scholarly journals Management of Cataract in Patients with Age-Related Macular Degeneration

2021 ◽  
Vol 10 (12) ◽  
pp. 2538
Author(s):  
Hemal Mehta
Keyword(s):  
Cataract Surgery ◽  
Macular Degeneration ◽  
Light Exposure ◽  
Intraoperative Complications ◽  
Visual Outcome ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Real World Data ◽  
Intravitreal Therapy ◽  
Age Related

Cataract and age-related macular degeneration (AMD) are two of the most common eye diseases of aging. This review addresses the pre-operative, intra-operative, and post-operative considerations in managing cataract in patients with age-related macular degeneration. Surgery for visually significant cataracts in patients with AMD can substantially improve the quality of life and reduce the risk of falls. Pre-operative optical coherence tomography is now recommended where possible to identify pre-existing macula disease. Careful counselling of patients is required before cataract surgery, especially with respect to the expected visual outcome, intraocular lens choice and potential risks of surgery. Real-world data has suggested 6 months of intravitreal anti-VEGF therapy for neovascular AMD before cataract surgery is compatible with optimum long-term visual outcomes. Patients receiving intravitreal therapy for neovascular AMD should be advised of the slightly higher risk of intraoperative complications and the surgeon should be prepared to manage these during the operation. During cataract surgery, unnecessary light exposure should be avoided to reduce phototoxicity. Careful planning of intravitreal therapy for neovascular AMD just before cataract surgery allows the eye greater recovery time in the post-operative period before further planned intravitreal therapy.

scholarly journals Limited Treatment Response during Follow-up after Switching to Aflibercept in Neovascular Age-related Macular Degeneration

2021 ◽  
Vol 62 (9) ◽  
pp. 1218-1226
Author(s):  
Gon Soo Choe ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Macular Degeneration ◽  
Treatment Response ◽  
Visual Outcome ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Age Related ◽  
The Mean

Purpose: To investigate the limited response to aflibercept after switching to aflibercept in neovascular age-related macular degeneration (AMD). Methods: This retrospective study included 70 eyes with neovascular AMD that were initially treated with ranibizumab and then switched to aflibercept. The incidence and timing of the limited response to aflibercept were identified and visual outcome was compared between eyes with and without limited response. In addition, factors predictive of limited response were analyzed. Results: A limited response to aflibercept was noted in approximately 1/5 of the patients who underwent switching to aflibercept in neovascular AMD. Switching to aflibercept was performed at a mean of 16.2 ± 12.7 months after diagnosis. During the mean 34.7 months of follow-up after switching, limited response was noted in 15 eyes (21.4%) at a mean of 22.0 ± 13.9 months after switching. The degree of reduction in visual acuity was mean logMAR 0.34 ± 0.41 in eyes with limited response and mean 0.06 ± 0.20 in eyes without (p = 0.002). In addition, the duration between the diagnosis and the switching was shorter (p = 0.012), and the number of ranibizumab injections before switching was lower (p = 0.016) in eyes with limited response than in eyes without. Conclusions: Patients who showed limited response to aflibercept after switching to aflibercept showed a worse visual outcome. The probability of having a limited response is higher when the switching is performed earlier.

Full‐field Electroretinography in Age‐related Macular Degeneration: can retinal electrophysiology predict the subjective visual outcome of cataract surgery?

2020 ◽  
Vol 98 (7) ◽  
pp. 693-700
Author(s):  
Thomas Richard Johansen Forshaw ◽  
Hassan Javed Ahmed ◽  
Troels Wesenberg Kjær ◽  
Sten Andréasson ◽  
Torben Lykke Sørensen
Keyword(s):  
Cataract Surgery ◽  
Macular Degeneration ◽  
Visual Outcome ◽  
Age Related Macular Degeneration ◽  
Full Field ◽  
Age Related

scholarly journals The role of future treatments in the management of neovascular age-related macular degeneration in Europe

2021 ◽  
pp. 112067212110183
Author(s):  
Laurent Kodjikian ◽  
Carl Joe Mehanna ◽  
Salomon-Yves Cohen ◽  
François Devin ◽  
Sam Razavi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Phase Iii ◽  
Vascular Endothelial ◽  
Real World Data ◽  
Phase Iii Clinical Trials ◽  
Age Related ◽  
Injection Frequency ◽  
Endothelial Growth Factor

Anti-vascular endothelial growth factor (VEGF) agents have transformed the management of patients with neovascular age-related macular degeneration (nAMD) over the past two decades. However, as more long-term real-world data become available, it is clear that treatment outcomes are inferior to those reported in large, controlled clinical trials. This is largely driven by undertreatment, that is, not maintaining a consistent injection frequency to achieve sustained VEGF suppression, whether due to patient non-compliance, an important injection burden, or non/incomplete anatomical response. Newer therapeutic advances under evaluation hold promise in achieving more, for less. We review the latest drugs currently in or having successfully finished phase III clinical trials, and determine their potential place in the management of patients with nAMD in Europe.

Cataract surgery in patients with age-related macular degeneration

2003 ◽  
Vol 29 (4) ◽  
pp. 686-693 ◽  
Author(s):  
Ana Maria Armbrecht ◽  
Catherine Findlay ◽  
Peter Alan Aspinall ◽  
Adrian Robert Hill ◽  
Baljean Dhillon
Keyword(s):  
Cataract Surgery ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Age Related

scholarly journals Long-term Use of Aspirin and Age-related Macular Degeneration

2013 ◽  
Vol 06 (02) ◽  
pp. 144 ◽  
Author(s):  
William G Christen ◽  
Emily Y Chew ◽  
◽  
Keyword(s):  
Macular Degeneration ◽  
Observational Studies ◽  
Randomized Trials ◽  
Epidemiologic Studies ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Age Related ◽  
The Us ◽  
Regular Aspirin

Recent findings from observational epidemiologic studies have raised concern about a possible adverse effect of regular aspirin use in age-related macular degeneration (AMD), and in particular neovascular AMD, which is the leading cause of severe irreversible blindness in the US. In this report, we consider these findings in light of the relative strengths and limitations of observational studies and randomized trials. While the findings are important and warrant further investigation, the inherent limitations of observation studies, most notably uncontrolled confounding, preclude an interpretation of causality. Alternatively, the most reliable evidence with which to evaluate the effects of regular aspirin use in AMD will derive from well-designed randomized trials of sufficient size and duration.

scholarly journals Drusen and pigment abnormality predict the development of neovascular age-related macular degeneration in Japanese patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255213
Author(s):  
Shoji Notomi ◽  
Satomi Shiose ◽  
Keijiro Ishikawa ◽  
Yosuke Fukuda ◽  
Kumiko Kano ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Japanese Patients ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Fellow Eye ◽  
Factors Associated ◽  
Asian Populations ◽  
Age Related ◽  
The Mean

Drusen are known to be the important hallmark to predict the development of age-related macular degeneration (AMD). The prevalence of drusen is lower in Asians compared with Caucasians so that the role of signs constituting early AMD is not well established in Asian populations as in Western countries. In this study, we retrospectively investigated clinical characteristics and 5-year incidence of neovascular AMD (nAMD) in the fellow eye of unilateral nAMD patients. Of 296 consecutive unilateral nAMD patients who had been followed up more than 5 years, 170 typical AMD, 119 polypoidal choroidal vasculopathy, and 7 retinal angiomatous proliferation were included. To examine factors associated with nAMD occurrence in the fellow eye, drusen and pigmentary abnormality in the fellow eye were classified into 4 categories; Category 1: no or small drusen < 63 μm (37.2%), Category 2: 63–125 μm medium drusen or pigmentary abnormality (22.2%), Category 3: large drusen > 125 μm (25.0%), Category P: pachydrusen (15.5%). The mean sub-foveal choroidal thickness (SFCT) was Category 1: 276 μm, Category 2: 308 μm, Category 3: 246 μm, and Category P: 302 μm, respectively. Of note, SFCT in Category 2 and Category P was significantly larger than those of Category 3. Finally, the 5-year incidence of nAMD in the fellow eye was 32/296 (10.8%); Category 1: 0/110 (0%), Category 2: 12/66 (18.2%), Category 3: 20/74 (27.0%), and Category P: 0/46 (0%). Thus, signs of intermediate AMD (large drusen) as well as those of early AMD, especially the pigmentary abnormality, may contribute to development of bilateral nAMD in Japanese patients.

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