ABSTRACT
PURPOSE: To evaluate baseline predictive markers of early and late anatomical response to anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with neovascular age-related macular degeneration (nAMD). METHODS: The records of the nAMD patients who underwent intravitreal ranibizumab or aflibercept treatment, received the 3 monthly loading doses, and completed a follow-up period of 12 months were included retrospectively. The anatomical treatment response at month 3 (early) and between month 3 and 12 (late) was classified as good, intermediate or poor. Baseline demographic, fluorescein angiography, and optical coherence tomography findings were compared among the three groups. RESULTS: One hundred and ten eyes (74.3%) showed good, 18 (12.2%) showed intermediate and 20 (13.5%) showed poor anatomical response at month 3, and 114 eyes (77.0%) showed good, 27 (18.2%) showed intermediate and 7 (4.7%) showed poor anatomical response between month 3 and month 12. Of the evaluated parameters, drug type (better in aflibercept), showed a statistically significant difference in regards to anatomical outcomes at both the early and late periods (P=0.02 and P=0.03). The greatest linear dimension of choroidal neovascularization (CNV) and presence of peaked pigment epithelial detachment (PED) were important factors for early anatomical anti-VEGF treatment response. CONCLUSION: Larger CNV and the presence of a peaked PED appeared to be associated with a good early response, and the drug type seemed to be associated with both early and late poor anatomical response of anti-VEGF treatment in nAMD patients. Aflibercept appears to be more effective than ranibizumab in regards to the percentage of patients with better anatomical response in both the early and late treatment periods.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Biomarkers, Pharmacological/analysis , Choroidal Neovascularization/drug therapy , Macular Degeneration/drug therapy , Multimodal Imaging/methods , Aged , Aged, 80 and over , Case-Control Studies , Choroidal Neovascularization/complications , Choroidal Neovascularization/diagnosis , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Intravitreal Injections , Macular Degeneration/complications , Macular Degeneration/diagnosis , Male , Prognosis , Ranibizumab/administration & dosage , Ranibizumab/adverse effects , Receptors, Vascular Endothelial Growth Factor/administration & dosage , Recombinant Fusion Proteins/administration & dosage , Recombinant Fusion Proteins/adverse effects , Retrospective Studies , Time Factors , Tomography, Optical Coherence , Treatment Outcome , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vascular Endothelial Growth Factor A/immunologyABSTRACT
PURPOSE: To compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) on neurosensory retinal detachment (SRD) associated with diabetic macular edema (DME) in the early treatment period. METHODS: This was a retrospective, interventional, case-control study. After three monthly loading doses of IVR or an initial IDI injection, the changes in best-corrected visual acuity (BCVA), central macular thickness (CMT) on OCT, and presence and height of SRD were evaluated. RESULTS: The IVR and IDI groups consisted of 101 and 35 eyes, respectively. The mean changes in CMT in the IVR and IDI groups were 204.4±176.6 and 311.4±163, respectively (P<0.001). The mean changes in SRD height in the IVR and IDI groups were 133.6±92.1 and 168.6±103.9µm, respectively. The decrease in SRD height was significantly greater in the IDI group than in the IVR group (P=0.002). The SRD resolved completely in 72.2% and 71.4% of the patients in the IVR and IDI groups, respectively (P=0.9). CONCLUSION: The mean reduction in CMT and SRD height was greater in the IDI group than in the IVR group. There was a negative correlation between baseline best-corrected visual acuity (BCVA) and SRD height and also between BCVA and CMT.
Subject(s)
Dexamethasone/administration & dosage , Diabetic Retinopathy/drug therapy , Macular Edema/drug therapy , Ranibizumab/administration & dosage , Retinal Detachment/drug therapy , Aged , Case-Control Studies , Dexamethasone/adverse effects , Diabetic Retinopathy/complications , Drug Implants , Female , Humans , Intravitreal Injections , Macular Edema/etiology , Male , Middle Aged , Ranibizumab/adverse effects , Retinal Detachment/etiology , Retrospective Studies , Tomography, Optical Coherence , Visual Acuity/drug effectsABSTRACT
The utility of Nordmann fir (Abies nordmanniana (Stev.) Spach. Subsp. nordmanniana) leaves from Eastern Black Sea region for the removal (sorption) of metal ions from aqueous solutions was investigated. For this, the optimum values of pH, time, metal concentration, leaf concentration, leaf particle size and adsorption capacity were determined. Also the recovery conditions of the metals from leaves were studied. Cd metal was selected because of its toxic properties. Freundlich isotherm model was used to describe the adsorption behaviour and the experimental results obtained for Cd(2+) adsorption, followed this model well. The utility of Nordmann fir leaves to remove toxic metals from aqueous solutions was proved. Hence, this study showed that the leaves of Nordmann fir can provide cheap source as biosorbents for toxic metal removal from natural or wastewaters.
