scholarly journals Cosmetic Nd:YAG Laser-assisted Maculopathy Treated with Early Anti-vascular Endothelial Growth Factor Antibody

2021 ◽  
Vol 20 (3) ◽  
pp. 119-123
Author(s):  
Gun-Jung Ma ◽  
Sun-Kyoung Park ◽  
Mirinae Kim ◽  
Young-Geun Park ◽  
Young-Hoon Park ◽  
...  

Purpose: To report a follow up of early intravitreal anti-vascular endothelial growth factor (VEGF) antibody treatment in a patient with maculopathy after accidental exposure to a high-powered cosmetic Nd:YAG laser.Case summary: A 36-year-old female patient visited our clinic with decreased visual acuity in the right eye after accidental exposure to a high-powered cosmetic Nd:YAG laser. The best-corrected visual acuity of the right eye was 0.1 and subretinal hemorrhage on the foveal area was observed during fundus examination. Optical coherence tomography revealed serous retinal detachment with hyperreflective disruption of the ellipsoid zone and retinal pigment epithelium-Bruch’s membrane complex. Intravitreal bevacizumab (Avastin®, 1.25 mg/0.05 mL; Roche Korea, Seoul, Korea) injections were performed three times. Visual acuity was unchanged at 6 months after the first visit. However, complete resolution of the subretinal hemorrhage was observed and there were no signs of secondary choroidal neovascularization or recurrence of choroidal hemorrhage.Conclusions: Early anti-VEGF antibody treatment in a patient with subfoveal hemorrhage and choroidal rupture after high-powered cosmetic Nd:YAG laser exposure improved morphology and prevented secondary choroidal neovascularization.

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Li Song ◽  
Fangtian Dong ◽  
Changxian Yi

Abstract Background Uveal effusion syndrome is a rare disease characterized by exudative detachments of the choroid, ciliary body, and retina. Various surgical procedures and nonsurgical strategies have been described to treat uveal effusion syndrome with limited success. The treatment for uveal effusion syndrome remains a serious challenge for clinicians. To the best of our knowledge, no previous report has described a severe uveal effusion syndrome patient with nanophthalmos treated by using an anti-vascular endothelial growth factor agent alone. We report here one such case with unexpected positive results. Case presentation A 30-year-old Chinese male patient presented with painless vision loss in both eyes that had persisted for 2 months. Examination of the right eye revealed a best corrected visual acuity of 0.03; the best corrected visual acuity of the left eye was finger count/20 cm. The intraocular pressure was normal on both eyes. A-scan revealed an right eye axial length of 15.88 mm and a left eye axial length of 16.21 mm. In the right eye, half of the peripheral choroid and nearly three-fourths of the retina were detached. The left fundus was not visible because of the total retinal detachment located just behind the lens, which could be clearly observed directly with a slit lamp. Considering all the possibilities and available treatments as well as the patient’s intentions after discussion, we first administered an intravitreal injection of ranibizumab 0.5 ml into both eyes. The patient’s visual perception improved 3 days after the injection. One month later, most of the effusion under the choroid and retina was absorbed. Visual acuity improved from finger count to 0.05 in both eyes, and vision quality was remarkably improved. Encouraged by this good result, the patient opted to undergo a second injection 1 month later. Choroidal and retinal detachment completely vanished 30 days after the second injection. Conclusions Using an anti-vascular endothelial growth factor agent alone may be a potentially effective and safe method for managing some types of uveal effusion syndrome, such as in nanophthalmos. The injection may be administered before considering more aggressive procedures in some uveal effusion syndrome patients.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chu-Hsuan Huang ◽  
Chang-Hao Yang ◽  
Yi-Ting Hsieh ◽  
Chung-May Yang ◽  
Tzyy-Chang Ho ◽  
...  

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.


Author(s):  
A.O. Nazarenko ◽  
◽  
E.E. Sidorenko ◽  
I.V. Suhanova ◽  
A.R. Shavaleeva ◽  
...  

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.


2020 ◽  
pp. bjophthalmol-2020-315836 ◽  
Author(s):  
Richard Gale ◽  
Maria Pikoula ◽  
Aaron Y Lee ◽  
Spiros Denaxas ◽  
Catherine Egan ◽  
...  

Background/aimsClinical trials suggest anti-vascular endothelial growth factor is more effective than intravitreal dexamethasone as treatment for macular oedema secondary to branch retinal vein occlusion. This study asks if ‘real world’ data from a larger and more diverse population, followed for a longer period, also support this conclusion.MethodsData collected to support routine care at 27 NHS (National Health Service) Trusts between February 2002 and September 2017 contained 5661 treatment-naive patients with a single mode of treatment for macular oedema secondary to branch retinal vein occlusion and no history of cataract surgery either during or recently preceding the treatment. Number of treatment visits and change in visual acuity from baseline was plotted for three treatment groups (anti-vascular endothelial growth factor (anti-VEGF), intravitreal dexamethasone, macular laser) for up to 3 years.ResultsMean baseline visual acuity was 57.1/53.1/62.3 letters in the anti-VEGF/dexamethasone/macular laser groups, respectively. This changed to 66.72 (+9.6)/57.6 (+4.5)/63.2 (+0.9) at 12 months. Adequate numbers allowed analysis at 18 months for all groups (66.6 (+9.5)/56.1 (+3.0)/60.8 (-1.5)) and for anti-VEGF at 36 months (68.0, +10.9) Mean number of treatments were 5.1/1.5/1.2 at 12 months, 5.9/1.7/1.2 at 18 months for all three groups and 10.3 at 36 months for anti-VEGF.ConclusionsVisual acuity improvements were higher and more sustained with anti-VEGF. Higher treatment burden occurred with anti-VEGF but this reduced over 36 months. Patients with better vision at baseline than those in the clinical trials maintained high levels of vision with both anti-VEGF and dexamethasone.


2017 ◽  
Vol 9 ◽  
pp. 117917211773824 ◽  
Author(s):  
Jason N Crosson ◽  
Lauren Mason ◽  
John O Mason

Introduction: To review important studies examining focal laser for diabetic macular edema (DME), to examine real-world data regarding actual treatments patients are receiving, to present long-term visual outcomes in real-world practice, and to suggest an evidence-based approach for the use of focal laser. Methods: This study is a review of landmark studies evaluating focal laser and pharmacologic therapy for DME. In addition, the authors include a retrospective review of 102 consecutive eyes of 53 patients in our practice setting in rural Alabama. A chart review was performed, and patients were included if they were diagnosed with DME and were treated with both focal laser and bevacizumab. Bevacizumab and focal laser were given on a “as needed basis” at the discretion of one treating physician (J.O.M.). Worse visual acuity or worsening macular edema were indications for additional treatment. Statistical analysis was performed using frequencies and percentages. Best-corrected visual acuity (BCVA) was recorded at baseline and at the end of treatment (mean of 5 years) in the medical record. Primary outcome measures were BCVA, patients with better than 20/40 BCVA, patients with worse than 20/200 BCVA, and patients with stable BCVA. Results: Anti–vascular endothelial growth factor (VEGF) therapies are the first-line treatment for DME, but real-world claims data suggest that diabetic patients cannot come in for monthly injections as in large clinical trials. In our series, after a mean of 5 lasers and 5.5 injections, 90% of eyes had stable or better BCVA, 65% were ≥20/40, and only 13% were ≤20/200. Conclusions: Laser treatment for DME remains an important adjunctive therapy


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