Radiation retinopathy; a journey with intravitreal injections through 12.5 years of treatment and follow-up

2021 ◽  
Vol 30 (1) ◽  
pp. 74
Author(s):  
Ezgi KARATAS ◽  
Ali Osman SAATCI
Keyword(s):  
Intravitreal Injections ◽  
Radiation Retinopathy

Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity

2021 ◽  
pp. bjophthalmol-2021-319131
Author(s):  
Yong Cheng ◽  
Shuang Sun ◽  
Xun Deng ◽  
Xuemei Zhu ◽  
Dandan Linghu ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Intravitreal Injections ◽  
Vascular Endothelial ◽  
Randomised Study ◽  
Limit Of Quantitation ◽  
Significant Difference ◽  
Endothelial Growth Factor ◽  
Type 1 Rop

BackgroundData on serum vascular endothelial growth factor (VEGF) and drug levels in patients with retinopathy of prematurity (ROP) following intravitreal injections of conbercept (IVC) are lacking.MethodsMulticentre, prospective, non-randomised study of patients with aggressive posterior retinopathy of prematurity (APROP) or type 1 ROP who had not received other treatment. All infants received therapy in both eyes plus intravitreal IVC 0.25 mg/0.025 mL in one eye and had at least 6 months of follow-up. Blood samples were collected before and 1 week and 4 weeks after IVC. The main outcome measures were serum conbercept and VEGF concentrations.ResultsForty infants with APROP or type 1 ROP were enrolled. The mean serum VEGF at baseline and 1 week and 4 weeks after a total of 0.25 mg of IVC was 953.35±311.90 pg/mL, 303.46±181.89 pg/mL and 883.12±303.89 pg/mL, respectively. Serum VEGF 1 week after IVC was significantly lower (p<0.05) than baseline, and at 4 weeks after IVC, it was significantly higher (p<0.05) than at 1 week. There was no significant difference (p>0.05) between baseline and 4 weeks. Serum conbercept was below the limit of quantitation (BLOQ) at baseline and 4 weeks and was 19.81±7.60 ng/mL at 1 week.ConclusionSerum VEGF 1 week after IVC was significantly lower than baseline but returned to baseline at 4 weeks. Serum conbercept increased at 1 week and was BLOQ at 4 weeks.

scholarly journals Long-Term Visual Outcomes for a Treat-and-Extend Antivascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration: Up to Seven-Year Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Simon Javidi ◽  
Ali Dirani ◽  
Fares Antaki ◽  
Marc Saab ◽  
Sofiane Rahali ◽  
...  
Keyword(s):  
Growth Factor ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Anti Vegf ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Number Of Injections

Purpose. To report long-term visual and anatomical outcomes in eyes with neovascular age-related macular degeneration (nAMD) treated with a treat-and-extend regimen (TER) of intravitreal antivascular endothelial growth factor (anti-VEGF) injections in real-world settings. Methods. Retrospective cohort study of consecutive patients with nAMD treated with a TER of anti-VEGF intravitreal injections by a single retina specialist (GC). Patients with nAMD who had at least one year of follow-up were identified using an electronic database. Best-corrected visual acuity (BCVA), comprehensive ophthalmologic examination, and macular OCT were performed at each visit. Patients received a loading dose of three monthly intravitreal injections and then were treated according to a TER of bevacizumab, ranibizumab, and/or aflibercept. The number of injections, BCVA, and central retinal thickness (CRT) were evaluated during the follow-up period. Results. 180 eyes from 180 patients were included in the study. Mean age was 75 ± 9 (range: 51–96). Mean BCVA was 0.77 ± 0.64 LogMAR at baseline, 0.69 ± 0.58 LogMAR (p=0.0057) after loading phase, 0.64 ± 0.55 LogMAR (p=0.0001) after 6 months of TER, and 0.76 ± 0.71 LogMAR after 6 years of treatment (n = 32 at year 6). CRT decreased significantly after the loading phase (p=0.0002). The mean number of intravitreal injections per year was 7.6 during the first three years of treatment and then decreased to 5.9 during year 4 to 7. Conclusions. This retrospective study of 180 nAMD patients treated with a TER of intravitreal anti-VEGF demonstrates an initial improvement of BCVA after loading phase, followed by long-term visual stabilization for at least six years. These results were obtained with a high number of injections, averaging close to six injections per year during long-term follow-up. In light of the natural evolution of nAMD, these data support the long-term efficacy of this treatment under real-world conditions of heterogeneity of patients and type of anti-VEGF used.

Impact of adjuvant ocular interventions on the quality of life of patients with uveal melanoma after proton beam therapy

2021 ◽  
Author(s):  
Johannes Gollrad ◽  
Christopher Rabsahl ◽  
Antonia M Joussen ◽  
Andrea Stroux ◽  
Volker Budach ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Proton Beam ◽  
Uveal Melanoma ◽  
Proton Beam Therapy ◽  
Primary Treatment ◽  
Intravitreal Injections ◽  
Signed Rank

Introduction Proton beam therapy is an established primary treatment for patients with non-metastasized uveal melanoma. Adjuvant local interventions, like intravitreal injections or surgery, were shown to improve long-term eye preservation; however, their impact on the patient’s quality of life (QOL) remains unknown. Methods In a post-radiotherapeutic follow-up, we prospectively collected data on QOL, visual acuity, and interventional adjuvant procedures. QOL was measured with QOL-C30 and QLQ-OPT30 questionnaires at baseline, and at three and twelve months after proton therapy. Patients were grouped by the type of adjuvant treatment. Impact on QOL was analyzed by comparing changes in mean score values and visual acuity for different interventional subgroups, with generalized linear mixed models and Wilcoxon signed-rank tests. Results We received 108 (100%) and 95 (88.0%) questionnaires at three and twelve months post-therapy, respectively. Adjuvant interventions included: observation (n=61, 56.5%), intravitreal injections (n=17, 15.7%), and an intraocular surgical procedure (n=30, 27.8%). In the latter group, several QOL items significantly declined after the 3 month adjuvant interval, but they partially recovered at the 12-month follow-up. In all adjuvant-intervention groups, global QOL scores returned to baseline levels at 12 months. Conclusion Post-treatment adjuvant interventions had no long-lasting effects on QOL in patients with uveal melanoma.

Longitudinal Follow-Up of Choroidal Thickness in Central Retinal Vein Occlusion With and Without Cystoid Macular Edema

2018 ◽  
Vol 2 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Atalie C. Thompson ◽  
Akshay S. Thomas ◽  
Adam L. Rothman ◽  
Duncan Berry ◽  
Sharon Fekrat
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Choroidal Thickness ◽  
Intravitreal Injections ◽  
Vein Occlusion ◽  
Over Time ◽  
Central Retinal Vein

Purpose: To investigate the longitudinal relationship between subfoveal choroidal thickness (CT) and central retinal vein occlusion (CRVO). Methods: Retrospective cohort of 104 subjects with enhanced-depth imaging optical coherence tomography for unilateral CRVO. Mean CT and best-corrected visual acuity (BCVA) were compared in eyes with and without CRVO and in eyes with CRVO with and without cystoid macular edema (CME). Results: CT was thicker in eyes with CRVO-related CME than uninvolved contralateral eyes at baseline (263.9 ± 86.9 versus 230.2 ± 87.9 µm; P < .001) and final follow-up (261.1 ± 94.7 versus 222.3 ± 86.2 µm; P = .007). CRVO eyes treated with intravitreal antivascular endothelial growth factor with or without steroid therapy showed a significant reduction in CT at final follow-up (256.3 ± 90.7 versus 236.9 ± 85.9 µm; P = .004). Subjects with CRVO who were not treated with intravitreal injections also showed a significant but more modest decline in CT over time (234.4 ± 94.2 versus 221.5 ± 97.1 µm; N = 31; P = .02). However, contralateral uninvolved eyes without CRVO did not show a significant change in CT over time (233.3 ± 87.9 versus 219.5 ± 90.6 µm; N = 71; P = .40). Persistent CME at final follow-up was associated with thicker baseline (277.6 ± 96.4 versus 235.1 ± 86.5 µm; P = .02) and final CT (265.7 ± 93.4 versus 215.0 ± 82.1 µm; P = .005). Change in CT was not related to change in BCVA ( P > .05). Conclusions: CT was greater in eyes with CRVO-related CME compared to eyes with CRVO but no CME and compared to uninvolved contralateral eyes. CT decreased in eyes with CRVO over time both among eyes that received intravitreal injections and among eyes that did not receive injections. CT may be a prognosticator of treatment response in CRVO-related CME.

scholarly journals Vitrectomized versus non-vitrectomized eyes in diabetic macular edema response to ranibizumab—retinal layers thickness as prognostic biomarkers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bernardete Pessoa ◽  
João Leite ◽  
João Heitor ◽  
João Coelho ◽  
Sérgio Monteiro ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Nerve Fiber ◽  
Diabetic Macular Edema ◽  
Intravitreal Injections ◽  
Final Visual Acuity ◽  
Foveal Thickness ◽  
Retinal Layers ◽  
Retinal Nerve Fiber

AbstractTo evaluate the role of the vitreous in the management of diabetic macular edema with ranibizumab intravitreal injections in a pro re nata regimen. Prospective study of 50 consecutive eyes with diabetic macular edema treated with ranibizumab and 12 months of follow-up. Primary endpoint: to assess differences between non-vitrectomized and vitrectomized eyes in the number injections needed to control the edema. Secondary endpoints: comparison of groups regarding best corrected visual acuity, central foveal thickness and thickness of seven retinal layers. 46 eyes from 38 patients, 10 vitrectomized and 36 non-vitrectomized, completed the follow-up. At month 12, the two groups achieved an equivalent anatomical outcome and needed a similar number of ranibizumab intravitreal injections. In vitrectomized eyes final visual acuity was worse when baseline retinal nerve fiber layers in the central foveal subfield were thicker, showing a strong correlation (r = − 0.942, p < 0.001). A similar, albeit moderate correlation was observed in non-vitrectomized eyes (r = − 0.504, p = 0.002). A decrease of retinal nerve fiber layers inner ring thickness was correlated with a better final visual acuity only in vitrectomized eyes (r = 0.734, p = 0.016). The effect of diabetic macular edema seems to be worse in vitrectomized eyes, with a thinner inner retina reservoir.Clinicaltrials.govNCT04387604.

scholarly journals Outcomes of Abrupt Switch to Bevacizumab of Patients Undergoing Aflibercept Intravitreal Injections for Neovascular Age-Related Macular Degeneration in a Tertiary Center in Lombardy, Italy: A Real-Life Retrospective Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Alessandro Randazzo ◽  
Raffaele Raimondi ◽  
Giovanni Fossati ◽  
Mary Romano ◽  
Tania Sorrentino ◽  
...  
Keyword(s):  
Chart Review ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Lombardy Region ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Tertiary Center

Purpose. To assess real-life anatomical and functional outcomes of switch to bevacizumab in patients undergoing aflibercept intravitreal injections for nAMD. Methods. Retrospective chart review of all patients diagnosed with nAMD and undergoing intravitreal injections of aflibercept who switched to bevacizumab after the resolution XI/1986 of Lombardy Region. Results. Among 128 patients undergoing intravitreal injections, a total of 29 eyes of 29 patients met all inclusion criteria and were included in the statistical analysis. Best corrected visual acuity and central macular thickness did not change significantly ( p > 0.05 ) between baseline, after the loading phase, and at the last follow-up. Conclusion. Switching to bevacizumab has been safe and efficacious in patients responding to the loading phase. According to our results, the restrictions imposed by Lombardy Region did not cause any harm to patients undergoing intravitreal anti-VEGF injections.

scholarly journals Anatomical and functional responses in eyes with diabetic macular edema treated with “1 + PRN” ranibizumab: one-year outcomes in population of mainland China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kunbei Lai ◽  
Chuangxin Huang ◽  
Longhui Li ◽  
Yajun Gong ◽  
Fabao Xu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Posterior Vitreous Detachment ◽  
Intravitreal Injections ◽  
Functional Responses ◽  
Ellipsoid Zone ◽  
Link Type ◽  
Time Point

Abstract Background To evaluate the anatomical and functional responses in eyes with diabetic macular edema (DME) treated with ranibizumab under “1 + pro re nata (PRN)” regimen. Methods This prospective interventional case series included 69 eyes of 69 patients with DME treated with intravitreal injections of 0.5 mg ranibizumab followed by repeated injections as needed. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and predictive factors for final visual outcomes were assessed. Results Logarithm of minimal angle of resolution (logMAR) BCVA improved from 0.64 ± 0.23 at baseline to 0.56 ± 0.27, 0.53 ± 0.26, 0.47 ± 0.25, 0.44 ± 0.32, 0.47 ± 0.26 and 0.46 ± 0.26 at time-point of months 1, 2, 3, 6, 9, and 12, respectively (P < 0.05 for any follow-up time-point except month 1). CFT decreased from 478.23 ± 172.31 μm at baseline to 349.74 ± 82.21 μm, 313.52 ± 69.62 μm, 292.59 ± 61.07 μm, 284.67 ± 69.85 μm, 268.33 ± 43.03 μm, and 270.39 ± 49.27 μm at above time-points, respectively (P < 0.05). The number of injections was 6.83 times over 12 months’ follow-up under “1 + PRN” regimen. Multivariate analysis showed that the factors including age, BCVA at baseline, disruption of ellipsoid zone, posterior vitreous detachment (PVD), and vitreomacular traction (VMT) were correlated with the final BCVA. Conclusions Intravitreal injections of ranibizumab under “1 + PRN” regimen is a not only effective but also safe way to improve visual acuity of DME patients. And older age, lower baseline BCVA, VMT, and disruption of ellipsoid zone are predictors for final poor BCVA while PVD is a positive predictive factor for good final BCVA. Trial registration The trial was registered retrospectively in ClinicalTrials.gov on 2 June 2019 (NCT03973138).

Episcleral brachytherapy for retinoblastoma

2019 ◽  
Vol 104 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Jose J Echegaray ◽  
Yahya A Al-Zahrani ◽  
Arun Singh
Keyword(s):  
Local Recurrence ◽  
Primary Treatment ◽  
Survival Outcomes ◽  
Secondary Treatment ◽  
Radiation Retinopathy ◽  
Kaplan Meier ◽  
Iodine 125 ◽  
Group B ◽  
Group D

Background/AimsTo report visual outcomes, survival outcomes and complications following episcleral brachytherapy (EB) for retinoblastoma.MethodsRetrospective review of retinoblastoma cases treated with EB in a single institution. Survival outcomes were analysed using the Kaplan-Meier method.ResultsEleven tumours of 11 eyes were treated with either iodine-125 or ruthenium-106 EB with a mean apical dose of 44 Gy. The tumours were classified as group B in 5 (46%), C in 3 (27%) or D in 3 (27%) eyes, respectively. Mean follow-up time was 75.4 months. EB served as primary treatment in 3 eyes (27%) and secondary treatment in 8 eyes (73%). Final visual acuity was better than 20/200 in 70% of cases. Globe preservation was achieved in 9 (82%) eyes. Local recurrence occurred in 18% of cases at a mean onset of 17.4 months after EB. Two group D tumours that recurred after secondary EB underwent enucleation. Mean onset of radiation retinopathy was 17.4 months following EB. No metastatic or fatal events were recorded. Kaplan-Meier analysis showed recurrence-free survival and ocular survival of 80% and overall survival of 100% at 5 years after EB.ConclusionEB is an effective primary or secondary treatment modality for selected retinoblastoma eyes (groups B and C). Advanced group D tumours may represent a risk factor for local recurrence. Visually significant complications such as radiation retinopathy should be anticipated.

Effects of three intravitreal injections of aflibercept on the ocular circulation in eyes with age-related maculopathy

2019 ◽  
Vol 104 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Anna Sophie Mursch-Edlmayr ◽  
Nikolaus Luft ◽  
Dominika Podkowinski ◽  
Michael Ring ◽  
Leopold Schmetterer ◽  
...  
Keyword(s):  
Laser Speckle ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Laser Speckle Flowgraphy ◽  
Ocular Perfusion ◽  
Age Related ◽  
Mean Blur Rate ◽  
Caucasian Patients ◽  
Fellow Eyes

AimsTo investigate changes in ocular perfusion following three consecutive intravitreal injections with aflibercept for treatment of neovascular age-related macular degeneration (nAMD).MethodsThe study included 20 eyes from 20 Caucasian patients with unilateral nAMD and 20 fellow eyes. All nAMD eyes were treated with standard intravitreal injection of aflibercept (IVA; 2 mg). Measurements of ocular perfusion at the optic nerve head (ONH) and the choroid were performed with laser speckle flowgraphy (LSFG). Measurements were conducted at baseline, 1 week after the first injection, at the time point of the second and third injection as well as 1 month after the third injection.ResultsIn treated eyes, mean blur rate (the main output parameter of LSFG) in the ONH microvasculature and in the choroid was significantly reduced 1 week after the first IVA treatment. The effect persisted throughout the entire follow-up period (p<0.001). No change in ocular perfusion was observed in fellow eyes.ConclusionsIVA for treatment of nAMD leads to a reduction in perfusion of the ONH and the choroid in the treated eye with no apparent effect on the fellow eye.

Sign in / Sign up

Export Citation Format

Share Document