scholarly journals Fellow eye effect of unilateral intravitreal anti-VEGF injections in eyes with diabetic macular edema

Eye ◽  
2014 ◽  
Vol 29 (2) ◽  
pp. 292-293 ◽  
Author(s):  
J Hanhart ◽  
I Chowers
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Fellow Eye ◽  
Anti Vegf

Comparative Eye Effect of Unilateral Intravitreal Bevacizumab, Ranibizumab, and Aflibercept for Diabetic Macular Edema

2019 ◽  
Vol 3 (2) ◽  
pp. 86-89
Author(s):  
Brett Malbin ◽  
Harshad P. Patel ◽  
Yuguang He ◽  
Kim Le ◽  
Xihui Lin
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Fellow Eye ◽  
Anti Vegf ◽  
Central Subfield Thickness ◽  
Bilateral Diabetic Macular Edema ◽  
Pharmacologic Treatments ◽  
Endothelial Growth Factor ◽  
Significant Therapeutic Effect

Purpose: The purpose of this article is to compare the fellow-eye effect of unilateral intravitreal antivascular endothelial growth factor (anti-VEGF) treatment (bevacizumab, ranibizumab, and aflibercept) in patients with bilateral diabetic macular edema (DME). Methods: A retrospective review was conducted of hemoglobin A1c-matched groups receiving unilateral anti-VEGF injections (1.25 mg bevacizumab, 0.5 mg ranibizumab, and 2 mg aflibercept) in which the second eye had subclinical DME. Two main outcome measures evaluated were central subfield thickness (CST) on optical coherence tomography and best-corrected visual acuity (BCVA). Patients were excluded if they had poor BCVA (< 20/100) or had received laser, vitrectomy, filtering surgery, or pharmacologic treatments in the 3 months prior in the noninjected eye. Results: A total of 2073 total intravitreal anti-VEGF injections for DME were reviewed and 94 met the inclusion criteria: 40 bevacizumab, 33 ranibizumab, and 21 aflibercept. At 1 month, the CST of the fellow eye in the bevacizumab group had a statistically significant decrease (296.82 µm to 292.46 µm, P = .01) while both the ranibizumab and aflibercept groups trended toward worsening edema. When compared to ranibizumab and aflibercept, the CST in the noninjected eye in the bevacizumab group had improvements of –15.03 µm and –13.47 µm, respectively ( P < .019). When bevacizumab was switched to ranibizumab or aflibercept, the edema in the fellow eye worsened by +49.60 µm and +5.50 µm, respectively. Conclusion: Bevacizumab injection has a statistically significant therapeutic effect in the fellow eye when compared to those treated with ranibizumab and aflibercept. The edema in the fellow eye worsened when injection in the primary eye was switched away from bevacizumab.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

Outcomes of patients with active diabetic macular edema at the time of cataract surgery managed with intravitreal anti-VEGF injections

2021 ◽  
Author(s):  
Matthew R. Starr ◽  
Michael A. Mahr ◽  
Wendy M. Smith ◽  
Raymond Iezzi ◽  
Andrew J. Barkmeier ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Anti Vegf

scholarly journals Endothelial cells derived from patients with diabetic macular edema recapitulate clinical evaluations of anti-VEGF responsiveness through the Neuronal Pentraxin 2 pathway

2020 ◽  
Author(s):  
Ada Admin ◽  
Marta Vila Gonzalez ◽  
Magdalini Eleftheriadou ◽  
Sophia Kelaini ◽  
Hojjat Naderi-Meshkin ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
First Year ◽  
Differential Outcomes ◽  
Anti Vegf ◽  
Neuronal Pentraxin

Diabetic macular edema (DME) remains a leading cause of vision loss worldwide. DME is commonly treated with intravitreal injections of vascular endothelial growth factor (VEGF) neutralising antibodies. Anti-VEGFs are effective but not all patients fully respond to them. Given their potential side effects, inconvenience and high cost, identifying who may not respond appropriately to anti-VEGFs and why is essential. <p>Herein, we determine first the response to anti-VEGFs in a cohort of DME patients using spectral-domain optical coherence tomography scans obtained throughout the first year of treatment. We found that in 28% of eyes full clearance of fluid occurred at any time during the first year (“full responders”); in 66% fluid cleared only partly (“partial responders”); in 6% fluid remained unchanged (“non-responders”). To understand this differential response, we generated induced pluripotent stem cells (iPS) from “full responders” and “non-responders” and from diabetic subjects with no DME and age-matched non-diabetic volunteers and differentiated them into endothelial cells (iPS-ECs). Monolayers of iPS-ECs derived from diabetics showed marked and prolonged increased permeability upon exposure to VEGF when compared with non-diabetic controls; the response was significantly exaggerated in iPS-ECs from “non-responders” when compared with “full responders”. Moreover, phosphorylation of key cellular proteins in response to VEGF, including VEGFR2, and gene expression profiles, such as Neuronal Pentraxin 2 (NPTX2) expression, differed between “full responders” and “non-responders”. </p> <p>In the current study, iPS were used to predict patient response to anti-VEGF and identify key mechanisms underpinning the differential outcomes observed in the clinic. This approach has identified NPTX2 as playing a significant role in patient-linked responses and has potential as a new therapeutic target for DME. </p>

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