scholarly journals Autologous Plasma Enriched with Platelet Lysate for the Treatment of Idiopathic Age-Related Macular Degeneration: A Prospective Study

2018 ◽  
Vol 73 (1) ◽  
pp. 40-48
Author(s):  
A. P. Lykov ◽  
O. V. Poveshchenk ◽  
M. A. Surovtseva ◽  
O. M. Stanishevskaya ◽  
D. V. Chernykh ◽  
...  

Background: Plasma enriched in growth factors is widely used in medical practice. However, the clinical efficacy of its application in the treatment of age-related retinal integrity violations is investigated insufficiently. Aims: The aim of the study was to evaluate the clinical efficacy of autologous plasma enriched with platelet lysate for treating age-related macular degeneration. Materials and methods: A three-port subtotal transconjunctival vitrectomy was performed and administration of the autologous plasma enriched with platelet lysate was indicated. Autologous plasma enriched with platelet lysate was received from the peripheral blood. We assessed visual acuity, intraocular pressure; conducted optical coherent tomography examination of the eye on the side of the pathological process. Results: The study demonstrated that the combination of a standard 3-port transconjunctival subtotal vitrectomy followed by tamponade of the gap using the autologous plasma enriched with platelet lysate with the injections of the autologous plasma enriched with platelet lysate in the area of pterygopalatine fossa on the side of the operated eyes statistically significantly promoted recovery of the visual acuity in the early postoperative period (15 days) and late period (90 days) if compared with patients who received only surgical treatment (p≤0.05). Use of the autologous plasma enriched with platelet lysate in the treatment increased the closing rate of the tearing of the retina in the macular region up to 62,5%, while only surgical treatment leads to the closure of the defect of the retina in 37.5% of cases. The study showed that autologous plasma enriched with platelet lysate contains cytokines, growth factors, and nitric oxide which are involved in the regeneration/reparation of the retina. Conclusions: Additional administration of the autologous plasma enriched with platelet lysate in the scheme of treatment patients with age-related macular degeneration is accelerating the closure of retinal tears of the eye and improves visual acuity.

Author(s):  
V.A. Rudenko ◽  

Purpose. To evaluate the result of surgical treatment of submacular hemorrhage in patient with exudative age-related macular degeneration (AMD) by subretinal injection Gemase® and pneumatic retinopexy of blood clot. Material and methods. The article presents a clinical case of surgical treatment of submacular hemorrhage in patient with exudative AMD. The patient underwent three-port 25G vitrectomy, subretinal injection Gemase® 2000 ME by 38G needle, after which pneumatic retinopexy was performed. Results. Next day after the operation, there was displacement of subretinal blood clot from macula beyond out the lower vascular arcade. When observed after 6 months, the subretinal hemorrhage completely resolved, there was a regression of activity of subretinal neovascular membrane and macular edema, the retina was adherent in all cases. Visual acuity has improved. There was no recurrence of hemorrhage. Conclusion. This method of treatment allows you to increase and maintain the central visual acuity, as well as significantly reduce size of absolute central scotoma. Key words: submacular hemorrhage, recombinant prourokinase, Gemase®, exudative age-related macular degeneration, choroidal neovascularization, subretinal neovascular membrane.


2019 ◽  
Vol 4 (1) ◽  
pp. e000273
Author(s):  
Irina Balikova ◽  
Laurence Postelmans ◽  
Brigitte Pasteels ◽  
Pascale Coquelet ◽  
Janet Catherine ◽  
...  

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.


Author(s):  
Kai Xiong Cheong ◽  
Alvin Wei Jun Teo ◽  
Chui Ming Gemmy Cheung ◽  
Issac Horng Khit Too ◽  
Usha Chakravarthy ◽  
...  

Eye ◽  
2017 ◽  
Vol 31 (6) ◽  
pp. 978-980 ◽  
Author(s):  
A Rasmussen ◽  
J Fuchs ◽  
L H Hansen ◽  
M Larsen ◽  
B Sander ◽  
...  

Ophthalmology ◽  
2001 ◽  
Vol 108 (10) ◽  
pp. 1893-1900 ◽  
Author(s):  
Barbara L Brody ◽  
Anthony C Gamst ◽  
Rebecca A Williams ◽  
Amanda R Smith ◽  
Philip W Lau ◽  
...  

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