Two-year outcomes of intravitreal ziv-aflibercept

AimTo assess the two-year outcome of intravitreal ziv-aflibercept (IVZ) in eyes with macular diseases.MethodsConsecutive subjects with various macular diseases that received six or more of 0.05 mL IVZ (1.25 mg) injections with at least 1 year follow-up were included. Outcome measures were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution) and central macular thickness (CMT) on spectral domain optical coherence tomography. Paired comparison was done using Wilcoxon signed-rank test calculator.Results107 eyes of 91 subjects received IVZ and were followed with mean±SD follow-up interval of 1.48±0.44 months following treat and extend or pro-re-nata protocol. The distribution included neovascular macular degeneration (42 eyes), diabetic macular oedema (32 eyes) and macular oedema secondary to retinal vein occlusion (11 eyes). Fifty eyes were naive, while 57 eyes were previously treated. Combining all disease categories, CMT decreased significantly by 133.0±153.0 µm at the 24-month follow-up (P<0.001) with BCVA gain of 0.35±0.37 at the 24-month follow-up (P<0.001) with mean number of injections of 8.5 at month 12, 2.4 between 12 and 18 month and 1.7 between 18 and 24 month. Ocular and systemic adverse effects included one episode of transient uveitis and one instance of central retinal artery occlusion after 1121 injections.ConclusionsIVZ appears safe and efficacious in the therapy of macular diseases through 2 years.

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Long-term outcome of treat and extend intravitreal ziv-aflibercept therapy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312593 ◽

2018 ◽

Vol 103 (7) ◽

pp. 938-941 ◽

Cited By ~ 2

Author(s):

Ahmad M Mansour ◽

Abdulrazzak Charbaji ◽

Michel Eid Farah ◽

Hana A Mansour ◽

Jay Chhablani

Keyword(s):

Paired Comparison ◽

Diabetic Macular Oedema ◽

Age Related Macular Degeneration ◽

Rank Test ◽

Term Outcome ◽

Long Term Outcome ◽

Treat And Extend ◽

Age Related ◽

Macular Diseases

AimTo assess the 30-month outcome of treat and extend (TAE) intravitreal ziv-aflibercept therapy in eyes with macular diseases.MethodsIn this prospective study, consecutive subjects received intravitreal 0.05 mL ziv-aflibercept (1.25 mg) injections for various macular diseases. Outcome measures were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution) and central macular thickness (CMT) on spectral domain optical coherence tomography. Paired comparison was done using Wilcoxon signed-rank test calculator.ResultsFifty-three eyes of 48 subjects (33 naïve eyes) received intravitreal ziv-aflibercept and were followed between 12 and 30 months following TAE included neovascular age-related macular degeneration (nAMD) (35 eyes) and diabetic macular oedema (DMO) (18 eyes). In eyes with nAMD, CMT decreased by 107.8 µm at the 30-month follow-up (p=0.012) with BCVA gain of 0.52 (p=0.001). In eyes with DMO, CMT decreased by 224.3 µm at the 30-month follow-up (p=0.027) with BCVA gain of 0.46 (p=0.042). Combining all disease categories, the mean number of injections was 9.2 at month 12, 2.5 between 12 and 18 months, 1.6 between 18 and 24 months and 1.0 between 24 and 30 months.ConclusionsUsing TAE regimen, intravitreal ziv-aflibercept appeared efficacious at managing retinal disease through month 30 using the TAE regimen.

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The Efficacy of Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors for the treatment of chronic diabetic macular oedema in vitrectomised eyes: a retrospective study

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2017-000130 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000130 ◽

Cited By ~ 4

Author(s):

Hiroki Mieno ◽

Kazuhito Yoneda ◽

Masahiro Yamazaki ◽

Ryosuke Sakai ◽

Chie Sotozono ◽

...

Keyword(s):

Macular Oedema ◽

Sglt2 Inhibitor ◽

Diabetic Macular Oedema ◽

Sglt2 Inhibitors ◽

Rank Test ◽

Sodium Glucose Cotransporter ◽

Signed Rank ◽

Before And After ◽

Patients With Diabetes ◽

Signed Rank Test

ObjectiveTo investigate the change of chronic diabetic macular oedema (DMO) in vitrectomised eyes when the administration of sodium–glucose cotransporter 2 (SGLT2) inhibitors is initiated as a systemic medical treatment.Methods and analysisThis study involved 10 eyes of five patients with chronic DMO lasting more than 6 months who had previously undergone vitrectomy and whose systemic medical treatments were newly changed to SGLT2 inhibitors. In this study, chronic DMO was defined as persistent diffuse macular oedema despite ophthalmic treatment in patients with diabetes. Patients who received antivascular endothelial growth factor therapy or steroids administration, or change of eye-drop medication from at 3 months before and after the initiation of SGLT2 inhibitors, were excluded. In this study, visual acuity (VA) and central retinal thickness (CRT, μm) prior to and at 3, 6 and 12 months after the initiation of SGLT2 inhibitors were retrospectively compared. The Wilcoxon signed-rank test was used for statistical analysis.ResultsIn the 10 treated eyes, from at baseline to at 3, 6 and 12 months after the initiation of SGLT2 inhibitor, median VA (logMAR) improved from 0.35 to 0.15 (p=0.038), 0.2 (p=0.157) and 0.2 (p=0.096), respectively, and median CRT significantly reduced from 500.5 µm to 410 µm (p<0.01), 378 µm (p<0.01) and 339 µm (p<0.01), respectively.ConclusionAlthough this study involved only five patients, our findings indicate that SGLT2 inhibitors might have structural efficacy for chronic DMO in vitrectomised eyes.

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Abstract T MP110: Central Retinal Artery Occlusion in Patients with Sickle Cell Disease

Stroke ◽

10.1161/str.46.suppl_1.tmp110 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Hashim Khan ◽

Morad Chughtai ◽

Ahmed A Malik ◽

Adnan I Qureshi ◽

Fareed K Suri

Keyword(s):

Risk Factors ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Central Retinal Artery Occlusion ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Cell Disease ◽

History Of ◽

Retinal Artery

Objective: To determine the rate of and risk factors for incident central retinal artery occlusion (CRAO) among patients with sickle cell disease enrolled in a large cohort with longitudinal follow-up. Background: Sickle cell disease increases the risk of ischemic stroke among women but the risk of CRAO is not studied. Design/Methods: A total of 4085 patients from newborns to 77 years-old, were enrolled in Phase 1 of Cooperative Study of Sickle Cell Disease from 23 centers across the US. Participants underwent a baseline examination for assessment of demographics, prior medical history, lab assessments, and clinical data. Post baseline data included routine follow-up examinations, measures of organ damage, and collection of acute and chronic complications. The risk factors for CRAO were identified using Cox Proportional Hazards analysis. Results: A total of 9 (0.002%) of 4085 patients with sickle cell disease developed CRAO over a mean follow-up of 5.2 (95% CI 0.9 - 11.3) months, with an estimated incidence of 0.02 per 100 patient years. The incidence of CRAO was 0.03 per 100 patient years and 0.05 per 100 patient years in men and women, respectively. The history of previous stroke (2.6% versus 0.0%, p=0.7) and the proportion of patients diagnosed with large arterial occlusive disease (55.6% versus 7.7%, p=<0.001) was greater in those who developed CRAO compared to those who did not develop CRAO. History of exchange transfusions (2.7 % versus 22.2 %, p=0.02) and cigarette smoking (13.7 % versus 22.2 %, p =0.4) were more common among patients who developed CRAO. The hematocrit (%) (mean ± SD) was similar between patients who did or did not develop CRAO (29.5 ± 9.6 versus 27.3 ± 5.6, p=0.3). At completion of follow-up, 22.2% (n=2) patients with CRAO reported disability compared with 11.1% (n=455) patients without CRAO (p=0.7) Conclusions: The incidence of CRAO is relatively high among patients with sickle cell disease and was associated with disability.

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Combined vitrectomy, near-confluent endolaser, bevacizumab and cyclophotocoagulation for neovascular glaucoma

10.1101/2020.01.19.20017889 ◽

2020 ◽

Author(s):

P. Strzalkowski ◽

A. Strzalkowska ◽

W. Göbel ◽

T. Ach ◽

N.A. Loewen ◽

...

Keyword(s):

Central Retinal Artery Occlusion ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Retinal Artery Occlusion ◽

Neovascular Glaucoma ◽

Pain Scale ◽

Artery Occlusion ◽

Panretinal Photocoagulation ◽

One Year

AbstractPurposeEvaluated the safety and efficacy of an integrative surgical approach to neovascular glaucoma (NVG).MethodsConsecutive interventional case series of NVG with one-year follow-up. Eyes underwent pars plana vitrectomy, near-confluent panretinal photocoagulation, intravitreal bevacizumab, and transscleral cyclophotocoagulation. Phakic eyes underwent concomitant cataract surgery. Best-corrected visual acuity (BCVA, logMAR), intraocular pressure (IOP, mmHg), glaucoma medication score (GMS), visual analog pain scale (VAPS, 0-10) were recorded at baseline, and 1, 3, 6 and 12 months. Blind eyes were excluded.Results83 eyes of 83 patients (53 male, 30 female, mean age 74.6±11.6 years) were included and 53 completed a one-year follow-up. NVG underlying conditions included retinal vein occlusion (n=41), proliferative diabetic retinopathy (n=25), central retinal artery occlusion (n=10), and ocular ischemic syndrome (n=6). Mean IOP decreased postoperatively from 46.0±10.3 mmHg to 14.2±8.9 mmHg (p<0.001), GMS from 4.8 to 1.8 (p<0.001) and VAPS from 6 to 0. BCVA was unchanged. All postoperative complications had resolved at 1 month postop. 26 eyes did not require additional surgical treatment during follow-up.ConclusionsA single, comprehensive surgery session was able to significantly lower IOP, reduce GMS and control pain.

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Combined vitrectomy, near-confluent panretinal endolaser, bevacizumab and cyclophotocoagulation for neovascular glaucoma — a retrospective interventional case series

F1000Research ◽

10.12688/f1000research.26879.2 ◽

2021 ◽

Vol 9 ◽

pp. 1236

Author(s):

Piotr Strzalkowski ◽

Alicja Strzalkowska ◽

Winfried Göbel ◽

Nils A. Loewen ◽

Jost Hillenkamp

Keyword(s):

Central Retinal Artery Occlusion ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Retinal Artery Occlusion ◽

Neovascular Glaucoma ◽

Pain Scale ◽

Artery Occlusion ◽

Panretinal Photocoagulation ◽

Glaucoma Medication

Background: Neovascular glaucoma (NVG) is a severe, potentially blinding disease and a therapeutic challenge. The purpose of this study was to evaluate the safety and efficacy of an integrative surgical approach to neovascular glaucoma. Methods: Retrospective analysis of a one-year follow-up of a consecutive interventional case series of NVG. Eyes underwent transscleral cyclophotocoagulation, pars plana vitrectomy, near-confluent panretinal photocoagulation, and intravitreal bevacizumab. Phakic eyes underwent concomitant cataract surgery. Best-corrected visual acuity (BCVA, logMAR), intraocular pressure (IOP, mmHg), number of glaucoma medication, visual analog pain scale (VAPS, 0-10) were recorded at baseline, and 1, 3, 6, and 12 months. Blind eyes were excluded. Results: Seventy-seven eyes of 77 patients (45 male, 32 female, mean age 73.6±12.2 years) were included. NVG underlying conditions included retinal vein occlusion (41.6%), proliferative diabetic retinopathy (35.1%), central retinal artery occlusion (19.5%), and ocular ischemic syndrome (3.9%). Mean IOP decreased postoperatively from 46.3±10.1 mmHg to 14.5±7.9 mmHg (p<0.001), glaucoma medication from 4.7±1.3 to 1.8±1.8 (p<0.001), and VAPS from 6.0±1.8 to 0. BCVA remained unchanged. Postoperative intraocular inflammation had resolved in all eyes at the one-month follow-up. 71.4% (55/77) eyes did not require additional major interventions during follow-up. Conclusions: A single, comprehensive surgery session lowered IOP significantly, reduced GMS, and controlled pain.

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Combined vitrectomy, near-confluent panretinal endolaser, bevacizumab and cyclophotocoagulation for neovascular glaucoma — a retrospective interventional case series

F1000Research ◽

10.12688/f1000research.26879.1 ◽

2020 ◽

Vol 9 ◽

pp. 1236 ◽

Cited By ~ 1

Author(s):

Piotr Strzalkowski ◽

Alicja Strzalkowska ◽

Winfried Göbel ◽

Nils A. Loewen ◽

Jost Hillenkamp

Keyword(s):

Central Retinal Artery Occlusion ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Retinal Artery Occlusion ◽

Neovascular Glaucoma ◽

Pain Scale ◽

Artery Occlusion ◽

Panretinal Photocoagulation ◽

Glaucoma Medication

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Local fibrinolysis in central retinal artery occlusion: follow-up in 36 cases

Proceedings of the XV Symposium Neuroradiologicum ◽

10.1007/978-3-642-79434-6_217 ◽

1995 ◽

pp. 458-460 ◽

Cited By ~ 1

Author(s):

M. Schumacher ◽

D. Schmidt

Keyword(s):

Central Retinal Artery Occlusion ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Central Retinal Artery ◽

Local Fibrinolysis ◽

Retinal Artery

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Sudden painless loss of vision following spine surgery: lessons learnt in darkness

BMJ Case Reports ◽

10.1136/bcr-2020-235888 ◽

2021 ◽

Vol 14 (1) ◽

pp. e235888

Author(s):

Eswar Ramakrishnan ◽

Sathish Muthu ◽

Bosco Aju ◽

Uvaraj R Nalli

Keyword(s):

Road Traffic ◽

Central Retinal Artery Occlusion ◽

Preoperative Assessment ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Posterior Stabilisation ◽

Oral Hypoglycemics ◽

Minimal Improvement ◽

History Of

A 26-year-old male driver presented with a history of pain in the neck for the past 1 week following trauma due to a road traffic accident. The patient had no neurological deficit. He had type 1 diabetes and was on regular oral hypoglycemics. After radiological investigations, the patient was diagnosed to have traumatic AO Spine Classification type C translational injury involving anterolisthesis of C6 over C7. After a detailed preoperative assessment, the patient was taken up for surgery. The patient underwent posterior stabilisation with instrumentation from C5 to T2. On extubation from anaesthesia, he immediately complained of complete painless loss of this vision in his left eye. Ophthalmological investigations attributed the cause to be due to central retinal artery occlusion. The patient was discharged with reassurance on the 20th postoperative day with minimal improvement in his vision and at 6-month follow-up, his vision improved to 1/60 and was advised for close follow-up.

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Central retinal artery occlusion in patients with cerobro vascular accident in a teaching hospital in rural Telangana, India

International Surgery Journal ◽

10.18203/2349-2902.isj20190830 ◽

2019 ◽

Vol 6 (3) ◽

pp. 953

Author(s):

Karthika N. ◽

Bharath Madhavaram ◽

Ashok Kumar

Keyword(s):

Vision Loss ◽

Central Retinal Artery Occlusion ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Central Retinal Artery ◽

Inclusion Criteria ◽

Medical Sciences ◽

Retinal Artery ◽

Criteria For Diagnosis

Background: Central retinal artery occlusion (CRAO) is a stroke of the eye caused by obstruction of the central retinal artery, usually by a thrombus or embolus that results in painless, disabling vision loss, hence it is an occular emergency. This study was done to know the visual outcomes in patients with CRAO.Methods: An observational study was conducted on the patients admitted with cerebrovascular accident at MediCiti Institute of Medical Sciences over a period of 2yrs i.e. from January 2015 to December 2016. The study included 75 patients with Cerebro-Vascular Accident (CVA) that met the inclusion criteria for diagnosis of CRAO.Results: A total of 75 cases with CVA admitted to the hospital were included in the study. The age group ranged from 50 to 80 years (median age 65 years). Among these, 64 cases were associated with hypertension and 46 cases with diabetes. Six patients (8%) had CRAO with sparing of cilio-retinal artery.Conclusions: CRAO has a diverse etiology. It can vary from hypertension to even snake bite. As it is an occular emergency, Identification of under lying cause is essential during follow-up for better intervention.

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