scholarly journals Conbercept for Treatment of Neovascular Age-Related Macular Degeneration and Visual Impairment due to Diabetic Macular Edema or Pathologic Myopia Choroidal Neovascularization: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pengxiang Zhou ◽  
Siqian Zheng ◽  
Ente Wang ◽  
Peng Men ◽  
Suodi Zhai
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Macular Edema ◽  
Age Related Macular Degeneration ◽  
Pathologic Myopia ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Background: Conbercept is a new anti-vascular endothelial growth factor (VEGF) drug. Here, we systematically conducted the efficacy, safety, compliance, and pharmacoeconomic evaluation of intravitreal conbercept (IVC) compared with other treatments in patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or pathologic myopia choroidal neovascularization (pmCNV).Methods: Databases of PubMed, Embase, Cochrane Library, ClinicalTrials.gov, SinoMed, China National Knowledge Infrastructure, and WanFang Data were systematically searched from the inception to July 27, 2021. Randomized clinical trials and pharmacoeconomic studies comparing IVC with control groups in adults with nAMD, DME, or pmCNV were reviewed and selected. Meta-analyses were performed using the fixed-effects model when pooled data were homogeneous. Heterogeneous data were analyzed using the random-effects model. Primary outcomes included visual improvement rate, mean change in visual acuity or best corrected visual acuity, and pharmacoeconomic outcomes. Additional outcomes were the mean change in fundus examination values, adverse events (AEs), quality-of-life measures, and number of injections.Results: Among 3,591 screened articles, 22 original studies with 1,910 eyes of patients were finally included. For nAMD and DME, IVC was significantly associated with better visual acuity or best corrected visual acuity improvement and fundus quantitative measures than placebo, laser photocoagulation (LP), or intravitreal triamcinolone acetonide (IVT). However, IVC showed non-inferior efficacy to intravitreal ranibizumab (IVR) according to low quality of evidence, and there was lack of trials comparing the priority of IVC to other anti-VEGF regimens. No definitive increased risk of ocular or non-ocular AEs were observed in the study groups. All patients with AEs recovered after symptomatic treatments, and no severe AEs occurred. Patients treated with IVC might have higher quality-of-life scores than those in IVR in nAMD or LP in DME. Additionally, IVC showed cost–utility advantages in nAMD and cost-effectiveness advantages than IVR in pmCNV in China.Conclusion: IVC is well-tolerated and effective for improving vision acuity and quantitative measures in fundus condition in patients with nAMD and DME compared with LP, IVT, and placebo, but gains comparable efficacy to IVR. However, well-designed, large-sample, and long-term evaluation of IVC shall be conducted in additional studies worldwide.

The efficacy of “IOL-Vip Revolution” telescopic intraocular lens in age-related macular degeneration cases with senile cataract

2018 ◽  
Vol 29 (6) ◽  
pp. 615-620
Author(s):  
Medine Yilmaz Dag ◽  
Filiz Afrashi ◽  
Serhad Nalcaci ◽  
Jale Mentes ◽  
Cezmi Akkin
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Intraocular Lens ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Age Related Macular Degeneration ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Purpose: To evaluate the efficacy of the IOL-Vip Revolution telescopic intraocular lens in age-related macular degeneration patients. Methods: A total of 13 eyes of 12 age-related macular degeneration patients with senile cataract were enrolled. Selection of the patients was done by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. After standard phacoemulsification surgery, the incision site was enlarged and the IOL-Vip Revolution system was implanted in the capsular bag. The outcome measures were best corrected visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, central corneal thickness, and quality-of-life questionnaire. Results: The mean age of the subjects was 72.3 ± 8.5 years. The mean positive power of the intraocular lens was 59 ± 2 D and the negative intraocular lens power was standard (–46 D). Pre- and postoperative best corrected visual acuity were 1.08 ± 0.14 and 0.81 ± 0.16 logMAR in the operated eye and 1.13 ± 0.36 and 1.01 ± 0.40 logMAR in the unoperated eye, respectively. The best corrected visual acuity was increased significantly in both operated and unoperated eyes (p = 0.005 and 0.021, respectively). Quality of life and anterior chamber depth increased significantly (p = 0.018 and 0.008, respectively), while endothelial cell density decreased (p = 0.002). No significant differences were detected in central corneal thickness or contrast sensitivity (p = 0.133 and 0.684, respectively). Conclusion: The results showed that IOL-Vip Revolution telescopic intraocular lens is a promising treatment option in age-related macular degeneration patients. The rehabilitation program may have an important role in the restored clinical results, which also provided visual improvement in the unoperated eyes.

Intravitreal aflibercept efficacy in neovascular age-related macular degeneration with suboptimal response to anti-vascular endothelial growth factor-A therapy

2019 ◽  
Vol 30 (5) ◽  
pp. 1082-1090
Author(s):  
Jordi Monés ◽  
Marc Biarnés ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Best Corrected Visual Acuity

Importance: To provide new insights into aflibercept effect in non-naive-treated patients with neovascular age-related macular degeneration. Purpose: To assess the efficacy of intravitreal aflibercept in patients with neovascular age-related macular degeneration without optimal response to previous anti-vascular endothelial growth factor A therapy. Design: Single-arm, multi-centre, prospective study. Participants: Patients ⩾50 years with active neovascular age-related macular degeneration, best-corrected visual acuity between 20/32 and 20/320 with suboptimal response to ranibizumab or bevacizumab. Methods: Aflibercept was administered monthly (3-first months), and bimonthly thereafter until month 8. Anatomical and functional outcomes were assessed. Main outcome measure: Percentage of eyes without intra or subretinal fluid on optical coherence tomography after 3-monthly loading doses of aflibercept. Results: A total of 46 patients were included. At week 12, 45.7% (95% confidence interval: 31.5%–60.1%) of eyes showed no fluid on optical coherence tomography. The mean (standard deviation) best-corrected visual acuity increased from 65.1 (8.3) to 69.6 (8.1) letters (+4.5 (5.8) p < 0.0001) and was stabilized at week 40 as compared to baseline. Mean central macular thickness decreased from 430 (119) µm to 323 (100) µm at week 12 (–107 (90) µm, p < 0.0001) and was reduced at week 40 (–46 (111) µm, p = 0.0056). At week 40, 21.7% (95% confidence interval: 9.8%–33.7%) had no fluid. There was a case of presumed noninfectious endophthalmitis that was successfully managed. Conclusion: Almost half of patients presented no fluid on optical coherence tomography at week 12, and there was a clinically significant improvement in best-corrected visual acuity. At week 40, one in five patients did not show intra or subretinal fluid, central macular thickness decreased and best-corrected visual acuity was stabilized compared to baseline.

scholarly journals Improvement of the Quality of Life in Patients with Age-Related Macular Degeneration by Using Filters

2020 ◽  
Vol 17 (18) ◽  
pp. 6751
Author(s):  
Daniel Caballe-Fontanet ◽  
Cristina Alvarez-Peregrina ◽  
Neus Busquet-Duran ◽  
Eduard Pedemonte-Sarrias ◽  
Miguel Angel Sanchez-Tena
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Longitudinal Study ◽  
Macular Degeneration ◽  
Optical Filters ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Before And After ◽  
Visual Function Questionnaire

Background: Age-related macular degeneration (AMD) is a disease with an increasing incidence due to the general aging of the population that decreases the patient’s quality of life. This work aims to study whether selective cut optical filters improve the AMD patient’s quality of life. Methods: Prospective and longitudinal study in 79 patients. Visual acuity, contrast sensitivity, and the line differences in the Colenbrander test were measured. Patients answered The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), which measures the quality of life related to vision before and after using cut optical filters. Results: There was an improvement of 5.99 points (3.7–8.3) in NEI VFQ-25 after wearing filters. This improvement was 4.0 points for 450-nm filters and 12.7 points for 511-nm filters. For patients with visual acuity (VA) < 0.25, results of NEI VFQ-25 increased by 10.11 points (1.19–19.02) and for patients with late AMDs, results increased by 5.33 points (1.31–9.35). Conclusions: Selective filters improve the quality of life of patients with AMD. The success rate in the fitting of filters is better for those with VA lower than 0.25 and those with late or advanced AMD.

Effect of 2-year nutritional supplementation on progression of age-related macular degeneration

2019 ◽  
Vol 30 (2) ◽  
pp. 376-381
Author(s):  
Alberto Piatti ◽  
Antonella Croce ◽  
Danilo Mazzacane ◽  
Giovanni Traina ◽  
Lina Ambrosino ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Exact Test ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

Purpose: To examine the effect of a long-term nutritional supplementation on age-related macular degeneration progression. Methods: In this prospective, double-blind, placebo-controlled study, 80 patients with intermediate age-related macular degeneration were randomized (2:1) to receive 1 tablet/day of a nutritional supplement containing a mixture of carotenoids, vitamins and omega-3 fatty acids or placebo. Age-related macular degeneration progression assessed by digital fundus photography (primary outcome) and best-corrected visual acuity were evaluated. Differences between arms were tested using chi-square test or Fisher’s exact test. Results: Seventy-four patients completed the follow-up at 24 months (48 in the treated arm and 26 in the placebo arm). An age-related macular degeneration progression was observed in the 2.1% of patients of the treated arm and in the 15.4% of patients in the placebo arm (p = 0.05, Fisher’s exact test). Best-corrected visual acuity data alone were not statistically significant among groups. Conclusion: A clinically meaningful stabilization of intermediate age-related macular degeneration over a period of 2 years may be obtained by treating patients with a mixture of carotenoids, vitamins and omega-3 fatty acids.

One-year outcomes of the Polish treatment program for the wet form of age-related macular degeneration using intravitreal therapy

2020 ◽  
Vol 30 (3) ◽  
pp. 586-594
Author(s):  
Małgorzata Figurska ◽  
Anna Matysik-Wożniak ◽  
Joanna Adamiec-Mroczek ◽  
Joanna Dolar-Szczasny ◽  
Marta Misiuk-Hojło ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Treatment Program ◽  
Median Number ◽  
Age Related Macular Degeneration ◽  
Therapeutic Program ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Treatment Naïve ◽  
Best Corrected Visual Acuity

Purpose: To report 12-month outcomes of a Polish National Treatment Program using aflibercept and ranibizumab in eyes with wet, age-related macular degeneration in routine clinical practice. Material and Methods: This was a non-randomized, retrospective, observational multicenter study. Anonymous data contained in the electronic Therapeutic Program Monitoring System were utilized in this study. Results: The study population consisted of 2828 eyes from 2718 patients. The median age was 76.0 [70.0, 81.0] years; 61.7% were female. Best corrected visual acuity increased from 58.86 [50.05, 69.95] letters to 65.1 [50.1, 73.9] letters (p < 0.001). The median change in best corrected visual acuity was 0.0 [−4.0, 12.2] letters: 2.9 [−2.9, 15.1] letters for treatment-naïve eyes and 0.0 [−4.0, 8.8] letters for those continuing treatment (p < 0.001). The median central retinal thickness was significantly reduced from 341.0 [281.0, 422.0] to 275.0 [221.0, 344.0] μm (p < 0.001). The median number of visits was 9.0 [8.0, 9.0]. The median number of injections was 7.0 [6.0, 8.0]: 8.0 [7.0, 8.0] for treatment-naïve eyes and 6.0 [5.0, 7.0] for those continuing treatment (p < 0.001). Conclusion: Eyes treated as part of the Polish therapeutic program gained functional stability and morphological improvement. Treatment-naïve eyes showed the greatest functional benefit.

Change in vision-related quality of life and influencing factors in Asians receiving treatment for neovascular age-related macular degeneration

2017 ◽  
Vol 102 (3) ◽  
pp. 377-382 ◽  
Author(s):  
Eva K Fenwick ◽  
Gemmy Chui Ming Cheung ◽  
Alfred TL Gan ◽  
Gavin Tan ◽  
Shu Yen Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Reading Scores ◽  
Related Factors ◽  
Age Related ◽  
Related Quality ◽  
The Impact

AimTo assess the change in vision-related quality of life (VRQoL) after treatment for neovascular age-related macular degeneration (nAMD) and factors influencing this change in an Asian population.MethodsIn this longitudinal study, 116 patients (mean age±SD=66.5±9.9 years; 59.5% male) who underwent treatment for nAMD were recruited from a tertiary eye centre in Singapore. Best-corrected visual acuity (BCVA) and the Impact of Vision Impairment (IVI) questionnaire were evaluated at baseline and month 12. We defined three categories of BCVA change in the treated eye: BCVA gain ≥2 lines; no change in BCVA; BCVA loss ≥2 lines. The main outcome measures were the Rasch-derived IVI Reading, Mobility, and Emotional Scores. Multivariable linear regression analyses assessed the influence of sociodemographic, clinical and treatment-related factors on change in VRQoL.ResultsFollowing treatment, mean treated-eye BCVA improved by almost 2 lines (−0.22±0.40 logMAR, p<0.001) and 43% (n=50) patients reported a gain in BCVA of ≥2 lines. Mean±SD scores for Reading, Mobility and Emotional demonstrated positive changes of 0.43±1.73, 0.45±1.54 and 0.66±1.6, respectively (p<0.001 for all). In multivariable models, a ≥2 line improvement in BCVA was independently associated with a 47% (β=0.20; CI 0.01 to 0.39) increase in Reading Scores, but was not independently associated with Mobility or Emotional Scores.ConclusionNearly half of patients undergoing treatment for nAMD reported a 2-line improvement in vision which was, in turn, associated with substantial positive increases in Reading Scores. Improvements in Mobility and Emotional Scores appear to be driven by factors other than visual acuity.

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