scholarly journals Intravitreal Ranibizumab for Treatment of Posttraumatic Choroidal Neovascularization: a Case Report

2021 ◽  
Vol 18 (3) ◽  
pp. 601-608
Author(s):  
A. N. Kulikov ◽  
A. Yu. Kuznetsova ◽  
N. A. Nekrash ◽  
D. S. Maltsev
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Choroidal Neovascularization ◽  
Angiogenesis Inhibitor ◽  
Fluorescence Angiography ◽  
Blunt Injury ◽  
Traumatic Rupture ◽  
Favorable Result ◽  
Intravitreal Ranibizumab ◽  
Dynamic Observation

An analysis of the case of applying a course of fibrinolytic therapy and one intravitreal injection of an angiogenesis inhibitor in a patient with traumatic rupture of the choroid complicated by choroidal neovascularization (CNV) is presented. Patient B., 20 years old, complained of a lack of objective vision after a blunt injury to his right eye in March 2018. Visual acuity decreased to 0.01 (ETDRS 0 characters). During the examination revealed: partial hemophthalmus, rupture of the choroid, Berlin retinal opacification. Local fibrinolytic conservative therapy with positive dynamics was carried out in the form of increasing visual acuity to 0.3 (ETDRS 21 characters) and partial resolution of hemophthalmus. According to optical coherence tomography angiography (OCTA), minimally active CNV was detected. Due to the weak activity of the pathological process, a decision was made on dynamic observation. A follow-up examination in August 2018 revealed an increase in CNV activity according to OCTA and fluorescence angiography (FAG), in connection with which intravitreal administration of ranibizumab (lucentis) was performed. Subsequently, the patient was under dynamic observation for one year. Positive dynamics was revealed in the form of an increase in visual acuity, first to 0.7 (ETDRS 48 characters) 3 months after intravitreal injection, and after a year — to 0.9 (ETDRS 55 characters). After treatment according to OCTA and FAG, the activity of CNV was not determined. Despite the favorable result of treatment, further monitoring of the patient is necessary, since the long-term prospects for maintaining the achieved high visual functions remain unclear due to the insufficient experience in treating patients with this pathology according to the literature.

Optical Coherence Tomographic Features and Visual Prognosis after Treatment for Idiopathic Choroidal Neovascularization

2015 ◽  
Vol 234 (2) ◽  
pp. 67-72
Author(s):  
Xu-Sheng Cao ◽  
Xiao-Yan Peng ◽  
Qi-Sheng You ◽  
Yong-Peng Zhang ◽  
Jost B. Jonas
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Univariate Analysis ◽  
Final Visual Acuity ◽  
Lower Amount ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Visual Prognosis ◽  
Ellipsoid Zone ◽  
Sd Oct

Background: The aim of this study was to determine whether pretreatment spectral-domain optical coherence tomographic (SD-OCT) features are associated with visual prognosis after treatment for idiopathic subfoveal choroidal neovascularization (ISCNV) with intravitreal ranibizumab. Methods: We retrospectively evaluated SD-OCT images of eyes with ISCNV undergoing treatment with intravitreal ranibizumab with a mean follow-up of 7 months. Results: This study included 22 patients (22 eyes) with a mean age of 32.7 ± 8.1 years. In univariate analysis, better final visual acuity expressed in logMAR units was significantly associated with a lower amount of pretreatment ellipsoid zone defects (p = 0.03; standardized correlation coefficient β = 0.46) and a lower amount of pretreatment external limiting membrane (ELM) damage (p = 0.007; β = 0.56). All other SD-OCT parameters were not significantly associated with final visual acuity. A higher improvement in visual acuity was marginally significantly associated with larger pretreatment ellipsoid zone defects (p = 0.049; β = -0.43). Conclusions: The integrity of the outer retinal layers at baseline, in particular of the ELM, is of importance in predicting the final visual outcome in patients undergoing intravitreal medical therapy for ISCNV.

scholarly journals Comparative characteristics of the outcomes of the use of multidirectional intravitreal pharmacotherapy in the treatment of diabetic macular edema

2021 ◽  
pp. 39-45
Author(s):  
М.М. Bikbov ◽  
◽  
K.I. Kudoyarova ◽  
R.M. Zainullin ◽  
T.R. Gilmanshin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Angiogenesis Inhibitor ◽  
Standard Technique ◽  
Macular Area ◽  
Dexamethasone Implant ◽  
Biodegradable Implant ◽  
Inflammatory Reactions

Purpose. To conduct a comparative analysis of the effectiveness of intravitreal injection of dexamethasone-containing implant and aflibercept in macular edema in patients with diabetes mellitus. Material and methods. The study involved 80 patients (80 eyes) with macular edema. The group 1 included 38 patients (38 eyes) who underwent a single intravitreal injection of dexamethasone-containing biodegradable implant «Ozurdex» in a dose of 0.7 mg according to the standard technique. In the group 2, 42 patients (42 eyes) received 5 loading doses of aflibercept with an interval of one month. All patients underwent monthly spectral optical coherence tomography (OCT) of the macular area, as well as visometry and tonometry during the observation period. Results. One month after intravitreal injection of the studied drugs in both groups, no inflammatory reactions were detected in any case. According to OCT data, cystic edema of the macular area with a tendency to decrease the thickness in the fovea was preserved. After treatment with aflibercept, the average retinal thickness in the macula was 186.4±15.1 µm, and visual acuity averaged 0.48±0.05 in 85.7% of patients. During therapy with intravitreal injection of Ozurdex, an increase in visual acuity was noted in 89.4% of patients. Conclusion. This study found that intravitreal pharmacotherapy with an angiogenesis blocker and a dexamethasone implant in patients with diabetic macular edema are comparable in its effectiveness – 85.7 and 89.4% respectively. If systematic anti-angiogenesis therapy is not possible for a number of reasons, it is advisable to use a prolonged dexamethasone implant. Key words: macular edema, intravitreal pharmacotherapy, angiogenesis inhibitor, implant with dexamethasone.

Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab

2018 ◽  
Vol 29 (2) ◽  
pp. 239-243
Author(s):  
Gilda Cennamo ◽  
Francesca Amoroso ◽  
Stefano Schiemer ◽  
Nunzio Velotti ◽  
Mariacristina Alfieri ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. Methods: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. Results: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = –2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = –1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = –3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). Conclusion: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.

scholarly journals Secondary choroidal neovascularization due to choroidal osteoma after 9 years follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Zhang ◽  
Jia Fang ◽  
Shixin Zhao ◽  
Xiangjun She ◽  
Jun Wang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Fluorescence Angiography ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Choroidal Osteoma ◽  
The Right

Abstract Background Choroidal osteoma is a benign intraocular tumor that can increase risk of developing choroidal neovascularization. The visual prognosis is influenced by the tumor location, decalcification status, overlying RPE atrophy, presence of choroidal neovascularization, persistence of subretinal fluid and occurrence of subretinal hemorrhages. Case presentation The authors present a 40-year-old woman diagnosed with choroidal osteoma of the right eye. Her best corrected visual acuity was 12/20 but decreased to 5/20 due to secondary choroidal neovascularization after 8 years follow up. Fundus examination revealed an enlarged choroidal osteoma in most margins at posterior pole with schistose hemorrhage beside macula. Optical coherence tomography angiography revealed unique features in the vascular changes of choroidal neovascularization in choroidal osteoma in the outer retinal layer and choroid capillary layers, and subretinal neovascularization. Indocyanine green fluorescence angiography showed there was hypo-fluorescence at the peripapillary with faint hyper-fluorescence at the macular, corresponding to the location on the fundus photograph. The patient received 3 injections of intravitreal ranibizumab. After 1 year follow up, her visual acuity of the right eye was 18/20 and the CNV had regressed. Conclusions We present the findings and treatment of a case of choroidal osteoma with secondary choroidal neovascularization. Optical coherence tomography angiography combined with FFA and ICGA is used to analysis the characteristics of secondary choroidal neovascularization. Optical coherence tomography angiography can reveal some unique characteristics in the vascular changes compared to fundus fluorescein angiography.

scholarly journals Electrophysiological study after ranibizumab in choroidal neovascularizat

2021 ◽  
pp. 3-13
Author(s):  
Mona Abdelkader ◽  
Ayman Fawzy ◽  
Wael El-doskey
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Choroidal Neovascularization ◽  
Electrophysiological Study ◽  
Multifocal Electroretinogram ◽  
Pattern Electroretinogram ◽  
Retinal Toxicity ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Subfoveal Choroidal Neovascularization

Purpose: To study the effects of intra-vitreal injection of ranibizumab on pattern electroretinogram (PERG) and multifocal electroretinogram(MF-ERG) parameters in choroidal neovascularization and to test the retinal toxicity of ranibizumab. Method: Fifty eyes of 50 patients with subfoveal choroidal neovascularization were included in the study. Thirty (30) eyes had neovascular age related macular degeneration (nAMD) and 20 eyes had myopic choroidal neovascularization. Ranibizumab was injected intravitreal monthly for3 months. Optical Coherence Tomography Angiography (OCT) was performed at the initial and final visits. Visual acuity, Pattern and multifocal electroretinography (PERG, MFERG) were performed before and at 1,2,3,6 months after intravitreal injection. Results: There was no clinical significant reduction of parameters of either MFERG or PERG after intravitreal injection of ranibizumab. There was significant increase in visual acuity, decrease in central macular thickness ,decrease in total macular volume and improvement in the parameters of both PERG and MFERG after intravitreal injection. Conclusion: Intravitreal injection of ranibizumab is effective in treatment CNV and safe. It has no retinal toxicity since no reduction in PERG& MFERG parameters. Keywords: AMD; Ranibizumab; PERG; MFERG

scholarly journals Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Panagiotis G. Mitropoulos ◽  
Irini P. Chatziralli ◽  
Efstratios A. Parikakis ◽  
Vasileios G. Peponis ◽  
Georgios A. Amariotakis ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Sickle Cell ◽  
Male Patient ◽  
Laser Photocoagulation ◽  
Stage Iv ◽  
Vitreous Hemorrhage ◽  
Ophthalmological Examination ◽  
Intravitreal Ranibizumab

Purpose. To present the case of a 27-year-old male patient with stage IV proliferative sickle cell retinopathy, treated with one intravitreal injection of ranibizumab, showing regression of the neovascularization and no recurrence at the 9-month follow-up. Methods. A 27-year-old male patient presented with blurred vision and floaters in the right eye since three days. His best corrected visual acuity was 6/18. Ophthalmological examination and fluorescein angiography revealed proliferative sickle cell retinopathy stage IV with vitreous hemorrhage and sea fan neovascularization, as well as ischemic areas at the temporal periphery. Results. The patient was treated with one intravitreal injection of ranibizumab, presenting improvement in the visual acuity from 6/18 to 6/6, resolution of vitreous hemorrhage, and regression of the neovascularization. Additionally, he underwent scatter laser photocoagulation at the ischemic areas. At the 9-month follow-up there was no recurrence, while no adverse effects were noticed. Conclusions. Intravitreal ranibizumab may be a useful adjunct to laser photocoagulation in the management of proliferative sickle cell retinopathy and may permit some patients to avoid pars plana vitrectomy for vitreous hemorrhage.

scholarly journals Treatment of Punctate Inner Choroidopathy with Choroidal Neovascularization Using Corticosteroid and Intravitreal Ranibizumab

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Wu ◽  
Shiying Li ◽  
Haiwei Xu ◽  
Yong Liu ◽  
Yi Wang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Oral Corticosteroid ◽  
Fundus Autofluorescence ◽  
Intravitreal Ranibizumab ◽  
Punctate Inner Choroidopathy ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
Ranibizumab Treatment

Background. To evaluate the treatment outcomes of patients with punctate inner choroidopathy (PIC) and secondary choroidal neovascularization (CNV). Methods. This is a retrospective study of 24 eyes in 22 patients suffering from PIC with CNV. Patients were treated with intravitreal ranibizumab monotherapy (14 eyes) or combined oral corticosteroid and intravitreal ranibizumab therapy (corticosteroid-ranibizumab group, 10 eyes). Mean follow-up duration was 24.0 months. We evaluated best-corrected visual acuity (BCVA), fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography, before and after treatment. The following variables were compared between groups: number of intravitreal ranibizumab injections, BCVA, recurrence of CNV, and change in PIC lesions. Results. The ranibizumab monotherapy group received an average of 3 intravitreal ranibizumab injections; mean logMAR visual acuity improvement was 0.34, and 8 eyes developed recurrent CNV during follow-up. The corticosteroid-ranibizumab group received an average of 1.9 intravitreal ranibizumab injections; mean logMAR visual acuity improvement was 0.61, and there was no recurrence of CNV. Combined corticosteroid-ranibizumab therapy also resulted in better resolution of PIC lesions and fewer new PIC lesions. Conclusion. Both corticosteroid-ranibizumab treatment and ranibizumab monotherapy could significantly improve the vision of PIC patients with CNV. Combined corticosteroid and intravitreal ranibizumab treatment appeared to reduce CNV recurrence and development of new PIC lesions compared with ranibizumab monotherapy.

Intravitreal Ranibizumab for Predominantly Hemorrhagic Choroidal Neovascularization in Age-Related Macular Degeneration

2015 ◽  
Vol 233 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Stefano Lazzeri ◽  
Michele Figus ◽  
Maria Sole Sartini ◽  
Fabio Scarinci ◽  
Giamberto Casini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Group ◽  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Time Interval ◽  
Intravitreal Ranibizumab ◽  
Age Related ◽  
Late Treatment ◽  
Predicting Factor

Purpose: To evaluate the effects of intravitreal ranibizumab monotherapy on predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Materials and Methods: Twenty-two consecutive eyes with hemorrhagic neovascularization were treated with 3 monthly intravitreal ranibizumab injections. Additional injections were administered according to retreatment criteria during 12 months of follow-up. Results: A mean of 6.64 ± 1.36 injections was administered. Overall, the mean visual acuity increased from 10.90 ± 6.02 to 12.81 ± 8.34 ETDRS letters (p > 0.05) at 12 months. The ‘early treatment group' gained a mean of 2.83 ± 2.24 ETDRS letters (p < 0.05), while the ‘late treatment group' gained a mean of 0.30 ± 1.25 ETDRS letters (p > 0.05) with significant differences between the groups (p < 0.05). A progressive resolution of macular bleeding was registered in 20 patients (mean time: 5.3 ± 1.6 months). Conclusions: Ranibizumab injections can be considered a beneficial approach for the management of predominantly hemorrhagic choroidal neovascularization with foveal involvement associated with age-related macular degeneration. Furthermore, the time interval between hemorrhage and the first injection seems to be an important predicting factor of final visual acuity.

Switching from ranibizumab to aflibercept in choroidal neovascularization secondary to angioid streaks

2019 ◽  
Vol 30 (3) ◽  
pp. 550-556 ◽  
Author(s):  
Rim Sekfali ◽  
Gérard Mimoun ◽  
Salomon Yves Cohen ◽  
Giuseppe Querques ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Subretinal Fluid ◽  
Central Macular Thickness ◽  
Angioid Streaks ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Secondary Endpoints ◽  
Best Corrected Visual Acuity

Purpose: To evaluate the efficacy of switching from intravitreal ranibizumab to intravitreal aflibercept in choroidal neovascularization secondary to angioid streaks. Design: Multicenter retrospective interventional case series. Methods: Patients previously treated with intravitreal ranibizumab with at least 12-month follow-up (M12) after switching (M0) to intravitreal aflibercept. Switch to intravitreal aflibercept was decided in cases of refractory or recurrent choroidal neovascularization. Primary endpoint: Change of best-corrected visual acuity using the Early Treatment Diabetic Retinopathy Study letters. Secondary endpoints: Mean change of central macular thickness, absence of intraretinal/subretinal fluid on spectral domain optical coherence tomography and the percentage of eyes with absence of leakage on fluorescein angiography. Results: Fourteen eyes of 13 patients were included. Mean best-corrected visual acuity was 65.0 ± 21.03 letters at M0 and 63.5 ± 17.30 letters at M12 (p = 0.5). Secondary endpoints: Mean central macular thickness was 344 ± 194.65 µm at M0 and 268 ± 79.97 µm at M12 (p = 0.008). Absence of intraretinal/subretinal fluid was observed in 71%. Fluorescein angiography (nine eyes) showed absence of leakage in 77% (seven eyes). Conclusion: Switching from intravitreal ranibizumab to intravitreal aflibercept represents a therapeutic option in patients with refractory or recurrent choroidal neovascularization secondary to angioid streaks.

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