Central Macular Thickness Monitoring after a Taxane-Based Therapy in Visually Asymptomatic Patients

Chemotherapy ◽  
2017 ◽  
Vol 62 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Elias Chelala ◽  
Nicolas Arej ◽  
Joelle Antoun ◽  
Hampig Raphael Kourie ◽  
Karen Zaarour ◽  
...  
Keyword(s):  
Macular Edema ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Ocular Symptoms ◽  
Age Related ◽  
Asymptomatic Patients ◽  
Before And After ◽  
The Mean ◽  
Ophthalmic Disease

Background: Taxanes are drugs used in various chemotherapeutical protocols to treat solid tumors. They have multiple systemic adverse effects, such as bone marrow suppression, alopecia, nausea, and vomiting, and may rarely cause ocular symptoms. In the past decade, a few reported cases have shown the occurrence of a cystoid macular edema with significant visual loss after the use of a taxane-based chemotherapy. The aim of this study was to compare the central macular thickness (CMT) before and after the initiation of a taxane-based therapy in visually asymptomatic patients and to elucidate the possible impact of these drugs on the vision of cancer patients. Methods: Patients with a confirmed diagnosis of a solid tumor were screened for any ophthalmic disease before inclusion and had a baseline macular spectral domain optical coherence tomography (OCT; RTVue-100; Optovue Inc., Fremont, CA, USA) before the initiation of a taxane-based chemotherapy according to different protocols, such as 4EC-4T, 3FEC/3T, or 4TC. OCT was repeated after 4 cycles (or 3 months) of treatment, and CMT was compared to baseline. Patients presenting diabetic retinopathy, age-related macular degeneration or any condition that causes macular edema confirmed by ophthalmic examination were excluded. Results: Fifty eyes of 25 patients were included; 92% of the subjects were female with a mean age of 48.52 years, 88% were diagnosed with breast cancer, 8% with esophageal cancer, and 4% with ovarian cancer. Docetaxel was the taxane administered to 92% of the patients. The received dose of docetaxel ranged between 110 and 160 mg. The other patients had paclitaxel in their protocols. No significant macular edema or drop in visual acuity were noted in any patient. Nevertheless, the mean CMT was found to be increased, particularly in the parafoveal and perifoveal areas (mean difference of +2.22 μm; p = 0.001). Conclusion: Taxane-based chemotherapy regimens seem to increase macular thickness, with a relative sparing of the fovea, in patients without significant macular edema. Further research is required to better explain the pathophysiology and possible impact of this phenomenon.

Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

2015 ◽  
Vol 21 (3.2) ◽  
pp. 413-416
Author(s):  
Vilma Jūratė Balčiūnienė ◽  
Rosita Lažaunykaitė
Keyword(s):  
Visual Acuity ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Before And After ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p < 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p < 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.

scholarly journals Comparison of Safety and Efficacy of Intravitreal Ziv-Aflibercept Vs Bevacizumab for the Treatment of Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Hussain Ahmad Khaqan ◽  
Usman Imtiaz ◽  
Hasnain Muhammad Buksh ◽  
Hafiz Ateeq Ur Rehman ◽  
Raheela Naz
Keyword(s):  
Macular Degeneration ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Macular Thickness ◽  
Age Related Macular Degeneration ◽  
Central Macular Thickness ◽  
Safety And Efficacy ◽  
Vein Occlusion ◽  
Age Related ◽  
The Mean

Purpose:  To study the safety and efficacy of intravitreal Ziv-Aflibercept vs. Bevacizumab for the management of edema caused by different retinal pathologies. Study Design:  Comparative interventional study. Place and Duration of Study:  Lahore General Hospital, Lahore, from July 2018 to June 2019. Material and Methods:  Patients with resistant, center involving macular edema due to diabetes, retinal vein occlusion and age related macular degeneration were recruited. Complete ocular examination was performed. All the patients were randomly grouped into two i.e. IVZ (intravitreal Ziv-Aflibercept) and IVB (intravitreal bevacizumab). Each eye underwent intravitreal injection of 0.05 ml of fresh filtered ziv-aflibercept (1.25 mg) or 0.05 ml of fresh filtered Bevacizumab. Outcome was measured in terms of variation in central macular thickness (CMT) and also best corrected visual acuity (BCVA) at 3 months. Results:  Total of 156 eyes of 136 patients completed whole duration of study and were included in the results. The mean baseline CMT was 510 μm (± 94 μm) in the IVB group and 493μm (±102 μm) in the IVZ group (P = 0.94). The mean baseline BCVA (log MAR) was 0.78 (Snellen's equivalent 6/36) in the IVZ and 0.70 (Snellen's equivalent 6/30) in the IVB group (P = 0.78). Central macular thickness was significantly reduced at 1st, 2nd and 3rd month in the IVZ group and IVB group (P < 0.001). Conclusion:  Intravitreal Ziv-Aflibercept is safe and more effective than Bevacizumab for the treatment of edema caused by diabetes mellitus, retinal vein occlusion and wet age related macular degeneration.

scholarly journals Intraocular Injection of Stivant® (A Biosimilar to Bevacizumab): A Case Series

2021 ◽  
Author(s):  
Ahmad Mirshahi ◽  
Alireza Lashay ◽  
Hamid Riazi-Esfahani ◽  
Nazanin Ebrahimiadib ◽  
Hassan Khojasteh ◽  
...  
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Intraocular Injection ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Limited Experience ◽  
The Mean

Purpose: To report the results of intravitreal injection of a bevacizumab biosimilar called Stivant®. Methods: This prospective interventional case series was conducted on eyes with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). Stivant® was injected in three consecutive months and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and monthly up to one month after the third injection. Results: Three hundred and eighty-five eyes with DME (234 eyes, 61%), nAMD (87 eyes, 22%), and macular edema secondary to RVO (64 eyes, 17%) were enrolled. The mean ± standard deviation age of the patients was 61.7 ± 7.20 years. The mean BCVA and CMT changed from 0.63 ± 0.3 to 0.51 ± 0.3 LogMAR (P = 0.12 ) and from 420.4 ± 47.3μm at baseline to 316.7 ± 50.6 μm (P < 0.001) in the DME group; from 0.79 ± 0.3 to 0.68 ± 0.3 LogMAR (P = 0.19) and from 376.1 ± 31.7 μm to 303 ± 31.3 μm (P = 0.019) in the nAMD group; and from 0.81 ± 0.4 to 0.63 ± 0.4 LogMAR (P = 0.05) and from 424.21 ± 18 μm to 303.4 ± 18.8 μm (P < 0.001) in the RVO group, respectively. Conclusion: Our limited experience showed that the intravitreal injection of Stivant® was well tolerated. Although the results of this case series showed relative improvement in CMT one month after the last injection of Stivant®, BCVA improvement was statistically significant only in the RVO group. This would be essential to design a randomized clinical trial to evaluate the non-inferiority of Stivant® in comparison to bevacizumab.

scholarly journals CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC MACULAR EDEMA

2021 ◽  
Vol 71 (2) ◽  
pp. 433-37
Author(s):  
Amash Aqil ◽  
Muhammad Moin ◽  
Khadijah Abid ◽  
Ahsan Mehmood
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Choroidal Thickness ◽  
Macular Thickness ◽  
Control Group ◽  
Central Macular Thickness ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
The Mean

Objective: To evaluate central macular thickness and choroidal thickness in patients with macular edema due to diabetic retinopathy versus controls. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital, Lahore, from Jan to Jul 2018. Methodology: A retrospective data of 100 eyes from 50 patients having with diabetic macular edema associated with diabetic retinopathy was extracted from hospital registry. Additionally, 100 eyes of 50 individuals without any preexisting ocular conditions, comprising a control group was included in the study. Choroidal thickness measurements were made from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at subfoveal level using optical coherence tomography. Central macular thickness was also measured for all the enrolled patients. Results: One hundred patients fulfilling the inclusion criteria were enrolled in our study. The mean age was 56.27 ± 14.41 years. The mean Central macular thickness of all the patients were reported as 270.49 ± 72.38 μm, while the choroidal thickness was 284.89 ± 96.51 μm. There was statistically significant difference in central macular thickness between both healthy and diabetic retinopathy with diabetic macular edema groups (p=0.001), whereas insignificant difference existed between the two groups forchoroidal thickness (p=0.735). Conclusion: In patients with diabetic macular edema no significant change in choroidal thickness was observed compared with healthy controls, while the thickness of the retina was high in patients with macular edema due to diabetes.

scholarly journals The Difference Of Visual Acuity And Macular Thickness Post Bevacizumab Therapy In Secondary Macular Edema Retinal Vein Occlusion

2018 ◽  
Vol 4 (2) ◽  
pp. 110
Author(s):  
Citra Rahmadani ◽  
Nur Khoma Fatmawati ◽  
Rahmat Bakhtiar
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Secondary Data ◽  
Macular Thickness ◽  
Vein Occlusion ◽  
Before And After ◽  
Quasi Experimental ◽  
The Mean ◽  
The Difference

Retinal vein occlusion is the second most common cause of blindness in retinal vascular disease after diabetic retinopathy and may lead to complications of macular edema. Bevacizumab is an influential treatment as an anti vascular endothelial growth factor (VEGF). This study aims to determine the difference of visual acuity and macular thickness before and after treatment of Bevacizumab. This is a quasi experimental study in patients with secondary macular edema retinal vein occlusion who meets the inclusion criteria. Visual acuity and macular thickness were evaluated after one month of treatment. This study was conducted for two months since May-June 2017 by collecting secondary data from medical record at SMEC Samarinda from January 2016 – June 2017. Data were analyzed using Wilcoxon. Sixteen eyes from 16 patients were diagnosed with macular edema secondary retinal vein occlusion given bevacizumab treatment. The mean visual acuity before therapy was 1.106 LogMAR ± 0.509 and increased to 0.889 logMAR ± 0.608 (p = 0.116) after treatment while the mean macular thickness before therapy was 504.06 μm ± 301.273 and decreased to 348.81 μm ± 181.17 (p = 0.017) after treatment. There was a significant effect on the decrease in macular thickness but no significant effect on visual acuity improvement in patients with macular edema secondary retinal vein occlusion at SMEC Samarinda.  Keywords: Retinal vein occlusion, macular edema, bevacizumab

scholarly journals CENTRAL MACULAR THICKNESS AFTER CATARACT SURGERY IN NON-DIABETICS AND DIABETICS WITHOUT RETINOPATHY

2021 ◽  
Vol 71 (6) ◽  
pp. 1993-96
Author(s):  
Marrium Shafi ◽  
Muhammad Akmal Khan ◽  
Yaseen Lodhi ◽  
Asma Aftab ◽  
Muhammad Haroon Sarfraz
Keyword(s):  
Cataract Surgery ◽  
Thickness Measurement ◽  
Case Control ◽  
Macular Thickness ◽  
P Value ◽  
Central Macular Thickness ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Objective: To determine the mean change in central macular thickness after cataract surgery and to compare the mean change in central macular thickness after cataract surgery in non-diabetics and diabetics without diabetic retinopathy Study design: Case control   Study settings and duration: A case control study was carried out at Ophthalmology department, POF hospital, Wah Cantt. Study duration was 6 months (April 2019-September 2019)   Material and methods: A sample size of 60 patients was calculated by using Open Epi Software. We used non probability consecutive sampling. Patients were divided into two groups; Cases (Diabetic) and controls (non-Diabetic). All patients underwent phacoemulsification and observed after 4 weeks for macular thickness measurement using optical coherence tomography before and after surgery. Data analysis was done with SPSS version 20. Post stratification t test was applied. P value ≤0.05 was considered significant.   Results: Total 60 patients were included. Mean age of patients was 65.31 ±7. 63SD.There were 35 (58.3%) males and 25 (41.7%) female patients in the study. We found a significant increase in central macular thickness in cases and controls [(223.100±15.86SD vs 227.2667±17.9SD, p=0.000) and (221.200±12.16SD vs 226.289±16.7861SD, p =0.001)] before and after phacoemulsification in cases and controls respectively. However, no significant difference was found between the groups (p=0.486).   Conclusion: Central macular thickness was increased after uncomplicated phacoemulsification in both diabetics and non-diabetics without retinopathy for up to a follow-up period of 4 weeks but the thickness did not differ between the two groups.

scholarly journals Real-Life Management of Patients with Retinal Vein Occlusion Using I-Macula Web Platform

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Massimo Nicolò ◽  
Monica Bonetto ◽  
Raffaella Rosa ◽  
Donatella Musetti ◽  
Maria Musolino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real Life ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Web Platform

Aim.Real-lifeevaluation in the management of patients affected by macular edema secondary to retinal vein occlusion.Material and Methods. A retrospective, observational study using theI-Macula Webplatform.Results. Thirty-five patients (37 eyes; 15 females and 20 male) affected by RVO were analysed. At 12 months, there was a statistically significant improvement of best-corrected visual acuity (p=0.0235) and central macular thickness (p<0.0001). The mean change in visual acuity was 8.9 letters. Twenty-seven eyes underwent DEX implant (n=62; mean: 2.29) only. Of these, 8, 4, 14, and 1 eyes underwent 1, 2, 3, and 4 DEX implants, respectively. The remaining 10 eyes were also injected with ranibizumab (n=49; mean: 4.9). At 12 months, 12 eyes (32.5%) presented a dry macula, whereas the remaining 25 eyes (67.5%) still had macular edema. Mean interval between the first and second treatment (T1) and between the second and third treatment (T2) were 5.15 and (T2) 3.7 months, respectively. Where only DEX implants were received, T1 and T2 was 5.1 and 4.9 months, respectively.Conclusions. This study confirms that DEX implants and/or anti-VEGF drugs improve visual acuity and central macular thickness in patients affected by RVO.

scholarly journals Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Anne-Laurence Best ◽  
Franck Fajnkuchen ◽  
Sylvia Nghiem-Buffet ◽  
Typhaine Grenet ◽  
Gabriel Quentel ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Real Life ◽  
Treatment Compliance ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Real Life Setting ◽  
The Mean

Purpose. To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME). Methods. A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA) and central retinal thickness (CRT) by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD) patients. Results. Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p<0.0001), 31.1% of patients had a VA > 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p=0.0001) after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n=55). Discussion/Conclusion. Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.

scholarly journals Karakteristik Ketebalan Makula Sentral Sebelum dan Sesudah Injeksi IntravitrealBevacizumab di RSKM Padang Eye Center Periode Januari 2018 – Januari 2019

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Haves Ashan
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Fluid Accumulation ◽  
Blood Retinal Barrier ◽  
Vein Occlusion ◽  
Before And After ◽  
Center Hospital ◽  
Age Range

Macular edema is a common cause of vision disturbing. Fluid accumulation in the retina and increased thickness of the retina cause damage to the blood retinal barrier. Intravitreal anti-VEGF (bevacizumab) injection aims to reduce VEGF activity, where retinal vein occlusion (RVO) induces an increase in VEGF levels which causes an increase in vascular permeability and results in macular edema. The aim of this study was to determine the central macular thickness before and after intravitreal injection of bevacizumab in patients with central retinal vein occlusion and branch retinal vein occlusion through observing the results of OCT (Optical Coherence Tomography) examination. This research is a retrospective descriptive study based on the results of medical records tracing of 8 RVO patients in the Padang Eye Center Hospital for the period January 2018 to January 2019. The study was conducted in March to April 2020. The study subjects consisted of 8 people (8 eyes) consisting of 2 men (25.0%) and 6 women (75.0%). The age range ranges from 41-80 years. The thickness of the central macula at the start was found to be majority > 300 μm, as many as 7 people (87.5%), while ≤ 300 μm was 1 person (12.5%). One month after injection found the majority of central macular thickness ≤ 300 μm by 5 people (62.5%), while> 300 μm is as many as 3 people (37.5%). All patients experienced a decrease in central macular thickness in 8 subjects (100%).

scholarly journals Sequential applied Benzalkonium Chloride and Insulin Eye Drops Reduces Ocular Central Macular Thickness and Improves vision of Diabetics and Non-Diabetics

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Herman C.I. Themen ◽  
Jerry R. Toelsie ◽  
Jerrel C. Pawiroredjo ◽  
Dinesh Jiawan ◽  
Robbert Bipat
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Benzalkonium Chloride ◽  
Macular Thickness ◽  
Eye Drops ◽  
Pathophysiological Mechanism ◽  
Central Macular Thickness ◽  
Efficient Treatment ◽  
Inflammatory Processes ◽  
The Mean

Introduction  Macular Edema is a rather disabling condition that can be the consequence of several disorders of the eye. Most of the time it occurs in patients suffering from diabetic eye retinopathy. The exact pathophysiological mechanism of this condition is not clear, but it is probably the result of inflammatory processes or structural and mechanical disturbances of the vitreomacular tissue. Due to this obscure pathophysiological mechanism, a targeted efficient treatment is still lacking. However, accumulating evidence is suggesting that local application of insulin might reduce the structural and functional defects of this disorder. The aim of this study is to assess the effects of sequential applied benzalkonium chloride and Insulin eye drops on the visual acuity and central macular thickness of eyes suffering from macular edema. Methods Patients refractive to or refusing treatment with anti-VEGF agents were selected. Their visual acuity and central macular thickness were measured immediately before and until six months after treatment. The treatment consisted of twice a day application of specially prepared benzalkonium chloride and Insulin eye drops. Results are expressed as mean ± SD. The procedures followed were all in line with the guides for ethics of the hospital and were not in conflict with the declaration of Helsinki. Result After six months, the mean visual acuity increased significantly from 0.28±0.17 to 0.53±0.27 (p = 0.001) and the central macular thickness decreased from 393±122 µm to 250±72 µm (p = 0.0001). Conclusion Sequential applied benzalkonium chloride and insulin eye drops improve visual acuity and reduce central macular thickness in eyes suffering from macular edema. Further studies to elucidate the exact mechanism of action are necessary. Apart from this, the use of these drops may prove to be a cheaper and more efficient method to treat the rather disabling condition.

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