scholarly journals Avaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia Patológica

2014 ◽  
Vol 27 (1) ◽  
pp. 49 ◽  
Author(s):  
Beatriz Carvalho ◽  
Paulo Freitas-Costa ◽  
João Pinheiro-Costa ◽  
Manuel Falcão ◽  
Ângela Carneiro ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Vision Loss ◽  
Long Term Results ◽  
Myopic Choroidal Neovascularization ◽  
Corrected Visual Acuity ◽  
Foveal Center ◽  
Best Corrected Visual Acuity

<strong>Introduction:</strong> Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes.<br /><strong>Material and Methods:</strong> In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment.<br />Results: The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p &lt; 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9μm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p &lt; 0.001).<br /><strong>Discussion/Conclusion:</strong> Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.

Comparison of structural and functional outcome of aflibercept versus ranibizumab in patients with myopic choroidal neovascularization

2019 ◽  
pp. 112067211988359
Author(s):  
Ahmed Howaidy ◽  
Zeiad H Eldaly
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Retinal Thickness ◽  
Secondary Outcome ◽  
Final Visit ◽  
Myopic Choroidal Neovascularization ◽  
Corrected Visual Acuity ◽  
Group A ◽  
Group B ◽  
Best Corrected Visual Acuity

Purpose: To compare visual functional improvement and retinal structural changes of aflibercept versus ranibizumab for the management of treatment-naïve choroidal neovascularization related to pathological myopia. Patients and methods: A prospective randomized study included patients suffering from myopic choroidal neovascularization. Patients received three intravitreal injections of aflibercept (2 mg) or ranibizumab (0.5 mg) in 1:1 ratio every 4 weeks. Ophthalmic evaluation and optical coherence tomography were performed at baseline, 1, 2, and 3 months after last injection. Primary outcome measure was the visual acuity change from baseline to month 3 after injection. Secondary outcome measures included change in retinal thickness and the relation of morphological and functional changes to baseline assessment parameters. Results: A total of 48 myopic patients (48 eyes) suffering from myopic choroidal neovascularization were randomly assigned to receive either aflibercept (Group A) or ranibizumab (Group B). In Group A, best-corrected visual acuity significantly improved from 0.53 ± 0.10 logMAR to 0.38 ± 0.11 logMAR, at 3 months, and from 0.55 ± 0.11 logMAR to 0.39 ± 0.12 logMAR in Group B. Whereas, retinal thickness reduced from 317.7 ± 53.6 µm to 164.5 ± 81.9 µm in Group A, and from 321.1 ± 98.8 µm at baseline to 178.9 ± 64.5 µm in Group B at month 3. Changes in best-corrected visual acuity and central macular thickness were statistically insignificant between the two groups at final visit. Conclusion: Both aflibercept and ranibizumab provided a significant improvement in visual acuity and retinal thickness in patients with myopic choroidal neovascularization. Comparable functional and architectural results were achieved by both treatment modalities.

Anti-VEGF-Therapie bei myopischer choroidaler Neovaskularisation: Langzeitergebnisse

2015 ◽  
Vol 1 (1) ◽  
pp. 38-39
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Myopic Choroidal Neovascularization ◽  
Retrospektive Analyse ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Best Corrected Visual Acuity

Ziel: Beurteilung der mittel- und langfristigen Wirksamkeit von Anti-VEGF-Wirkstoffen in der Behandlung der choroidalen Neovaskularisation infolge einer pathologischen Myopie (myopic choroidal neovascularization; mCNV).Methoden: Retrospektive Analyse von mCNV-Patienten, die 2 Jahre oder länger mit einer intravitrealen Anti-VEGF-Therapie behandelt worden waren. Wir verglichen die Sehschärfe mit bester Korrektur (best-corrected visual acuity; BCVA) sowie die zentrale Netzhaut-Dicke (central retinal thickness; CRT) vor und nach der Behandlung. Die Anzahl der Injektionen pro Jahr wurde ebenfalls erfasst.Ergebnisse: Auswertungen der Ergebnisse erfolgten nach 2 Jahren für 67 Augen, nach 3 Jahren für 52 Augen, nach 4 Jahren für 28 Augen und nach 5 Jahren für 13 Augen. Die mittlere Veränderung der BCVA gegenüber dem Ausgangswert war nach 2 Jahren signifikant (+8,6 Buchstaben; p < 0,001); diese Verbesserung blieb über einen Zeitraum von 5 Jahren signifikant stabil bestehen. Die mittlere CRT nahm im Verlauf signifikant ab; der Tiefstwert war nach 2 Jahren erreicht (-104,0 μm; p < 0,001). Die mittlere Anzahl der Injektionen betrug im 1. Jahr 5,2 und ging in den nachfolgenden Jahren zurück (p < 0,001).Schlussfolgerung: In der hier beschriebenen Untergruppe von mCNV-Patienten war die intravitreale Anti-VEGF-Therapie über einen Zeitraum von 5 Jahren wirksam, wobei sich der BCVA-Wert fortwährend erhöhte.Übersetzung aus Ophthalmologica 2014;232:57-63 (DOI: 10.1159/000360307)

Intravitreal aflibercept for management of choroidal neovascularization secondary to angioid streaks

2020 ◽  
pp. 112067212092830
Author(s):  
Maurizio Battaglia Parodi ◽  
Maria Vittoria Cicinelli ◽  
Alessandro Marchese ◽  
Chiara Giuffrè ◽  
Francesco Viola ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Choroidal Neovascularization ◽  
Central Macular Thickness ◽  
Angioid Streaks ◽  
Serious Adverse Events ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Best Corrected Visual Acuity

Purpose To investigate the effect and the safety of intravitreal aflibercept in patients affected by choroidal neovascularization secondary to angioid streaks with a long-term follow-up. Methods Multicentre, open-label, phase IIb study (EYLEA-STRIE, EudraCT Number 2014-000986-30) involving four Italian centres (IRCCS Ospedale San Raffaele (Milano), Fondazione G.B. Bietti (Roma), Policlinico (Milano), Ospedale Luigi Sacco (Milano)). Patients with active choroidal neovascularization secondary to angioid streaks with foveal involvement were prospectively enrolled and followed for 18 months. All the patients received intravitreal 2 mg/0.05 mL aflibercept at the time of enrolment, followed by a pro-re-nata regimen for 48 weeks. Best-corrected visual acuity and central macular thickness were measured monthly. Adverse events were monitored at each visit. Results Twenty-three eyes of 20 patients were analysed. Mean number of injections per patient was 4.30 ± 1.2. At week 48, the best-corrected visual acuity was 0.42 ± 0.40 LogMAR (p = 0.6 from baseline) and 18 eyes (81.8%) featured stability within 15 letters. The central macular thickness significantly reduced (p = 0.03). Eleven ocular non-serious adverse events and two serious adverse events were observed (one case of endophthalmitis and one case of acute gastritis were reported). Conclusion Intravitreal aflibercept represents a valid option for the management of choroidal neovascularization complicating angioid streaks. Further studies with longer follow-up and different therapeutic regimens are warranted to ascertain the best control of the disease.

Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab

2018 ◽  
Vol 29 (2) ◽  
pp. 239-243
Author(s):  
Gilda Cennamo ◽  
Francesca Amoroso ◽  
Stefano Schiemer ◽  
Nunzio Velotti ◽  
Mariacristina Alfieri ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. Methods: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. Results: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = –2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = –1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = –3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). Conclusion: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.

scholarly journals Long-term efficacy and safety after corneal collagen crosslinking in pediatric patients: Three-year follow-up

2018 ◽  
Vol 28 (4) ◽  
pp. 415-418 ◽  
Author(s):  
Maria A Henriquez ◽  
Sandra Villegas ◽  
Mirel Rincon ◽  
Carmen Maldonado ◽  
Luis Izquierdo
Keyword(s):  
Visual Acuity ◽  
Progression Rate ◽  
Collagen Crosslinking ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
Best Corrected Visual Acuity ◽  
Corneal Collagen

Purpose: To evaluate the effectiveness of standard corneal collagen crosslinking for children with progressive keratoconus. Methods: Prospective study including 26 eyes of 26 patients younger than 18 years old with progressive keratoconus at Oftalmosalud Instituto de Ojos, Lima, Peru. Standard epi-off corneal crosslinking was performed in all eyes between January 2012 and January 2013. Pre- and postoperative evaluation (at 3 years) included uncorrected and best-corrected visual acuity and Scheimpflug analysis. Crosslinking failure was defined as an increase in maximum keratometry (Kmax) of more than 1 diopter after 1 year or more. Results: Mean uncorrected visual acuity improvement was 0.24 LogMAR (p = 0.07) and mean best-corrected visual acuity improvement was 0.18 LogMAR (p = 0.01). None of the eyes lost more than one line in the best-corrected visual acuity. Four eyes (15.38%) lost two lines in the uncorrected visual acuity at 3 years postoperative. Mean steeper keratometry improvement was 1.14 diopters (p = 0.60). Progression rate was 23.07%. Conclusion: Standard epi-off corneal collagen crosslinking is safe and effective to halt the progression of the keratoconus with significant improvement in the best-corrected visual acuity at 3-year follow-up.

Intravitreal Bevacizumab (Avastin) as Primary Treatment for Myopic Choroidal Neovascularization

2007 ◽  
Vol 17 (4) ◽  
pp. 620-626 ◽  
Author(s):  
S. Mandal ◽  
P. Venkatesh ◽  
R. Sampangi ◽  
S. Garg
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Intravitreal Bevacizumab ◽  
Efficacy And Safety ◽  
Short Term ◽  
Myopic Choroidal Neovascularization ◽  
Term Efficacy ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Best Corrected Visual Acuity

Purpose To evaluate the short-term efficacy and safety of intravitreal bevacizumab in myopic choroidal neovascularization (mCNV). Methods In this noncomparative, consecutive, interventional case series, 12 eyes of 11 patients with mCNV without any previous treatment were included. Patients received intravitreal bevacizumab (1.25 mg/0.05 mL) at baseline and at 4 weeks interval, if optical coherence tomography (OCT) showed presence of intraretinal edema, subretinal fluid, and/or pigment epithelial detachment. Patients were followed up for a minimum of 6 months and changes in best-corrected visual acuity, central macular thickness (CMT) on OCT, angiographic characteristics, and complications were assessed. Results The mean refractive error was −11.25 diopters. At 6 months the mean best-corrected visual acuity (BCVA) improved from 20/235 (median 20/235) to 20/71 (median 20/80) (p=0.01). The mean CMT was reduced from 403 μm (median 365 μm) to 229 μm (median 239 μm) (p=0.002). At final visit 9 eyes (75%) had an improvement of BCVA of three lines or more, and only 1 eye (8%) lost two lines. No significant ocular or untoward systemic side effects were observed. Conclusions In this small series short-term results suggest that intravitreal bevacizumab (1.25 mg/0.05 mL) is safe, effective, and well tolerated in patients with choroidal neovascularization due to high myopia. Further evaluation in large series with longer follow-up is needed to confirm long-term efficacy and safety in such cases.

scholarly journals Factors determining the compliance of patients receiving anti-VEGF therapy for macular diseases with long-term follow-up in real-life practice

2021 ◽  
Vol 14 (1) ◽  
pp. 21-29
Author(s):  
E. V. Bobykin ◽  
V. Y. Krokhalev ◽  
R. V. Buslaev ◽  
O. V. Morozova
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Choroidal Neovascularization ◽  
Final Visual Acuity ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
Macular Diseases ◽  
Long Term Follow Up

Purpose: to identify statistically significant factors that determine adherence to long-term follow-up on the part of patients receiving anti-VEGF therapy for macular diseases.Material and methods. A retrospective analysis was performed on 247 patients (153 women, 94 men) aged 24 to 92 years treated with anti-VEGF for “wet” age-related macular degeneration (n = 164), diabetic macular edema (n = 18), macular edema due to retinal vein occlusion (n = 35) and myopic choroidal neovascularization (n = 30). Demographic data and treatment results were statistically analyzed with the STATISTICA 13.3 program (normal conditions for variables, non-parametric and parametric criteria were determined).Results. Follow-up duration was shown to depend on gender (women are more committed to long-term treatment, p < 0.05), diagnosis (the longest follow-up related to myopic choroidal neovascularization patients), initial and final visual acuity. The comparison of subgroups of patients with the longest (over 30 months, n = 56) and shortest (till 12 months, n = 92) follow-up showed that prolonged monitoring corresponds to higher values of the initial (p < 0.01) and final (p < 0.05) visual acuity, as well as a lower average number of injections over the entire follow-up (p < 0.001) and a younger age of patients (p = 0.02).Conclusion. The follow-up duration depends on gender and age, the intensity of treatment, as well as on the initial and final visual acuity at a significance level of ˂ 0.05. Also, the follow-up duration depends on the particular diagnosis. An indicator clearly reflecting the severity of the burden of treatment is proposed: the coefficient of therapy intensity which is inversely related to the patient’s adherence to therapy.

scholarly journals Patológiás myopia talaján kialakult érújdonképződés intravitrealis ranibizumabkezelése

2017 ◽  
Vol 158 (15) ◽  
pp. 579-586
Author(s):  
Regina Lukács ◽  
Gábor Sándor ◽  
Miklós Resch ◽  
Antal Szabó ◽  
György Barcsay ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Vision Loss ◽  
Pathological Myopia ◽  
Intravitreal Ranibizumab ◽  
Myopic Choroidal Neovascularization ◽  
Working Age ◽  
Patients Experience ◽  
Number Of Injections

Abstract: Introduction: Pathological myopia is one of the leading causes of vision loss worldwide, especially among young people of working age. Choroidal neovascularization is one of the most important cause of visual impairment in pathological myopia. Aim: To evaluate the efficacy of intravitreal ranibizumab for the treatment of myopic choroidal neovascularization. Method: In this retrospective analysis 14 eyes of 14 patients (mean age: 61 ± 17 years) with myopic choroidal neovascularization were treated with intravitreal ranibizumab as needed. Best-corrected visual acuity, thickness of choroidal neovascularization lesion and the number of injections were assessed. Results: The mean visual acuity changed from 55.8 ± 19.3 letters to 64.8 + 15.5 at 12 months (p = 0.0414), and 62.6 ± 16.3 during follow-up time (p = 0.2896). Mean follow-up time was 19.7 ± 23.9 months, average number of injections was 2.8 ± 2.1. Visual acuity declined in four patients despite the treatment. Conclusions: Intravitreal ranibizumab is an effective therapy in pathological myopia. Some patients experience deterioration of visual acuity despite of treatment. Orv. Hetil., 2017, 158(15), 579–586.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

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