ABSTRACT
@#Anti-vascular endothelial growth factor(VEGF)drugs have been used to treat various ophthalmic diseases, especially in the treatment of vascular proliferative ophthalmopathy. Anti-VEGF drugs can significantly inhibit the formation of new blood vessels and reduce retinal edema, thereby improving the patient's vision. However, their long-term therapeutic effect and safety require longer-term follow-up and research. This article reviews the application and research progress of anti-VEGF drugs in ophthalmology and provides references for clinical application and further research.
ABSTRACT
@#AIM: To observe the effects of combined anti-VEGF therapy on neovascular glaucoma.<p>METHODS: A total of 62 patients(68 eyes)with neovascular glaucoma admitted to our hospital from February 2012 to October 2018 were retrospectively analyzed. Group A were given intravitreal injection of anti-VEGF drug(conbercept ophthalmic injection)0.05mL, and complex trabeculectomy was performed 1wk after injection, and total retinal laser photocoagulation was performed 3wk after injection. Cyclocryosurgery was performed in group B. Intraocular pressure(IOP), best corrected visual acuity(BCVA), axial length and postoperative complications of patients in two groups were observed before treatment and 2wk, 1mo, 3mo and 6mo after treatment. <p>RESULTS: The regression degree of iris neocescularization in group A was significantly better than that in group B. IOP at 2wk, 1mo, 3mo and 6mo after surgery in the two groups showed statistical differences(<i>P</i><0.05). There was a statistically significant difference in axial length 6mo after treatment(<i>P</i><0.05). The total effective rate was 94% in anti-VEGF group(group A)and 78% in cyclocryosurgery group(group B), the difference was not statistically significant(<i>P</i>=0.073).<p>CONCLUSION: It is safe and effective for the combined treatment of anti-VEGF drug, combined trabeculectomy and total retinal laser photocoagulation in the treatment of neovascularization glaucoma.
ABSTRACT
PURPOSE: A case of bilateral rhegmatogenous retinal detachment is reported after pazopanib treatment of a patient with breast angiosarcoma. CASE SUMMARY: A 53-year-old female presented with bleeding in a right breast mass prior to an emergency room visit. She was diagnosed with metastatic breast angiosarcoma after a breast mass biopsy. She was treated with paclitaxel and radiation therapy. Systemic pazopanib treatment was added to treat lung metastasis. After 3 weeks, she felt sudden floaters in her right eye. In her fundus examination, there was vitreous hemorrhage, but no retinal detachment was noted. Five weeks later, she visited the clinic for a bilateral temporal visual field defect. A fundus examination showed bilateral retinal detachments with superonasal retinal tears. Both the patient and her family did not want surgery for her systemic condition because of her terminal cancer. CONCLUSIONS: Retinal detachment has been reported as a rare complication after systemic pazopanib treatment, but there has been no previous report in the Republic of Korea, therefore this is the first case of bilateral retinal detachments after systemic pazopanib treatment.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Breast , Emergency Service, Hospital , Hemangiosarcoma , Hemorrhage , Lung , Neoplasm Metastasis , Paclitaxel , Republic of Korea , Retinal Detachment , Retinal Perforations , Retinaldehyde , Visual Fields , Vitreous HemorrhageABSTRACT
Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 40 and 59 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significantpublic health issue. The Early Treatment Diabetic Retinopathy Study (ETDRS) showed the benefit of focal/grid laser for the management of DME, reducing the risk of moderate visual loss by approximately 50%, and since then,macular photocoagulation (MPC) has been the gold standard treatment. Vascular endothelial growth factor (VEGF) is an important mediator of blood-retinalbarrier breakdown, which leads to fluid leakage and the development of macular edema. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an optionthat must be considered for the treatment of DME. The aim of this study to evaluate intravitreal bevacizumab and modified Early Treatment Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) in patients with clinically significant macular edema (CSME). Methods: In a1-year, single-center, randomized controlled trial, 70 patients with center-involving CSME were randomized to receive either bevacizumab or MLT. Result: The baseline mean ETDRS BCVA was 58.3±8.6 (range 38–71) in the bevacizumab group and 56.6±7.3 (range 37–69) in the laser group. The mean ETDRS BCVA at one year was 63.2±12.5 (range 41–80) in the bevacizumab group and53.0±8.3 (range 35–74) in the laser group (p=0.0004). At one year, central macular thickness decreased from 405±121 μm (range 275–715 μm) at baseline to 247±141 μm (range 178±541 μm) in the bevacizumab group and in the laser group from 392±137 μm (range 284–741 μm) to 318±129 μm (range 165–615 μm) (p=0.05). Conclusioni: The study provides evidence to support the use of bevacizumab in patients with center involving CSME without advanced macular ischemia.
ABSTRACT
PURPOSE: To evaluate the long-term clinical outcomes of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration (AMD). METHODS: The authors performed a retrospective chart review of 13 eyes of 13 patients who developed RPE tears after intravitreal anti-VEGF injection between February 2009 and June 2013. We investigated continuation of the treatment after tear, visual acuity, presence of cystoid macular edema, and central macular thickness (CMT) using optical coherence tomography (OCT) before and after treatment and visual outcomes depending on foveal sparing. RESULTS: After RPE tear, 12 of 13 patients continued injection of an anti-VEGF agent. The average number of injections was 6.08 +/- 5.18. Mean visual acuity immediately after tear was 1.65 +/- 0.8 log MAR, and that at the last visit was 1.82 +/- 0.88 log MAR. Nine eyes with macular edema in OCT continued receiving injection, and improvement of macular edema was observed in four eyes at the final visit. The final visual acuity of patients with foveal involvement was 2.17 +/- 0.49 log MAR, which was worse than the 1.51 +/- 1.06 log MAR in patients without foveal involvement, although the difference was not significant (p = 0.295). CONCLUSIONS: When anti-VEGF injections were continued after RPE tear, no improvement in visual acuity was observed, although better anatomical outcomes did result. Patients with foveal involvement had worse visual acuity than patients without foveal involvement, but the difference was not significant.