scholarly journals Long Term Outcome and Histologic Findings of a Retinal Astrocytic Hamartoma Treated with Intravitreal Injection of Anti-VEGF: A Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kinza T. Ahmad ◽  
Hana A. Mansour ◽  
Benjamin T. Rollins ◽  
Sergio Pina Oviedo ◽  
Paul H. Phillips ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Subependymal Giant Cell Astrocytoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anti Vegf ◽  
Histopathologic Evaluation ◽  
Progressive Growth ◽  
Astrocytic Hamartoma

Background. To our knowledge, this is the first report to describe the histologic changes of a retinal astrocytic hamartoma (RAH) in a patient with tuberous sclerosis complex (TSC) treated with antivascular endothelial growth factor (anti-VEGF), as well as the longest anti-VEGF treatment that such a patient has received (3 years). Case Presentation. We present a case of a 20-year-old female with TSC who developed progressive growth of a papillary astrocytic hamartoma that caused significant retinal edema, vitreous hemorrhage, and neovascular glaucoma. The patient was initially treated with 25 intravitreal anti-VEGF injections about every 1-3 months, but eventually developed a blind painful eye from neovascular glaucoma. Histopathologic evaluation of the enucleated globe showed a peculiar difference of the tumor according to its topography, with features reminiscent of pilocytic astrocytoma at the optic nerve head and features reminiscent of subependymal giant cell astrocytoma at the retrolaminar optic nerve. We hypothesize that these changes occurred as a secondary effect of the anti-VEGF treatment. Conclusions. Anti-VEGF agents may decrease the ophthalmologic complications of RAH. We recommend that this treatment should be started early and continued for a protracted time at regular and frequent intervals. Moreover, a combination of therapies might prove to be superior to monotherapy and should therefore be considered in aggressive retinal astrocytic hamartomas.

scholarly journals Use of Anti-VEGF Agents in Glaucoma Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mark Slabaugh ◽  
Sarwat Salim
Keyword(s):  
Anterior Segment ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Delivery Methods ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Process Use ◽  
Anti Vegf ◽  
Repeated Use ◽  
Endothelial Growth Factor

A number of antivascular endothelial growth factor agents are currently available to treat various ocular conditions. These agents have similar, but distinct, biologic qualities and have been explored in the management of neovascular glaucoma and in glaucoma surgery. Several different delivery methods are described, and because these medications are routinely given as intraocular injections, some benefits over traditional antifibrotic medications when used in glaucoma surgery are noted. These agents effectively induce regression of anterior segment neovascularization and facilitate initial surgical management of neovascular glaucoma, but the long-term outcome of this condition remains dependent on definitive management of the underlying process. Use in trabeculectomy or tube shunt procedures for other types of glaucoma has shown promise in modulating bleb morphology but has not yet been found to be as effective as traditional antifibrotic agents. There are reports of persistently raised intraocular pressure after repeated use of the anti-VEGF agents, possibly related to frequency of injection. These medications have wide application in the field of surgical glaucoma, but a definitive role has yet to be defined.

scholarly journals Coats’ Disease: Very Long-Term Outcome After Early Stage Conventional Treatment

2016 ◽  
Vol 10 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Salvatore Perrone ◽  
Alberto Rossetti ◽  
Patrick Sportiello ◽  
Pierfrancesco Mirabelli ◽  
Pierangela Cimatti ◽  
...  
Keyword(s):  
Conventional Treatment ◽  
Early Stage ◽  
Argon Laser ◽  
Neovascular Glaucoma ◽  
Disease Stage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Advanced Stages ◽  
Coats Disease ◽  
The Mean

Purpose: To report on the outcome of conventional therapy in patients with Coats’ disease. Methods: Retrospective analysis of the charts of thirteen patients with Coats’ disease. Results: Mean age of 9 male (70%) and 4 female (30%) patients was 17.7 (range, 5-33) years; one female had bilateral disease. Eleven eyes with retinal telangiectasia and exudation were treated with argon laser photocoagulation alone or photocoagulation associated with cryotherapy; the mean follow up was 32.5 (range,17-41) years. In four eyes without foveal involvement (stage 2a) the mean presenting visual acuity (VA) remained at 0.8 or improved, whereas poor VA in seven stage 2b eyes deteriorated minimally over time. In one and two of the three eyes with total retinal detachment, phthisis or neovascular glaucoma ensued. Conclusion: About three decades after conventional treatment of Coats’ disease stage 2a, treated eyes maintained good VA, and stage 2b eyes did not progress to advanced stages.

scholarly journals Visual Outcome after Intravitreal Anti-VEGF Therapy for Macular Neovascularisation Secondary to Sorsby’s Fundus Dystrophy: A Systematic Review

2021 ◽  
Vol 10 (11) ◽  
pp. 2433
Author(s):  
Arthur Baston ◽  
Christin Gerhardt ◽  
Souska Zandi ◽  
Justus G. Garweg
Keyword(s):  
Treatment Outcomes ◽  
Meta Analysis ◽  
Visual Outcome ◽  
Cochrane Central Register ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anti Vegf ◽  
Mesh Terms ◽  
Sorsby's Fundus Dystrophy

The aim of this paper is to summarise our own and to review published experience regarding the long-term outcome of intravitreal treatment for macular neovascularisation (MNV) secondary to Sorsby’s fundus dystrophy (SFD). A systematic literature search using the MeSH terms [Sorsby] and [anti-vascular endothelial growth factor (VEGF)] was conducted in NCBI/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ScienceDirect, Google Scholar and ClinicalTrials.gov to identify publications reporting anti-VEGF treatment outcomes in SFD. Treatment outcomes were extracted for this meta-analysis from 14 publications and an own patient reporting a total of 31 cases with a mean follow-up (FU) of 54 months. Both eyes were affected in ten (32.3%) instances. Heterogenous reporting limited the comparability of the outcomes. All papers in common, however, reported satisfied to excellent responses to anti-VEGF therapy if patients were diagnosed and treated immediately after onset of symptoms. Of 20 eyes, for which visual acuity was reported before and after treatment, five worsened and seven improved by more than 1 line, whereas eight eyes maintained their function by end of the follow up, and 11 eyes (55%) maintained a driving vision (Snellen VA ≥ 0.5). Of six eyes with a VA < 0.5, VA improved in one to VA ≥ 0.5, whereas of 14 eyes with an initial VA ≥ 0.5, this dropped to <0.5 despite therapy. In MNV secondary to SFD, the delay between first symptoms and access to anti-VEGF treatment determines subretinal scar formation and thereby, functional prognosis. If treated early, this is generally favourable under regular controls and a consequent anti-VEGF treatment of MNV activity.

scholarly journals Management of patients with operated refractory neovascular glaucoma (clinical observation)

2021 ◽  
pp. 374-378
Author(s):  
A. A. Gamidov ◽  
Z. V. Surnina ◽  
I. V. Andreeva
Keyword(s):  
Optic Nerve ◽  
Antihypertensive Drugs ◽  
Optimal Algorithm ◽  
Venous Blood ◽  
Neovascular Glaucoma ◽  
Laser Coagulation ◽  
Venous Blood Flow ◽  
Anti Vegf ◽  
Vascular Growth Factor ◽  
Central Retinal Vein

Introduction. Thrombosis (occlusion) of the central retinal vein (RCVO) and its branches is one of the main causes of loss or significant decrease in vision, including in people of working age, while RCVO is the second most common retinal vascular disease after diabetic retinopathy. The incidence rates steadily increase with age, amounting to 0.7% in the 49–60 age group and reaching 4.6% in people over 80 years old. Acute violation of retinal venous blood flow often leads to retinal ischemia, triggering the mechanism of activation of endothelial vascular growth factor (VEGF). In a quarter of patients, occlusions of the retinal veins and its branches initially proceed according to the ischemic type, which is characterized by the formation of extensive non-perfused retinal zones occupying an area of 10 or more areas of the optic nerve head (optic nerve disc) according to fluorescent angiography (FAG). In 34% of such patients, the non-ischemic type of venous occlusion becomes ischemic within 3 years.Aim. To develop an optimal algorithm for  the  management of  patients with operated neovascular uncompensated glaucoma against the background of occlusion of the central retinal vein.Materials and methods. Two patients with operated secondary neovascular glaucoma of stage III-c. In the combined sequential therapy, the anti-VEGF medication Aflibercept (0.5 mg) was used, laser coagulation of residual newly formed vessels, laser reconstruction in the surgical area, contact transcleral cyclolazercoagulation, and laser coagulation of the peripheral parts of the retina were performed.Results. The combined sequential treatment, combined with the appointment of antihypertensive drugs in drops, allowed to stabilize the level of IOP. IOP indicators remained at the level of normal values during 1 year of follow-up.Conclusion. The use of combined laser technologies and anti-VEGF therapy allows potentiating and prolonging the hypotensive effect in the treatment of patients with operated secondary refractory neovascular glaucoma against the background of occlusion of the central retinal vein. 

Optic nerve gliomas: role of Ki-67 staining of tumour and margins in predicting long-term outcome

2010 ◽  
Vol 95 (8) ◽  
pp. 1077-1081 ◽  
Author(s):  
S. N. Yeung ◽  
V. A. White ◽  
M. Nimmo ◽  
J. Rootman
Keyword(s):  
Optic Nerve ◽  
Ki 67 ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Outcomes of 23-Gauge Vitrectomy Combined with Phacoemulsification, Panretinal Photocoagulation, and Trabeculectomy without Use of Anti-VEGF Agents for Neovascular Glaucoma with Vitreous Hemorrhage

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Hua Yan
Keyword(s):  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
Light Perception ◽  
Anti Vegf ◽  
The Mean ◽  
23 Gauge ◽  
One Year ◽  
Time Point

Purpose. To evaluate the outcomes of 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF-agents for NVG. Methods. Eighteen eyes of 18 patients with NVG underwent 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF agents. The preoperative BCVA ranged from light perception to 0.2. The preoperative IOP ranged from 38 mmHg to 64 mmHg with a mean of 54±8 mmHg. The average follow-up time was 14.5±3 months with a range from 11 to 24 months. Results. The postoperative VA increased in 14 eyes and was stable in 4 eyes at the final follow-up. The mean IOP was 12±3 mmHg at postoperative day 1. The mean IOP was 15±2 mmHg, 16±3 mmHg, 23±5 mmHg, 28±4 mmHg, 22±5 mmHg, 17±3 mmHg, and 19±4 mmHg at postoperative days 2 and 3, 1, 2, 3, and 12 weeks, and 1 year postoperatively, respectively, with a range from 10 to 30 mmHg at the final follow-up time point of one year. The IOP was significantly lower than the preoperative one 12 weeks postoperatively (p<0.05). Conclusion. 23-gauge vitrectomy combined with phacoemulsification, PRP, and trabeculectomy without use of anti-VEGF-agents is a safe and effective method in treating NVG.

Sign in / Sign up

Export Citation Format

Share Document