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1.
Malaysian Journal of Medicine and Health Sciences ; : 144-150, 2022.
Article in English | WPRIM | ID: wpr-987175

ABSTRACT

@#Introduction: Anti-vascular endothelial growth factors (anti-VEGF) intravitreal injection is one of the popular procedures for medical retina diseases. However, the incidence of angle-closure post intravitreal injection was reported. Several similar studies were conducted previously, but the results were inconsistent and mostly focused on bevacizumab. Methods: A prospective cohort study was conducted. After informed consent, patients who were more than 17 years old and received the first intravitreal anti-VEGF injections (ranibizumab or aflibercept) were recruited. Exclusion criteria included patients with underlying glaucoma, ocular hypertension, intumescence cataract, high refractive error or those with history of intraocular operation or ocular trauma. Pre- and post-injection’s intraocular pressure (IOP) and ocular biometry included “central anterior chamber depth” (CACD), “angle opening distance” (AOD500), and “trabeculo-iris angle” (TIA500) at nasal and temporal 500 µm away the scleral spur were acquired and analyzed. Results: 72 eyes from 66 patients were studied. Mean (SD) increment of IOP following injection within 30 minutes and 1 hour were 6.16 (0.68) mmHg (p<0.001) and 1.26 (0.35) mmHg (p=0.002) respectively. Mean (SD) differences of temporal TIA500 between pre with within 30 minutes and 1-hour post-injection were 1.66 (0.66) degrees (p=0.04) and 1.45 (0.57) degrees (p=0.04) respectively. No significant relationship between the changes of IOP and ocular biometry was found. Conclusion: A single dose of anti-VEGF in a normal population is relatively safe. However, concern on the risk of glaucoma progression and acute angle-closure still needs to be addressed. Further studies on at-risk populations and repeated injections are useful.

2.
Rev. bras. oftalmol ; 80(4): e0026, 2021. graf
Article in English | LILACS | ID: biblio-1288636

ABSTRACT

ABSTRACT A 10-year-old Malay girl with underlying HbE/beta-thalassemia, on regular blood transfusion and deferoxamine iron chelation therapy, presented with two-month history of bilateral blurring of vision. On examination, her vision was 6/36 both eyes. Other optic nerve functions were normal. Anterior segment examination of both eyes was unremarkable. Fundus examination of both eyes revealed dull foveal reflex. Optical coherence tomography of both maculae showed increased central subfield thickness. Fundus fluorescence angiography showed patchy hypofluorescence over macular region for both eyes and late staining, indicating retinal pigment epithelium anomalies. A diagnosis of iron-chelation-therapy-related bilateral maculopathy was made. Patient was co-managed with pediatric hematology team to adjust the dose of deferoxamine, and was given three monthly appointments to monitor the progression of maculopathy at the ophthalmology clinic. However patient defaulted ophthalmology follow-up after the first visit.


RESUMO Uma menina malaia de 10 anos de idade com doença de base- B/beta-talassemia, em transfusão de sangue regular e terapia quelante de ferro deferoxamina, apresentou história de dois meses de visão turva bilateral. Ao exame, sua visão era de 6/36 em ambos os olhos. Outras funções do nervo óptico estavam normais. O exame do segmento anterior de ambos os olhos foi normal. Exame do fundo de ambos os olhos revelou reflexo foveal opaco. A tomografia de coerência óptica de ambas as máculas mostrou aumento da espessura do subcampo central. A angiografia de fluorescência do fundo mostrou hipofluorescência irregular sobre a região macular de ambos os olhos e coloração tardia, indicando anomalias de epitélio pigmentar da retina. Um diagnóstico de maculopatia bilateral relacionada à terapia quelante de ferro foi feito. A paciente foi avaliada em conjunto com a equipe de hematologia pediátrica para ajustar a dose de deferoxamina, e foram oferecidas três consultas mensais na clínica oftalmológica, para monitorar a progressão da maculopatia. No entanto, ela não compareceu para acompanhamento oftalmológico após a primeira visita.


Subject(s)
Humans , Female , Child , Siderophores/adverse effects , beta-Thalassemia/drug therapy , Deferoxamine/adverse effects , Transfusion Reaction , Macular Degeneration/complications , Blood Transfusion , Siderophores/therapeutic use , beta-Thalassemia/diagnosis , Deferoxamine/therapeutic use
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