Antivascular Endothelial Growth Factor as an Approach for Macular Edema

2010 ◽  
pp. 111-122 ◽  
Author(s):  
P.M. Buchholz ◽  
A.P. Buchholz ◽  
A.J. Augustin
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Evaluation of Patients Receiving Intravitreal Antivascular Endothelial Growth Factor for Diabetic Macular Edema in Clinical Practice in the United States

2020 ◽  
pp. 247412642095306
Author(s):  
John D. Pitcher ◽  
Andrew A. Moshfeghi ◽  
Genevieve Lucas ◽  
Nick Boucher ◽  
Hadi Moini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Growth Factor ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
The United States ◽  
Treatment Frequency ◽  
Anti Vegf ◽  
Injection Frequency ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Purpose: We assessed the effect of treatment frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents on visual acuity (VA) in diabetic macular edema (DME). Methods: This retrospective analysis assessed electronic medical records of eyes newly diagnosed with DME and treated with an anti-VEGF agent at US clinics using the Vestrum Health (Naperville, Illinois) treatment and outcomes database. Eyes were divided into 2 injection frequency subcohorts (≤ 6 vs > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated. Results: Among 155 240 eyes assessed, 3028 met inclusion criteria for analysis in year 1 and 1292 in year 2. During year 1 of treatment, 57% (n = 1725) received > 6 injections; most continued to receive the same injection frequency during year 2. Mean VA gain from baseline at year 1 was lower in the ≤ 6 than in the > 6 injections/year subcohort (3.7 vs 8.0 letters, respectively; P < .001). Mean VA change from the end of year 1 to year 2 for eyes receiving ≤ 6 injections in year 1 generally remained unchanged, irrespective of year 2 dosing frequency. In eyes that received > 6 injections in year 1, mean VA loss was significantly greater for eyes receiving less-frequent dosing in year 2 than in those maintained on > 6 injections. Conclusions: More than 50% of eyes with DME in routine clinical practice that completed at least 1 year of follow-up received > 6 injections of an anti-VEGF agent during the first year, resulting in better VA gains than eyes treated less frequently.

Treatment of Eyes With Diabetic Macular Edema That Had a Suboptimal Response to Antivascular Endothelial Growth Factor Therapy: 2-mg Intravitreal Triamcinolone Acetonide vs 0.7-mg Dexamethasone Implant

2020 ◽  
Vol 4 (5) ◽  
pp. 372-376
Author(s):  
Brandon Kuley ◽  
Philip P. Storey ◽  
Maitri Pancholy ◽  
Turner D. Wibbelsman ◽  
Anthony Obeid ◽  
...  
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Triamcinolone ◽  
Treatment Groups ◽  
Antivascular Endothelial Growth Factor ◽  
Factor Therapy ◽  
Growth Factor Therapy ◽  
Endothelial Growth Factor

Purpose: This article compares 2-mg intravitreal triamcinolone (IVT) and 0.7-mg dexamethasone (DEX) implant for the treatment of diabetic macular edema in eyes that had a suboptimal response to antivascular endothelial growth factor therapy. Methods: A single-center, retrospective review was conducted of patients receiving either IVT between January 1, 2013, and January 1, 2018, or patients receiving DEX between October 1, 2015, and January 1, 2018. Visual acuity and central macular thickness (CMT) were recorded at visit of first injection and all subsequent visits. Results: Twenty-five eyes were included in the DEX group and 32 eyes were included in the IVT group. Change in vision from baseline was similar between DEX and IVT at 6-month follow-up (1.1 lines vs 2.3 lines, respectively; P = .24). Mean decrease in CMT from baseline was not different at 6-month follow-up (DEX: 120 µm vs IVT: 185 µm; P = .17). Conclusions: DEX and 2-mg IVT both achieved improvement in vision and CMT with no significant differences between treatment groups at 6-month follow-up.

Longitudinal Assessment of Ellipsoid Zone Mapping Parameters in Retinal Venous Occlusive Disease With Associated Macular Edema

2020 ◽  
pp. 247412642094341
Author(s):  
Joseph R. Abraham ◽  
Joseph Boss ◽  
Amy S. Babiuch ◽  
Rishi P. Singh ◽  
Sunil Srivastava ◽  
...  
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Functional Improvement ◽  
Retinal Layer ◽  
Ellipsoid Zone ◽  
Total Attenuation ◽  
Antivascular Endothelial Growth Factor ◽  
Factor Therapy ◽  
Growth Factor Therapy ◽  
Endothelial Growth Factor

Purpose: This work evaluated the longitudinal dynamics of ellipsoid zone (EZ) integrity in retinal vein occlusion (RVO) with macular edema and their relation to outcomes. Methods: Clinical characteristics and optical coherence tomography data of patients with RVO and associated macular edema were collected at baseline and at 3 and 12 months. Macular cube scans were exported into EZ and retinal-layer analysis software. Longitudinal EZ parameters and visual acuity (VA) outcomes were regressed and correlated. Results: The study included 108 eyes of 108 patients; all eyes were treated with antivascular endothelial growth factor therapy at the baseline visit. VA improved from 20/97 at baseline to 20/52 at 3 months and 12 months ( P < .001), correlating with EZ integrity at each time point ( P < .001). At 12 months following initiation of antivascular endothelial growth factor therapy, EZ partial attenuation and EZ total attenuation improved over 12 months from 16.4% to 8.5% ( P < .001) and from 12.3% to 5.9% ( P < .001), respectively. VA improvement from baseline to 12 months correlated with improvement of EZ partial and total attenuation ( P < .001). Baseline EZ characteristics did not predict VA outcomes, but at 3 months, EZ parameters did predict improvement in visual outcomes by 12 months ( P < .01). Conclusions: EZ and outer retinal integrity are correlated with functional outcomes in RVO. Following treatment, EZ integrity improves and is associated with functional improvement. In RVO baseline, EZ features were not associated with 1-year VA outcomes, but evaluation of EZ integrity at 3 months was linked to 1-year outcomes.

scholarly journals Association between Inflammatory Factors in the Aqueous Humor and Hyperreflective Foci in Patients with Intractable Macular Edema Treated with Antivascular Endothelial Growth Factor

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Min Li ◽  
Jing Li ◽  
Kaichuan Chen ◽  
Jia Wang ◽  
Minjie Sheng ◽  
...  
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Aqueous Humor ◽  
Inflammatory Factors ◽  
Hyperreflective Foci ◽  
Anti Vegf ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Prognosis Evaluation ◽  
Sd Oct

Background. To evaluate the correlations between the inflammatory factors in the aqueous humor and hyperreflective foci (HRF) in patients with intractable macular edema treated with antivascular endothelial growth factor (anti-VEGF). Methods. This study included 17 patients with intractable macular edema (ME) treated with anti-VEGF agents. Inflammatory factors in the aqueous humor were measured by the Cytometric Beads Array before injection, and the numbers of HRF pre- and post-anti-VEGF treatment were counted from four different directions (90 degrees, 45 degrees, 180 degrees, and 135 degrees) in the SD-OCT images, respectively, before treatment and one month after treatment. The correlations between inflammatory factors and the numbers of HRF were assessed. Results. The numbers of HRF were reduced significantly after anti-VEGF treatment. The change in the HRFs at the 90-degree location was significantly positively correlated with IL-8 and VCAM-1. The change of all HRFs was significantly positively correlated with IL-8. The HRFs before the treatment also had a positive correlation with IL-8 and VCAM-1. Conclusion. After anti-VEGF treatment, the numbers of HRF in intractable ME declined greatly. The higher the levels of IL-8 and VCAM-1 before treatment, the more significant the reduction of HRF after anti-VEGF treatment, which indicated that HRF could be an effective noninvasive imaging indicator for evaluating the effect of anti-VEGF on intractable macular edema. The OCT images at the 90-degree location could better show the inflammatory reaction of patients and also had better clinical significance for the prognosis evaluation of ME associated with inflammation.

Use of Anti-VEGF Drugs in Retinal Vein Occlusions

2020 ◽  
Vol 21 (12) ◽  
pp. 1181-1193
Author(s):  
Manuel AP Vilela
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Laser Therapy ◽  
Visual Loss ◽  
Western World ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Retinal Vein Occlusions

Retinal vein occlusion (RVO) is one of the most prevalent causes of visual loss in the Western World. Its pathogenesis is still not completely known. Chronic macular edema and ischemia compromise the functional and anatomical status of the retina. Antivascular endothelial growth factor (anti-VEGF) injections have demonstrated better results than other previous options, including observation or laser therapy. This narrative review aims to analyze the current aspects related to these drugs.

scholarly journals Treatment of Diabetic Macular Edema with Intravitreal Antivascular Endothelial Growth Factor and Prompt versus Deferred Focal Laser during Long-Term Follow-Up and Identification of Prognostic Retinal Markers

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Birgit Weingessel ◽  
Kata Miháltz ◽  
Andreas Gleiss ◽  
Florian Sulzbacher ◽  
Christopher Schütze ◽  
...  
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Morphological Characteristics ◽  
Antivascular Endothelial Growth Factor ◽  
Long Term Follow Up ◽  
Endothelial Growth Factor ◽  
Deferred Group

Purpose. Long-term follow-up of patients with diabetic macular edema (DME) treated with intravitreal antivascular endothelial growth factor (anti-VEGF) combined focal laser and identification of prognostic morphological characteristics. Methods. Prospective clinical trial (50 treatment-naive eyes) with DME randomized 1 : 1 receiving intravitreal ranibizumab (0.5 mg/0.05 ml) and prompt grid laser compared with ranibizumab and deferred laser. Morphological characteristics potentially relevant for prognosis were assessed at baseline, month 6, month 9, and years 1, 2, 3, 4, and 5 of follow-up. Results. Although functional results were slightly higher in the prompt group at week 12 (0.5; 20/40 Snellen (SD = 0.04, 0.3 logMAR) versus 0.4; 20/50 Snellen (SD = 0.04, logMAR: 0.4), p=0.4) and month 9 (prompt group: 0.5; 20/40 Snellen (SD = 0.03, 0.3 logMAR) versus deferred group: 0.4; 20/50 Snellen (SD = 0.04, 0.4 logMAR), p=0.4), these were statistically insignificant. There was no significant benefit regarding functionality during long-term follow-up in the prompt group compared to the deferred group. BCVA in the eyes with clusters of hyperreflective foci in the central macular region was inferior compared with the eyes without these alterations at year 5 (0.39; 20/50 Snellen, (SD = 0.25, 0.4 logMAR) versus 0.63; 20/80 Snellen (SD = 0.22, 0.2 logMAR), p<0.01). Conclusion. Grid laser and ranibizumab therapy are effective in DME management during the long-term follow-up. Intraretinal hyperreflective material in SD-OCT is negatively related to BCVA.

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