THE IMPACT OF FLUID COMPARTMENTS ON FUNCTIONAL OUTCOMES FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Background. To date, there are limited prospective real-world data on the impact of optical coherence tomography (OCT) diagnostics on treatment outcomes in neovascular age-related macular degeneration (nAMD). Therefore, the prospective, noninterventional OCEAN study (NCT02194803) evaluated the use of OCT imaging and its impact on functional outcomes in Germany. Methods. The use of OCT imaging for treatment decisions was documented in nAMD patients receiving intravitreal ranibizumab injections at 347 study centres. Best-corrected visual acuity (BCVA) testing and treatment were performed according to routine clinical practice and documented over 24 months. Results. The majority of the 3,631 nAMD patients (59.6%) received a combination of OCT and fluorescein angiography imaging within the first 6 months. Over the remaining study course, this combination was used infrequently (range: 7.6% to 13.4%) and continually decreased over time; most patients received only OCT examinations (range: 48.9% to 52.5%; median: 3 within 12 months and 4 within 24 months). Subgroups according to the number of OCT examinations (≤4, rarely OCT examined; 5–8, moderately OCT examined; ≥8, well monitored) were associated with different treatment frequencies and outcomes: Rarely OCT-examined patients had received a median of 4 injections (range: 1–19) at 24 months; well-monitored patients had received a median of 8 injections (range: 1–21) at 24 months. Rarely OCT-examined patients had a mean change of BCVA of −0.3 letters (±26.1) at 24 months (n = 165); well-monitored patients showed a change of +2.0 letters (±20.8) at 24 months (n = 249). Time-to-response was greater for rarely examined than well-monitored patients, while duration-of-response was similar. Conclusion. Low number of visits as well as high number of treatment decisions without the use of OCT may contribute to undertreatment and poorer functional outcomes in patients undergoing ranibizumab treatment for nAMD in Germany. One potential reason for this could be that OCT was not covered by insurance for all patients during the study.

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The Impact of Oxidative Stress on Blood-Retinal Barrier Physiology in Age-Related Macular Degeneration

Cells ◽

10.3390/cells10010064 ◽

2021 ◽

Vol 10 (1) ◽

pp. 64

Author(s):

Annamaria Tisi ◽

Marco Feligioni ◽

Maurizio Passacantando ◽

Marco Ciancaglini ◽

Rita Maccarone

Keyword(s):

Oxidative Stress ◽

Macular Degeneration ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Age Related Macular Degeneration ◽

Blood Retinal Barrier ◽

Functional Changes ◽

Beneficial Effects ◽

Age Related ◽

The Impact

The blood retinal barrier (BRB) is a fundamental eye component, whose function is to select the flow of molecules from the blood to the retina and vice-versa, and its integrity allows the maintenance of a finely regulated microenvironment. The outer BRB, composed by the choriocapillaris, the Bruch’s membrane, and the retinal pigment epithelium, undergoes structural and functional changes in age-related macular degeneration (AMD), the leading cause of blindness worldwide. BRB alterations lead to retinal dysfunction and neurodegeneration. Several risk factors have been associated with AMD onset in the past decades and oxidative stress is widely recognized as a key factor, even if the exact AMD pathophysiology has not been exactly elucidated yet. The present review describes the BRB physiology, the BRB changes occurring in AMD, the role of oxidative stress in AMD with a focus on the outer BRB structures. Moreover, we propose the use of cerium oxide nanoparticles as a new powerful anti-oxidant agent to combat AMD, based on the relevant existing data which demonstrated their beneficial effects in protecting the outer BRB in animal models of AMD.

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The Impact of Disease Activity on 5 year Outcomes in patients undergoing treatment for Neovascular Age Related Macular Degeneration

Retina ◽

10.1097/iae.0000000000003267 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Kelvin Yi Chong Teo ◽

Vuong Nguyen ◽

Chui Ming Gemmy Cheung ◽

Jennifer J Arnold ◽

Fred K. Chen ◽

...

Keyword(s):

Disease Activity ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Age Related ◽

The Impact

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The Impact of Switching Anti-Vascular Endothelial Growth Factor Therapy in the Management of Exudative Age-Related Macular Degeneration

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/23258160-20170928-14 ◽

2017 ◽

Vol 48 (10) ◽

pp. 859-869 ◽

Cited By ~ 2

Author(s):

Karen Jhi Wen Chia ◽

Dinesh Visva Gunasekeran ◽

Augustinus Laude

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Vascular Endothelial ◽

Age Related ◽

Factor Therapy ◽

Growth Factor Therapy ◽

Endothelial Growth Factor ◽

The Impact

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ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD)

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315717 ◽

2020 ◽

pp. bjophthalmol-2019-315717 ◽

Cited By ~ 2

Author(s):

Sandra Liakopoulos ◽

Georg Spital ◽

Christian K Brinkmann ◽

Tina Schick ◽

Focke Ziemssen ◽

...

Keyword(s):

Macular Degeneration ◽

Image Interpretation ◽

Subretinal Fluid ◽

Treatment Decisions ◽

Age Related Macular Degeneration ◽

Correct Identification ◽

Age Related ◽

Ocean Study ◽

The Impact ◽

Sd Oct

Background/aimsThe prospective, non-interventional ORCA module of the OCEAN study (Observation of Treatment Patterns with Lucentis in Approved Indications) evaluated the qualiy of spectral domain-optical coherence tomography (SD-OCT) image interpretation and treatment decisions by clinicians in Germany and the impact on visual outcomes over 24 months in patients with neovascular age-related macular degeneration (nAMD).Methods2286 SD-OCT scans of 205 eyes were independently evaluated by clinicians and reading centres (RCs) regarding signs of choroidal neovascularisation (CNV) activity, including presence of intraretinal fluid, subretinal fluid, and/or increase in pigment epithelial detachments. Agreement between clinicians and RCs was calculated. Treatment decisions by clinicians and the impact on treatment outcomes were evaluated.ResultsCNV activity was detected by RCs on 1578 scans (69.0%) and by clinicians on 1392 scans (60.9%), with agreement in 74.9% of cases. Of the 1578 scans with RC detected CNV activity, anti-vascular endothelial growth factor injections were performed by clinicians in only 35.5% (560/1578). In 19.7% of cases (311/1578), lack of treatment was justified by patients request, termination criteria or chronic cystoid spaces without other signs for CNV activity. In 44.8% of cases (707/1578) with RC detected CNV activity, clinicians claimed no treatment was necessary despite having correctly detected CNV activity in about 2/3 of these cases. In 34% of cases with presumed undertreatment, visual acuity declined in the following visit.ConclusionAlthough broad agreement on CNV activity parameters was observed between clinicians and RCs, correct identification of CNV activity did not always lead to the initiation of (re-)treatment. To preserve vision over time, correct interpretation of SD-OCT scans and careful retreatment decisions are required.Trial registration numberNCT02194803.

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PDG3 ANTI-VEGF DRUGS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION - A SYSTEMATIC REVIEW OF THE IMPACT OF ANTI-VEGF THERAPY ON REDUCING BLINDNESS AND VISUAL IMPAIRMENT

Value in Health ◽

10.1016/j.jval.2019.09.1017 ◽

2019 ◽

Vol 22 ◽

pp. S597

Author(s):

J. Carrasco ◽

K. Pantiri

Keyword(s):

Systematic Review ◽

Visual Impairment ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Anti Vegf ◽

Age Related ◽

The Impact

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Scanning Laser Ophthalmoscope in the Management of Age-related Macular Degeneration

European Ophthalmic Review ◽

10.17925/eor.2012.06.04.242 ◽

2012 ◽

Vol 06 (04) ◽

pp. 242

Author(s):

Nicole K Scripsema ◽

and Richard B Rosen ◽

◽

...

Keyword(s):

Macular Degeneration ◽

Fundus Autofluorescence ◽

Disease Process ◽

Scanning Laser Ophthalmoscope ◽

Age Related Macular Degeneration ◽

Scanning Laser ◽

Functional Changes ◽

Age Related ◽

The Impact ◽

Improved Methods

Recent advances in retinal imaging have improved the evaluation and prognostication of age-related macular degeneration. The development and modification of the scanning laser ophthalmoscope (SLO) has played a pivotal role in our understanding of the disease. SLO has led to improved methods of visualising characteristics of the disease, such as drusen and alterations in autofluorescence, and also provided a platform for the quantification of structural and functional changes occurring as a result of the disease process. This article provides a review of the current literature on the impact and clinical utility of SLO devices for infrared viewing, fundus autofluorescence, microperimetry, and as integraded multimodal imaging systems such as optical coherence tomography and SLO.

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