Sustained-Release Microspheres of Rivoceranib for the Treatment of Subfoveal Choroidal Neovascularization

The wet type of age-related macular degeneration (AMD) accompanies the subfoveal choroidal neovascularization (CNV) caused by the abnormal extension or remodeling of blood vessels to the macula and retinal pigment epithelium (RPE). Vascular endothelial growth factor (VEGF) is known to play a crucial role in the pathogenesis of the disease. In this study, we tried to repurpose an investigational anticancer drug, rivoceranib, which is a selective inhibitor of VEGF receptor-2 (VEGFR2), and evaluate the therapeutic potential of the drug for the treatment of wet-type AMD in a laser-induced CNV mouse model using microsphere-based sustained drug release formulations. The PLGA-based rivoceranib microsphere can carry out a sustained delivery of rivoceranib for 50 days. When administered intravitreally, the sustained microsphere formulation of rivoceranib effectively inhibited the formation of subfoveal neovascular lesions in mice.

Electrophysiological study after ranibizumab in choroidal neovascularizat

Purpose: To study the effects of intra-vitreal injection of ranibizumab on pattern electroretinogram (PERG) and multifocal electroretinogram(MF-ERG) parameters in choroidal neovascularization and to test the retinal toxicity of ranibizumab. Method: Fifty eyes of 50 patients with subfoveal choroidal neovascularization were included in the study. Thirty (30) eyes had neovascular age related macular degeneration (nAMD) and 20 eyes had myopic choroidal neovascularization. Ranibizumab was injected intravitreal monthly for3 months. Optical Coherence Tomography Angiography (OCT) was performed at the initial and final visits. Visual acuity, Pattern and multifocal electroretinography (PERG, MFERG) were performed before and at 1,2,3,6 months after intravitreal injection. Results: There was no clinical significant reduction of parameters of either MFERG or PERG after intravitreal injection of ranibizumab. There was significant increase in visual acuity, decrease in central macular thickness ,decrease in total macular volume and improvement in the parameters of both PERG and MFERG after intravitreal injection. Conclusion: Intravitreal injection of ranibizumab is effective in treatment CNV and safe. It has no retinal toxicity since no reduction in PERG& MFERG parameters. Keywords: AMD; Ranibizumab; PERG; MFERG

Photodynamic Therapy of Subfoveal Choroidal Neovascularization in Age-Related Macular Degeneration with Verteporfin

In this chapter, report 1 of the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study details the one-year results of two double-masked, placebo-controlled, randomized clinical trials to determine whether photodynamic treatment with verteporfin reduces the risk of vision loss in patients with age-related macular degeneration (AMD) due to subfoveal choroidal neovascularization (CNV) measuring 5400 µm or less in greatest linear dimension with evidence of classic CNV and best-corrected visual acuity of approximately 20/40 to 20/200. At the month-12 examination, 61% of eyes assigned to verteporfin compared with 46% of eyes assigned to placebo had lost fewer than 15 letters of visual acuity from baseline). Verteporfin therapy was found to be safe and effective in reducing the risk of vision loss, and the authors recommended verteporfin therapy for treatment of patients with predominantly classic CNV from AMD.

Optical Coherence Tomography Angiography Detects Choriocapillaris Loss in Decalcification of Choroidal Osteoma

Purpose: Choroidal osteoma, which typically affects young women, is a benign intraocular tumor composed of mature bone within the choroid. Tumor decalcification and subfoveal choroidal neovascularization often lead to poor visual acuity although the etiology is unknown. Choriocapillaris characteristics in choroidal osteoma also are unknown. Methods: We report 4 cases of choroidal osteoma with decalcification in which the choriocapillaris could be imaged by optical coherence tomography angiography (OCTA). Results: OCTA showed that the choriocapillaris structure was maintained in the calcified portion, whereas a loss occurred in parts of the decalcified portion in all cases. Conclusions: OCTA may be useful for understanding the pathological states of choroidal osteoma.

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA) or spectral-domain optical coherence tomography (SD-OCT) at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA). OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.