Treatment for neovascular glaucoma with Ranibizumab and trabeculectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the curative effect of intravitreal injection of ranibizumab combined with trabeculectomy on neovascular glaucoma(NVG).<p>METHODS: The clinical data of 52 patients(52 affected eyes)with NVG who were admitted to the hospital between September 2015 and April 2017 were collected and retrospectively analyzed. The patients were divided into group A(intravitreal injection of ranibizumab combined with trabeculectomy, 31 affected eyes)and group B(intravitreal injection of ranibizumab combined with Ahmed glaucoma valve implantation, 21 affected eyes)according to the surgical method. They were followed up for 6mo after surgery. The intraocular pressure before surgery and after surgery, eyesight, visual field and complications after surgery were compared between two groups. The clinical curative effect was assessed. <p>RESULTS: The intraocular pressure of both groups decreased gradually after surgery. The intraocular pressure of group A was lower than that of group B at 7d, 1mo and 3mo after surgery(<i>P</i><0.05). There was no significant difference in the improvement of eyesight between the two groups at 6mo after surgery(<i>P</i>>0.05). The total effective rate of treatment in group A at 6mo after surgery was obviously higher than that in group B(97% <i>vs</i> 71%, <i>P</i>=0.013). The incidence rates of corneal edema and hyphema in group A were lower than those in group B(<i>P</i><0.05).<p>CONCLUSION: Intravitreal injection of ranibizumab combined with trabeculectomy for treating NVG can effectively decrease and maintain intraocular pressure and reduce the incidence of postoperative complications, with marked curative effect.

Intravitreal Ranibizumab Injection in Adult-onset Coats' Disease: A Case Report

PURPOSE: To report a case of adult-onset Coats' disease which showed decreased retinal edema and improved visual acuity following intravitreal ranibizumab injection. CASE SUMMARY: A 21-year-old woman visited our hospital for decreased visual acuity in left eye from 3 months ago. Her best corrected visual acuity was 1.0 in the right eye, and 0.4 in the left eye. The intraocular pressure was 19 mmHg in the right eye and 16 mmHg in the left eye. At anterior segment examination, no abnormal findings were found. On fundus examination, subretinal exudates, superior retinal edema at posterior pole, and telangiectasia along superortemporal vascular arcade were observed in the left eye. Upon diagnosis as Coats' disease, intravitreal ranibizumab was performed, and laser photocoagulation was done around the retinal telangiectasia and nonperfusion area. Then, the second and third intravitreal ranibizumab injections were performed by a month, and her best visual acuity was improved to 0.8 and optical coherence tomography revealed decreased retinal edema. CONCLUSIONS: We report a case of adult-onset Coats' disease. Intravitreal ranibizumab injection is effective in rapid visual improvement and decrease of retinal edema as combination therapy with laser photocoagulation which was a generalized treatment of choice in Coats' disease.

Comparison of Choroidal Hyperpermeability Change after Photodynamic Therapy and Ranibizumab for Chronic Central Serous Chorioretinopathy

PURPOSE: To compare changes in choroidal hyperpermeability after half-energy photodynamic therapy (PDT) and intravitreal ranibizumab in the treatment of chronic central serous chorioretinopathy (CSC). METHODS: Post-hoc analysis was performed in a randomized, controlled trial comparing half-energy PDT versus intravitreal ranibizumab for chronic CSC; during the experiments, the other treatment was available for salvage treatment if the original was unsuccessful at 3 months. A commercially available image analysis program (Adobe(R) Photoshop(R) CS6 [Adobe Systems, Inc., San Jose, CA]) was used for quantification of change in choriodal hyperpermeability on indocyanine green angiography after half-energy PDT or three consecutive intravitreal injections of ranibizumab. Post-treatment images were subtracted from pre-treatment images after adjustments were made to create images depicting the change in choroidal hyperpermeability with treatment. Integrated gray scale values per area in this image were used for analysis of change in choroidal hyperpermeability. RESULTS: The calculated change in choroidal hyperpermeability was significantly greater in the half-energy PDT group (17.36 +/- 8.74) than in the ranibizumab group (6.78 +/- 5.03) (p < 0.001). All eyes in the half-energy PDT group showed complete resolution of subretinal fluid, and no significant difference in change of choroidal hyperpermeability was found in eyes that received half-energy PDT as primary or salvage treatment. In the ranibizumab-treated group, subretinal fluid resolution was accomplished in 5 eyes, and these eyes showed a significantly larger decrease in choroidal hyperpermeability when compared with eyes showing poor response (10.31 +/- 4.00 vs. 2.74 +/- 2.16, p = 0.005). In the successfully treated eyes with ranibizumab, there was no significant difference in choroidal hypopermeability change when compared to half-energy PDT (p = 0.124). CONCLUSIONS: Using our novel method of analysis of change in choroidal hyperpermeability following treatment for chronic CSC, greater change was found in eyes with good response, and the superior outcome of half-energy PDT over ranibizumab may be attributed to greater influence on choroidal hyperpermeability.

Application of the intravitreal Ranibizumab combined with retinal photocoagulation for the neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM:To observe the clinical effect of the intravitreal Ranibizumab ( lVR ) combined with retinal photocoagulation for the neovascular glaucoma ( NVG) . ? METHODS: Clinical data of 30 patients with the neovascular glaucoma ( 36 eyes ) in our hospital from Ocuober 2012 to Sepember 2013 were analyzed retrospectively. All eyes accepted the photocoagulation 7d after lVR (0. 05mL/1. 25mg). Visual acuity, intraocular pressure ( lOP) , the degradation of iris neovascularization and complications were observed and compared statistically before treatment and 1wk, 1, 3mo after treatment. ?RESULTS:The new vessels on the iris and the angle of anterior chamber regressed completely in all eyes 5d after lVR, the mean time was 3. 7±1. 4d. The differences were statistically significant when compared lOP ( 18. 2±2. 1, 16. 8 ± 3. 1, 17. 2 ± 2. 4mmHg,) at 1wk, 1, 3mo postoperatively with 30. 5±3. 6mmHg preoperatively. The visual acuity of all the eyes was stable and rose slightly. ? CONCLUSlON: lVB combined with retinal photocoagulation can make the new vessels on the iris and the angle of anterior chamber regression and to lower the lOP. No serious complications were observed after treatment. lt is a new security and effective method for neovascular glaucoma.