scholarly journals Presentation, etiology and treatment outcome of neovascular glaucoma in Ekiti state, South Western Nigeria

2021 ◽  
Vol 21 (3) ◽  
pp. 1266-1272
Author(s):  
Iyiade Ajayi ◽  
Olusola Omotoye ◽  
Kayode Ajite ◽  
Emmanuel Abah
Keyword(s):  
Social Sciences ◽  
Visual Acuity ◽  
Neovascular Glaucoma ◽  
Tertiary Hospital ◽  
Retinal Ischemia ◽  
Secondary Glaucoma ◽  
Vascular Endothelial ◽  
Health Promotion And Education ◽  
Endothelial Growth Factor

Background: Neovascular glaucoma (NVG), a form of secondary glaucoma has varying causes across geographical loca- tions. Objective: The objective of this study was to determine the presentation, aetiology, and outcome of treatment of patients with NVG in a Nigerian tertiary hospital. Method: A retrospective review of records of all cases of NVG seen over a 5year period was carried out. Demographic characteristics, presenting visual acuity and coexisting ocular and systemic conditions were noted. Data were analysed with Statistical Package for Social Sciences (SPSS) version 25. Results: 29 eyes of patients with NVG were analysed. Most of the patients (89.70%) presented with visual acuity less than 3/60 in the affected eye. All patients except one were treated with anti-glaucoma medications while only 9(31%) consented to and received anti-vascular endothelial growth factor. No patient had improvement in visual acuity despite resolution of other symptoms at 12week follow up. Conclusion: NVG though not as common as other forms of glaucoma accounted for a large proportion of monocular blindness in the affected eyes at presentation. There is need for health promotion and education among our people on the need for early preventive eye check practices. Keywords: Neovascular glaucoma; retinal ischemia; rubeosis iridis; secondary glaucoma.

scholarly journals Association between Retinal Thickness Variability and Visual Acuity Outcome during Maintenance Therapy Using Intravitreal Anti-Vascular Endothelial Growth Factor Agents for Neovascular Age-Related Macular Degeneration

2021 ◽  
Vol 11 (10) ◽  
pp. 1024
Author(s):  
Timothy Y. Y. Lai ◽  
Ricky Y. K. Lai
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Age Related ◽  
Thickness Variability ◽  
The Mean ◽  
Endothelial Growth Factor

Previous studies based on clinical trial data have demonstrated that greater fluctuations in retinal thickness during the course of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) is associated with poorer visual acuity outcomes. However, it was unclear whether similar findings would be observed in real-world clinical settings. This study aimed to evaluate the association between retinal thickness variability and visual outcomes in eyes receiving anti-VEGF therapy for nAMD using pro re nata treatment regimen. A total of 64 eyes which received intravitreal anti-VEGF therapy (bevacizumab, ranibizumab or aflibercept) for the treatment of nAMD were evaluated. Variability in spectral-domain optical coherence tomography (OCT) central subfield thickness (CST) was calculated from the standard deviation (SD) values of all follow-up visits after three loading doses from month 3 to month 24. Eyes were divided into quartiles based on the OCT CST variability values and the mean best-corrected visual acuity values at 2 years were compared. At baseline, the mean ± SD logMAR visual acuity and CST were 0.59 ± 0.39 and 364 ± 113 µm, respectively. A significant correlation was found between CST variability and visual acuity at 2 years (Spearman’s ρ = 0.54, p < 0.0001), indicating that eyes with lower CST variability had better visual acuity at 2 years. Eyes with the least CST variability were associated with the highest mean visual acuity improvement at 2 years (quartile 1: +9.7 letters, quartile 2: +1.1 letters, quartile 3: −2.5 letters, quartile 4: −9.5 letters; p = 0.018). No significant difference in the number of anti-VEGF injections was found between the four CST variability quartile groups (p = 0.21). These findings showed that eyes undergoing anti-VEGF therapy for nAMD with more stable OCT CST variability during the follow-up period were associated with better visual outcomes. Clinicians should consider adopting treatment strategies to reduce CST variability during the treatment course for nAMD.

scholarly journals Effect of Alternate Treatment with Intravitreal Corticosteroid and Anti-VEGF for Macular Edema Secondary to Retinal Vein Occlusion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Young Hwan Bae ◽  
Seong Mi Kim ◽  
Jin Young Kim ◽  
So Hyun Bae ◽  
Hakyoung Kim ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
Endothelial Growth Factor

Purpose. To evaluate whether treatment with intravitreal corticosteroid and anti-vascular endothelial growth factor (VEGF) injections alternately can improve treatment outcomes of macular edema (ME) caused by retinal vein occlusion (RVO). Methods. This dual-center retrospective study included 112 eyes with treatment-naïve ME secondary to RVO that were alternately treated with intravitreal corticosteroid and anti-VEGF injections (33 eyes, alternate group) or treated only with intravitreal anti-VEGF injections (79 eyes, anti-VEGF group) on a pro re nata basis. Results. During the 12-month follow-up period, the alternate group achieved a visual acuity gain of 0.39 logMAR, while the anti-VEGF group achieved a gain of 0.21 logMAR ( P = 0.042 ). The alternate group demonstrated a reduction in the central macular thickness of 229.9-μm, while the anti-VEGF group achieved a reduction of 220.1 μm ( P = 0.887 ). The alternate group required an average of 5.2 injections, while the anti-VEGF received 4.2 injections ( P < 0.001 ). In a propensity score-matched cohort to compensate for the differences in the injection numbers between the two groups, the alternate group achieved a better visual acuity gain than the anti-VEGF group at month 12 (0.39 logMAR vs. 0.17 logMAR, P = 0.048 ). Conclusions. In ME secondary to RVO, treatment with intravitreal corticosteroid and anti-VEGF injections alternately resulted in a more favorable visual outcome compared with intravitreal anti-VEGF monotherapy.

scholarly journals Long-Term Outcomes of Treat and Extend Regimen of Anti-Vascular Endothelial Growth Factor in Neovascular Age-Related Macular Degeneration

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Age Related ◽  
Injection Frequency ◽  
Endothelial Growth Factor

This retrospective cross-sectional cohort study describes the long-term visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) treatment using a treat and extend (TAE) regimen. The cohort consisted of 224 treatment-naïve eyes with age related macular degeneration (NV-AMD) from 202 patients that were treated with anti-VEGF agents bevacizumab, ranibizumab, and aflibercept using a TAE regimen by four physician investigators in a large urban referral center from 2008-2015. Subjects were evaluated for visual acuity, injection frequency and optical coherence tomography (OCT). Over a seven-year follow-up period (mean 3.4 years), an average 20.2 ± 14.7 injections were administered per patient. Visual acuity was 0.70 logMAR (20/100 Snellen) at the first visit and 0.67 logMAR (20/93 Snellen) at the final visit, with 74% of eyes maintaining or gaining more than 2 lines of vision. Longterm, 45.1% of eyes achieved 20/50 or better, while 27.1% were 20/200 or worse. 61.2% received monotherapy with no difference in visual acuity outcomes or injection frequency between the agent used. OCT analysis showed decreased fluid from initial to final follow-up visit: 70.1% to 15.6% with sub-retinal fluid (SRF) and 47.3% to 18.8% with intraretinal fluid (IRF) with no difference between the agent used. This study demonstrates that most patients (74%) improve or maintain visual acuity gains long-term using a TAE model with a significant portion (45.1%) achieving 20/50 or better with sustained treatment.

scholarly journals Visual outcome of Anti-Vascular Endothelial Growth Factor Injections at the University College Hospital, Ibadan

2020 ◽  
Author(s):  
Tunji Sunday Oluleye ◽  
Yewande Olubunmi Babalola ◽  
Oluwole Majekodunmi ◽  
Modupe Ijaduola ◽  
Adeyemi Timothy Adewole
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
The Mean ◽  
One Year ◽  
Endothelial Growth Factor ◽  
Number Of Injections

AbstractAimTo evaluate the four-year outcome of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in an eye unit in sub-Saharan Africa.MethodologyThis retrospective study included 182 eyes of 172 patients managed in the vitreoretinal unit between 2016 and 2019 who were treated with intravitreal anti-VEGF Bevacizumab (1.25 mg/0.05 ml) with at least one year of follow up. The outcome measures were change in best-corrected visual acuity (BCVA) over one year of follow-up, the number of injections taken and complications.ResultsThe mean age was 61.1 ± 16.3 years (M: F of 1:1.1) and about 62.1% were > 60 years. A total of 330 injections were given during the period audited. The mean number of injections was 1.8 ± 0.93. Ninety-four (51.7%) eyes had only one injection while 33 (18.1%), 50 (27.5%) and 5 (2.7%) had 2, 3 and 4 injections, respectively. About 78.5% had moderate-severe visual impairment at baseline and 44.5%, 16.4%,12.6% and 7.1% at 1, 3, 6- and 12-months post injections, respectively. The mean BCVA improved for all eyes from 1.67 ±0.91 logMAR at baseline to 1.50±1.27 logMAR at one year. The logMAR letters gained was 23 at 1 month and 8.25 at 1 year with a statistically significant association between increasing number of injections and improved visual outcome (p= 0.015). One patient each developed endophthalmitis (0.6%) and inferior retinal detachment (0.6%) post-injection.ConclusionVisual acuity gain was recorded in patients who had at least two intravitreal Anti-VEGF injections in 1 year.

Transillumination Guided Cyclocryotherapy in the Treatment of Secondary Glaucoma

1992 ◽  
Vol 2 (4) ◽  
pp. 190-195 ◽  
Author(s):  
E. Vesti ◽  
W. Rong-Guang ◽  
C. Raitta
Keyword(s):  
Visual Acuity ◽  
Pain Relief ◽  
Clinical Signs ◽  
Neovascular Glaucoma ◽  
Secondary Glaucoma ◽  
Consecutive Series ◽  
Chronic Uveitis ◽  
Best Response ◽  
Iris Neovascularisation

A consecutive series of 38 eyes of 35 glaucoma patients treated with transillumination guided cyclocryotherapy (CCT) either to obtain pain relief or to achieve IOP control was studied at Helsinki University Eye Hospital. Transillumination was used to guide the applications to the correct site. The follow-up range was 1 - 43 months (mean 9 months). Pretreatment IOP was 39 ± 13 mm Hg and postoperative 26 ± 16 mm Hg (mean ± SD). Twenty-three eyes underwent one and 15 eyes 2 - 5 procedures. IOP control (IOP 9 - 23 mm Hg) was achieved in 50%. The response was more favorable in eyes without iris neovascularisation (59% achieved IOP control) than in eyes with neovascular glaucoma (38% achieved IOP control). The best response was achieved in eyes with chronic uveitis (5/7 eyes achieved IOP control). Repeated procedures improved the IOP control rate. Hypotony (IOP < 9 mm Hg) without clinical signs of phthisis occurred in three eyes (8%). Thirteen eyes needed primarily pain relief and 92% achieved it. Postoperatively vision was better in 8%, unchanged in 37% and worse in 55%. Visual acuity was 0.05 or better in nine eyes pretreatment and in eight eyes after treatment.

scholarly journals Hyperreflective foci in predicting the treatment outcomes of diabetic macular oedema after anti-vascular endothelial growth factor therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chu-Hsuan Huang ◽  
Chang-Hao Yang ◽  
Yi-Ting Hsieh ◽  
Chung-May Yang ◽  
Tzyy-Chang Ho ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Treatment Response ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Vascular Endothelial ◽  
Outer Retina ◽  
Hyperreflective Foci ◽  
Endothelial Growth Factor

AbstractThis retrospective study evaluated the association of hyperreflective foci (HRF) with treatment response in diabetic macular oedema (DME) after anti-vascular endothelial growth factor (VEGF) therapy. The medical records, including of ophthalmologic examinations and optical coherence tomography (OCT) images, of 106 patients with DME treated with either intravitreal ranibizumab or aflibercept were reviewed. The correlations between best-corrected visual acuity (BCVA) changes and HRF along with other OCT biomarkers were analysed. The mean logMAR BCVA improved from 0.696 to 0.461 after an average of 6.2 injections in 1 year under real-world conditions. Greater visual-acuity gain was noted in patients with a greater number of HRF in the outer retina at baseline (p = 0.037), along with other factors such as poor baseline vision (p < 0.001), absence of epiretinal membrane (p = 0.048), and presence of subretinal fluid at baseline (p = 0.001). The number of HRF after treatment was correlated with the presence of hard exudate (p < 0.001) and baseline haemoglobin A1C (p = 0.001). Patients with proliferative diabetic retinopathy had greater HRF reduction after treatment (p = 0.018). The number of HRF in the outer retina, in addition to other baseline OCT biomarkers, could be used to predict the treatment response in DME after anti-VEGF treatment.

Long-Term Follow-Up of Immunocytochemical Analysis of Vascular Endothelial Growth Factor (VEGF), and Its Two Receptors, VEGF-R1 (Flt-1) and VEGF-R2 (Flk-1/KDR), in Oesophagogastric Cancer

2013 ◽  
Vol 28 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Ronan T. Gray ◽  
Mark E. O'Donnell ◽  
Perry Maxwell ◽  
James A. McGuigan ◽  
Gary M. Spence
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Epithelial Cells ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Vascular Endothelial ◽  
Immunocytochemical Analysis ◽  
Endothelial Growth Factor ◽  
Oesophagogastric Cancer

Background The prognostic significance of immunocytochemical analysis of tumour vascular endothelial growth factor (VEGF) and its 2 receptors, VEGF-R1 and VEGF-R2, remains incompletely investigated in patients with oesophagogastric cancer. Methods Patients undergoing surgical resection were prospectively recruited between February 1999 and August 2000. Immunocytochemical analysis of VEGF, VEGF-R1 (Flt-1) and VEGF-R2 (Flk-1/KDR) was undertaken using validated techniques. Patients were followed up over a 10-year period using the Northern Ireland Cancer Registry. Results Sixty-one patients were recruited (male=45, 73.8%) with a median age of 66.0 years (range 39-83). Forty-seven (77.0%) adenocarcinomas and 14 (23.0%) squamous cell carcinomas were resected. UICC tumour staging was: stage I=14.7%, II=24.6%, III=54.1% and IV=6.6%. VEGF, VEGF-R1 and VEGF-R2 were over-expressed in tumour epithelial cells. VEGF-R2 expression was decreased in the presence of lymphovascular invasion and higher tumour grade. The 10-year survival rate was 19.7% (n=12) with a median follow-up of 808 (IQR 356-2313) days. On univariate analysis only lymphovascular invasion significantly predicted poor prognosis in this cohort (p=0.05). Conclusion VEGF, VEGF-R1 and VEGF-R2 were over-expressed in tumour epithelial cells. VEGF-R2 expression was decreased in the presence of more aggressive pathological variables. Larger studies are required to assess the prognostic significance of these biomarkers in oesophagogastric cancer.

A vascular endothelial growth factor A genetic variant is associated with improved ventricular function and transplant-free survival after surgery for non-syndromic CHD

2017 ◽  
Vol 28 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Constantine D. Mavroudis ◽  
Daniel Seung Kim ◽  
Nancy Burnham ◽  
Alexandra H. Morss ◽  
Jerry H. Kim ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Single Nucleotide Polymorphism ◽  
Growth Factor ◽  
Ventricular Function ◽  
Vascular Endothelial ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
Free Survival ◽  
Endothelial Growth Factor

AbstractBackgroundWe have previously shown that the minor alleles of vascular endothelial growth factor A (VEGFA) single-nucleotide polymorphism rs833069 and superoxide dismutase 2 (SOD2) single-nucleotide polymorphism rs2758331 are both associated with improved transplant-free survival after surgery for CHD in infants, but the underlying mechanisms are unknown. We hypothesised that one or both of these minor alleles are associated with better systemic ventricular function, resulting in improved survival.MethodsThis study is a follow-up analysis of 422 non-syndromic CHD patients who underwent neonatal cardiac surgery with cardiopulmonary bypass. Echocardiographic reports were reviewed. Systemic ventricular function was subjectively categorised as normal, or as mildly, moderately, or severely depressed. The change in function was calculated as the change from the preoperative study to the last available study. Stepwise linear regression, adjusting for covariates, was performed for the outcome of change in ventricular function. Model comparison was performed using Akaike’s information criterion. Only variables that improved the model prediction of change in systemic ventricular function were retained in the final model.ResultsGenetic and echocardiographic data were available for 335/422 subjects (79%). Of them, 33 (9.9%) developed worse systemic ventricular function during a mean follow-up period of 13.5 years. After covariate adjustment, the presence of the VEGFA minor allele was associated with preserved ventricular function (p=0.011).ConclusionsThese data support the hypothesis that the mechanism by which the VEGFA single-nucleotide polymorphism rs833069 minor allele improves survival may be the preservation of ventricular function. Further studies are needed to validate this genotype–phenotype association and to determine whether this mechanism is related to increased vascular endothelial growth factor production.

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