scholarly journals Intravitreal Dexamethasone in Patients with Wet Age-Related Macular Degeneration Resistant to Anti-VEGF: A Prospective Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ermete Giancipoli ◽  
Antonio Pinna ◽  
Francesco Boscia ◽  
Gianluigi Zasa ◽  
Giovanni Sotgiu ◽  
...  
Keyword(s):  
Pilot Study ◽  
Treatment Group ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Anti Vegf ◽  
Age Related ◽  
Intravitreal Dexamethasone

Purpose. To evaluate the efficacy and safety of a single intravitreal dexamethasone implant (DXI) combined with intravitreal antivascular endothelial growth factor (anti-VEGF) therapy, in patients with neovascular age-related macular degeneration (wet-AMD) resistant to conventional treatment. Methods. In this randomized, controlled pilot study, 16 eyes of 15 patients, unresponsive to anti-VEGF therapy, were enrolled and randomly assigned to two groups: DXI + anti-VEGF (treatment group: 11 eyes) and monthly anti-VEGF alone (control group: 5 eyes). Patients were treated at baseline and followed for 6 months. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) parameters, and fluorescein angiography (FA) were evaluated. Results. Eight eyes (72.7%) in the treatment group and 2 eyes in the control group (40%) showed complete retinal fluid resorption (p=0.049). BCVA showed no significant change from baseline in both the treatment group and the control group (p=0.40 and p=0.29, respectively). Both median central foveal thickness (CFT) and median macular volume showed a greater reduction from baseline in the treatment group. Conclusion. In patients showing an incomplete response to anti-VEGF therapy, DXI combined with intravitreal anti-VEGF seems to improve retinal fluid resorption without functional advantage. This trial is registered with ACTRN12618001102268.

Apelin-13: A Promising Biomarker for Age-Related Macular Degeneration?

2020 ◽  
Author(s):  
Esra Vural ◽  
Leyla Hazar ◽  
Cigdem Karakukçu ◽  
M. Erkam Arslan ◽  
M. Raşit Sirem ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Age Related ◽  
Treatment Naïve ◽  
Healthy Control ◽  
Group 2

Purpose: To investigate the value of serum apelin-13 levels in age-related macular degeneration patients. Methods: Patients with dry-type AMD, treatment-naive neovascular-type AMD and the healthy control group were included in this study. Patients diagnoses were confirmed with detailed fundus examination, optical cohorence tomography and fundus flourescein angiography findings. Central foveal thickness and subfoveal choroidal thickness were evaluated. Both serum apelin-13 and vascular endothelial growth factor (VEGF) levels were measured by competitive-enzyme-linked immunosorbent assay (ELISA) principle. Results: A total of 84 patients, including 24 patients in the dry-type AMD group (group 1), 27 patients in the neovascular-type AMD (group 2) group and 33 in the control group (group 3) were included in the study. Mean BCVA were 76±4,5, 48,4±16,3, 83,4±3,09 ETDRS letters in groups 1, 2 and 3, respectively. Values of serum VEGF were 44.11±26.14 pg/mL, 56.53±53.77 pg/mL and 61.47±41.62 pg/mL in groups 1, 2 and 3, respectively (p=0.553, p=0.286, p=0.896, respectively). Values of serum apelin-13 were 586.47±167.56 pg/mL, 622.18±324.52 pg/mL, 379. 31±171.96 pg/mL in groups 1, 2 and 3, respectively (p=0.847, p=0.04, p≤0.001, respectively). There was a negative correlation between the value of serum apelin and visual acuity and choroid thickness. Conclusion: Serum apelin-13 were higher in both dry-type AMD patients and neovascular AMD patients compared to the control group. Further studies are needed.

scholarly journals Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

2019 ◽  
Vol 4 (1) ◽  
pp. e000369 ◽  
Author(s):  
Henrik Faatz ◽  
Marie-Louise Farecki ◽  
Kai Rothaus ◽  
Matthias Gutfleisch ◽  
Daniel Pauleikhoff ◽  
...  
Keyword(s):  
Age Related Macular Degeneration ◽  
Fluid Distribution ◽  
Repeated Treatment ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Anti Vegf ◽  
Age Related ◽  
Sd Oct

ObjectiveOptical coherence tomography angiography (OCT-A) enables detailed visualisation of the vascular structure of choroidal neovascularisation (CNV). The aim of this study was to determine whether mathematically ascertained OCT-A vascular parameters of type 1 and type 2 CNV in exudative age-related macular degeneration (AMD) change during antivascular endothelial growth factor (anti-VEGF) treatment. The OCT-A vascular parameters were also compared with previously obtained activity parameters (fluid distribution on spectral domain OCT (SD-OCT)) to establish whether they could potentially be used as further ‘activity parameters’ for assessment of anti-VEGF treatment.Methods and AnalysisWe evaluated 27 eyes of 27 patients (mean follow-up 9.8 months) with type 1, type 2 or mixed CNV who had received anti-VEGF treatment (IVAN scheme). The parameters analysed were area (aCNV), total length of all vessels (tlCNV), overall number of vascular segments (nsCNV) and fractal dimension (FD) of the CNV. The changes in each of these parameters were correlated with the central foveal thickness (CFT).ResultsRegression and renewed perfusion of the CNV corresponded with the decrease or increase, respectively, of macular fluid distribution on SD-OCT. The increase and decrease of CFT during anti-VEGF treatment were highly significantly correlated with changes in FD (p<0.00001), aCNV (p<0.00001), tlCNV (p<0.00001) and nsCNV (p<0.00001).ConclusionOCT-A enables detailed analysis of AMD with regard to FD, aCNV, tlCNV and nsCNV. As the changes in these parameters correlate closely with changes on SD-OCT, they can be used as new activity parameters, alongside fluid distribution, for assessment of treatment effect and as parameters of stabilisation or the need for repeated treatment.

scholarly journals Topical Triamcinolone Acetonide-Loaded Liposome Formulation Used as an Adjuvant to Intravitreal Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration

Pharmaceutics ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1491
Author(s):  
Jose Navarro-Partida ◽  
Juan Carlos Altamirano-Vallejo ◽  
Luis Abraham Aceves Franco ◽  
Jesús Gonzalez-Cortes ◽  
Sergio Hernandez-Da Mota ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Triamcinolone Acetonide ◽  
Age Related Macular Degeneration ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Liposome Formulation ◽  
Age Related ◽  
Treatment Naïve ◽  
Vitreoretinal Diseases

Novel strategies have been developed to reduce or avoid intravitreal injections (IVTs) of the antiangiogenic (ranibizumab (RBZ)) and anti-inflammatory (triamcinolone acetonide (TA)) agents used to treat vitreoretinal diseases. One of the strategies includes liposomes. This study evaluated the safety and efficacy of a topical triamcinolone-loaded liposome formulation (TALF) as an adjuvant to intravitreal RBZ therapy in treatment- naïve patients with neovascular age-related macular degeneration (nAMD). Subjects were randomly assigned to the RBZ-TALF or the RBZ-pro re nata (RBZ-PRN) groups. Patients from the RBZ-TALF group were instructed to apply TALF for 12 months after a single dose of RBZ. Patients from the RBZ-PRN group received three monthly RBZ-IVTs. Retreatment with RBZ was considered in the case of nAMD reactivation. Regarding safety, non-ocular abnormalities were observed during TALF therapy. Concerning efficacy, non-significant differences were identified in terms of visual acuity or central foveal thickness when the RBZ-PRN and RBZ-TALF groups were compared. It is worth noting that the average number of RBZ injections was significantly lower in the RBZ-TALF group (2.5 ± 1.4 vs. 6.1 ± 1.3 IVTs; p = 0.0004). Therefore, TALF used as an adjuvant to RBZ reduces the need for RBZ-IVT retreatment with optimal visual and anatomic results.

Ganglion Cell Layer Thickness Change in Neovascular Age-Related Macular Degeneration Treated With Anti-VEGF Injections

2021 ◽  
pp. 247412642110403
Author(s):  
Dimosthenis Mantopoulos ◽  
Hetal Ray ◽  
George Sanchez ◽  
Russell Pokroy ◽  
Daniel B. Roth
Keyword(s):  
Ganglion Cell ◽  
Macular Degeneration ◽  
Ganglion Cell Layer ◽  
Cell Layer ◽  
Treated Group ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Fellow Eye ◽  
Anti Vegf ◽  
Age Related

Purpose: This work assesses bilateral ganglion cell layer–inner plexiform layer (GCL-IPL) thickness changes in patients with unilateral neovascular age-related macular degeneration (nAMD) treated with antivascular endothelial growth factor (anti-VEGF). Methods: In this single-center, retrospective, cohort study, the medical records of patients with unilateral nAMD treated with anti-VEGF were reviewed. The treated group included eyes with newly diagnosed nAMD that subsequently underwent treatment with intravitreal anti-VEGF injections. The control group was the fellow eye with dry AMD. Eyes receiving at least 10 intravitreal injections were included. Measurement of GCL-IPL thickness was performed at different time points using spectral domain–optical coherence tomography. Results: A total of 216 eyes of 108 patients met the inclusion criteria. The mean age ± SD was 80.1 ± 10.7 years. Eyes in the treated group underwent a mean ± SD of 20.2 ± 7.2 injections in 21.3 ± 6.8 months. At baseline, average mean ± SD of GCL-IPL thickness was 73.71 ± 8.81 µm and 73.84 ± 8.26 µm in the treated and fellow eye, respectively ( P = .795). After 10 injections the average thickness was 65.41 ± 14.08 µm and 68.77 ± 13.24 µm in the treated and fellow eye, respectively ( P = .007). The absolute decrease in thickness was significantly greater in the treated eye than the fellow eye (mean ± SD, 8.31 ± 11.19 µm vs 5.07 ± 10.83 µm, respectively; P = .002). Conclusions: GCL-IPL thickness decreased significantly in the treated group more than in the control group after 10 anti-VEGF injections. The mechanism and clinical significance of this observation warrants further study.

scholarly journals Aqueous Flare, Functional-Morphological Parameters, and Cytokines in Age-Related Macular Degeneration after Anti-VEGF Treatment

2021 ◽  
Vol 15 (1) ◽  
pp. 209-216
Author(s):  
Ryosuke Motohashi ◽  
Hidetaka Noma ◽  
Kanako Yasuda ◽  
Yuko Kasezawa ◽  
Hiroshi Goto ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Aqueous Humor ◽  
Patient Group ◽  
Inflammatory Mediators ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Suspension Array ◽  
Aqueous Flare ◽  
Anti Vegf ◽  
Age Related

Purpose: The role of inflammation and cytokines in AMD and anti-Vascular Endothelial Growth Factor (anti-VEGF) treatment remains unclear. Therefore, this study aimed to examine whether anti-VEGF treatment for exudative Age-related Macular Degeneration (AMD) affects aqueous flare value (an indicator of inflammation), functional-morphologic parameters, and aqueous humor levels of cytokines or inflammatory mediators. Methods: We compared aqueous humor levels of 8 cytokines, growth factors (including VEGF), and inflammatory mediators in 43 patients who received anti-VEGF treatment with aflibercept for AMD and 24 healthy controls by the suspension array method. In addition, we measured aqueous flare values with a laser flare meter and Central Macular Thickness (CMT) and Macular Volume (MV) by optical coherence tomography. Results: The patient group had a significantly higher aqueous flare value than the control group. At baseline, CMT showed significant correlations with aqueous humor levels of soluble intercellular adhesion molecule-1 (sICAM-1), monocyte chemoattractant protein 1 (MCP-1), interleukin (IL)-6, and IL-8 and MV, with aqueous humor levels of VEGF, sICAM-1, MCP-1, IL-6, and IL-8. Moreover, we found significant correlations between aqueous flare value and aqueous humor levels of MCP-1, IL-6, IL-8, and interferon-gamma–inducible protein 10. One month after anti-VEGF treatment, the patient group showed a significant correlation between the change in MV and improvement in best-corrected visual acuity (BCVA); CMT showed no such correlation. Conclusion: Inflammation appears to be involved in AMD. Change in MV may be an index of improvement in BCVA in patients receiving anti-VEGF treatment for AMD.

scholarly journals Topical Triamcinolone Acetonide-Loaded Liposomes Formulation Used as an Adjuvant to Intravitreal Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

2021 ◽  
Author(s):  
Jose Navarro-Partida ◽  
Juan Carlos Altamirano-Vallejo ◽  
Luis Abraham Aceves Franco ◽  
Jesús Gonzalez-Cortes ◽  
Sergio Hernandez Da Mota ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Triamcinolone Acetonide ◽  
Age Related Macular Degeneration ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Age Related ◽  
Treatment Naïve ◽  
Vitreoretinal Diseases ◽  
Anatomic Results

Novel strategies have been developed to reduce or to avoid the intravitreal injections (IVTs) of the antiangiogenic (ranibizumab; RBZ) and the anti-inflammatory (triamcinolone acetonide; TA) agents used to treat vitreoretinal diseases. One of the strategies include liposomes. In this study, it was evaluated the safety and efficacy of topical triamcinolone-loaded liposomes formulation (TALF) as an adjuvant to intravitreal RBZ therapy in treatment-naive patients with neovascular age related macular degeneration (nAMD). Subjects were randomly assigned to the RBZ-TALF or the RBZ-pro re nata (RBZ-PRN) group. Patients from the RBZ-TALF group were instructed to apply TALF for a 12-month period after a single dose of RBZ. Patients from the RBZ-PRN group received three monthly RBZ-IVTs. Retreatment with RBZ was considered in case of nAMD reactivation. Related to safety, non-ocular abnormalities were observed during TALF therapy. Owing to the efficacy, non-significant differences are identified in visual acuity or central foveal thickness when the RBZ-PRN and RBZ-TALF groups are compared. Importantly the average number of RBZ injections was significantly lower in the RBZ-TALF group (2.5 &plusmn; 1.4 vs 6.1 &plusmn; 1.3 IVTs; p=0004). Therefore, TALF used as an adjuvant to RBZ reduce the number of RBZ-IVTs retreatment with optimal visual and anatomic results.

scholarly journals Choroidal neovascularization activity and structure by optical coherence tomography angiography in age related macular degeneration

2021 ◽  
Vol 6 (6-1) ◽  
pp. 12-18
Author(s):  
M. A. Kovalevskaya ◽  
O. A. Pererva
Keyword(s):  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Vascular System ◽  
Developed Countries ◽  
Age Related Macular Degeneration ◽  
Control Group ◽  
Type I ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Age Related

Background. In economically developed countries, age-related macular degeneration (AMD) is the leading cause of visual disability among the population of the older age group. The main criterion for the anti-VEGF treatment of neovascular AMD is the activity of choroidal neovascularization (CNV), which is determined by its confi guration. The search for optimal criteria for quantifying the state of the macular region in order to decide on the appointment of anti-VEGF therapy continues.Aim: improving the effi ciency of diagnosis and treatment of AMD based on the assessment of the configuration of vascular system on the “Key to Diagnosis II” platform.Material and methods. The study included 341 patients: 64 % (218 patients, 267 eyes) with non-neovascular AMD, 36 % (123 patients, 174 eyes) – with neovascular AMD. 56 patients (58 eyes) had active type I CNV. Group 1A – active CNV before treatment (9 patients, 9 eyes), group 1B – non-active CNV after treatment with antiVEGF (9 patients, 9 eyes); control group – 10 patients (10 eyes) without AMD. Analysis of OCT-angio images of choriocapillaries included the isolation of CNV, its area, fractal dimension (Df) and the complexity of the vascular system (CVS) counting.Results. Group 1A: Df – 1.5871 ± 0.05, CVS – 2.29 ± 0.29, area – 11734 ± 4866; group 1B: Df – 1.6462 ± 0.08, CVS – 1.65 ± 0.18, area – 6797 ± 3818; control: Df – 1.9167 ± 0.06, CVS – 1, area – 0. Significant differences were found for CVS (p = 0.0003). Df correlates with the CNV area (p = 0.7) and is probably an unreliable parameter due to incomplete visualization of active CNV.Conclusions. CVS is a quantitative biomarker for determining the activity of type 1 CNV in patients with AMD and can serve as a parameter for convolutional neural networks training for automated analysis of OCT angiography images based on the “Key to Diagnosis II” platform

scholarly journals Comparison Between Ranibizumab Biosimilar, Innovator Ranibizumab and Bevacizumab in a Real World Situation

2021 ◽  
Author(s):  
Dhanashree Ratra ◽  
Krishnakanta Roy ◽  
Sneha Giridhar ◽  
Sushant Madaan
Keyword(s):  
Age Related Macular Degeneration ◽  
Maximum Effect ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Anti Vegf ◽  
Age Related ◽  
Significant Difference ◽  
Pro Re Nata ◽  
Real World Situation

Abstract PurposeTo analyze the efficacy of biosimilar ranibizumab as compared to innovator ranibizumab and bevacizumab.MethodsWe retrospectively analyzed consecutive patients treated with biosimilar ranibizumab for wet age related macular degeneration (AMD) and macular edema (ME) and compared them with ranibizumab and bevacizumab treated patients.ResultsOut of 202 patients, 67 (33.2%) received biosimilar ranibizumab (BSR), 69 (34.2%) ranibizumab (RBZ) and 66 (32.7%) bevacizumab (BEV). All patients received 3 consecutive injections followed by pro re nata dosing. The follow up ranged from 3 -24 months. The mean number of injections were 6.68 RBZ, 6.4 BEV and 4.7 BSR. At 3 months, nAMD (n=115, 56.9%) and ME (n= 87, 43.1%) groups showed significant improvement in vision and central foveal thickness (CFT) across all 3 agents. After ≥ 6 months, the effects were maintained in AMD group but not in ME group. Maximum effect was seen at 1 month. At no point of time, significant difference was noted among the 3 anti VEGF agents. No major safety concerns were noted.ConclusionsBiosimilar ranibizumab is comparable to innovator ranibizumab and bevacizumab in efficacy and safety. It can be added to the list of available anti VEGF agents for the treatment of vascular disorders.

scholarly journals Effects of treatment interruption on anatomical and functional status of eyes with neovascular age-related macular degeneration receiving anti-VEGF therapy

2021 ◽  
Vol 14 (1) ◽  
pp. 35-42
Author(s):  
Alexandr S. Kharakozov ◽  
Alexey N. Kulikov ◽  
Dmitrii S. Maltsev
Keyword(s):  
Treatment Group ◽  
Macular Degeneration ◽  
Treatment Interruption ◽  
Age Related Macular Degeneration ◽  
First Year ◽  
Anti Vegf ◽  
Age Related ◽  
End Of Treatment ◽  
Intraretinal Fluid ◽  
Second Year

AIM: To study anatomical and functional changes in eyes with neovascular age-related macular degeneration (AMD) receiving anti-VEGF therapy and experienced treatment interruption during COVID pandemic. MATERIAL AND METHODS: This retrospective study included 58 eyes (49 patients, 34 males and 15 females with a mean age of 73.2 9.4 years) with nAMD. Eyes in the first-year treatment group (18 eyes) received up to 7 intravitreal aflibercept injections, eyes in the second-year treatment group (21 eyes) were treated with pro re nata regimen. The treatment interruption period in the first and second-year treatment group was 5.5 0.7 and 5.5 1.0 months, respectively. RESULTS: Over the treatment interruption period, the first-year treatment group showed no statistically significant differences in best-corrected visual acuity (BCVA) and central retinal thickness (CRT), p = 0.25 and p = 0.09, respectively. At the same time, the second-year treatment group showed a statistically significant decrease in BCVA (p = 0.0004) and an increase in CRT (p = 0.002). Baseline BCVA was positively associated with BCVA at the end of treatment interruption (r = 0.82; p 0.0001). Presence of sub- and intraretinal fluid (p = 0.015 and p = 0.007, respectively), low BCVA (p 0.0001), high CRT (p = 0.019), alteration of the ellipsoid zone (p 0.001) were negatively associated with BCVA at the end of treatment interruption. Age (p = 0.8), gender (p = 0.41), and the number of intravitreal injections (p = 0.5) showed no association with changes in BCVA. CONCLUSIONS: NAMD patients of the second year of anti-VEGF therapy appear to have a higher risk of functional loss during treatment interruption. Higher CRT and lower BCVA, as well as sub- and intraretinal fluid before treatment interruption, are associated with poorer functional status at the end of the interruption period.

Sign in / Sign up

Export Citation Format

Share Document