Treatment of cystoid macular oedema secondary to pentosan polysulfate maculopathy using anti-VEGF and intravitreal steroid injections

2021 ◽  
pp. 112067212110663
Author(s):  
Samantha Roshani De Silva ◽  
Isuru De Silva ◽  
Bishwanath Pal
Keyword(s):  
Treatment Outcomes ◽  
Macular Oedema ◽  
Therapeutic Options ◽  
Cystoid Macular Oedema ◽  
Pentosan Polysulfate ◽  
Steroid Injections ◽  
Anti Vegf ◽  
Drug Cessation

Background Pentosan polysulfate-related maculopathy is a recently described clinical entity, related to dose and long term use of this medication, and may progress despite drug cessation. Cystoid macular oedema (CMO) has been reported in some cases, but there are few reports of treatment outcomes in the literature. Aims We present the case of a 55 year old female, with CMO secondary to pentosan polysulfate maculopathy, that was responsive to treatment with both intravitreal anti-VEGF and steroid injections, stabilising vision over a four year follow up period. Conclusions This is the first report, to our knowledge, of CMO related to pentosan polysulfate maculopathy responding to intravitreal steroid injections, broadening the therapeutic options for preserving vision in these patients.

scholarly journals Joint-preserving surgical treatment options for irreparable posterosuperior rotator cuff tear

2021 ◽  
Author(s):  
Florian Grubhofer ◽  
Jon JP Warner
Keyword(s):  
Rotator Cuff ◽  
Treatment Outcomes ◽  
Treatment Options ◽  
Term Treatment ◽  
Therapeutic Options ◽  
Rotator Cuff Tears ◽  
Long Term Treatment ◽  
Long Term Follow Up

AbstractTreatment of irreparable rotator cuff tears in young active patients is challenging. A variety of therapeutic options are available. Only a few joint-preserving treatment options show reliable improvements over a long-term follow-up period. However, the treatment outcomes of joint preservation procedures are not comparable to those of RTSA, as patients are typically younger and have higher expectations. It is remarkable that most of the joint-preserving therapeutic options for irreparable rotator cuff ruptures lack long-term treatment results. This article highlights the indications, technical aspects, and treatment outcomes of the most commonly performed joint-preserving surgeries for irreparable rotator cuff rupture.

Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

2013 ◽  
Author(s):  
Christina Marel ◽  
Maree Teesson ◽  
Shane Darke ◽  
Katherine Mills ◽  
Joanne Ross ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Term Treatment ◽  
Heroin Dependence ◽  
Long Term Treatment

scholarly journals Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities

2018 ◽  
Vol 3 (5) ◽  
pp. e001018 ◽  
Author(s):  
Ramnath Subbaraman ◽  
Laura de Mondesert ◽  
Angella Musiimenta ◽  
Madhukar Pai ◽  
Kenneth H Mayer ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Healthcare Providers ◽  
Research Priorities ◽  
Directly Observed Therapy ◽  
Loss To Follow Up ◽  
Individualised Care ◽  
Health System Efficiency ◽  
Tuberculosis Therapy

Poor medication adherence may increase rates of loss to follow-up, disease relapse and drug resistance for individuals with active tuberculosis (TB). While TB programmes have historically used directly observed therapy (DOT) to address adherence, concerns have been raised about the patient burden, ethical limitations, effectiveness in improving treatment outcomes and long-term feasibility of DOT for health systems. Digital adherence technologies (DATs)—which include feature phone–based and smartphone-based technologies, digital pillboxes and ingestible sensors—may facilitate more patient-centric approaches for monitoring adherence, though available data are limited. Depending on the specific technology, DATs may help to remind patients to take their medications, facilitate digital observation of pill-taking, compile dosing histories and triage patients based on their level of adherence, which can facilitate provision of individualised care by TB programmes to patients with varied levels of risk. Research is needed to understand whether DATs are acceptable to patients and healthcare providers, accurate for measuring adherence, effective in improving treatment outcomes and impactful in improving health system efficiency. In this article, we describe the landscape of DATs that are being used in research or clinical practice by TB programmes and highlight priorities for research.

Long-term outcome of neovascular age-related macular degeneration: association between treatment outcome and major risk alleles

2021 ◽  
pp. bjophthalmol-2021-319054
Author(s):  
Brice Nguedia Vofo ◽  
Gala Beykin ◽  
Jaime Levy ◽  
Itay Chowers
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Long Term Outcome ◽  
Risk Alleles ◽  
Macular Atrophy ◽  
Anti Vegf ◽  
Age Related

AimsTo evaluate the long-term functional and anatomical outcomes of neovascular age-related macular degeneration (nvAMD) treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for up to 10 years, and to identify associated risk factors.MethodsClinical and optical coherence tomography findings were retrieved for nvAMD cases treated with intravitreal anti-VEGF compounds using a treat-and-extend protocol. In addition, the major risk alleles for AMD in the CFH (rs1061170), HTRA1 (rs1200638) and C3 (rs2230199) genes were genotyped.ResultsFrom 276 eligible eyes in 206 patients, 80 eyes (29%) in 66 patients (32.0%) had a follow-up period of ≥8 years and were included in this study. Over a 10-year period, 73.3±28.0 (mean±SD) anti-VEGF injections were administered. Best-corrected visual acuity (BCVA; LogMAR) deteriorated from 0.55±0.53 at baseline to 1.00±0.73 at 10 years (p<0.0005). Central subfield thickness (CST) decreased from 415.8±162.1 µm at baseline to 323±113.6 µm (p<0.0005) after three monthly injections and remained lower than baseline throughout the follow-up period. Visual outcome was associated with BCVA and intraretinal fluid (IRF) at baseline, macular atrophy, and macular thinning at follow-up. The decrease in CST was inversely correlated with the number of CFH and/or C3 risk alleles carried by the patient (Pearson’s r: −0.608; p=0.003).ConclusionsPatients with nvAMD who received anti-VEGF therapy for 10 years developed substantial vision loss associated with the presence of IRF at baseline and macular atrophy. Major risk alleles for AMD in two complement genes were associated with a reduced long-term reduction in macular thickness.

Safety of 6000 intravitreal dexamethasone implants

2019 ◽  
Vol 104 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Bindu Rajesh ◽  
Javier Zarranz-Ventura ◽  
Adrian T Fung ◽  
Catharina Busch ◽  
Niroj Kumar Sahoo ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Macular Oedema ◽  
Real Life ◽  
Cystoid Macular Oedema ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone ◽  
Phakic Eyes

PurposeTo evaluate the real-life safety profile of intravitreal dexamethasone implant injection for various retinal conditions.MethodsRetrospective multicenter analysis of intravitreal dexamethasone implant injections (700 µg) due to various retinal conditions including central retinal venous occlusion (1861 injections), diabetic macular oedema (3104 injections), post-surgical cystoid macular oedema (305 injections) and uveitis (381 injections). The eyes were evaluated mainly for the occurrence of adverse events such as glaucoma, cataract, retinal detachment and endophthalmitis along during the follow-up period.ResultsA total of 6015 injections in 2736 eyes of 1441 patients (mean age of 65.7±12.9 years) were in total analysed over an average period of 18 months (range 6 months to 102 months). A total of 576 eyes (32.5% of the phakic eyes) developed cataract requiring surgical intervention. However, visually insignificant cataract progression was observed in another 259 phakic eyes (14.6%) which did not require surgical removal. A total of 727 eyes (26.5%) experienced an intraocular pressure (IOP) rise of >25 mm Hg, with 155 eyes (5.67%) having a prior history of glaucoma and 572 eyes (20.9%) having new onset IOP rise. Overall, more than 90% of eyes with IOP rise were managed medically, and 0.5% eyes required filtering surgery. Endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous haemorrhage (0.03%) were rare. There was no significant change in visual acuity (p=0.87) and central macular thickness (p=0.12) at the last follow-up.ConclusionThis is the largest real-life study assessing the safety of intravitreal dexamethasone implant injections in various retinal conditions. Cataract progression and intraocular pressure rise are the most common side effects, but are often rather easily manageable.

Long-term control of cystoid macular oedema in noninfectious uveitis with Mycophenolate Mofetil

2008 ◽  
Vol 29 (3) ◽  
pp. 127-133 ◽  
Author(s):  
Piergiorgio Neri ◽  
Cesare Mariotti ◽  
Luca Cimino ◽  
Lucia Mercanti ◽  
Alfonso Giovannini
Keyword(s):  
Mycophenolate Mofetil ◽  
Macular Oedema ◽  
Cystoid Macular Oedema
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