent/persistent edema is common. The recent reports may lead to a shift in treatment paradigm for DME, from laser photocoagulation, to newer approaches using anti-VEGF drugs. There have been several well-publicized prospective, randomized studies that demonstrated the efficacy of intravitreal injection of anti-VEGF drugs for patients with AMD. Adjuvant bevacizumab for neovascular glaucoma may prevent further PAS formation, and it is likely to open up a therapeutic window for a panretinal photocoagulation and trabeculectomy. Intravitreal injection of bevacizumab (IVB) results in a substantial decrease in bleeding from the retinal vessels or new vessels during a standard vitrectomy. IVB has also been reported to be effective for inducing the regression of new vessels in proliferative diabetic retinopathy. The use of bevacizumab in stage 4 or 5 retinopahty of permaturity (ROP) is to reduce the plus sign to help reduce hemorrhage during the subsequent vitrectomy. Some authors reported cases of resolution of stage 4 A ROP after bevacizumab injection.



Author(s):  
Anibal Francone ◽  
Andrea Govetto ◽  
Lisa Yun ◽  
Juliet Essilfie ◽  
Kouros Nouri-Mahdavi ◽  
...  

Abstract Purpose We aimed to investigate non-exudative microcystoid macular abnormalities for visual and anatomical outcome in patients with retinal vein occlusion (RVO) with and without glaucomatous optic neuropathy (GON). Methods Medical records of 124 eyes (105 patients) with RVO were reviewed and analyzed. Eyes demonstrating microcystoid macular abnormalities were divided into 2 groups, those with evidence of glaucoma (group A) and those without glaucoma (group B). Best-corrected visual acuity (BCVA), the prevalence and number of microcystoid macular abnormalities, and number of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections were compared at baseline and follow-up. Results Seventy-one out of 105 eyes (67.6%) with RVO displayed microcystoid macular abnormalities. Thirty-eight out of 71 eyes (53.5%) presented with concomitant glaucoma (group A), while the remaining 33 eyes (42.6%) had no history of glaucoma (group B). At the end of the follow-up period, mean BCVA was worse in group A versus group B (20/80 versus 20/40, respectively; p = .003). The mean number of anti-VEGF injections was 10.1 ± 9.2 in group A versus 5.9 ± 6.9 in group B (p = .03). Conclusion Eyes with RVO and concomitant glaucoma exhibited a significantly higher number of microcystoid macular abnormalities and worse BCVA versus eyes with RVO without glaucoma.



2021 ◽  
Author(s):  
Kaveh Fadakar ◽  
Mohammadreza Mehrabi Bahar ◽  
Hamid Riazi-Esfahani ◽  
Afsaneh Azarkish ◽  
Afsar Dastjani Farahani ◽  
...  

Abstract Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.



Marine Drugs ◽  
2021 ◽  
Vol 19 (8) ◽  
pp. 471
Author(s):  
Beiying Qiu ◽  
Alison Tan ◽  
Yu Zhi Tan ◽  
Qi-Yin Chen ◽  
Hendrik Luesch ◽  
...  

Ocular angiogenic diseases, characterized by abnormal blood vessel formation in the eye, are the leading cause of blindness. Although Anti-VEGF therapy is the first-line treatment in the market, a substantial number of patients are refractory to it or may develop resistance over time. As uncontrolled proliferation of vascular endothelial cells is one of the characteristic features of pathological neovascularization, we aimed to investigate the role of the class I histone deacetylase (HDAC) inhibitor Largazole, a cyclodepsipeptide from a marine cyanobacterium, in ocular angiogenesis. Our study showed that Largazole strongly inhibits retinal vascular endothelial cell viability, proliferation, and the ability to form tube-like structures. Largazole strongly inhibits the vessel outgrowth from choroidal explants in choroid sprouting assay while it does not affect the quiescent choroidal vasculature. Largazole also inhibits vessel outgrowth from metatarsal bones in metatarsal sprouting assay without affecting pericytes coverage. We further demonstrated a cooperative effect between Largazole and an approved anti-VEGF drug, Alflibercept. Mechanistically, Largazole strongly inhibits the expression of VEGFR2 and leads to an increased expression of cell cycle inhibitor, p21. Taken together, our study provides compelling evidence on the anti-angiogenic role of Largazole that exerts its function through mediating different signaling pathways.



2018 ◽  
Vol 1 (2) ◽  
pp. 45-53
Author(s):  
Nova Herdana ◽  
AK Ansyori ◽  
Ramzi Amin

Introduction. Diabetic retinopathy (RD) is one of the most common complications of diabetes mellitus, and is a major cause of blindness in patients aged 20-64 years worldwide. The main principle of the management of RD is to prevent, inhibit and overcome complications that occur. Vitrectomy, laser photocoagulation, intravitreal anti VEGF injection become modalities in RD therapy. If PDR has occurred, vitreous hemorrhage can occur or the retina is attracted by proliferation tissue, vitrectomy should be performed. Case Presentation. The patient is a 52-year-old man who came with the main complaint that both eyes have blurred slowly since ± 6 months ago. Blurred vision is not accompanied by red eyes, there is smoke-like vision. In the past the history of the disease obtained a history of DM 15 years of irregular control and hypertension of 3 years with regular control, a history of spectacles present. The ophthalmological examination of the right eye revealed a vision of 6/30 pH (-), TIOD within normal limits, and a grade II nuclear cataract in the lens. Right eye fundoscopy revealed decreased foveal reflexes and exudates in the macula, dot, blot, flame-shaped bleeding in 4 quadrants of the retina, exudate, venous beading, micro-aneurism. Management in these patients is pars plana vitrectomy, endolaser, and intravenous OS anti-VEGF injection under general anesthesia. Whereas the right eye was intravitreal photocoagulation laser and anti-VEGF laser (done 2 weeks before). Conclusion. A case of advanced left eye PDR with severe NPDR and right eye DME and grade II nuclear cataracts has been described in both eyes. Patients treated with laser photocoagulation in the right eye. In the left eye pars plana vitrectomy, endolaser, and intravitreal bevacizumab injection. Sharp vision of the left eye progressed postoperatively.



2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Raul Velez-Montoya ◽  
Idaira Sanchez-Santos ◽  
Mauricio Galvan-Chavez ◽  
Lihteh Wu ◽  
J. Fernando Arevalo ◽  
...  

Purpose. To assess the risk for capsular rupture during routine phacoemulsification in patients with a history of anti-VEGF injections and other possible risk modifiers such as treatment patterns, type of anti-VEGF agent, and experience of the surgeon, among others. Methods. This study reviewed the medical records of 11,129 patients from 7 different hospitals in 5 countries. The study included 939 patients that underwent routine phacoemulsification and had a history of anti-VEGF therapy. We excluded patients with known risk factors for capsular rupture, as well as patients with a history of other retinal procedures. The study extracted data regarding general demographics, the number of previous injections, type of anti-VEGF agent, details of cataract surgery, and anti-VEGF treatment patterns. Results. Overall prevalence of posterior capsular rupture: 7.45% (95% CI: 5.9–9.32%). The mean number of injections per patient was 3.37 ± 2.8. More than 50% of the patients received their last anti-VEGF injection within three months before cataract surgery. The complication rate during intravitreal injections was 1.07%. In the univariate analysis, the experience of the cataract surgeon (inexperience surgeons; OR: 2.93) and the history of prior anti-VEGF therapy (OR: 1.77) were significant risk indicators for PCR ( p < 0.05 ). However, after controlling for age in the multivariate analysis, the trend did not reach a statistical significance. Conclusion. The risk for capsular rupture is higher in patients with a history of intravitreal anti-VEGF injections.



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