scholarly journals Treatment of Retinitis Pigmentosa-Associated Cystoid Macular Oedema Using Intravitreal Aflibercept (Eylea) despite Minimal Response to Ranibizumab (Lucentis): A Case Report

2016 ◽  
Vol 7 (2) ◽  
pp. 389-397 ◽  
Author(s):  
Stacey A. Strong ◽  
Avinash Gurbaxani ◽  
Michel Michaelides
Keyword(s):  
Case Report ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Macular Thickness ◽  
Cystoid Macular Oedema ◽  
Inadequate Response ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Intravitreal Aflibercept ◽  
Minimal Reduction

Background: We present an interesting case of bilateral retinitis pigmentosa (RP)-associated cystoid macular oedema that responded on two separate occasions to intravitreal injections of aflibercept, despite previously demonstrating only minimal response to intravitreal ranibizumab. This unique case would support a trial of intravitreal aflibercept for the treatment of RP-associated cystoid macular oedema. Case Presentation: A 38-year-old man from Dubai, United Arab Emirates, presented to the UK with a 3-year history of bilateral RP-associated cystoid macular oedema. Previous treatment with topical dorzolamide, oral acetazolamide, and intravitreal ranibizumab had demonstrated only minimal reduction of cystoid macular oedema. Following re-confirmation of the diagnosis by clinical examination and optical coherence tomography imaging, bilateral loading doses of intravitreal aflibercept were given. Central macular thickness reduced and the patient returned to Dubai. After 6 months, the patient was treated with intravitreal ranibizumab due to re-accumulation of fluid and the unavailability of aflibercept in Dubai. Only minimal reduction of central macular thickness was observed. Once available in Dubai, intravitreal aflibercept was administered bilaterally with further reduction of central macular thickness observed. Visual acuity remained stable throughout. Conclusions: This is the first case report to demonstrate a reduction of RP-associated CMO following intravitreal aflibercept, despite inadequate response to ranibizumab on two separate occasions. Aflibercept may provide superior action to other anti-VEGF medications due to its intermediate size (115 kDa) and higher binding affinity. This is worthy of further investigation in a large prospective cohort over an extended time to determine the safety and efficacy of intravitreal aflibercept for use in this condition.

scholarly journals Aflibercept or ranibizumab for the treatment of diabetic macular edema; a retrospective study

2019 ◽  
Vol 10 (4) ◽  
pp. 3000-3005
Author(s):  
Khlood M. Aldossary ◽  
Anfal Alruzuq ◽  
Ghady Almohanna ◽  
Hessa Almusallam ◽  
Sara Alamri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
P Value ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Injectable Drugs ◽  
Significant Difference ◽  
Intravitreal Aflibercept

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.

scholarly journals Prospective exploratory study to assess the safety and efficacy of aflibercept in cystoid macular oedema associated with retinitis pigmentosa

2020 ◽  
pp. bjophthalmol-2019-315152
Author(s):  
Stacey A Strong ◽  
Tunde Peto ◽  
Catey Bunce ◽  
Wen Xing ◽  
Michalis Georgiou ◽  
...  
Keyword(s):  
Adverse Events ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Exploratory Study ◽  
Cystoid Macular Oedema ◽  
Open Label ◽  
Safety And Efficacy ◽  
Intravitreal Aflibercept ◽  
Clinically Significant

AimsTo report the safety and efficacy of intravitreal aflibercept (Eylea) (ivA) for retinitis pigmentosa-associated cystoid macular oedema (RP-CMO) at 12 months via mean central macular thickness (CMT) and reported adverse events.MethodsA prospective, exploratory, phase II, non-randomised, single-centre, open-label, 1-arm clinical trial involving 30 eyes of 30 patients. Serial ivA was given via loading dose (three injections) followed by treat and extend protocol over 12 months.ResultsTwenty-nine out of 30 (96.7%) patients completed 12 months of follow-up. A total of four to 11 injections per patient were given over the 12 month study. No statistically significant reduction of CMT or visual acuity (VA) improvement was demonstrated in the group overall. Eleven out of 29 (37.9%) participants were considered as ‘responders’, demonstrating at least an 11% reduction of CMT at 12 months on spectral domain optical coherence tomography compared with baseline. A reduction of CMT by mean (SD) 28.1% (12.9 %) was observed in responders at 12 months, however, no statistically significant corresponding improvement in best corrected VA was seen. Baseline characteristics were similar between responder and non-responder groups. No clinically significant adverse events were deemed secondary to ivA.ConclusionThis first prospective exploratory study demonstrates both the safety and acceptability of serial ivA in patients with RP-CMO, effective at reducing CMT in 37.9% of patients. All patients demonstrating anatomical response did so after their first injection. Longer duration of CMO did not negatively affect response to anti-VEGF. Further study in a larger cohort of patients with shorter CMO duration would be valuable to better establish the utility of VEGF blockade in RP-CMO.Trial registration numbersEudraCT (2015-003723-65); ClinicalTrials.gov (NCT02661711).

scholarly journals Cystoid macular oedema in Cogans syndrome-a case report

Cases Journal ◽  
2008 ◽  
Vol 1 (1) ◽  
pp. 339 ◽  
Author(s):  
Anupama Pherwani ◽  
Shveta Bansal ◽  
Shailesh Agrawal ◽  
Timothy Gillow
Keyword(s):  
Case Report ◽  
Macular Oedema ◽  
Cystoid Macular Oedema

scholarly journals AYURVEDIC APPROACH ON CYSTOID MACULAR OEDEMA - A CASE REPORT

2021 ◽  
Vol 9 (8) ◽  
pp. 1904-1907
Author(s):  
Sabarinath M K ◽  
Pasha S M
Keyword(s):  
Case Report ◽  
Macular Oedema ◽  
Marked Improvement ◽  
Cystoid Macular Oedema ◽  
Field Of Vision ◽  
The Subject ◽  
One Year ◽  
The Right ◽  
Photocoagulation Therapy

Cystoid Macular Oedema or CME is a painless disorder that affects the central retina or macula. It refers to the accumulation of fluid in the outer plexiform and inner nuclear layer of the retina with the formation of a fluid-filled cyst. The primary symptom of macular oedema is blurry or wavy vision near or in the centre of your field of vision. Materials and Methods: A male patient of 48 yrs. presented in Shalakya OPD of GAMC Bengaluru with symp- toms of diminished vision in his right eye for one year. The patient was diagnosed with cystoid macular oedema in the right eye for which he was given photocoagulation therapy but did not find much relief. So, he approached our OPD. After thorough examination patient was started with Ayurvedic Medicines. Result: The subject showed marked improvement both subjectively and objectively. Discussion: Oedema which is the terminus of the pathology in this condition has to be understood as Ekanga Shopha. Though Kapha is the predominant dosha involved in forming Shopha here, the lakshanas manifesting are that of Vataja Timira. So, in this case study, Kapha Vata Hara followed by Shopha Hara line of treatment is adopted. Keywords: Cystoid macular oedema, Shopha, Vataja Timira, Nasya, Punarnavadi Kashaya.

scholarly journals Efficacy of additional topical betamethasone in persistent cystoid macular oedema after carbonic anhydrase inhibitor treatments in retinitis pigmentosa

2018 ◽  
Vol 3 (1) ◽  
pp. e000107
Author(s):  
Shohei Kitahata ◽  
Yasuhiko Hirami ◽  
Seiji Takagi ◽  
Cody Kime ◽  
Masashi Fujihara ◽  
...  
Keyword(s):  
Carbonic Anhydrase ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Medical Records ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Iop Elevation

ObjectiveWe investigated the efficacy of additional topical betamethasone in persistent cystoid macular oedema (CMO) after carbonic anhydrase inhibitors (CAIs) therapy.Methods and analysisThis retrospective cohort study included 16 eyes of 10 patients with retinitis pigmentosa (RP). All patients were previously administered CAI for at least 3 months to treat CMO secondary to RP and lacking an effective reduction (≥11%) of central foveal thickness (CFT). We administered topical 0.1% betamethasone daily in each affected eye following a preceding course of the CAI medication as a first treatment. CMO was diagnosed using spectral-domain optical coherence tomography. CFT was regarded as the average of vertical and horizontal foveal thickness. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained from patient medical records. We compared the CFT and BCVA between baseline and the average of 1–3, 5–7, 10–14 and 16–20 months period.ResultsIn treatments with brinzolamide in 14 eyes, dorzolamide in 2 eyes and bromfenac in 2 eyes, CFT effectively decreased in 12 of 16 eyes (81%). CFT decreased significantly in 1–3 months (326±102 µm; n=16; P=0.029) and 5–7 months (297±102 µm; n=12; P=0.022) compared with baseline but not within 10–14 months (271±96 µm; n=9; P=0.485) or 16–20 months (281±134 µm; n=9; P=0.289). There were no significant intergroup differences in BCVA throughout the study. Betamethasone treatment was stopped in three patients because of IOP elevation.ConclusionOur data suggested that additional betamethasone might improve treatments for persistent CMO. Topical steroids could be an alternative option for managing persistent CMO in RP.

scholarly journals Effect of intravitreal Triamcinolone (2mg) on diabetic macular oedema in the pseudophakic patient as primary treatment

2020 ◽  
Vol 11 (3) ◽  
pp. 3533-3539
Author(s):  
Mohammed Qasim Al Nuwaini ◽  
Giyathaldeen T. Neameh ◽  
Mustafa A. Al Zubaidi Md ◽  
Farook M. Albusultan
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intravitreal Injection ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Visual Outcome ◽  
Primary Treatment ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Intravitreal Triamcinolone

Diabetic macular oedema is still a significant cause of vision drop in the diabetic patient with no definitive regime for treatment. This study was on the result of effects of intravitreal injection of (2mg) triamcinolone on central macular thickness measured by OCT, visual acuity and intraocular pressure in pseudophakic eyes with diabetic macular oedema as a primary treatment line followed in six months. This study is a prospective, interventional case study series. It was on patients who received intravitreal injection of Triamcinolone in a single dose of ( 2 mg/0. 05 ml). Central macular thickness by OCT, visual acuity, and intraocular pressure was measured pre-injection and 1,3,6 months after injection. This study was performed in Iraq, Baghdad, Ibn Al-Haitham Teaching Eye Hospital from October 2014 to July 2015. Results showed 25 eyes received intravitreal injection of Triamcinolone Acetoniod with pre-injection central macular thickness 597.9+98.02 µm, visual acuity 1.096+0.61 Log MAR and intraocular pressure of 16.5+ 2.53 mmHg. After six months of follow up on central macular thickness 341.6+163.1 µm, visual acuity was 0.63 + 0.40 Log MAR and IOP was 18. 04+ 5. 63mmHg. This study suggests that intravitreal injection of Triamcinolone in a dose 2mg / 0. 05ml improves both anatomical and visual outcome in 21 eyes (84%) out of 25 pseudophakic eyes with diabetic macular oedema during first six months after injection and an increase in intraocular pressure in 2 eyes (8%). The intraocular pressure was despite the use of anti-glaucoma medications during this period.

scholarly journals Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa

2020 ◽  
Author(s):  
Lian Tan ◽  
Yanling Long ◽  
Ziyang Li ◽  
Xi Ying ◽  
Jiayun Ren ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Western China ◽  
Vitreomacular Traction ◽  
Cystoid Macular Oedema ◽  
Epiretinal Membranes ◽  
Ocular Abnormalities ◽  
Vitreomacular Traction Syndrome ◽  
Macular Holes

Abstract Background: To report the prevalence of ocular abnormalities and investigate visual acuity in a large Western China cohort of retinitis pigmentosa (RP) patients.Methods: A retrospective study was performed, reviewing the medical records and ophthalmic examination reports of 2,127 eyes from 1,065 RP patients in one eye hospital. The authors investigated the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities.Results: Nyctalopia (58.2%) and blurred vision (27.1%) were the leading consultation causes. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were cataracts (43.1%) and macular abnormalities (59.7%), including epiretinal membranes (51.1%), cystoid macular oedema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (P = 0.001) and macular holes (P = 0.008) increased significantly with age. The proportions of vitreomacular traction syndrome (P = 0.003) and epiretinal membranes (P < 0.001) in pseudophakia and aphakia eyes were significantly higher than in eyes that had not received operations (including cataracts and clear lens). Cystoid macular oedema was significantly associated with poorer visual acuity in RP patients with clear lens (P = 0.002).Conclusion: Cataracts and macular abnormalities are common in RP patients. In the macular abnormalities, cystoid macular oedema may have a negative effect on BCVA in RP patients with clear lens.

scholarly journals DYNAMICS OF THE COURSE OF RETINITIS PIGMENTOSA IN A CHILD WITH MACULAR INVOLVEMENT OVER 6 YEARS.

2021 ◽  
Vol Volume 2 (Fall) ◽  
pp. 1-4
Author(s):  
Nushaba Hasan Nuri
Keyword(s):  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Early Progression

Purpose: The purpose of this work was to describe retinitispigmentosa involving themaculain a child with a follow-upof6years.Methods: Casereport.Results: Over 6 years, the child exhibited an expansion of thelesionareaofthecentralretina.Onopticalcoherencetomography (OCT), there is a sharp thinning of the centralregion of the retina with pathology of the photoreceptorandpigmentlayers.Conclusion: In some cases of retinitis pigmentosa, there arechangesinthemacula,characteristicofthedryformofmaculardegeneration; in other cases, there are cysts associatedwith cystoid macular oedema; and in other cases, there is amacularhole.Inourcase,therewasanatrophiclesionofthemacula,characteristicofthedryformofage-relatedmaculardegeneration. Apparently, such involvement of the macula inthe process is typical for children with early progression of thedisease.

Therapeutic effect of prolonged treatment with topical dorzolamide for cystoid macular oedema in patients with retinitis pigmentosa

2013 ◽  
Vol 97 (9) ◽  
pp. 1187-1191 ◽  
Author(s):  
Yasuhiro Ikeda ◽  
Noriko Yoshida ◽  
Shoji Notomi ◽  
Yusuke Murakami ◽  
Toshio Hisatomi ◽  
...  
Keyword(s):  
Retinitis Pigmentosa ◽  
Therapeutic Effect ◽  
Macular Oedema ◽  
Prolonged Treatment ◽  
Cystoid Macular Oedema ◽  
Topical Dorzolamide
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