scholarly journals Intravitreal Ranibizumab for Diabetic Macular Oedema

2015 ◽  
Vol 09 (01) ◽  
pp. 32 ◽  
Author(s):  
Francesco Bandello ◽  
Maria Vittoria Cicinelli ◽  
Maurizio Battaglia Parodi ◽  
◽  
◽  
...  
Keyword(s):  
Macular Oedema ◽  
Vision Loss ◽  
Diabetic Macular Oedema ◽  
Standard Of Care ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Remarkable Effect ◽  
The Past ◽  
Endothelial Growth Factor ◽  
Ranibizumab Treatment

Diabetic macular oedema (DMO) is the most frequent cause of vision loss in patients affected by diabetes mellitus, and has a remarkable effect on public health. The treatment with focal/grid laser photocoagulation was considered in the past decades as the standard of care, but the recent advent of new pharmacological approaches, based on the use of intravitreal anti-vascular endothelial growth factor (anti-VEGF), has completely revolutionised the management of DMO. The most important molecule of this class of drugs is represented by ranibizumab, which has been clinically supported by several randomised clinical trials. The present review aims at providing a comprehensive summary of the most important investigations regarding the ranibizumab treatment of DMO.

scholarly journals Evidence for Anti-vascular Endothelial Growth Factor Treatment of Diabetic Macular Oedema

2010 ◽  
Vol 8 (1) ◽  
pp. 36 ◽  
Author(s):  
Francesco Bandello ◽  
Umberto De Benedetto ◽  
Karl Anders Knutsson ◽  
Maurizio Battaglia Parodi ◽  
Maria Lucia Cascavilla ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Oedema ◽  
Vision Loss ◽  
Diabetic Macular Oedema ◽  
Standard Of Care ◽  
Vascular Endothelial ◽  
Cell Mitogen ◽  
Endothelial Growth Factor

Diabetic macular oedema (DME) represents the most common cause of vision loss in patients affected by diabetes mellitus. Diabetic retinopathy has a significant impact on public health and the quality of life of many patients and thus requires serious consideration. The first line of treatment remains the management of systemic risk factors but this is often insufficient in controlling DME and currently, laser retinal photocoagulation is considered the standard of care. However, laser treatment reduces the risk of moderate visual loss by approximately 50 % without guaranteeing remarkable effects on visual improvement. For these reasons, new approaches in the treatment of DME have been considered, in particular the employment of anti-vascular endothelial growth factor (VEGF) drugs. VEGF is a pluripotent growth factor that functions as a vasopermeability factor and an endothelial cell mitogen and thereby represents an appealing candidate as a therapeutic target for the treatment of DME. The goal of this article is to present the evidence behind the use of anti-VEGF drugs in the treatment of DME.

Aflibercept – Setting its Sights on Diabetic Macular Oedema

2014 ◽  
Vol 08 (02) ◽  
pp. 152
Author(s):  
Jean-François Korobelnik ◽  
Reinier Schlingemann ◽  
Ian Pearce ◽  
◽  
◽  
...  
Keyword(s):  
Macular Oedema ◽  
Large Scale ◽  
Fluid Transport ◽  
Diabetic Macular Oedema ◽  
Standard Of Care ◽  
Glycated Haemoglobin ◽  
Vascular Endothelial ◽  
Significant Efficacy ◽  
Endothelial Growth Factor

A satellite symposium entitled ‘Aflibercept* – Setting Its Sights On Diabetic Macular Oedema (DMO)’ was chaired by Jean-François Korobelnik and was convened at the 2014 European Association for Vision and Eye Research (EVER) Congress. The symposium discussed the science behind DMO, in particular, the role of vascular endothelial growth factor (VEGF) and associated inflammatory mechanisms that alter fluid transport from capillaries into retinal tissues leading to focal leakage, fluid accumulation, macular damage and eventual blindness. This discussion of the pathophysiology emphasised the importance of VEGF as a target for DMO treatments. Management of diabetes and prevention of progression of diabetic retinopathy leading to DMO requires strict control of glycated haemoglobin (HbA1c), blood pressure and lipid levels. Once DMO has developed and vision is impaired, the anti-VEGF agents have emerged as vital components of disease management and are becoming the first-line standard of care. Aflibercept (EYLEA®) and ranibizumab (Lucentis®) are approved agents for DMO and have shown significant efficacy in clinical trials in terms of visual acuity gains, decreased retinal thickness and have good safety profiles. The symposium finally focused on the use of aflibercept in DMO. In large-scale trials (VIVID and VISTA), this treatment has been compared head-to-head with laser treatment and during 1 year of treatment, showed substantial efficacy benefits, no new safety signals and the potential for lower frequency intravitreal dosing at 8- rather than 4-week intervals for monitoring andpro re natadosing.

The Treatment of Diabetic Macular Oedema with ILUVIEN® Intravitreal Implant Following Prior Anti-VEGF Therapy – Case Study

2014 ◽  
Vol 08 (02) ◽  
pp. 140
Author(s):  
Fahd Quhill ◽  
Keyword(s):  
Macular Oedema ◽  
Vision Loss ◽  
Diabetic Macular Oedema ◽  
Fluocinolone Acetonide ◽  
Vascular Endothelial ◽  
Foveal Thickness ◽  
Intravitreal Implant ◽  
The Uk ◽  
Endothelial Growth Factor

Diabetic macular oedema (DMO) is the main cause of vision loss in diabetic retinopathy. The ILUVIEN® intravitreal implant, which contains fluocinolone acetonide and is administered by injection into the vitreous cavity, should be considered if the patient is not responding to anti-vascular endothelial growth factor (VEGF) therapy, and the patient fulfils the recommendations of the National Institute for Health and Care Excellence (NICE) Technology Appraisal 301. The efficacy and safety of the ILUVIEN implant has been demonstrated in clinical studies, and a pre-planned subgroup analysis has shown that it is particularly beneficial in patients with chronic DMO. This case study is the first report in the UK of the effectiveness of the ILUVIEN implant in a patient in whom therapy with ranibizumab did not result in sustained improvements in terms of visual outcomes and foveal thickness.

Intravitreal ILUVIEN® Implant for Diabetic Macular Oedema – Early Case Experiences

2013 ◽  
Vol 07 (02) ◽  
pp. 122 ◽  
Author(s):  
Thomas Bertelmann ◽  
Anke Messerschmidt-Roth ◽  
◽  
Keyword(s):  
Macular Oedema ◽  
Vision Loss ◽  
Treatment Options ◽  
Diabetic Macular Oedema ◽  
Fluocinolone Acetonide ◽  
Comprehensive Treatment ◽  
Vascular Endothelial ◽  
Intravitreal Implant ◽  
Early Case ◽  
Endothelial Growth Factor

Diabetic macular oedema (DMO) is an important cause of vision loss and challenges remain in the treatment of this progressive disease. Corticosteroids provide a comprehensive treatment approach, lowering the concentration of inflammatory cytokines and growth factors such as vascular endothelial growth factor (VEGF). However, intravitreal injections are often short-lived and are associated with intraocular side effects. The ILUVIEN® intravitreal implant contains fluocinolone acetonide and is administered by injection into the vitreous cavity. Its efficacy and safety have been demonstrated in clinical studies, and a subgroup analysis has shown that it is particularly beneficial in patients with long-standing DMO – a group with poor visual outcomes and limited treatment options. As a result, the ILUVIEN implant has been approved in Europe for the treatment of visual impairment due to chronic DMO considered insufficiently responsive to available therapies. These data have been supported by real-use clinical experience and two cases are presented that demonstrate the effectiveness of the ILUVIEN implant in two patients where prior therapies including ranibizumab have not produced a sustained beneficial effect.

scholarly journals An Overview of Intravitreal Aflibercept in Diabetic Macular Oedema

2015 ◽  
Vol 09 (01) ◽  
pp. 37
Author(s):  
Jean-François Korobelnik ◽  
Sebastian Wolf ◽  
◽  
◽  
◽  
...  
Keyword(s):  
Macular Oedema ◽  
Vision Loss ◽  
Safety Data ◽  
Diabetic Macular Oedema ◽  
Intravitreal Bevacizumab ◽  
Standard Of Care ◽  
Intravitreal Ranibizumab ◽  
Intravitreal Aflibercept ◽  
Working Age

Diabetic macular oedema (DMO) is responsible for much of the vision loss associated with diabetic retinopathy, which is the leading cause of blindness in working-age adults. Approximately 21 million people worldwide have DMO. The standard of care for DMO has been laser photocoagulation: this option has only a limited ability to reverse vision loss and is associated with a risk of scarring and complications. Corticosteroids have also been used in DMO treatment, but are associated with side effects such as elevated intraocular pressure and cataract. Knowledge of the role of vascular endothelial growth factor (VEGF) in the pathogenesis of DMO has led to the widespread use of anti-VEGF agents. Intravitreal bevacizumab, which is not approved for any retinal disorders, is used off-label for the treatment of DMO. Intravitreal ranibizumab (IVT-AFL) (once monthly) and intravitreal aflibercept (once every 2 months after a loading dose) have been approved for the treatment of DMO. This review summarises the clinical evidence supporting the role of IVT-AFL in the treatment of DMO. Analysis of efficacy and safety data suggests that aflibercept could be used as a first-line treatment in DMO.

scholarly journals Hyperreflective foci in predicting the treatment outcomes of diabetic macular oedema after anti-vascular endothelial growth factor therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chu-Hsuan Huang ◽  
Chang-Hao Yang ◽  
Yi-Ting Hsieh ◽  
Chung-May Yang ◽  
Tzyy-Chang Ho ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Treatment Response ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Vascular Endothelial ◽  
Outer Retina ◽  
Hyperreflective Foci ◽  
Endothelial Growth Factor

AbstractThis retrospective study evaluated the association of hyperreflective foci (HRF) with treatment response in diabetic macular oedema (DME) after anti-vascular endothelial growth factor (VEGF) therapy. The medical records, including of ophthalmologic examinations and optical coherence tomography (OCT) images, of 106 patients with DME treated with either intravitreal ranibizumab or aflibercept were reviewed. The correlations between best-corrected visual acuity (BCVA) changes and HRF along with other OCT biomarkers were analysed. The mean logMAR BCVA improved from 0.696 to 0.461 after an average of 6.2 injections in 1 year under real-world conditions. Greater visual-acuity gain was noted in patients with a greater number of HRF in the outer retina at baseline (p = 0.037), along with other factors such as poor baseline vision (p < 0.001), absence of epiretinal membrane (p = 0.048), and presence of subretinal fluid at baseline (p = 0.001). The number of HRF after treatment was correlated with the presence of hard exudate (p < 0.001) and baseline haemoglobin A1C (p = 0.001). Patients with proliferative diabetic retinopathy had greater HRF reduction after treatment (p = 0.018). The number of HRF in the outer retina, in addition to other baseline OCT biomarkers, could be used to predict the treatment response in DME after anti-VEGF treatment.

Hyperreflective cystoid spaces in diabetic macular oedema: prevalence and clinical implications

2020 ◽  
pp. bjophthalmol-2020-317191
Author(s):  
Aude Couturier ◽  
Valerie Mane ◽  
Carlo Alessandro Lavia ◽  
Ramin Tadayoni
Keyword(s):  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Functional Improvement ◽  
Vascular Endothelial ◽  
Hard Exudates ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Endothelial Growth Factor

AimsTo analyse the prevalence and evolution of hyper-reflective cystoid spaces with decorrelation signal detected using optical coherence tomography angiography (OCTA) in diabetic macular oedema (DMO).MethodsA retrospective study of consecutive eyes with DMO imaged using OCTA over a 1-year period was conducted. All eyes with hyper-reflective cystoid spaces at baseline and at least 3 months of follow-up were included in a longitudinal analysis.ResultsThe prevalence of hyperreflective cystoid spaces with decorrelation signal was of 37% (61/165) in DMO eyes. Hyperreflective foci within hyperreflective cystoid spaces were observed in 85% of eyes. The longitudinal study included 33 eyes (10 observed and 23 treated with intravitreal anti-vascular endothelial growth factor), with a median follow-up of 15 months. The hyperreflective cystoid spaces resolved in 85% of eyes. The mean best-corrected visual acuity remained stable during the follow-up, even in the eyes achieving a resolution of the hyperreflective cystoid spaces. Hard exudates appeared in the area of resolved hyperreflective cystoid spaces in 33% of eyes.ConclusionHyperreflective cystoid spaces detected by OCTA affected more than one-third of the DMO eyes. Their disappearance was not associated with any functional improvement and led to the formation of new hard exudate deposits in about one-third of the eyes.

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