scholarly journals Two Year Study of Aflibercept and Ranibizumab Intravitreal Therapy in Patients with Wet AMD

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1293
Author(s):  
Dorota Luksa ◽  
Anna Heinke ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
First Year ◽  
Intravitreal Therapy ◽  
Exudative Amd ◽  
Medical Program ◽  
Group A ◽  
Second Year ◽  
Group B ◽  
Observation Period

Background and objectives: The aim of this study was to evaluate the therapeutic results in patients with exudative AMD treated with ranibizumab and aflibercept intravitreal injections over a two-year observation period. Materials and methods: A retrospective observational study was conducted in a clinical hospital on a group of patients who randomly qualified for treatment with Aflibercept (group A) and Ranibizumab (group B) as part of the Polish National Health Fund Medical Program for exudative AMD. Group A consisted of 90 patients, and group B contained 54 patients. The choice of drug in a patient depended solely on the availability of the medication at the time. Before each injection, best corrected visual acuity (BCVA) on the ETDRS scale and central retinal thickness (CRT) were assessed using optical coherence tomography (OCT). Patients from both groups were treated in the first year of treatment with a rigid scheme of 3 doses of 2.0 mg Aflibercept (group A) and 0.5 mg Ranibizumab (group B) at monthly intervals, followed by 4 doses at bimonthly intervals. In the second year, a “pro re nata” scheme was applied. The aim was to evaluate changes in BCVA and CRT after three injections, after 7 injections (about 12 months), and after the second year of therapy (24 months) with reference to the baseline and to compare the effectiveness of the medications. The influences of the following factors were studied: age, gender, initial BCVA, and initial CRT, as well as the number of injections received. Results: No significant statistical differences were found between patients receiving Aflibercept and Ranibizumab therapy in terms of achieving improved visual acuity and reducing retinal thickness after two years of therapy. Conclusions: Both aflibercept and ranibizumab were found to be effective for treating exudative AMD.

Reduction therapy of ALT levels and prevention of HCC development in patients with HCV-associated cirrhosis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1529-1529
Author(s):  
Y. Rino ◽  
N. Yukawa ◽  
T. Yamada ◽  
T. Imada ◽  
S. Morinaga ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
First Year ◽  
Factors Affecting ◽  
Group A ◽  
Second Year ◽  
Group B ◽  
Observation Period

1529 Background: Approximately 30 million people worldwide are estimated to have liver cirrhosis (LC) associated with hepatitis C virus (HCV). In addition, patients with HCV-associated liver cirrhosis (HCV-LC) have a high risk of developing hepatocellular carcinoma (HCC). Namely, 60–80% of the patients may develop HCC in 10 years. So, preventing these patients from developing HCC is an urgent problem to be solved. To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C-virus associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had reduction therapy of ALT levels was performed. Patients and Methods: Seventy-four consecutive HCV-LC patients of Child Stage A were followed for > 10 years for the development of HCC. They were divided into two groups: In group A, the reduction therapy for ALT levels is aggressively performed and in group B, the reduction therapy was not performed aggressively. Results: Initial ALT was higher in group A than in group B, but there was no significance. After reduction therapy, ALT level was significantly high in group A in the first year. However, there were no significant differences between ALT levels in groups A and B of after the second year. In total, 39 patients out of 74 (52.7%) developed HCC within 13 years from the beginning of the study and 35 patients did not developed HCC in the same observation period. The incidence of HCC development in group B [65.7% (23/35)] was significantly higher than in group A [41.0% (16/39)] (p=0.039). The median HCC developing time in group A (12.8 years) was significantly longer than in group B (3.8 years) (p=0.0013). Multivariate analysis demonstrated that reduction therapy and ALT levels were the significant factors affecting HCC development. The incidence of HCC development in group B was 5.8 times higher than in group A. The high and unclassified ALT groups were 4.6 times and 2.2 times higher than in the low ALT group. Conclusion: The chances of surviving for more than 10 years without developing HCC in the HCV-LC patients of Child Stage A were far more favorable in group A than in group B. These results suggest that aggressive reduction therapy for ALT levels in HCV-LC patients could significantly prevent HCC development. No significant financial relationships to disclose.

Comparison of structural and functional outcome of aflibercept versus ranibizumab in patients with myopic choroidal neovascularization

2019 ◽  
pp. 112067211988359
Author(s):  
Ahmed Howaidy ◽  
Zeiad H Eldaly
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Retinal Thickness ◽  
Secondary Outcome ◽  
Final Visit ◽  
Myopic Choroidal Neovascularization ◽  
Corrected Visual Acuity ◽  
Group A ◽  
Group B ◽  
Best Corrected Visual Acuity

Purpose: To compare visual functional improvement and retinal structural changes of aflibercept versus ranibizumab for the management of treatment-naïve choroidal neovascularization related to pathological myopia. Patients and methods: A prospective randomized study included patients suffering from myopic choroidal neovascularization. Patients received three intravitreal injections of aflibercept (2 mg) or ranibizumab (0.5 mg) in 1:1 ratio every 4 weeks. Ophthalmic evaluation and optical coherence tomography were performed at baseline, 1, 2, and 3 months after last injection. Primary outcome measure was the visual acuity change from baseline to month 3 after injection. Secondary outcome measures included change in retinal thickness and the relation of morphological and functional changes to baseline assessment parameters. Results: A total of 48 myopic patients (48 eyes) suffering from myopic choroidal neovascularization were randomly assigned to receive either aflibercept (Group A) or ranibizumab (Group B). In Group A, best-corrected visual acuity significantly improved from 0.53 ± 0.10 logMAR to 0.38 ± 0.11 logMAR, at 3 months, and from 0.55 ± 0.11 logMAR to 0.39 ± 0.12 logMAR in Group B. Whereas, retinal thickness reduced from 317.7 ± 53.6 µm to 164.5 ± 81.9 µm in Group A, and from 321.1 ± 98.8 µm at baseline to 178.9 ± 64.5 µm in Group B at month 3. Changes in best-corrected visual acuity and central macular thickness were statistically insignificant between the two groups at final visit. Conclusion: Both aflibercept and ranibizumab provided a significant improvement in visual acuity and retinal thickness in patients with myopic choroidal neovascularization. Comparable functional and architectural results were achieved by both treatment modalities.

scholarly journals Control of Imported and Acquired Methicillin-resistant Staphylococcus aureus (MRSA) in Mechanically Ventilated Patients: A Dose-response Study of Enteral Vancomycin to Reduce Absolute Carriage and Infection

2005 ◽  
Vol 33 (3) ◽  
pp. 361-372 ◽  
Author(s):  
M. Viviani ◽  
H. K. F. Van Saene ◽  
R. Dezzoni ◽  
L. Silvestri ◽  
R. Di Lenarda ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
First Year ◽  
High Dose ◽  
Mechanically Ventilated ◽  
Group A ◽  
Second Year ◽  
The Absolute ◽  
Group B ◽  
Dose Response Study ◽  
The Impact

This study aimed to quantify the animate source provided by the patients using the concept of “absolute carriage” by multiplying the carrier rate by the level of carriage; and to compare the impact of a low and high dose of an oropha-ryngeal vancomycin gel on the absolute MRSA carriage and infection. In all, 265 patients were included, 126 were MRSA positive. Fifty-five patients received 2% vancomycin gel during the first year whilst 4% vancomycin gel was given to 50 patients during the second year. Surveillance swabs of throat and rectum were obtained from all eligible patients on admission and then twice weekly. The vancomycin protocol was started as soon as the surveillance cultures were positive for MRSA. Those patients received one gram of enteral vancomycin daily, divided into four doses. During the first year 2% vancomycin gel 4 ml (80 mg) was applied in the oropharynx in four doses in addition to the enteral solution (Group A). During the second year 4% vancomycin gel 4 ml (160 mg) was used (Group B). The absolute carriage was high during both periods: 3.6 for Group A, and 3.2 for Group B. The 4% vancomycin protocol significantly reduced the absolute carriage, compared to the 2% vancomycin protocol: 2.6 versus 1.5 (P<0.01). Significant reduction in secondary endogenous infections was found in the second year: seven versus 15 patients (P<0.05). A total of 3,588 microbiological samples were processed. Neither Staphylococcus aureus with intermediate sensitivity to vancomycin (VISA) nor vancomycin-resistant enterococci (VRE) were detected.

Immunity to Diphtheria, Pertussis, Tetanus, and Poliomyelitis in Children with Acute Lymphocytic Leukemia After Cessation of Chemotherapy

PEDIATRICS ◽  
1981 ◽  
Vol 67 (2) ◽  
pp. 222-229 ◽  
Author(s):  
A. van der Does-van den Berg ◽  
J. Hermans ◽  
J. Nagel ◽  
G. van Steenis
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
First Year ◽  
Healthy Children ◽  
Healthy Control ◽  
Antibody Titers ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Antibody Levels

Antibody titers to diphtheria, pertussis, tetanus, and poliomyelitis (types I to III) were measured in previously vaccinated children with acute lymphocytic leukemia in remission after cessation of therapy. The response to revaccination one year after therapy was stopped was also studied. The patients' antibody titers were compared with those of healthy children, matched for age and sex. Two groups of patients were studied: one group (group A, N = 30) was given two drugs (6-mercaptopurine, methotrexate); the other group (group B, N= 19) was given three drugs (6-mercaptopurine, methotrexate, and cyclophosphamide) for maintenance treatment. In general, the patients' antibody titers were lower than those of healthy children, but in most patients they were still at levels considered to be protective. No significant differences in antibody levels between the two patient groups were found. A spontaneous rise in antibody titers in the first year after termination of therapy was not observed. After revaccination the rise in antibody titers was correlated with preexisting antibody titers in the same way in patients as in healthy children, and the antibody titers in patients and in healthy control subjects were on roughly the same level.

scholarly journals Comparative study of patient-based versus case-based teaching in prescription writing skills of second year MBBS students

2020 ◽  
Vol 9 (2) ◽  
pp. 289
Author(s):  
Shilpa P. Jadav ◽  
Nishant B. Bhansali ◽  
Dinesh M. Parmar
Keyword(s):  
Comparative Study ◽  
Writing Skills ◽  
Educational Interventions ◽  
Good Tool ◽  
Significant Difference ◽  
Group A ◽  
Second Year ◽  
Group B ◽  
Case Based ◽  
Prescription Writing

Background: Prescription writing errors can lead to deficiencies in healthcare. Although prescription writing is a part of the medical students' curriculum with traditional methods, their prescribing skills are still poor due to inadequate training. To fulfil the need for new educational interventions this study aims to compare patient-based teaching with case-based teaching in improving prescription writing skills of second year MBBS students.Methods: This prospective comparative study was carried out after orientation of participants to prescription writing as per WHO prescribing guidelines (n=71). Group A (n=37) and group B (n=34) were given patient-based teaching and case-based teaching respectively of prescription writing for the same five common clinical conditions. The prescription writing skill was assessed by evaluating the prescriptions written by both the groups and scored by 19-point scoring system. Feedback from the group A students was also taken.Results: Statistical analysis of mean scores of group A (15.90) and group B (13.14) was done by Mann-Whitney U test (p<0.001). Comparison of both the groups for the individual parameters was done by Chi-square test which found significant difference in writing some important parameters like doctor’s registration no., contacts of prescriber, name of the medicine, strength of drug, dosage form, dosing instructions, total quantity of medicine and duration of medication etc. Group A students’ feedback brought out the fact that patient-based teaching is a good tool for teaching and learning.Conclusions: Patient-based teaching for prescription writing improves students’ prescription writing skills in an effective way in comparison with traditional case-based teaching.

scholarly journals Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

2020 ◽  
Vol 17 (1) ◽  
pp. 61-68
Author(s):  
Dominique Clare Oh ◽  
Yiong Huak Chan ◽  
Sao Bing Lee ◽  
Jovina Li Shuen See
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Recovery Time ◽  
Visual Outcome ◽  
Cross Linking ◽  
Safe Procedure ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Group A ◽  
Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

scholarly journals Evaluation of changes in choroidal thickness after implantable collamer lens surgery in high myopia patients with Graves’ Ophthalmopathy (inactive phase)

2020 ◽  
Author(s):  
Fanglin He ◽  
Yan Liu ◽  
Renbing Jia ◽  
Jing zhang
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Control Group ◽  
Safety Index ◽  
Implantable Collamer Lens ◽  
Graves Ophthalmopathy ◽  
Group A ◽  
Efficacy Index ◽  
Group B

Abstract Background To evaluate the safety and effectiveness of the Visian Implantable Collamer Lens (ICL) implantation in high myopic patients with inactive Graves’ ophthalmopathy (GO) by observing the changes of choroidal thickness (CT). Methods Eight patients (16 eyes) with high myopia accompanied with inactive GO were selected as the experimental group (group A) and 18 high myopic patients (36 eyes) without GO were selected as a control group (group B). The outcomes of uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), safety index, efficacy index, intraocular pressure (IOP), vault, corneal endothelial count, and choroidal thickness (CT) were observed. The values of CT were measured using swept-source optical coherence tomography (SS-OCT) scans. Results The UCVA and BCVA in all operated eyes were better than that before surgery. The postoperative safety index and efficacy index were 1.23 and 1.19 in the group A, respectively, and 1.26 and 1.21 in the group B, respectively. In both groups, foveal CT increased significantly in high myopic patients at 2 hours and at 3 months after surgery, compared to preoperative values. The same tendencies were observed in the inner nasal and outer nasal regions. Compared with patients without GO, the increase of CT was more obvious in GO patients, 2 hours postoperatively (P = 0.006) and 3 months postoperatively (P = 0.011). Conclusions The ICL implantation is safe and effective in high myopic patients with inactive GO. Subfoveal and nasal CT may be useful parameters for monitoring the activity of GO patients.

scholarly journals The Impact of Unilateral or Bilateral Cataract Surgery on Visual Acuity and Life Quality of Elderly Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Lei Zuo ◽  
Haidong Zou ◽  
Xinfeng Fei ◽  
Weiqi Xu ◽  
Jianhong Zhang
Keyword(s):  
Visual Acuity ◽  
Elderly Patients ◽  
Cataract Surgery ◽  
Life Quality ◽  
Weighted Average ◽  
Bilateral Cataract ◽  
Surgical Methods ◽  
Group A ◽  
Group B ◽  
The Impact

In the current study, the CLVQOL was used to assess VRQOL before unilateral or bilateral cataract surgery and at the end of the follow-up period in order to determine the greater beneficial mode of surgery for patients, if one of the two surgical methods is more beneficial over the other. The patients were classified as receiving unilateral (group A) and bilateral cataract surgery (group B). There were no significant differences between groups A and B before the operation in terms of life quality scores, binocular weighted average LogMAR BCVA, age, educational level, gender, systematic and ocular comorbidities, and the complications of the operation. It was shown that visual acuity improved more significantly with bilateral cataract surgery than with unilateral surgery in elderly patients with a high preoperative disease burden in Shanghai city. However, the improvement in life quality was not different in patients receiving either bilateral or unilateral cataract surgery.

Abstract W P414: Midterm Clinical Outcomes After Intervention versus Conservative Management for Brain Arteriovenous Malformation

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Ichiro Yuki ◽  
Tomoaki Suzuki ◽  
Hideaki Arakawa ◽  
Toshihiro Ishibashi ◽  
Shougo Kaku ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Clinical Outcomes ◽  
Conservative Management ◽  
Neurological Deterioration ◽  
Initial Presentation ◽  
Neurological Sequela ◽  
Brain Arteriovenous Malformation ◽  
Group A ◽  
Group B ◽  
Observation Period

Purpose: Brain arteriovenous malformation (AVM) patients presented in our institution were divided into two groups based on the initial treatment strategy, “intervention” vs. “conservative management”, and the mid-term clinical outcomes of the two groups were compared. Methods: A total of 149 AVM patients were enrolled in this study. After thorough discussions with each patient on the risk and benefit of the treatment, 83 patients underwent either endovascular, surgical intervention, radiosurgery or combination of these different modalities (Group A). 66 patients chose conservative management until hemorrhage or clinical worsening from the AVM occurred (Group B). In each group, 1) the type of the initial presentation, 2) Spetzler-Martin (S-M) Grade, 3) modified Rankin Scale (mRS) and 4) symptomatic bleeding or neurological deterioration during the follow-ups were recorded. The clinical outcomes of each group was compared. Results: Group A; The type of initial presentation was, bleeding 45%, epilepsy 21%, incidental 18%, headache 8%, focal neurological deficit 5% and others 2%. During the average observation period of 1569 days, 42 patients (51%) showed angiographical obliteration. Overall complications were seen in 15 patients (18%). Complications with neurological deterioration (mRS≧3) was seen in 2 patients (2.4%). Group B; The type of initial presentation was, incidental 33%, epilepsy 23%, bleeding 18%, headache 17%, focal neurological symptoms 3% and others 6%. During the follow-ups (778 days), 7 patients (10%) had hemorrhage or neurological deterioration, and all of them underwent treatment. One patient died immediately before the surgery due to substantial re-bleeding. Rupture rate was 4.5% / year, and neurological sequela (mRS≧3) was seen in 2.7% in this group. Conclusion: The risk of neurological deterioration during the observation period was similar in both groups. Considering the “treatment group” has higher risk of bleeding, the intervention (s) might have contributed to the prevention of the neurological deterioration. However, given the limited magnitude of neurological sequela induced by the bleeding, caution should be exercised in determining the treatment indications especially for the asymptomatic patients.

scholarly journals Small Incision Cataract Surgery (SICS) with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

2014 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Md Shafiqul Alam ◽  
Khaleda Nazneen Bari
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Age Related ◽  
Postoperative Astigmatism ◽  
Group A ◽  
Group B

Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3%) was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B) than in SICS with clear corneal incision (Group-A). DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17793 Delta Med Col J. Jan 2014; 2(1): 22-27

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