scholarly journals Management of Uveitis-Related Choroidal Neovascularization: From the Pathogenesis to the Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Enzo D’Ambrosio ◽  
Paolo Tortorella ◽  
Ludovico Iannetti
Keyword(s):  
Choroidal Neovascularization ◽  
Intravitreal Bevacizumab ◽  
Posterior Uveitis ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Serpiginous Choroiditis ◽  
Age Related ◽  
Stromal Cell Derived Factor ◽  
Endothelial Growth Factor

Inflammatory choroidal neovascularization is a severe but uncommon complication of uveitis, more frequent in posterior uveitis such as punctate inner choroidopathy, multifocal choroiditis, serpiginous choroiditis, and Vogt-Koyanagi-Harada syndrome. Its pathogenesis is supposed to be similar to the wet age related macular degeneration: hypoxia, release of vascular endothelial growth factor, stromal cell derived factor 1-alpha, and other mediators seem to be involved in the uveitis-related choroidal neovascularization. A review on the factors implicated so far in the pathogenesis of inflammatory choroidal neovascularization was performed. Also we reported the success rate of single studies concerning the therapies of choroidal neovascularization secondary to uveitis during the last decade: photodynamic therapy, intravitreal bevacizumab, and intravitreal ranibizumab, besides steroidal and immunosuppressive therapy. Hereby a standardization of the therapeutic approach is proposed.

scholarly journals Human Vascular Endothelial Growth Factor A165 Expression Induces the Mouse Model of Neovascular Age-Related Macular Degeneration

Genes ◽  
2018 ◽  
Vol 9 (9) ◽  
pp. 438 ◽  
Author(s):  
Emmi Kokki ◽  
Tommi Karttunen ◽  
Venla Olsson ◽  
Kati Kinnunen ◽  
Seppo Ylä-Herttuala
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Gene Transfer ◽  
Mouse Model ◽  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Time Points ◽  
Age Related ◽  
Endothelial Growth Factor

Vascular endothelial growth factor (VEGF) expression induces age-related macular degeneration (AMD), which is a common vision-threatening disease due to choroidal neovascularization and a fibrovascular membrane. We describe a mouse model of neovascular AMD with the local expression of human VEGF-A165 in the eye. We use a transgenic mouse in which human VEGF-A165 has been silenced with the loxP-STOP fragment. The choroidal neovascularization and human VEGF-A165 expression in the mouse are induced by subretinal adenoviral Cre gene delivery. Cre gene transfer is compared with adenoviral LacZ gene transfer control. We characterize the AMD phenotype and changes in the vasculature by using fluorescein angiography, optical coherence tomography, and immunohistochemistry. At early time points, mice exhibit increases in retinal thickness (348 ± 114 µm vs. 231 ± 32 µm) and choroidal neovascularization area (12000 ± 15174 µm2 vs. 2169 ± 3495 µm2) compared with the control. At later time points, choroidal neovascularization develops into subretinal fibrovascular membrane. Human VEGF-A165 expression lasts several weeks. In conclusion, the retinas display vascular abnormalities consistent with choroidal neovascularization. Together with immunohistochemical findings, these changes resemble clinical AMD-like ocular pathologies. We conclude that this mouse model of Cre-induced choroidal neovascularization is useful for mimicking the pathogenesis of AMD, studying the effects of human VEGF-A165 in the retina, and evaluating anti-VEGF treatments for choroidal neovascularization.

scholarly journals Long-term Efficacy of a Treat-and-Extend Regimen With Ranibizumab in Patients With Neovascular Age-Related Macular Disease: An Open-label 12-month Extension to the CANTREAT Study

2021 ◽  
Author(s):  
Peter J. Kertes ◽  
Tom Sheidow ◽  
Geoff Williams ◽  
Mark Greve ◽  
Ivan J. Galic ◽  
...  
Keyword(s):  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Open Label ◽  
Intravitreal Ranibizumab ◽  
Macular Disease ◽  
Treat And Extend ◽  
Age Related ◽  
The Mean ◽  
Endothelial Growth Factor

Introduction: To assess the long-term effectiveness of a treat-and-extend (T&E) anti-vascular endothelial growth factor regimen in patients with neovascular age-related macular degeneration who remain on T&E and those switched from once-monthly (OM) dosing to T&E (OM-T&E). Methods: In this 12-month extension of the 2-year CANTREAT study, patients received intravitreal ranibizumab 0.5 mg in a T&E regimen. Main outcome measures included mean change in best-corrected visual acuity (BCVA) from baseline and from month 24 to month 36; percentages of patients who gained ≥5, ≥10, or ≥15 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters or lost ≥5, ≥10, or ≥15 letters from baseline and from month 24 to month 36; and number of injections administered from baseline and from month 24 to month 36 for both groups. Results: Of the 139 patients (73 T&E, 66 OM-T&E) in the extension, 121 (68 T&E, 53 OM-T&E) completed 36 months. Mean (standard deviation [SD]) BCVA changes from baseline to the extension last visit (month 33-36) were +6.6 (11.4) letters in the T&E group and +4.8 (14.3) letters in the OM-T&E group, representing maintenance of 24-month gains. The mean (SD) numbers of injections during the extension were 7.3 (2.7) for T&E and 7.1 (2.8) for OM-T&E. Discussion/Conclusion: These findings suggest that after 36 months of treatment, the mean BCVA improvement achieved at 24 months is maintained for both the patients exclusively treated with the T&E regimen and those that switched to T&E after 24 months in the OM regimen.

scholarly journals Aqueous Interleukin-6 Levels Are Superior to Vascular Endothelial Growth Factor in Predicting Therapeutic Response to Bevacizumab in Age-Related Macular Degeneration

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kakarla V. Chalam ◽  
Sandeep Grover ◽  
Kumar Sambhav ◽  
Sankarathi Balaiya ◽  
Ravi K. Murthy
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Degeneration ◽  
Interleukin 6 ◽  
Intravitreal Bevacizumab ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Sd Oct

Objective. To prospectively evaluate the effect of intravitreal bevacizumab on aqueous levels of interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with exudative age-related macular degeneration (AMD) and correlate clinical outcomes with cytokine levels.Methods. 30 eyes of 30 patients with exudative AMD underwent intravitreal injection of bevacizumab three times at monthly intervals. The aqueous samples prior to the 1st injection (baseline) and 3rd injection were analyzed for VEGF and IL-6 levels. Subjects were subgrouped based upon change in the central subfield (CSF) macular thickness on SD-OCT at 8 weeks. Group 1 included patients (n=14) with a decrease in CSF thickness greater than 10% from the baseline (improved group). Group 2 included patients (n=16) who had a decrease in CSF thickness 10% or less (treatment-resistant).Results. In subgroup analysis, in both groups 1 and 2 patients, compared to aqueous VEGF, aqueous IL-6 levels showed a better correlation with CSF thickness on SD-OCT (r=0.72and 0.71, resp.).Conclusions. Aqueous IL-6 may be an important marker of treatment response or resistance in wet macular degeneration. Future therapeutic strategies may include targeted treatment against both VEGF and IL-6, in patients who do not respond to anti-VEGF treatment alone.

scholarly journals Myopic Choroidal Neovascularization

2017 ◽  
pp. 280-284
Keyword(s):  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Pathologic Myopia ◽  
Vascular Endothelial ◽  
Myopic Choroidal Neovascularization ◽  
Age Related ◽  
Factor Therapy ◽  
Growth Factor Therapy ◽  
Endothelial Growth Factor

Myopic choroidal neovascularization (mCNV) is the second most common form of CNV after age-related macular degeneration. It is a sight-threatening complication of pathologic myopia and often affects patients in their working years and affects the quality of life of the patients. Previous therapies employed in the 2000's such as photodynamic therapy have shown limited visual improvement. Anti-vascular endothelial growth factor therapy (anti-VEGF) has been shown to be effective in the treatment of mCNV in several multicentric studies and has become the first-line treatment of choice. This article aims to review the epidemiology, pathophysiology, clinical features, and treatment of mCNV.

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