A new approach to the treatment of macular edema associated with toxocaral uveitis in remission in pediatric ophthalmology using a VEGF inhibitor

2021 ◽  
pp. 139-142
Author(s):  
A.O. Nazarenko ◽  
◽  
V.S. Cha ◽  
E.E. Sidorenko ◽  
I.B. Astasheva ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Macular Edema ◽  
Clinical Case ◽  
Vascular Endothelial ◽  
Pediatric Ophthalmology ◽  
New Approach ◽  
Vegf Inhibitor ◽  
Results Of Treatment ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Purpose. To demonstrate the results of treatment with the use of a VEGF inhibitor (anti-VEGF) in a clinical case of severe edema of the macular and paramacular regions against the background of toxocaral uveitis in remission. Material and methods. This article presents a clinical case of an 11-year-old female patient with increasing severe macular edema with neovascularization, which appeared against the background of toxocaral uveitis in remission. In connection with the progression of the disease, the patient was injected intravitreally with an inhibitor of vascular endothelial growth factor aflibercept. Results. At discharge, the patient showed positive dynamics in the form of an increase in visual acuity in the left eye from 0.04 to 0.07. According to the results of ophthalmoscopy and OCT of the left eye, a decrease in the area of exudation is determined, which confirms the effectiveness of the treatment. Conclusion. The description of this case can be provided as information about the possibility of using a VEGF inhibitor for exudative processes of the macular region of various etiologies in the absence of the effectiveness of conservative treatment methods. Key words: toxocariasis, uveitis, macular edema, aflibercept, anti-VEGF, OCT.

Treatment of Coates retinitis in both eyes in a 5-year-old girl

2021 ◽  
pp. 63-65
Author(s):  
A.O. Nazarenko ◽  
◽  
E.E. Sidorenko ◽  
I.V. Suhanova ◽  
A.R. Shavaleeva ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinal Detachment ◽  
Clinical Case ◽  
Vascular Endothelial ◽  
Vegf Inhibitor ◽  
Vascular Activity ◽  
Factor Inhibitor ◽  
The Right ◽  
Endothelial Growth Factor

Purpose. To present a rare clinical case of bilateral Coates retinitis in a 5-year-old girl. Material and methods. A clinical case of a 5-year-old girl with rare Coat's retinitis in both eyes is described. The disease occurred abruptly: the child's parents noted the appearance of leukocoria in the right eye. After the examination Coates ' retinitis was diagnosed. At the time of examination in the clinic, there was a retinal detachment in the right eye, the surgical treatment was performed: lensvitrshvartectomy, plastic surgery of the anterior chamber, with the melting of the retina with perfluoroorganic compounds, drainage of subretinalfluid, endolaser coagulation on the right eye. A month after the first symptoms appeared in the right eye, the patient complained of decreased vision in the left eye. Examination on the pediatric retinal camera showed an increase in vascular activity in the left eye, and signs of Coats' retinitis were revealed. Results. As a therapy for this disease, the patient was twice injected intravitreally inhibitor of vascular endothelial growth factor (VEGF inhibitor) into the left eye with positive dynamics noted as a decrease in the activity of retinal vessels and leveling of the exudative component, as well as with an increase in visual acuity in the left eye. Conclusion. This clinical case demonstrates that intravitreal administration of inhibitor VEGF with traditional methods of treatment can be used as a treatment for patients with Coates retinitis. Key words: Coat's retinitis, Coats' disease, vascular endothelial growth factor inhibitor, aflibercept, intravitreal injection, anti-VEGF, retinal detachment.

Intravitreous Vascular Endothelial Growth Factor (VEGF) Inhibitor Therapy for Tamoxifen Induced Macular Edema

2007 ◽  
Vol 22 (2) ◽  
pp. 87-88 ◽  
Author(s):  
Dan H. Bourla ◽  
Christine R. Gonzales ◽  
Charles W. Mango ◽  
Joel N. Moral ◽  
Robert S. Wirthlin ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Edema ◽  
Inhibitor Therapy ◽  
Vascular Endothelial ◽  
Vegf Inhibitor ◽  
Endothelial Growth Factor

scholarly journals Combination Treatment of Diabetic Macular Edema with Anti-Vascular Endothelial Growth Factor and Steroids: Analysis of DRCR.net Protocol U

2018 ◽  
Vol 1 ◽  
pp. 2
Author(s):  
Cindy Ung ◽  
Kareem Moussa ◽  
Yoshihiro Yonekawa
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
First Line ◽  
Second Line Therapy ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) is the main cause of visual impairment in diabetic patients. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is considered the first-line treatment option in the management of DME with corticosteroids used as second-line therapy. The DRCR.net Protocol U study was a Phase II trial that sought to compare the combination of a steroid and anti-VEGF therapy to anti-VEGF monotherapy regarding visual acuity and anatomic outcomes. This review highlights the strengths, weaknesses, and clinical implications of this study.

scholarly journals Short term visual and structural outcomes of anti-vascular endothelial growth factor (anti-VEGF) treatment delay during the first COVID-19 wave: A pilot study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247161
Author(s):  
Ameay V. Naravane ◽  
Rusdeep Mundae ◽  
Yujia Zhou ◽  
Christopher Santilli ◽  
Frederik J. G. M. van Kuijk ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Pilot Study ◽  
Growth Factor ◽  
Macular Edema ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Delayed Group ◽  
Endothelial Growth Factor

Regularly scheduled intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are essential to maintaining and/or improving many ocular conditions including: neovascular age-related macular degeneration (nAMD), diabetic retinopathy, and retinal vein occlusions with macular edema (RVO). This study aims to assess the effect of unintended delays in anti-VEGF treatment during the first wave of the COVID-19 pandemic. This retrospective case series identified patients receiving regularly scheduled anti-VEGF intravitreal injections based on current procedural terminology (CPT) code at two practices in Minnesota. Diagnoses were limited to nAMD, diabetic macular edema (DME), proliferative diabetic retinopathy, and RVO. Patients were divided into two groups based on whether they maintained or delayed their follow-up visit by more than two weeks beyond the recommended treatment interval during the COVID-19 lockdown. The ‘COVID-19 lockdown’ was defined as the period after March, 28th, 2020, when a lockdown was declared in Minnesota. We then compared the visual acuity and structural changes to the retina using ocular coherence tomography (OCT) to assess whether delayed treatment resulted in worse visual outcomes. A total of 167 eyes from 117 patients met criteria for inclusion in this study. In the delayed group, the average BCVA at the pre- and post-lockdown visits were 0.614 and 0.715 (logMAR) respectively (p = 0.007). Central subfield thickness (CST) increased from 341 to 447 in the DME delayed group (p = 0.03) while the CST increased from 301 to 314 (p = 0.4) in the nAMD delayed group. The results of this pilot study suggests that treatment delays may have a negative impact on the visual and anatomic outcomes of patients with nAMD and DME. Future studies with larger sample sizes are required for further investigation.

Aflibercept: A Review of Its Use in the Management of Diabetic Eye Complications

2016 ◽  
Vol 30 (5) ◽  
pp. 534-540 ◽  
Author(s):  
Oluwaranti Akiyode ◽  
Jateh Major ◽  
Abiola Ojo
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vascular Endothelial ◽  
Efficacy And Safety ◽  
Vegf Inhibitor ◽  
Anti Vegf ◽  
Visual Acuity Loss ◽  
Endothelial Growth Factor

Aflibercept is the most recently approved vascular endothelial growth factor (anti-VEGF) inhibitor for the management of diabetic macular edema and diabetic retinopathy. The purpose of this article is to review the efficacy and safety of aflibercept in the management of diabetic eye complications and to describe its place in therapy. Anti-VEGF agents have been noted in clinical trials to be superior to laser photocoagulation, the standard therapy ( P < .0001, P ≤ .0085, respectively). Aflibercept has been comparatively studied with other anti-VEGF agents, namely, bevacizumab and ranibizumab, and noted to be equally efficacious and safe in patients with mild visual acuity loss ( P > .50). However, in the treatment of patients with diabetic macular edema having moderate to severe visual acuity loss, aflibercept outperformed the other 2 anti-VEGF agents (aflibercept vs bevacizumab, P < .001; aflibercept vs ranibizumab, P = .003). However, additional studies are needed to fully appreciate the long-term safety and efficacy of aflibercept and the anti-VEGF therapy class.

Anti-VEGF and Retinal Dystrophies

2020 ◽  
Vol 21 (12) ◽  
pp. 1201-1207
Author(s):  
Maurizio Battaglia Parodi ◽  
Pierluigi Iacono ◽  
Stefano Da Pozzo
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Edema ◽  
Choroidal Neovascularization ◽  
Therapeutic Approach ◽  
Functional Limitations ◽  
Vascular Endothelial ◽  
Retinal Dystrophies ◽  
Anti Vegf ◽  
Endothelial Growth Factor

The therapeutic approach based on anti-vascular endothelial growth factor (anti-VEGF) molecules can be used to treat two important complications of retinal dystrophies: choroidal neovascularization and macular edema. The macular involvement in retinal dystrophies can lead to further visual deterioration in patients at a young age and already affected by functional limitations. The study reports the effect of anti-VEGF treatment in several subforms of retinal dystrophies, critically discussing advantages and limitations.

scholarly journals Intravitreal Therapy for Diabetic Macular Edema: An Update

2021 ◽  
Vol 2021 ◽  
pp. 1-23
Author(s):  
Claudio Furino ◽  
Francesco Boscia ◽  
Michele Reibaldi ◽  
Giovanni Alessio
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Sustained Release ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Functional Outcomes ◽  
Surgical Removal ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular endothelial growth factor inhibitors or corticosteroids therapies), and surgical removal are currently available. Although laser has been considered as the gold standard for many years, over the past several years vascular endothelial growth factor inhibitors (anti-VEGFs) have become first-line therapy. However, many patients do not adequately respond to them. With the development of sustained-release corticosteroid devices, steroids have gained a presence in the management of the DME. We review and update the role of anti-VEGF and intravitreal sustained-release corticosteroid management of DME. According to the currently available scientific evidence, the choice of one anti-VEGF over another critically depends on the baseline best-corrected visual acuity (BCVA). While aflibercept may be the drug of choice in low baseline BCVA, the three anti-VEGFs (bevacizumab, ranibizumab, and aflibercept) provided similar functional outcomes when the baseline BCVA was higher. DEX implants are a valuable option for treating DME, although they are usually seen as a second choice, particularly in those eyes that have an insufficient response to anti-VEGF. The new evidence suggested that, in eyes that did not adequately respond to anti-VEGF, switching to a DEX implant at the time to 3 monthly anti-VEGF injections provided better functional outcomes.

scholarly journals Concomitant Bilateral Intravitreal Injection of Anti-Vascular Endothelial Growth Factor: Experience in Covid-19 Pandemic

2021 ◽  
Author(s):  
SERKAN ÖZEN ◽  
Hakan Koc ◽  
Hasan Burhanettin Kaptı ◽  
Murat Atabey Ozer
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Adverse Events ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Before And After ◽  
The Mean ◽  
Endothelial Growth Factor

Abstract Purpose: To report the concomitant bilateral intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection preference rates of patients before and after the Covid-19 outbreak and to evaluate whether this practice is safe when compared to unilateral injection. Materials and Methods: This is a single-center, retrospective study including consecutive series of 198 eyes of 112 patients received bilateral same-day (concomitant) or unilateral anti-VEGF injections of bevacizumab, ranibizumab, and aflibercept in the operating-room between January 2020 and January 2021. One-year medical record data including preference of bilateral over unilateral injection and adverse events were reviewed with 3-month intervals as before and after Covid-19 pandemic due to the labile Covid-19 outbreak course.Results: A total of 504 injections with 234 concomitant bilateral (%46) were administered to 112 patients. The study group consisted of 58 neovascular age-related macular degeneration (nAMD- 63.7% had bilateral nAMD), 46 diabetic macular edema (DME- 67.3% had bilateral DME) and 8 macular edema complicating retinal vein occlusion (RVO- 25% had bilateral RVO) patients. Of the injections, 156 (31%) were bevacizumab, 144 (29%) were aflibercept, and 204 (40%) were ranibizumab. The mean follow-up time per patient was 7.4 ± 4.3 months (range 4-11 months) and the mean number of injections was 3.6 ± 2.1 (range 2-10). None of the patients experienced serious vision-threatening complications or non-ocular adverse events. 85% of patients whose both eyes involved strongly preferred concomitant bilateral injection during Covid-19 pandemic while it was %35 before Covid-19 (P<0.001). The ratio of the number of concomitant bilateral injections to a total of injections increased from 30% to 57% after Covid-19 (P=0.03). Only 3 patients (2.6%) requested alternating unilateral injections after receiving the second concomitant bilateral injections.Conclusion: Concomitant bilateral injection approach was preferred by the majority of patients and did not increase the adverse event rate when applied under meticulous precautions; This intravitreal injection option may be preferred during still ongoing pandemic to reduce the clinical visits of patients at risk of Covid-19 related mortality due to their comorbidities and age.

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