Efficacy of Intravitreal Injections of Antivascular Endothelial Growth Factor Agents in a Rat Model of Anterior Ischemic Optic Neuropathy

2015 ◽  
Vol 56 (4) ◽  
pp. 2290 ◽  
Author(s):  
Tzu-Lun Huang ◽  
Chung-Hsing Chang ◽  
Shu-Wen Chang ◽  
Kung-Hung Lin ◽  
Rong-Kung Tsai
Keyword(s):  
Growth Factor ◽  
Optic Neuropathy ◽  
Rat Model ◽  
Intravitreal Injections ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

scholarly journals Long-Term Visual Outcomes for a Treat-and-Extend Antivascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration: Up to Seven-Year Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Simon Javidi ◽  
Ali Dirani ◽  
Fares Antaki ◽  
Marc Saab ◽  
Sofiane Rahali ◽  
...  
Keyword(s):  
Growth Factor ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Anti Vegf ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Number Of Injections

Purpose. To report long-term visual and anatomical outcomes in eyes with neovascular age-related macular degeneration (nAMD) treated with a treat-and-extend regimen (TER) of intravitreal antivascular endothelial growth factor (anti-VEGF) injections in real-world settings. Methods. Retrospective cohort study of consecutive patients with nAMD treated with a TER of anti-VEGF intravitreal injections by a single retina specialist (GC). Patients with nAMD who had at least one year of follow-up were identified using an electronic database. Best-corrected visual acuity (BCVA), comprehensive ophthalmologic examination, and macular OCT were performed at each visit. Patients received a loading dose of three monthly intravitreal injections and then were treated according to a TER of bevacizumab, ranibizumab, and/or aflibercept. The number of injections, BCVA, and central retinal thickness (CRT) were evaluated during the follow-up period. Results. 180 eyes from 180 patients were included in the study. Mean age was 75 ± 9 (range: 51–96). Mean BCVA was 0.77 ± 0.64 LogMAR at baseline, 0.69 ± 0.58 LogMAR (p=0.0057) after loading phase, 0.64 ± 0.55 LogMAR (p=0.0001) after 6 months of TER, and 0.76 ± 0.71 LogMAR after 6 years of treatment (n = 32 at year 6). CRT decreased significantly after the loading phase (p=0.0002). The mean number of intravitreal injections per year was 7.6 during the first three years of treatment and then decreased to 5.9 during year 4 to 7. Conclusions. This retrospective study of 180 nAMD patients treated with a TER of intravitreal anti-VEGF demonstrates an initial improvement of BCVA after loading phase, followed by long-term visual stabilization for at least six years. These results were obtained with a high number of injections, averaging close to six injections per year during long-term follow-up. In light of the natural evolution of nAMD, these data support the long-term efficacy of this treatment under real-world conditions of heterogeneity of patients and type of anti-VEGF used.

scholarly journals Repeated intravitreal injections of antivascular endothelial growth factor in patients with neovascular age-related macular degeneration may increase the risk of ischemic optic neuropathy

2019 ◽  
Author(s):  
Yu-Yen Chen ◽  
Pesus Chou ◽  
Yu-Fang Huang ◽  
Hung-Jen Chien ◽  
Yu-Chieh Wu ◽  
...  
Keyword(s):  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Study Cohort ◽  
Ischemic Optic Neuropathy ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Kaplan Meier ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Abstract Background Previous case reports presented the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD). Methods A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the period were enrolled in the study cohort. Enrollees were divided into three groups according to categorized levels of injection number (first level: < 10 times, second level: 10–15 times, third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyzes were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to different levels of injection numbers. Confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma). Results In total, the study cohort had 77210 patients. Of these, 26520, 38010, and 12680 were in the first, second, and third level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second and third levels of injection number were 1.91 (95% confidence interval [CI], 1.32–2.76), and 2.20 (95% CI, 1.42–3.43), respectively, compared with the first level. Conclusions Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections are at a significantly higher risk of developing ION when compared with individuals who receive a lower number of injections.

EVALUATION OF SAFETY FOR BILATERAL SAME-DAY INTRAVITREAL INJECTIONS OF ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY

Retina ◽  
2009 ◽  
Vol 29 (9) ◽  
pp. 1213-1217 ◽  
Author(s):  
LUIZ H. LIMA ◽  
SANDRINE A. ZWEIFEL ◽  
MICHAEL ENGELBERT ◽  
JOHN A. SORENSON ◽  
JASON S. SLAKTER ◽  
...  
Keyword(s):  
Growth Factor ◽  
Intravitreal Injections ◽  
Antivascular Endothelial Growth Factor ◽  
Factor Therapy ◽  
Growth Factor Therapy ◽  
Endothelial Growth Factor

scholarly journals Repeated intravitreal injections of antivascular endothelial growth factor in patients with neovascular age-related macular degeneration may increase the risk of ischemic optic neuropathy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu-Yen Chen ◽  
Pesus Chou ◽  
Yu-Fang Huang ◽  
Hung-Jen Chien ◽  
Yu-Chieh Wu ◽  
...  
Keyword(s):  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Study Cohort ◽  
Ischemic Optic Neuropathy ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Kaplan Meier ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Abstract Background Previous case reports have demonstrated the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD). Methods A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the study period were enrolled in the study cohort. Enrollees were divided into three groups according to the categorized levels of injection number (first level: < 10 times, second level: 10–15 times, and third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyses were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to the different levels of injection numbers. The confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma). Results In total, the study cohort included 77,210 patients. Of these, 26,520, 38,010, and 12,680 were in the first-, second-, and third-level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second- and third-level groups were 1.91 (95% confidence interval [CI], 1.32–2.76) and 2.20 (95% CI, 1.42–3.43), respectively, compared with those in the first-level group. Conclusions Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections have a significantly higher risk of developing ION compared with individuals who receive a lower number of injections.

scholarly journals Repeated intravitreal injections of antivascular endothelial growth factor in patients with neovascular age-related macular degeneration may increase the risk of ischemic optic neuropathy

2019 ◽  
Author(s):  
Yu-Yen Chen ◽  
Pesus Chou ◽  
Yu-Fang Huang ◽  
Hung-Jen Chien ◽  
Yu-Chieh Wu ◽  
...  
Keyword(s):  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Study Cohort ◽  
Ischemic Optic Neuropathy ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Kaplan Meier ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Abstract Background: Previous case reports have demonstrated the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD). Methods: A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the study period were enrolled in the study cohort. Enrollees were divided into three groups according to the categorized levels of injection number (first level: < 10 times, second level: 10–15 times, and third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyses were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to the different levels of injection numbers. The confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma). Results: In total, the study cohort included 77210 patients. Of these, 26520, 38010, and 12680 were in the first-, second-, and third-level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second- and third-level groups were 1.91 (95% confidence interval [CI], 1.32–2.76) and 2.20 (95% CI, 1.42–3.43), respectively, compared with those in the first-level group. Conclusions: Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections have a significantly higher risk of developing ION compared with individuals who receive a lower number of injections.

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