scholarly journals Intravitreal Pharmacotherapy in the Treatment of Retinitis Pigmentosa-related Cystoid Macular Oedema

2017 ◽  
Vol 11 (01) ◽  
pp. 55
Author(s):  
Oya Donmez ◽  
Ali Osman Saatci ◽  
◽  
Keyword(s):  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Vitreoretinal Surgery ◽  
Cystoid Macular Oedema ◽  
Vascular Endothelial ◽  
Central Vision ◽  
Endothelial Growth Factor ◽  
Treatment Alternatives ◽  
Visual Field Constriction

Peripheral visual field constriction and night blindness are the main features of retinitis pigmentosa (RP). However, central vision is often impaired dramatically even in the early stages of the disease when macular complications such as cystoid macular oedema (CME) occur. The pathogenesis of RP-related CME is still not well explained. Therefore, several treatment alternatives such as topical, oral and systemic pharmacotherapy; laser photocoagulation and even vitreoretinal surgery are employed by the clinicians. In this review, we summarise the clinical data on intravitreal pharmacotherapeutic agents and focus mainly on the steroids and anti-vascular endothelial growth factor agents.

scholarly journals Intravitreal fluocinolone acetonide implant (ILUVIEN®) for diabetic macular oedema: a literature review

2018 ◽  
Vol 47 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Horace Massa ◽  
Anindyt M. Nagar ◽  
Athanasios Vergados ◽  
Panagiotis Dadoukis ◽  
Sudeshna Patra ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Fluocinolone Acetonide ◽  
Vascular Endothelial ◽  
Common Complication ◽  
Severe Visual Loss ◽  
Fluocinolone Acetonide Implant ◽  
Endothelial Growth Factor ◽  
Review Current

Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy and may lead to severe visual loss. In this review, we describe the pathophysiology of DMO and review current therapeutic options such as macular laser photocoagulation, anti-vascular endothelial growth factor agents, and steroid implants with a focus on the new fluocinolone acetonide implant, ILUVIEN®. The results of the Fluocinolone Acetonide in Diabetic Macular Edema (FAME) studies are also presented together with the results of real-world studies to support the clinical use of ILUVIEN® in achieving efficient resolution of DMO and improving vision and macular anatomy in this challenging group of patients.

scholarly journals Hyperreflective foci in predicting the treatment outcomes of diabetic macular oedema after anti-vascular endothelial growth factor therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chu-Hsuan Huang ◽  
Chang-Hao Yang ◽  
Yi-Ting Hsieh ◽  
Chung-May Yang ◽  
Tzyy-Chang Ho ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Treatment Response ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Vascular Endothelial ◽  
Outer Retina ◽  
Hyperreflective Foci ◽  
Endothelial Growth Factor

AbstractThis retrospective study evaluated the association of hyperreflective foci (HRF) with treatment response in diabetic macular oedema (DME) after anti-vascular endothelial growth factor (VEGF) therapy. The medical records, including of ophthalmologic examinations and optical coherence tomography (OCT) images, of 106 patients with DME treated with either intravitreal ranibizumab or aflibercept were reviewed. The correlations between best-corrected visual acuity (BCVA) changes and HRF along with other OCT biomarkers were analysed. The mean logMAR BCVA improved from 0.696 to 0.461 after an average of 6.2 injections in 1 year under real-world conditions. Greater visual-acuity gain was noted in patients with a greater number of HRF in the outer retina at baseline (p = 0.037), along with other factors such as poor baseline vision (p < 0.001), absence of epiretinal membrane (p = 0.048), and presence of subretinal fluid at baseline (p = 0.001). The number of HRF after treatment was correlated with the presence of hard exudate (p < 0.001) and baseline haemoglobin A1C (p = 0.001). Patients with proliferative diabetic retinopathy had greater HRF reduction after treatment (p = 0.018). The number of HRF in the outer retina, in addition to other baseline OCT biomarkers, could be used to predict the treatment response in DME after anti-VEGF treatment.

scholarly journals Efficacy of additional topical betamethasone in persistent cystoid macular oedema after carbonic anhydrase inhibitor treatments in retinitis pigmentosa

2018 ◽  
Vol 3 (1) ◽  
pp. e000107
Author(s):  
Shohei Kitahata ◽  
Yasuhiko Hirami ◽  
Seiji Takagi ◽  
Cody Kime ◽  
Masashi Fujihara ◽  
...  
Keyword(s):  
Carbonic Anhydrase ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Medical Records ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Iop Elevation

ObjectiveWe investigated the efficacy of additional topical betamethasone in persistent cystoid macular oedema (CMO) after carbonic anhydrase inhibitors (CAIs) therapy.Methods and analysisThis retrospective cohort study included 16 eyes of 10 patients with retinitis pigmentosa (RP). All patients were previously administered CAI for at least 3 months to treat CMO secondary to RP and lacking an effective reduction (≥11%) of central foveal thickness (CFT). We administered topical 0.1% betamethasone daily in each affected eye following a preceding course of the CAI medication as a first treatment. CMO was diagnosed using spectral-domain optical coherence tomography. CFT was regarded as the average of vertical and horizontal foveal thickness. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained from patient medical records. We compared the CFT and BCVA between baseline and the average of 1–3, 5–7, 10–14 and 16–20 months period.ResultsIn treatments with brinzolamide in 14 eyes, dorzolamide in 2 eyes and bromfenac in 2 eyes, CFT effectively decreased in 12 of 16 eyes (81%). CFT decreased significantly in 1–3 months (326±102 µm; n=16; P=0.029) and 5–7 months (297±102 µm; n=12; P=0.022) compared with baseline but not within 10–14 months (271±96 µm; n=9; P=0.485) or 16–20 months (281±134 µm; n=9; P=0.289). There were no significant intergroup differences in BCVA throughout the study. Betamethasone treatment was stopped in three patients because of IOP elevation.ConclusionOur data suggested that additional betamethasone might improve treatments for persistent CMO. Topical steroids could be an alternative option for managing persistent CMO in RP.

Delayed Laser photocoagulation following intravitreal anti–vascular endothelial growth factor injection allows immature retinal vessels to regrow without recurrence of retinopathy of prematurity

2019 ◽  
Author(s):  
Ki Yup Nam ◽  
Ji Eun Lee ◽  
Joo Eun Lee ◽  
Hyun Wong Kim ◽  
Sang Joon Lee
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Laser Photocoagulation ◽  
Retinal Vessel ◽  
Disease Recurrence ◽  
Retinal Vessels ◽  
Vascular Endothelial ◽  
Zone Ii ◽  
Vessel Development ◽  
Endothelial Growth Factor

Abstract Purpose: The effects of delayed laser photocoagulation (LP) for ROP patients who received intravitreal anti–vascular endothelial growth factor injections (IVAs) on peripheral vascularization and disease recurrence in ROP patients. Methods: A total of 26 consecutive infant eyes of 14 patients who received IVA treatments were retrospectively investigated. The patients were divided into two groups depending on the initial treatment as follows: IVA group and prompt LP group. Recurrence of ROP, growth of the retinal vessels, and associated complications were evaluated. Results: There were 16 eyes in the IVA group and 10 eyes in the LP group. In the IVA group, delayed LP was performed in six eyes due to recurrences of ROP. In 16 eyes of the IVA group, the retinal vessels grew upto Zone III in eyes received IVA only. Among the IVA groups, Delayed LP was needed in six eyes due to ROP recurrence following IVA. Delayed LP was performed average 7~8 weeks after IVA, which could give the immature neurovascular tissues time to continue vascular development upto Zone II without further ROP recurrence. However, the prompt LP group did not show vessel development beyond the laser scar. Conclusions: Delayed LP following IVA might provide a chance for retinal vessel development in the immature retina to continue without unexpected ROP recurrences.

scholarly journals Real world evidence on 5661 patients treated for macular oedema secondary to branch retinal vein occlusion with intravitreal anti-vascular endothelial growth factor, intravitreal dexamethasone or macular laser

2020 ◽  
pp. bjophthalmol-2020-315836 ◽  
Author(s):  
Richard Gale ◽  
Maria Pikoula ◽  
Aaron Y Lee ◽  
Spiros Denaxas ◽  
Catherine Egan ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Macular Oedema ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Intravitreal Dexamethasone ◽  
Endothelial Growth Factor

Background/aimsClinical trials suggest anti-vascular endothelial growth factor is more effective than intravitreal dexamethasone as treatment for macular oedema secondary to branch retinal vein occlusion. This study asks if ‘real world’ data from a larger and more diverse population, followed for a longer period, also support this conclusion.MethodsData collected to support routine care at 27 NHS (National Health Service) Trusts between February 2002 and September 2017 contained 5661 treatment-naive patients with a single mode of treatment for macular oedema secondary to branch retinal vein occlusion and no history of cataract surgery either during or recently preceding the treatment. Number of treatment visits and change in visual acuity from baseline was plotted for three treatment groups (anti-vascular endothelial growth factor (anti-VEGF), intravitreal dexamethasone, macular laser) for up to 3 years.ResultsMean baseline visual acuity was 57.1/53.1/62.3 letters in the anti-VEGF/dexamethasone/macular laser groups, respectively. This changed to 66.72 (+9.6)/57.6 (+4.5)/63.2 (+0.9) at 12 months. Adequate numbers allowed analysis at 18 months for all groups (66.6 (+9.5)/56.1 (+3.0)/60.8 (-1.5)) and for anti-VEGF at 36 months (68.0, +10.9) Mean number of treatments were 5.1/1.5/1.2 at 12 months, 5.9/1.7/1.2 at 18 months for all three groups and 10.3 at 36 months for anti-VEGF.ConclusionsVisual acuity improvements were higher and more sustained with anti-VEGF. Higher treatment burden occurred with anti-VEGF but this reduced over 36 months. Patients with better vision at baseline than those in the clinical trials maintained high levels of vision with both anti-VEGF and dexamethasone.

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