Association between Inflammatory Factors in the Aqueous Humor and Hyperreflective Foci in Patients with Intractable Macular Edema Treated with Antivascular Endothelial Growth Factor

Background. To evaluate the correlations between the inflammatory factors in the aqueous humor and hyperreflective foci (HRF) in patients with intractable macular edema treated with antivascular endothelial growth factor (anti-VEGF). Methods. This study included 17 patients with intractable macular edema (ME) treated with anti-VEGF agents. Inflammatory factors in the aqueous humor were measured by the Cytometric Beads Array before injection, and the numbers of HRF pre- and post-anti-VEGF treatment were counted from four different directions (90 degrees, 45 degrees, 180 degrees, and 135 degrees) in the SD-OCT images, respectively, before treatment and one month after treatment. The correlations between inflammatory factors and the numbers of HRF were assessed. Results. The numbers of HRF were reduced significantly after anti-VEGF treatment. The change in the HRFs at the 90-degree location was significantly positively correlated with IL-8 and VCAM-1. The change of all HRFs was significantly positively correlated with IL-8. The HRFs before the treatment also had a positive correlation with IL-8 and VCAM-1. Conclusion. After anti-VEGF treatment, the numbers of HRF in intractable ME declined greatly. The higher the levels of IL-8 and VCAM-1 before treatment, the more significant the reduction of HRF after anti-VEGF treatment, which indicated that HRF could be an effective noninvasive imaging indicator for evaluating the effect of anti-VEGF on intractable macular edema. The OCT images at the 90-degree location could better show the inflammatory reaction of patients and also had better clinical significance for the prognosis evaluation of ME associated with inflammation.

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Evaluation of Patients Receiving Intravitreal Antivascular Endothelial Growth Factor for Diabetic Macular Edema in Clinical Practice in the United States

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420953067 ◽

2020 ◽

pp. 247412642095306

Author(s):

John D. Pitcher ◽

Andrew A. Moshfeghi ◽

Genevieve Lucas ◽

Nick Boucher ◽

Hadi Moini ◽

...

Keyword(s):

Clinical Practice ◽

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

The United States ◽

Treatment Frequency ◽

Anti Vegf ◽

Injection Frequency ◽

Antivascular Endothelial Growth Factor ◽

Endothelial Growth Factor

Purpose: We assessed the effect of treatment frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents on visual acuity (VA) in diabetic macular edema (DME). Methods: This retrospective analysis assessed electronic medical records of eyes newly diagnosed with DME and treated with an anti-VEGF agent at US clinics using the Vestrum Health (Naperville, Illinois) treatment and outcomes database. Eyes were divided into 2 injection frequency subcohorts (≤ 6 vs > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated. Results: Among 155 240 eyes assessed, 3028 met inclusion criteria for analysis in year 1 and 1292 in year 2. During year 1 of treatment, 57% (n = 1725) received > 6 injections; most continued to receive the same injection frequency during year 2. Mean VA gain from baseline at year 1 was lower in the ≤ 6 than in the > 6 injections/year subcohort (3.7 vs 8.0 letters, respectively; P < .001). Mean VA change from the end of year 1 to year 2 for eyes receiving ≤ 6 injections in year 1 generally remained unchanged, irrespective of year 2 dosing frequency. In eyes that received > 6 injections in year 1, mean VA loss was significantly greater for eyes receiving less-frequent dosing in year 2 than in those maintained on > 6 injections. Conclusions: More than 50% of eyes with DME in routine clinical practice that completed at least 1 year of follow-up received > 6 injections of an anti-VEGF agent during the first year, resulting in better VA gains than eyes treated less frequently.

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Aqueous Humor Levels of Soluble Vascular Endothelial Growth Factor Receptor and Inflammatory Factors in Diabetic Macular Edema

Ophthalmologica ◽

10.1159/000475603 ◽

2017 ◽

Vol 238 (1-2) ◽

pp. 81-88 ◽

Cited By ~ 14

Author(s):

Hidetaka Noma ◽

Tatsuya Mimura ◽

Kanako Yasuda ◽

Ryosuke Motohashi ◽

Osamu Kotake ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Aqueous Humor ◽

Growth Factor Receptor ◽

Inflammatory Factors ◽

Vascular Endothelial ◽

Endothelial Growth Factor

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Use of Anti-VEGF Drugs in Retinal Vein Occlusions

Current Drug Targets ◽

10.2174/1389450121666200428101343 ◽

2020 ◽

Vol 21 (12) ◽

pp. 1181-1193

Author(s):

Manuel AP Vilela

Keyword(s):

Growth Factor ◽

Macular Edema ◽

Laser Therapy ◽

Visual Loss ◽

Western World ◽

Vein Occlusion ◽

Anti Vegf ◽

Antivascular Endothelial Growth Factor ◽

Endothelial Growth Factor ◽

Retinal Vein Occlusions

Retinal vein occlusion (RVO) is one of the most prevalent causes of visual loss in the Western World. Its pathogenesis is still not completely known. Chronic macular edema and ischemia compromise the functional and anatomical status of the retina. Antivascular endothelial growth factor (anti-VEGF) injections have demonstrated better results than other previous options, including observation or laser therapy. This narrative review aims to analyze the current aspects related to these drugs.

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Factors associated with the duration of action of dexamethasone intravitreal implants in diabetic macular edema patients

Scientific Reports ◽

10.1038/s41598-019-56143-1 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Young Gun Park ◽

Moon Young Choi ◽

Jin-woo Kwon

Keyword(s):

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Aqueous Humor ◽

Average Duration ◽

Vascular Endothelial ◽

Duration Of Action ◽

Hyperreflective Foci ◽

Intravitreal Dexamethasone ◽

Endothelial Growth Factor

AbstractWe designed this study to determine the association between the duration of action of intravitreal dexamethasone implants and aqueous humor biomarkers or optical coherence tomography (OCT) findings of diabetic macular edema (DME) patients. We measured the concentrations of interleukin (IL)-1β, -8, -10, -17; placental growth factor; and vascular endothelial growth factor in the aqueous humor, and identified the number of hyperreflective foci (HF), grades of ellipsoid zone disruptions, and baseline central subfield thicknesses (CSTs) using OCT of patients with DME. The average duration of action of dexamethasone implants was 4.32 ± 1.18 months. In multivariate linear regression analyses, the duration of action was associated with aqueous IL-8 levels and the number of HF (β = −0.016, p = 0.037 and β = −0.073, p = 0.035, respectively). Multivariate logistic regression showed that the number of HF (>10) was significantly associated with a shorter duration (<4 months) of action (odds ratio: 17.17, p = 0.010). The duration of action of intravitreal dexamethasone implants in DME patients was associated with the level of aqueous IL-8 and the number of HF using OCT. Specifically, higher number of HF in the OCT was associated with a shorter duration of action.

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Choroidal Vascularity Index as a Biomarker for Visual Response to Antivascular Endothelial Growth Factor Treatment in Diabetic Macular Edema

Journal of Diabetes Research ◽

10.1155/2021/3033219 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Ningxin Dou ◽

Shanshan Yu ◽

Ching-Kit Tsui ◽

Boyu Yang ◽

Jianqiang Lin ◽

...

Keyword(s):

Visual Acuity ◽

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Subretinal Fluid ◽

Visual Response ◽

Anti Vegf ◽

Antivascular Endothelial Growth Factor ◽

Endothelial Growth Factor ◽

Growth Factor Treatment

Purpose. To investigate the choroidal vascularity index (CVI) as a prognostic factor for the visual efficacy of antivascular endothelial growth factor (VEGF) treatment in diabetic macular edema (DME). Methods. We retrospectively reviewed 92 DME eyes receiving anti-VEGF treatment, which were stratified as responders (≥5 letters gained) and nonresponders (<5 letters gained or lost). Baseline systematic features and optical coherence tomography features, including the CVI, adjusted ellipsoid zone (EZ) reflectivity, subretinal fluid (SRF), and disorganization of the retinal inner layers (DRIL), were evaluated between the two groups. Results. The baseline CVI was significantly lower in nonresponders than in responders ( 0.66 ± 0.05 , 0.69 ± 0.05 , and 0.72 ± 0.05 , p = 0.014 ). After adjusting for other factors, the baseline CVI, DRIL, SRF, and adjusted EZ reflectivity were significantly associated with visual outcomes (CVI: odds ratio OR = 0.17 , p = 0.006 ; adjusted EZ reflectivity: OR = 0.56 , p = 0.007 ; DRIL: OR = 6.71 , p = 0.001 ; and SRF: OR = 0.29 , p = 0.008 ). Conclusion. DME patients with a higher CVI, higher adjusted EZ reflectivity, the presence of SRF, and the absence of DRIL at baseline were more likely to gain >5 letters in visual acuity after anti-VEGF treatment. CVI may serve as a novel biomarker for visual response to anti-VEGF treatment in DME.

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Association of Systemic or Intravitreal Antivascular Endothelial Growth Factor (Anti-VEGF) and Impaired Wound Healing in Pediatric Patients

Journal of Wound Ostomy and Continence Nursing ◽

10.1097/won.0000000000000764 ◽

2021 ◽

Vol 48 (3) ◽

pp. 256-261

Author(s):

Vita Boyar

Keyword(s):

Wound Healing ◽

Growth Factor ◽

Pediatric Patients ◽

Impaired Wound Healing ◽

Anti Vegf ◽

Antivascular Endothelial Growth Factor ◽

Endothelial Growth Factor

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Treatment of Eyes With Diabetic Macular Edema That Had a Suboptimal Response to Antivascular Endothelial Growth Factor Therapy: 2-mg Intravitreal Triamcinolone Acetonide vs 0.7-mg Dexamethasone Implant

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420917268 ◽

2020 ◽

Vol 4 (5) ◽

pp. 372-376

Author(s):

Brandon Kuley ◽

Philip P. Storey ◽

Maitri Pancholy ◽

Turner D. Wibbelsman ◽

Anthony Obeid ◽

...

Keyword(s):

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Triamcinolone ◽

Treatment Groups ◽

Antivascular Endothelial Growth Factor ◽

Factor Therapy ◽

Growth Factor Therapy ◽

Endothelial Growth Factor

Purpose: This article compares 2-mg intravitreal triamcinolone (IVT) and 0.7-mg dexamethasone (DEX) implant for the treatment of diabetic macular edema in eyes that had a suboptimal response to antivascular endothelial growth factor therapy. Methods: A single-center, retrospective review was conducted of patients receiving either IVT between January 1, 2013, and January 1, 2018, or patients receiving DEX between October 1, 2015, and January 1, 2018. Visual acuity and central macular thickness (CMT) were recorded at visit of first injection and all subsequent visits. Results: Twenty-five eyes were included in the DEX group and 32 eyes were included in the IVT group. Change in vision from baseline was similar between DEX and IVT at 6-month follow-up (1.1 lines vs 2.3 lines, respectively; P = .24). Mean decrease in CMT from baseline was not different at 6-month follow-up (DEX: 120 µm vs IVT: 185 µm; P = .17). Conclusions: DEX and 2-mg IVT both achieved improvement in vision and CMT with no significant differences between treatment groups at 6-month follow-up.

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Antivascular Endothelial Growth Factor Treatment Might Be Continued Even After Vitrectomy for Endophthalmitis in Neovascular Age-Related Macular Degeneration

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419883561 ◽

2019 ◽

Vol 4 (1) ◽

pp. 6-12

Author(s):

Zofia Michalewska ◽

Jerzy Nawrocki

Keyword(s):

Growth Factor ◽

Macular Degeneration ◽

Visual Outcome ◽

Age Related Macular Degeneration ◽

Anti Vegf ◽

Endothelial Growth Factor ◽

Mean Time

Purpose: This article studies visual outcome and frequency of antivascular endothelial growth factor (anti-VEGF) injections continued in patients with neovascular age-related macular degeneration (AMD) who had an earlier vitrectomy for postinjection endophthalmitis. Methods: A retrospective interventional study was conducted reviewing our database for patients with a diagnosis of endophthalmitis in the course of anti-VEGF injections. Endophthalmitis diagnosis was made on clinical examination of pain, rapid decrease in visual acuity (VA), conjunctival hyperemia, hypopyon, and vitritis. In all eyes, core vitrectomy with intravitreal antibiotics was performed. Spectral-domain optical coherence tomography was performed monthly before and after surgery during follow-up. Anti-VEGF injections were continued after surgery in all cases. Results: Eight eyes with postinjection endophthalmitis were included. Mean VA immediately before endophthalmitis was 20/50 Snellen with a mean of 19 intravitreal anti-VEGF injections ( P = .45). At time of endophthalmitis diagnosis, mean VA was 20/1000 (range, 20/2000-20/200). Mean time from injection to when the patient noted first symptoms was 4.3 days (range, 1-8 days). Mean time from first symptoms to surgery was 12 hours (range, 2.5-26 hours). Final mean VA at the end of follow-up (range, 12-84 months) did not statistically differ from VA at the visit immediately before endophthalmitis diagnosis ( P = .69). Mean frequency of injections after vitrectomy did not significantly differ from the presurgical course of treatment ( P =.97). Conclusions: Anti-VEGF treatment might be continued after vitrectomy for endophthalmitis and results in satisfactory anatomical and visual outcome. Surgery did not influence the frequency of anti-VEGF injections for neovascular AMD.

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