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.

Increased bowel toxicity in patients treated with a vascular endothelial growth factor inhibitor (VEGF-i) following stereotactic body radiotherapy (SBRT).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14507-e14507
Author(s):  
Brandon M. Barney ◽  
Svetomir Markovic ◽  
Nadia N. Laack ◽  
Robert C. Miller ◽  
Jann Nagina Sarkaria ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Stereotactic Body Radiotherapy ◽  
Rank Test ◽  
Vegf Receptor ◽  
Vascular Endothelial ◽  
Vegf Inhibitor ◽  
Factor Inhibitor ◽  
Grade 3 ◽  
Endothelial Growth Factor

e14507 Background: Serious gastrointestinal injury (SGI) is a rare but documented side effect that can occur independently with agents that affect the vascular endothelial growth factor (VEGF) receptor or with stereotactic body radiotherapy (SBRT). The risk of SGI in patients treated with the combination of SBRT sequentially followed by a VEGF inhibitor (VEGF-i) is not yet quantified. We explored the incidence of SGI in patients treated with SBRT with or without VEGF-i therapy at a single institution. Methods: From May 2008 to August 2011, 76 patients with 84 primary or metastatic intraabdominal lesions underwent SBRT (median dose, 50 Gy in 5 fractions). Twenty of these patients (26%) received a VEGF-i within two years of completing SBRT (bevacizumab, n=14; sorafenib, n=4; pazopanib, n=1; sunitinib, n=1). The most common site treated with SBRT was the liver (n=43, 57%), and the most common histology was colorectal adenocarcinoma (n=18, 24%). Other common histologies included melanoma of the skin (n=14, 18%) and non-small cell lung cancer (n=10, 13%). The incidence of SGI (CTCAE v4.0 grade 3 to 5 ulceration or perforation) after SBRT was obtained, and the relationship between SGI and VEGF-i was examined. Other factors that could potentially contribute to SGI, such as radiotherapy dose to bowel, were also analyzed. Results: Seven patients (9%) experienced SGI at a median 4.6 months (range, 3-17 months) after SBRT. All seven had received a VEGF-i prior to SGI and within 13 months of completing SBRT, and five received the VEGF-i within three months of SBRT. The six-month estimate of SGI in patients receiving a VEGF-i within three months of SBRT was 38%. No SGI was noted in the 63 patients not receiving VEGF-i therapy after SBRT. The Log-Rank test showed a significant correlation between SGI and VEGF-i therapy within three months of SBRT (p=0.0006) but not between SGI and maximum radiotherapy bowel dose (p=0.20). Conclusions: The combination of SBRT and VEGF-i therapy results in a much higher risk of SGI than would be expected with either treatment given independently. Local therapies other than SBRT should be considered if a patient is likely to be treated with a VEGF-i in the future.

scholarly journals Intraokulare Entzündungen bei Brolucizumab-Anwendung

2021 ◽  
Author(s):  
F. G. Holz ◽  
C. Heinz ◽  
A. Wolf ◽  
H. Hoerauf ◽  
U. Pleyer
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Phase Iii ◽  
Vascular Endothelial ◽  
Review Committee ◽  
Oder Eine ◽  
Diagnostik Und Therapie ◽  
Factor Inhibitor ◽  
Antientzündliche Therapie ◽  
Endothelial Growth Factor

ZusammenfassungDer VEGF(„vascular endothelial growth factor“)-Inhibitor Brolucizumab ist seit Oktober 2019 in den USA und seit Februar 2020 in Europa zur Behandlung der neovaskulären altersabhängigen Makuladegeneration (nAMD) zugelassen. Grundlage der Zulassung bildeten die randomisierten, doppel-blinden Phase-III-Studien HAWK und HARRIER mit insgesamt 1817 Patienten. Hierbei zeigte Brolucizumab 6 mg (je nach Krankheitsaktivität alle 12 oder alle 8 Wochen verabreicht) eine nichtunterlegene Wirksamkeit in Bezug auf den bestkorrigierten Visus gegenüber Aflibercept 2 mg (alle 8 Wochen verabreicht). Erste Rückmeldungen zum Einsatz von Brolucizumab nach der Marktzulassung in den USA haben einzelne, z. T. schwerwiegende Fälle behandlungsassoziierter intraokularer Entzündungen mit retinaler Vaskulitis und/oder retinaler, vaskulärer Okklusion beschrieben, die teilweise zu einem schweren Visusverlust führten. Die Daten der Zulassungsstudien wurden daraufhin durch ein Safety Review Committee (SRC) unabhängig retrospektiv analysiert. Ziel der vorliegenden Publikation ist es, Anwendern eine Orientierungshilfe aus Autorensicht bei der Therapie einer Brolucizumab-assoziierten intraokularen Entzündung zu bieten. Von zentraler Bedeutung ist hierbei auch eine erweiterte Aufklärung der Patienten über Symptome einer intraokularen Entzündung. Obwohl die Fallserien und die HAWK/HARRIER-Daten es nicht abschließend beantworten, bleiben eine zu späte Detektion, eine unterdosierte antientzündliche Therapie oder eine unbedachte Wiederbehandlung mit Brolucizumab dem Verdacht ausgesetzt, Komplikationen zu verstärken. Ein Stopp der Brolucizumab-Therapie sollte grundsätzlich erfolgen, sobald es nach Gabe des Medikaments zu intraokularen Entzündungen mit oder ohne retinalen Vaskulitiden und oder Gefäßverschluss kam. Abhängig vom Schwerpunkt der Entzündung werden dem Behandler an die Leitlinien und Stellungnahmen angelehnte Empfehlungen für Diagnostik und Therapie dargestellt. Diese Übersichtsarbeit ersetzt nicht die fachgesellschaftlichen Stellungnahmen.

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.

Tractional retinal detachment (‘crunch’ phenomenon) from intravitreal anti-vascular endothelial growth factor injection in central retinal vein occlusion

2021 ◽  
Vol 14 (4) ◽  
pp. e240506
Author(s):  
Albert John Bromeo ◽  
Amadeo Veloso ◽  
Sweet Jorlene Lerit ◽  
Myron Carlo Gomez
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinal Detachment ◽  
Central Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Tractional Retinal Detachment ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein

Tractional retinal detachment is an uncommon complication of intravitreal anti-vascular endothelial growth factor (VEGF) injection wherein the drug triggers tractional retinal detachment as a result of fibrovascular membrane contraction. We present a case of a 42-year-old hypertensive woman diagnosed with chronic central retinal vein occlusion on both eyes. The right eye had total retinal detachment and neovascular glaucoma, while the left eye had retinal neovascularisation. Panretinal photocoagulation and intravitreal anti-VEGF injection was started on the left eye. However, she was lost to follow-up. She returned 4 months later with extensive tractional retinal detachment involving the macula on the left eye. She subsequently underwent vitrectomy with endolaser and silicone oil tamponade on the left eye. The anti-VEGF ‘crunch’ results from regression of fibrovascular proliferation with a concurrent increase in fibrosis, resulting in worsening retinal traction. With the widespread use of anti-VEGF agents, ophthalmologists need to be aware of this vision-threatening complication.

Sign in / Sign up

Export Citation Format

Share Document