Response of OCT Biomarkers Based on New Diabetic Macular Edema Classification TCED-HFV to Anti-VEGF Therapy and Its Prognostic Role in Vision Benefits

Abstract Introduction. To investigate the association between OCT biomarkers and visual prognosis, based on TCED-HFV,and to explore whether these biomarkers have predictive value in visual prognosis of DME patients.Methods. The retrospective study included 166 eyes from 122 DME patients, who received 3 initial monthly intravitreal injections followed by PRN dosing. Results. The significant improvement of BCVA, as well as statistical decrement of CMT and HF, could be observed(p < 0.001, P=0.023, P=0.002, respectively). The BCVA in early and advanced DME is significantly better than that in severe DME in baseline (P=0.027, P=0.009, respectively) and 1 year (P=0.017, P=0.030, respectively). The broken EZ/ELM was generally accompanied by the existence of SF (P=0.032). The presence of DRIL and persistence SF were associated with negative visual effects (P＜0.001, P=0.045, respectively). At month 12 the mean BCVA was significantly improved in both intact and disrupted EZ/ELM groups (P=0.023, P=0.033, respectively). The number of the DME patients with ERM increases after treatment (P＜0.001).Conclusions. Intact EZ/ELM, the absence of DRIL and ERM might contribute to better response in patients. The persistence SF was a negative factor. Intravitreal anti-VEGF therapy was associated with ERM development and progression. It is not objective to consider only the OCT biomarkers but not the stages, and the indicators of different stages should be studied separately.

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Effects of Orthokeratology Lens On Axial Length Elongation in Myopia With Anisometropia Children

10.21203/rs.3.rs-741927/v1 ◽

2021 ◽

Author(s):

Ziyang Chen ◽

Kai-Ming Chen ◽

Ying Shi ◽

Zhao-Da Ye ◽

Sheng Chen ◽

...

Keyword(s):

Retrospective Study ◽

Axial Length ◽

Statistical Significance ◽

Spherical Equivalent ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Better Than ◽

Group 1

Abstract AimTo investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in myopia with anisometropia children.MethodsThirty-seven unilateral myopia (group 1) and fifty-nine bilateral myopia with anisometropia children were involved in this 1-year retrospective study. And bilateral myopia with anisometropia children were divided into group 2A (diopter of the lower SER eye under − 2.00D) and group 2B(diopter of the lower SER eye is equal or greater than − 2.00D). The change in AL were observed.The datas were analysed using SPSS 21.0.Results(1) In group 1, the mean baseline AL of the H eyes and L eye were 24.70 ± 0.89 mm and 23.55 ± 0.69 mm, respectively. In group 2A, the mean baseline AL of the H eyes and L eyes were 24.61 ± 0.84 mm and 24.00 ± 0.70 mm respectively. In group 2B, the mean baseline AL of the H eyes and L eyes were 25.28 ± 0.72 mm and 24.70 ± 0.74 mm. After 1 year, the change in AL of the L eyes was faster than the H eyes in group 1 and group 2A (all P<0.001).While the AL of the H eyes and L eyes had the same increased rate in group 2B. (2) The effect of controlling AL elongation of H eyes is consistent in three groups (P = 0.559).The effect of controlling AL elongation of L eyes in group 2B was better than that in group 1 and group 2A (P < 0.001). And the difference between group 1 and group 2A has no statistical significance. (3) The AL difference in H eyes and L eyes decreased from baseline 1.16 ± 0.55mm to 0.88 ± 0.68mm after 1 year in group 1.And in group 2A, the AL difference in H eyes and L eyes decreased from baseline 0.61 ± 0.34mm to 0.48 ± 0.28mm. There was statistically significant difference (all P<0.001). In group 2B, the baseline AL difference in H eyes and L eyes has no significant difference from that after 1 year (P = 0.069).ConclusionsMonocular OK lens is effective on suppression AL growth of the myopic eyes and reduce anisometropia value in unilateral myopic children. Binocular OK lenses only reduce anisometropia with the diopter of the low eye under − 2.00D. Binocular OK lenses cannot reduce anisometropia with the diopter of the low eye equal or greater than − 2.00D. Whether OK lens can reduce refractive anisometropia value is related to the spherical equivalent refractive of low refractive eye in bilateral myopia with anisometropia children after 1-year follow-up.

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Hyperreflective Material in Optical Coherence Tomography Images of Eyes with Myopic Choroidal Neovascularization May Affect the Visual Outcome

Journal of Clinical Medicine ◽

10.3390/jcm9082394 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2394

Author(s):

Yasuaki Mushiga ◽

Sakiko Minami ◽

Atsuro Uchida ◽

Norihiro Nagai ◽

Misa Suzuki ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Choroidal Neovascularization ◽

Initial Treatment ◽

Visual Outcome ◽

Optical Coherence ◽

Myopic Choroidal Neovascularization ◽

Anti Vegf ◽

The Mean ◽

Better Than ◽

Myopic Cnv

The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division of Medical Retina Clinic, Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017. The mean age was 70.6 ± 2.1 years, and 16 (66.7%) patients were female. Overall, the mean best-corrected visual acuity (BCVA) improved (p = 0.034), and the mean height of the hyperreflective material (HRM), involving the CNV lesion recorded by optical coherence tomography, decreased (p < 0.01) 12 months after the initial treatment. Fifteen eyes (62.5%) achieved a BCVA of better than 0.10 in LogMAR at 12 months; they had a better BCVA (p = 0.015) and lower HRM intensity (p = 0.033) at baseline than the others. Remarkably, the BCVA improved (p < 0.05) and the HRM height (p < 0.01) decreased only in eyes with a final BCVA better than 0.10 as early as 1 month after the initial treatment, which was still present at 12 months. The HRM height and intensity, not only the BCVA, would be valuable in evaluating the prognosis of myopic CNV after anti-VEGF therapy, although further study is required.

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Switch to Aflibercept in Diabetic Macular Edema Patients Unresponsive to Previous Anti-VEGF Therapy

Journal of Ophthalmology ◽

10.1155/2017/5632634 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Filipe Mira ◽

Manuel Paulo ◽

Filipe Henriques ◽

João Figueira

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retrospective Review ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Functional Improvement ◽

Anti Vegf ◽

The Mean

Purpose. The aim was to evaluate the efficacy of aflibercept in patients with diabetic macular edema (DME) unresponsive to prior anti-VEGF therapy. Methods. Retrospective review of DME unresponsive to previous anti-VEGF switched to aflibercept with 3 months of follow-up. Changes in best correct visual acuity (BCVA), central retinal thickness (CRT), and frequency of injections were analyzed. The percentage of subjects who had ≥20/40 (logMAR equivalent 0.3) and ≤20/200 (logMAR equivalent 1) was evaluated. Results. A total of 32 eyes from 26 patients were included. Mean age was 65 ± 10 years old. The mean number of previous anti-VEGF injections was 5.34 ± 2.38, and the mean number of aflibercept injections at the end of the study was 2.00 ± 0.00. The CRT at baseline was 501.47 ± 150.51 μm and 367.97 ± 124.61 μm at 3 months of follow-up (P<0.001). The logMAR BCVA at baseline was 0.71 ± 0.36 and 0.65 ± 0.33 at the end of the follow-up (P=0.037). At baseline, 12.5% of patients had ≥20/40 compared with 25% at the end of follow-up. At baseline, 28.13% of patients had 20/200 or inferior vision compared with 15.63% at the end of the follow-up. Conclusions. DME patients unresponsive to previous multiple ranibizumab injections demonstrate a significant anatomical and functional improvement with the switch to aflibercept.

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Efficacy and safety of vitamin supplements with resveratrol in diabetic macular edema: Long-term results of a comparative study

European Journal of Ophthalmology ◽

10.1177/11206721211057682 ◽

2021 ◽

pp. 112067212110576

Author(s):

Irini Chatziralli ◽

Eleni Dimitriou ◽

Alexandros Chatzirallis ◽

Evaggelia Aissopou ◽

Dimitrios Kazantzis ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Efficacy And Safety ◽

Vitamin Supplements ◽

Anti Vegf ◽

Group I ◽

The Mean ◽

Group Ii

Purpose To investigate the adjunct efficacy and safety of vitamin supplements, including resveratrol, in patients with diabetic macular edema (DME) treated with intravitreal anti-vascular endothelial factor (anti-VEGF) agents. Methods Participants in this prospective study were 45 patients with DME, who were treated with either intravitreal anti-VEGF injections (n = 23, Group I) or with combination of intravitreal anti-VEGF injections and vitamin supplements, including resveratrol (n = 22, Group II). All patients underwent visual acuity measurement, slit-lamp examination and spectral domain-optical coherence tomography (SD-OCT) at baseline and monthly after the loading phase of three-monthly anti-VEGF injections, following a PRN protocol. Results There was a statistically significant improvement in visual acuity in both groups at month 12 compared to baseline, although the mean change in visual acuity did not differ between the two groups (p = 0.183). Accordingly, there was a statistically significant decrease in central retinal thickness in both groups at month 12 compared to baseline, while the mean difference in central retinal thickness was significantly greater in the “combination” group. The mean number of intravitreal anti-VEGF injection was less in Group II (6.45 ± 1.12 in Group II vs. 7.39 ± 1.31 in Group I, p = 0.018). Conclusions Vitamin supplements with resveratrol was found to be an effective adjunct to intravitreal anti-VEGF injections in patients with DME, offering better anatomic restoration with less injections at the 12-month follow-up.

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Diagnostic value of lymphopaenia and elevated serum ACE in patients with uveitis

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316563 ◽

2020 ◽

pp. bjophthalmol-2020-316563

Author(s):

Philippine Cotte ◽

Pierre Pradat ◽

Laurent Kodjikian ◽

Yvan Jamilloux ◽

Pascal Seve

Keyword(s):

Retrospective Study ◽

Predictive Value ◽

Elevated Serum ◽

Diagnostic Value ◽

Granulomatous Uveitis ◽

Registration Number ◽

The Mean ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

AimTo evaluate the diagnostic worth of elevated serum ACE (sACE) and lymphopaenia, singly or combined, in diagnosing sarcoid uveitis.MethodsMonocentric retrospective study, on a cohort of 996 adult patients referred to our department between March 2001 and December 2018 for a diagnostic work-up of uveitis. The sensitivity (SE), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of the two biomarkers were calculated in different contexts.ResultsEight hundred and sixty-eight patient cases were reviewed. The mean age at uveitis onset was 49.4 (±18.6) years. Of them, 144 patients had a diagnosis of sarcoid uveitis. An elevated sACE had SE of 45.8%, Sp of 88.8%, PPV of 44.9% and NPV of 89.2% in diagnosing sarcoid uveitis. For lymphopaenia, SE was 15.3%, Sp was 96.7%, PPV was 47.8% and NPV was 85.2%. For the combination of elevated sACE and lymphopaenia, SE was 18.9%, Sp was 99.0%, PPV was 73.9% and NPV was 89.5%. The value of this combination varied according to patient age at diagnosis plus anatomoclinical entities: for patients aged ≤50 years, SE was 31.3%, Sp was 99.7%, PPV was 90.9% and NPV was 94.3%. For granulomatous uveitis, SE was 26.2%, Sp was 97.3%, PPV was 73.3% and NPV was 82.5%.ConclusionA combination of elevated serum ACE and lymphopaenia more convincingly suggests sarcoid uveitis than these investigational tests used alone, especially in patients with granulomatous uveitis, while a lack of these markers corresponds to a high NPV.Trial registration numberNCT03863782.

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Uterine and tubal anatomical abnormalities in infertile women: diagnosis with routine hysterosalpingography prior to selective laparoscopy

South African Journal of Radiology ◽

10.4102/sajr.v15i4.354 ◽

2011 ◽

Vol 15 (4) ◽

pp. 120 ◽

Cited By ~ 3

Author(s):

Mwaffaq Heis ◽

Zouhair Amarin ◽

Alaa Ibrahim ◽

Nael Obeidat ◽

Basil Obeidat ◽

...

Keyword(s):

Retrospective Study ◽

Predictive Value ◽

University Hospital ◽

Tubal Occlusion ◽

Infertile Women ◽

The North ◽

Procedural Complications ◽

The Mean ◽

Bilateral Salpingectomy ◽

Very High

Objective: To assess the findings and usefulness of hysterosalpingography as a routine investigation in the fertility workup prior to selective laparoscopy. Design: Descriptive retrospective study. Setting: A university hospital in the north of Jordan. Subjects: All hysterosalpingographies performed in the period between 1st January and 31 December 2008. Outcome measures: Detection of uterine and fallopian tube abnormalities and their correlation with laparoscopic findings. Results: During the study period, 281 infertile women underwent hysterosalpingography with no post procedural complications. The mean (SD) age was 31.5 (5.91) years. Mean (SD) duration of infertility was 4 (3.44) years. Infertility was reported as primary and secondary by 119 (42.3 %) and 162 (57.6 %), respectively. Altogether 281 patients and 562 tubes were examined. Of those, 402 were patent and 160 occluded. There was only one woman in whom peritubal adhesions were diagnosed. Because of hysterosalpingographically diagnosed tubal occlusion, 46 women (16.4 %) were referred for laparoscopy. Eight (17.3%) of them were treated with unilateral salpingectomy and 28 (60.8%) with bilateral salpingectomy. Salpingolysis was performed for 7 (15.2%) women, and 3 (6.7%) women had untreatable adhesions. The concordance was 71.7%. The sensitivity of HSG was 80%, the specificity 50%, the negative predictive value 61% and the positive predictive value 71%. Of the total of 281 women, 30 (10.7%) conceived within 1 - 11 months after the hysterosalpingography. Conclusions: The very high abnormal predictive value of hysterosalpingography in the diagnosis of tubal occlusion suggests that this procedure could be performed as a screening examination.

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Vitreomacular interface after anti-VEGF injections in diabetic macular edema

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00295-8 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Carlos E. Veloso ◽

Daniel N. Brocchi ◽

Rishi P. Singh ◽

Márcio B. Nehemy

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Short Term ◽

Vitreomacular Adhesion ◽

Corrected Visual Acuity ◽

Anti Vegf ◽

Vitreomacular Interface ◽

The Mean

Abstract Background The purpose of this study was to evaluate the incidence of vitreomacular adhesion (VMA) release after anti-VEGF therapy for the treatment of diabetic macular edema (DME) and to evaluate further changes in outcome. Methods This was a retrospective study that enrolled 66 eyes of 66 patients with DME who presented with VMA diagnosed by spectral-domain optical coherence tomography (OCT) at baseline. VMA was classified as focal (attachment: ≤ 1500 μm) or broad (attachment: > 1500 μm). All patients received at least three monthly intravitreal injections of an anti-VEGF agent. Follow-up visits were performed 1 month after each injection to evaluate the incidence of VMA release. Results The mean patient age was 61.4 years (range: 29 to 78 years), and 72.7 % were male. The mean best-corrected visual acuity was 0.62 logMAR, and the mean central retinal thickness (CRT) was 473 μm at baseline. The mean length of follow-up was 18.5 months, and the mean number of injections was 5.8. The intravitreal drugs used were aflibercept (40.9 %), ranibizumab (37.9 %) and bevacizumab (21.2 %). Forty-seven eyes had broad VMA, and 19 had focal VMA. Twenty-two eyes (33.3 %) developed VMA release following a mean of 5.7 injections (range: 3–13). Sixteen eyes (72.7 %) with focal VMA and 6 eyes (27.3 %) with broad VMA at baseline developed VMA release. Twenty-one eyes that developed VMA release showed an improvement in CRT following VMA release (mean: -106 μm; range: 22 to 289 μm). Conclusions VMA release occurs in approximately 1/3 of patients with DME following anti-VEGF therapy. Most of them show a short-term decrease in CRT.

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Panretinal photocoagulation after or prior to intravitreal conbercept injection for diabetic macular edema: a retrospective study

BMC Ophthalmology ◽

10.1186/s12886-021-01920-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Zhang ◽

Guiyang Zhao ◽

Weijie Fan ◽

Taihong Zhao

Keyword(s):

Diabetic Retinopathy ◽

Retrospective Study ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Panretinal Photocoagulation ◽

Significant Difference ◽

Photocoagulation Treatment ◽

The Mean ◽

The Difference

Abstract Background Panretinal photocoagulation treatment (PRP) have been known as a standard treatment for proliferative diabetic retinopathy (PDR) or severe nonproliferative diabetic retinopathy (sNPDR). However, there is no consensus on when PRP should be administrated if anti-VEGF treatment is needed for the concurrent diabetic macular edema (DME). This study is to evaluate the difference between two groups of PRP prior to, or after intravitreal conbercept (IVC) for patients with PDR or sNPDR combined with DME. Methods This was a retrospective study. Fifty-eight eyes with DME secondary to PDR or sNPDR were divided into two groups; the PRP after (PRP-after group), or prior to (PRP-prior group), IVC. Changes in number of IVC injections, best corrected visual acuity (BCVA), and central subfield macular thickness (CSMT) were compared after 4 weeks, 12 weeks, 1 year, and 2 years from the first IVC injection. Results The mean number of injections in PRP-after group was 4.8 (1 year) and 6.4 (2 year), lower than 6.4 (1 year) and 8.5 (2 year) in PRP-prior group (both p = 0.002). There was no significant difference in change in BCVA and CSMT between two groups after each follow-up. Conclusion PRP after IVC requires less injections but also yields similar visual and anatomic outcome comparing with PRP prior to IVC in patients with diabetic retinopathy combined with DME.

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Predictive Value of 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG PET) Performed after Two Cycles of Standard Chemotherapy (CT) on Treatment Outcome in Hodgkin Disease.

Blood ◽

10.1182/blood.v104.11.310.310 ◽

2004 ◽

Vol 104 (11) ◽

pp. 310-310

Author(s):

Andrea Gallamini ◽

Luigi Rigacci ◽

Francesco Merli ◽

Pasquale Errico ◽

Alessandro Levis ◽

...

Keyword(s):

Treatment Outcome ◽

Predictive Value ◽

Fdg Pet ◽

Pet Scan ◽

Prognostic Role ◽

Fdg Pet Scan ◽

The Mean ◽

Pet Scans

Abstract Objectives: Several prognostic models based on simple clinical variables have been proposed for Hodgkin’s Disease (HD); however, when applied in a prospective way, they showed unsatisfactory predictive value and scarce reproducibility. The prognostic role of early evaluation of treatment response by TC or Gallium scan has been proved in the past. We report here the preliminary results of a clinical trial on the prognostic role of FDG PET scan performed very early during treatment in advanced stage HD patients (pts), treated by conventional, standard-dose, CT. Matherials and methods: Starting from january 2002, 55 new HD pts were consecutively enrolled into the trial; 42 completed the program and are valuable for the analysis. Pts characteristics were: mean age 34.9 years (16-79), advanced disease (stages IIB-IVB) in 24, and stage IIA in 18. Bulky and extra-nodal disease were recorded in in 12 and 11 pts, respectively. Histopathology was: NS in 36, LP in 3, MC in 2 and LD in 1. All pts were staged at baseline with TC scan, bone marrow trephine biopsy and FDG PET scan (PET-0); they were re-staged after 2 CT courses and at the end of the treatment, including radiotherapy, by TC scan and PET scan (TC-2, PET-2 and TC-8, PET-8, respectively). Standardized Uptake Value (SUV) was calculated in all FDG PET scans. PET-0 and PET-8 were considerate positive when the SUV value was ≥ 3 and PET-2 when the SUV ratio PET-2/PET 0 was > 33%. CT was ABVD in 36 pts, escalated BEACOPP in 5 and MOPP/EBV/CAD in 1. In 19/42 additional radiotherapy was given. The mean interval between the end of the 2nd CT course and PET-2 was 11.5 days (6-32); the interval between the end of the therapy (either CT or radiotherapy) and PET-8 was never shorter than 50 days. Results: The mean follow-up from the final restaging was 328.7 days (11-690). Mean SUV value of PET-0 was 12.04. At the end of the program 38 pts were in CR and 4 in progression; one relapsed 13 months after CR entry. TC-2 showed PR in 37 pts and CR in 5. By contrast, PET-2 was positive in only 5 pts: two of them, with a mean SUV-2/SUV-0 ratio of 26.5% (20-33), showed a progressive reduction of SUV in subsequent PET scans, up to a complete negativity: both are in continuous CR. Two out of three pts with a mean SUV reduction to 61% (49-85) of the basal values progressed after the 5th and the 8th CT course, respectively; the third relapsed in CR one year after CT completion. 34/37 (92%) pts with a negative PET-2 showed a PET-8 persistently negative and remained in CR; 2 progressed during CT and one relapsed 12 months after the end of the therapy. Upon assuming that a PET-2 is positive when the ratio of SUV-2/SUV-0 is >33%, the Predictive Positive Value (PPV) of a PET-2 was 100% and the Predictive Negative Value (PNV) was 92%. The sensitivity of PET-2 was 50%, the specificity was 100% and the overall accuracy 93%. Conclusions: The FDG PET scan performed very early during therapy predicts the treatment outcome in most pts. (39/42: 93%), with a PPV value of 100% and a PNV value of 92%. However, since most relapses of HD occur within 24 months from diagnosis, definite conclusions will be drawn after a minimum follow-up of two years.

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Correlation between macular vessel density and number of intravitreal anti-VEGF agents for macular edema associated with branch retinal vein occlusion

Scientific Reports ◽

10.1038/s41598-019-52732-2 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Ryo Tomita ◽

Takeshi Iwase ◽

Kensuke Goto ◽

Kentaro Yamamoto ◽

Eimei Ra ◽

...

Keyword(s):

Regression Analysis ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Vessel Density ◽

Intravitreal Injections ◽

Systemic Hypertension ◽

Vein Occlusion ◽

Anti Vegf ◽

The Mean

Abstract We evaluated whether the reduction of macular vessel density was correlated with the number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents in eyes with a branch retinal vein occlusion (BRVO). The mean vessel density was determined by optical coherence tomography angiography in 29 eyes with macular edema associated with a BRVO. Our results showed that the mean vessel density in the group that had a resolution of the macular edema after one anti-VEGF injection was significantly higher than group that had a recurrence of the macular edema (P = 0.028). Single regression analysis showed that the number of intravitreal injections was significantly correlated with the reduction of the modified vessel density (r = −0.421, P = 0.023) and systemic hypertension (r = 0.377, P = 0.044). Multiple stepwise regression analysis showed that the reduction of the modified vessel density (β = −0.442, P = 0.009) and hypertension (β = 0.403, P = 0.016) were independent factors associated with the number of intravitreal injections. We conclude that the vessel density reduction can be used to predict whether recurrences of the macular edema will develop after the initial anti-VEGF injection in eyes with macular edema associated with a BRVO.

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