scholarly journals Application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of prematurity

2021 ◽  
Vol 16 (3) ◽  
pp. 5-10
Author(s):  
M. A. Kariakin ◽  
E. A. Stepanova ◽  
S. A. Korotkikh ◽  
N. S. Timofeeva ◽  
S. I. Surtaev

AIM: To conduct a retrospective study of the application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of prematurity in Ural State children`s ophthalmological center at State Autonomic Health Institution of the Sverdlovsk Region Multiprofile Clinical Medical Center BONUM in Yekaterinburg. MATERIAL AND METHODS: The study included 17 patients (33 eyes). The gestation age was from 23 to 30 weeks (mean: 26.51.7 weeks), birth weight was from 600 to 1850 g (mean: 867229 g). 8 patients (47%) had APROP, and 9 patients (53%) had ROP stage III, type 1, plus disease. Laser coagulation of the avascular areas of the retina as the start in ROP therapy was performed in three patients with APROP (4 eyes, 12.1%). Intravitreal injection of the anti-VEGF ranibizumab was performed in 17 patients (33 eyes), including patients with previous laser coagulation. The age of the patients at the time of injection was from 7.7 to 15.6 weeks (10.51.9 weeks), PCA from 32.3 to 39.6 weeks (37.01.8 weeks). Patients with stage IVa ROP (5 patients, 6 eyes) underwent 25G or 27G lens sparing vitrectomy. RESULTS: As a result of the complex treatment of ROP, the following results were obtained: complete regression in 13 patients (28 eyes, 84.8%). Partial regression in two patients (2 eyes, 6.1%). ROP progression to stage V in two patients (3 eyes, 9.1%). CONCLUSION: Complex treatment of severe stages of active ROP with laser treatment, IVI injections, ranibizumab, and vitrectomy made it possible to preserve vision in 90.9% of patients.

Author(s):  
M.A. Kariakin ◽  
◽  
E.A. Stepanova ◽  
S.A. Korotkikh ◽  
N.S. Timofeeva ◽  
...  

Material and methods. The study included 16 patients (31 eyes). Types and terms of treatment. Stage I in the treatment of ROP, laser coagulation of the avascular areas of the retina was performed in three patients with aggressive posterior ROP (4 eyes, 12.9%). In all patients, the progression of the disease was noted. Intravitreal injection of ranibizumab was performed in the period from 8 to 16 weeks (10.5±2.0 weeks), PCV from 32.3 to 39.6 weeks (37.0±1.8 weeks). Result. After laser treatment and IVI of ranibizumab, 11 patients (31 eyes, 81.6%) showed regression of the disease. In 5 patients (6 eyes, 19.4%) - progression. If the ROP progressed, a 25G or 27G lenssparing vitrectomy was performed. Complete regression of ROP was achieved in one patient (1 eye, 16.7%). Partial regression was observed in two patients (2 eyes, 33.3%). In two patients (3 eyes, 50%), the disease progressed to stage 5 with the development of total retinal detachment. Conclusion. As a result of the complex treatment of severe forms of the active stage of retinopathy of prematurity in the regional children's ophthalmological center MKMC "Bonum" in Yekaterinburg, the following data were obtained: complete regression with retinal adhesion is observed in 12 patients (26 eyes, 83.4%), of which in one patient (1 eye, 3.2%) regression was achieved after vitrectomy. Partial regression with the formation of a peripheral retinal detachment after vitrectomy was achieved in two patients (two eyes - 6.5%). Progression of retinopathy of prematurity to stage V with the development of total retinal detachment in two patients (3 eyes, 9.6%). Complex treatment of severe stages of active ROP using laser treatment, IVI and vitrectomy allows to preserve vision in 90.4% of patients. Key words: retinopathy of prematurity; intravitreal injection; laser coagulation of the retina; vitrectomy.


Ophthalmology ◽  
2017 ◽  
Vol 124 (5) ◽  
pp. 619-633 ◽  
Author(s):  
Deborah K. VanderVeen ◽  
Michele Melia ◽  
Michael B. Yang ◽  
Amy K. Hutchinson ◽  
Lorri B. Wilson ◽  
...  

Author(s):  
Hamid Riazi-esfahani ◽  
Alireza Mahmoudi ◽  
Mehdi Sanatkar ◽  
Afsar Dastjani Farahani ◽  
Fatemeh Bazvand

Abstract Background To evaluate the outcome of intravitreal bevacizumab (IVB) and aflibercept (IVA) injection for patients with retinopathy of prematurity (ROP). Methods In this single-center retrospective cohort, the recorded medical data of the infants who had been undergone intravitreal injection with either bevacizumab or aflibercept for type 1 ROP were reviewed. The infants were allocated into two groups. IVB group included patients who were treated with bevacizumab as initial treatment and the IVA group included patients who were treated with aflibercept as initial treatment. The rate and time of complete regression, as well as the recurrence rates, were compared between the groups. Results A total of 889 eyes of 453 infants were enrolled in the study. There were 865 eyes of 441 infants in the IVB group and 24 eyes of 12 infants in the IVA group. Follow-up time was 289 ± 257 days in the IVB group and 143 ± 25 days in the IVA group (p < 0.001). The difference in the ROP zone was not statistically significant between the 2 treatment groups (p = 0.328). All eyes in the IVA group showed initial regression of ROP after the intravitreal injections. These regressions were achieved in 830 (96.0%) eyes that were injected with IVB (p = 0.023). The median observed regression time was 10 days and 16 days in eyes treated with bevacizumab and aflibercept respectively. Recurrence was noted in 3.9% of eyes (34/865) in the IVB group and 58.3% of eyes (14/24) in the IVA group (p < 0.001). Conclusion While the regression rate in the IVA group was significantly higher than in the IVB group, the recurrence rate was significantly more in the IVA group, which may be attributed to differences in the pharmacokinetics of these drugs in the vitreous body.


2020 ◽  
pp. 82-94 ◽  
Author(s):  
V. O. Belash ◽  
L. R. Urazgalieva ◽  
R. I. Fayzullina ◽  
L. G. Agasarov

Introduction. Degenerative-dystrophic changes in the spine are the most common chronic human diseases. Pronounced clinical manifestations of vertebrogenic diseases are observed during active labor activity and represent one of the most frequent causes of temporary disability. It is also known that any pain syndromes are accompanied by the development of psychovegetative disorders, which reduces the effectiveness of treatment. In recent years, there has been a reasonable increase in the interest of the medical community to the non-drug treatment methods. It is caused by the polypharmacotherapy side effects, an increased numbers of allergic reactions, problems with polypragmasia, and a low level of compliance. At the same time, the question of the possibility of various non-drug treatment methods combining is quite acute.The goal of research is to substantiate the clinical effectiveness of the combined application of osteopathic correction and reflexotherapy in the complex treatment of patients with dorsopathy at the cervical-thoracic level.Materials and methods. A prospective controlled randomized study was conducted on the basis of the medical clinics of LLC «Family Health» (Kazan) and ANO «Center for SEB assistance» (Kazan) from April 2018 to May 2019. The study involved 52 people with dorsopathy at the cervical-thoracic level, aged from 25 to 45 years. In accordance with the exclusion criteria, 7 people dropped out of the study. The remaining patients (45 people), depending on the used treatment method, were divided by a simple randomization method using a random number generator into three groups of 15 people. The first group (main group) received osteopathic correction and reflexotherapyon the background of standard drug therapy; the second and the third groups (control groups) received only osteopathic correction orreflexotherapy, respectively, on the background of standard drug therapy. The osteopathic examination was performed for all patients regardless of the group, before and after the course of therapy, with the formation of an osteopathic conclusion.Also there was the estimation of the degree of pain syndrome severity,the asthenia, and the degree of accumulated emotional and energy charge that does not get out in a person.Results. It was found in the course of the study that the inclusion of osteopathic correction and reflexotherapy in the complex therapy of patients with dorsopathy at the cervical-thoracic level is clinically more effective than the isolated use of these methods. Such complex therapy allows to achieve a more significant reduction in the severity of the pain syndrome by VAS (p<0,05), relief of internal emotional tension (p<0,05), and increase the effectiveness of correction of dominant somatic dysfunction. Based on the obtained data, it could be assumed that reflexotherapy potentiates the effects of osteopathic correction.Conclusion. Based on the study, it can be concluded that the combination of osteopathic correction and reflexotherapy in the treatment of patients with dorsopathy at the cervical-thoracic level increases the clinical effectiveness of the standard drug therapy. At the same time, it is worth noting the potentiating effect of the combined use of two non-medicinal methods. The question of combining of various non-drug treatment methods is quite acute today, so this study will be continued. 


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1559-P
Author(s):  
JANET K. SNELL-BERGEON ◽  
JANE E.B. REUSCH ◽  
AMY D. BAUMGARTNER ◽  
MELANIE CREE-GREEN ◽  
KRISTEN J. NADEAU

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