Effect of vitreomacular adhesion on anti-vascular endothelial growth factor therapy for branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of vitreous macular adhesion(VMA)on the efficacy of anti-VEGF therapy in patients with branch retinal vein occlusion(BRVO).<p>METHODS: Retrospective case study. According to initially diagnosed OCT characteristics, 110 patients(110 eyes), selected from those who received intravitreal injection of Conbercept in the ophthalmology department of our hospital from January 2017 to May 2019,were divided into VMA-present group(VMA+ group, 34 eyes)and VMA-free group(VMA- group, 76 eyes). After the first injection, at least 6mo follow-up was ensured, to record the number of injection and to examine the best corrected visual acuity(BCVA)and central macular thickness(CMT). And it's <i>via</i> the OCT reports to evaluate status of the vitreous macular adhesion and the occurrence of posterior vitreous detachment(PVD).<p>RESULTS: During the 6mo follow-up after the first injection, there was no difference in the average number of intravitreal injections between patients in VMA+ group and VMA- group(2.91±1.05 times <i>vs</i> 3.08±1.22 times, <i>P</i>=0.915). At the 6mo after the first injection, BCVA and CMT were significantly improved in both groups, and BCVA gain in VMA+ group was more obvious than that in VMA- group \〖-0.20(-0.33, -0.10)LogMAR <i>vs</i> -0.20(-0.30, -0.10), <i>P</i>=0.041\〗, but there was no difference in CMT changes between the two groups(<i>P</i>=0.914). During this follow-up period, in the VMA+ group, 3 eyes, which were focal VMA at baseline, all developed into macular PVD(100.0%); and 5 of 31 eyes, which were extensive VMA at baseline, developed into macular PVD(16.1%). Compared with the extensive VMA, PVD was more likely to develop into focal VMA(<i>P</i>=0.009).<p>CONCLUSION: BRVO patients combined with VMA have greater potentiality in visual improvements under anti-VEGF treatments. Therefore, the presence of VMA does not prevent BRVO patients from receiving anti-VEGF therapy.

Research progress on anti-VEGF therapy for retinal capillary in diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#Anti-vascular endothelial growth factor(VEGF)agents are revolutionary in the treatment of retinal diseases, such as exudative age-related macular degeneration,diabetic retinopathy(DR), and retinal vein occlusion. Intravitreal injection of anti-VEGF agents can reduce macular edema significantly, but whether anti-VEGF therapy impairs retinal microcirculation and facilitates retinal vascular occlusion. This article reviews on the effect of anti-VEGF therapy on retinal capillary in diabetic macular edema, from three aspects of foveal avascular zones, areas of nonperfusion and retinal capillary density, using optical coherence tomography angiography(OCTA)and ultra-wide field fluorescein angiography(UWFA).

Research progress of anti-VEGF for the therapy in wet age-related macular degeneration / 中华实验眼科杂志

Age-related macular degeneration (AMD) is the primary cause of the blindness among the population aged more than 50 years old.The prevalence of AMD increases with age growing.Wet AMD is the main cause of the visual impairment in over 90％ of AMD patients,which is characterized by formation of choroidal neovascularization.It takes the hypersecretion of vascular endothelial growth factor (VEGF) as a mechanism,leading to vision loss and blindness finally.Targeted anti-VEGF therapy for angiogensis,like ranibizumab and aflibercept can reduce the rate of blindness greatly in AMD patients.It has become the front-line therapy in clinical.However,there still exist some problems.Some patients do not respond to the treatment or their eyesight cannot sustain after long-term treatment.In addition,repeated injection increases the risk of complications and economic burden.In order to further increase their quality of life and improve long-term outcome in patients with wet AMD,a steady flow of new therapy has emerged,such as function towards the same or different targets of antiangiogenesis to enhance the effect by combination therapy,improving or simplifying the mode of administration,inhibiting VEGFR tyrosine protein kinase,etc.This paper reviewed the research progress of anti-VEGF for the therapy in wet AMD.

Outcomes of Anti-vascular Endothelial Growth Factor Treatment for Foveal Serous Retinal Detachment Associated with Inferior Staphyloma

PURPOSE: To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) treatment of eyes with foveal serous retinal detachment (SRD) associated with inferior staphyloma and to investigate choroidal thickness changes following anti-VEGF therapy. METHODS: In this observational case series, eyes with inferior staphyloma accompanied by foveal SRD were treated with a single intravitreal anti-VEGF injection, followed by further injections as needed. Changes in height and width of subretinal fluid (SRF) and visual acuity after treatment were assessed. Choroidal thickness was measured at the subfovea, 1.5 mm superior and inferior to the fovea using enhanced depth imaging optical coherence tomography at baseline and 1 month after initial anti-VEGF therapy. RESULTS: Six eyes from six patients were included. One month after the initial injection, the mean SRF height and width had decreased significantly from 112.5 ± 40.1 to 44.5 ± 48.7 µm (p = 0.046) and from 1,401.8 ± 627.3 to 690.7 ± 634.7 µm (p = 0.028), respectively. Mean choroidal thickness at the superior point decreased from 218.7 ± 59.3 to 200.5 ± 61.0 µm (p = 0.046). SRF resolved completely in three of the six eyes (50%) with a mean of 6.8 ± 5.9 injections (range, 1 to 15). All eyes experienced at least one recurrence of exudation, at a mean interval of 4.8 months. Mean visual acuity improvement was 0.17 logarithm of the minimum angle of resolution units at a mean of 28.7 months follow-up. CONCLUSIONS: Anti-VEGF therapy resulted in an SRF decrease and modest visual improvement in eyes with foveal SRD associated with inferior staphyloma. Reduction in superior choroidal thickness appeared to contribute to the clinical improvements that were observed.

Research progress of anti-VEGF for the therapy in wet age-related macular degeneration / 中华实验眼科杂志

Age.related macular degeneration ( AMD ) is the primary cause of the blindness among the population aged more than 50 years old. The prevalence of AMD increases with age growing. Wet AMD is the main cause of the visual impairment in over 90％ of AMD patients, which is characterized by formation of choroidal neovascularization. It takes the hypersecretion of vascular endothelial growth factor ( VEGF) as a mechanism,leading to vision loss and blindness finally. Targeted anti.VEGF therapy for angiogensis,like ranibizumab and aflibercept can reduce the rate of blindness greatly in AMD patients. It has become the front.line therapy in clinical. However,there still exist some problems. Some patients do not respond to the treatment or their eyesight cannot sustain after long.term treatment. In addition,repeated injection increases the risk of complications and economic burden. In order to further increase their quality of life and improve long.term outcome in patients with wet AMD,a steady flow of new therapy has emerged, such as function towards the same or different targets of antiangiogenesis to enhance the effect by combination therapy,improving or simplifying the mode of administration,inhibiting VEGFR tyrosine protein kinase, etc. This paper reviewed the research progress of anti.VEGF for the therapy in wet AMD.

Research progress of surgery for age-related macular degeneration with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

Age-related macular degeneration (AMD) and cataract are the most common causes of low vision worldwide.Nowadays, there is still a controversy about whether cataract surgery should be taken in patients combined with AMD and when should the surgery be taken.The aim of this review is to assess the influence of cataract surgery on the occurrence and development of AMD, to analyze the risk factors, to explore the occasion of cataract surgery in patients with AMD, and joint with anti-vascular endothelial growth factor (VEGF) treatment, also including the development and application of intraocular lens.It helps to avoid and postpone the development and progression of macular degeneration after cataract surgery and get good visual outcome.

Status and progress of diagnosis and treatment of polypoidal choroidal vasculopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Polypoidal choroidal vasculopathy(PCV) is a common disease of the retina,the disease is more found in colored race.In China,the mainly nosogenic population is the female about 60 years old.The pathogenesis of PCV is unknown and there is no specific medicine at present.The funduscopic present is orangered lesions,bleed and exudation.Indocyanine green angiography(ICGA) could make a definite diagnosis of PCV.In recent,the main treatment of PCV includes photodynamic therapy,intravitreal anti-VEGF therapy,surgery for treatment of complications and combined therapy.We review the treatment and diagnosis of PCV,and propose the further research direction.

Retrospective hospital‑based analysis of age‑related macular degeneration patterns in India: 5‑year follow‑up.

Purpose: To provide a detailed analysis of age‑related macular degeneration (AMD) with a 5‑year follow‑up at a Tertiary Eye Care Center in India. Methods: In this retrospective institutional study, 408 eyes of 204 subjects (100 males) with a diagnosis of AMD with minimum 5‑year follow‑up were included. Data collected included demographics, details of the ocular exam, special investigations performed, treatment offered, complications, and systemic diseases, if any. Results: The median age was 74.24 ± 8.23 years. Median follow‑up was 5.77 years. The visual acuity (VA) at baseline and last visit was 0.74 ± 0.12 (Snellen’s equivalent 20/100) and 0.54 ± 0.12 logarithm of the minimum angle of resolution (Snellen’s equivalent 20/50; P = 0.032) in patients with choroidal neovascular membrane (CNVM). The most common complaint was decreased vision (94.5%). AMD (any stage) was found to be bilateral in 93% of patients at baseline and 197 patients (96.56%) at 5 years. Seventeen eyes had active CNVM (12 of these were occult) at presentation. At baseline, 43 eyes had a disciform scar. Three hundred twenty‑one eyes had dry AMD at baseline (geographic atrophy ‑ 12 [3.7%] eyes). Five‑year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%. Median number of anti‑vascular endothelial growth factor injections administered per patient was 2.8 ± 1.2. CNVM bilaterality was low (7.5%). Conclusion: Patients with AMD in India presented later in the course of the disease. Bilateral advanced AMD and geographic atrophy were uncommon. Five‑year conversion rate into wet AMD and geographic atrophy was 2.87% and 3.12%.

Recognition of anti-VEGF therapy base on the mechanism of VEGF in wet age-related macular degeneration / 中华实验眼科杂志

Age-related macular degeneration (AMD) is the leading cause of visual impairment among older population worldwide,and wet AMD is more threatened to vision because of the choroidal neovascularization.Some physical therapies are thought to destroy the lesions but can not improve the visual acuity.Therefore,anti-VEGF drug therapy is becoming a new approach to the management of wet AMD.Vascular endothelial growth factor(VEGF) is thought to play an important role in the complicated pathogenesis,which can be addressed by disease reduction strategies.Among the anti-VEGF drug therapies,anti-VEGF monoclonal antibodies are proved to maintain and improve visual acuity.Other therapies have been or now being developed for the treatment of neovascular AMD with the goal of inhibiting VEGF.These inhibitors include VEGF receptor decoy aflibercept,small interfering RNA-based therapies (bevasiranib) and tyrosine kinase inhibitors (vatalanib),which could offer the potential for further advances.To completely realize the active mechanism of VEGF in wet AMD is helpful for the rational use of anti-VEGF drugs.