Intravitreal aflibercept for the treatment of patients with neovascular age-related macular degeneration in routine clinical practice in Latin America: the AQUILA study.

BACKGROUND: AQUILA (NCT03470103) was a prospective, observational, 12-month cohort study evaluating treatment patterns, clinical effectiveness, and safety of intravitreal aflibercept (IVT-AFL) in patients from Latin America with neovascular age-related macular degeneration (nAMD). METHODS: Treatment-naïve and previously treated (switching to IVT-AFL) patients (aged ≥ 55 years) were enrolled from March 2018, with a primary completion date of September 2020, from Argentina, Colombia, Costa Rica, and Mexico. Patients received IVT-AFL in a routine clinical practice setting. RESULTS: Of 274 patients in the full analysis set, 201 were treatment-naïve and 73 had received previous treatment. The mean ± standard deviation number of IVT-AFL injections received by month 12 was 4.2 ± 1.9 (treatment-naïve) and 5.2 ± 2.7 (previously treated). The median duration from diagnosis to IVT-AFL treatment was 1.2 months (treatment-naïve) and 19.5 months (previously treated). Mean best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] letters) improved from baseline to month 12 by + 5.2 ± 18.3 (treatment-naïve; baseline: 48.2 ± 23.5) and + 3.1 ± 15.3 letters (previously treated; baseline: 47.7 ± 21.4). CONCLUSION: AQUILA is the first study to assess the use of IVT-AFL in routine clinical practice in Latin America. Mean BCVA and other visual acuity outcomes improved in both treatment groups, despite many patients not receiving the IVT-AFL label-recommended regimen of three initial monthly doses, or seven or more injections in 12 months. Patients who did receive the label-recommended number of injections had numerically greater improvements in visual acuity outcomes. Patients with nAMD treated regularly and more frequently with IVT-AFL, therefore, have the potential to achieve outcomes consistent with those observed in interventional studies. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03470103. Registered February 5, 2018, https://clinicaltrials.gov/ct2/show/NCT03470103.

Intravitreal aflibercept for the treatment of patients with diabetic macular edema in routine clinical practice in Latin America: the AQUILA study.

BACKGROUND: AQUILA (NCT03470103) was a prospective, observational, 12-month cohort study to understand treatment patterns and to evaluate the clinical effectiveness and safety of intravitreal aflibercept (IVT-AFL) in patients from Latin America with diabetic macular edema (DME). METHODS: Treatment-naïve and previously treated (switching to IVT-AFL) patients (aged ≥ 18 years) were enrolled from March 2018, with a primary completion date of September 2020, from Argentina, Colombia, Costa Rica and Mexico. Patients received IVT-AFL in a routine clinical practice setting. RESULTS: Of 258 patients in the full analysis set, 181 were treatment-naïve and 77 had received previous treatment. The mean ± standard deviation number of IVT-AFL injections by Month 12 was 3.7 ± 1.8 (treatment-naïve) and 4.0 ± 2.2 (previously treated). The median duration from diagnosis to IVT-AFL treatment was 1.8 months (treatment-naïve) and 16.0 months (previously treated). Mean best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study letters) improved from baseline to Month 12 by + 8.1 ± 17.7 (treatment-naïve; baseline: 54.5 ± 19.4) and + 4.6 ± 15.4 letters (previously treated; baseline: 52.9 ± 18.6). CONCLUSION: AQUILA is the first study to assess the use of IVT-AFL in routine clinical practice in Latin America. Despite few patients being treated with the label-recommended regimen of 5 initial monthly doses or receiving ≥ 8 injections in 12 months, functional and anatomic visual outcomes improved during 12 months of treatment with IVT-AFL. Patients receiving the label-recommended number of injections had numerically greater improvements in visual acuity outcomes. Patients with DME treated regularly and more frequently with IVT-AFL therefore have the potential to achieve outcomes consistent with those observed in interventional studies. Trial registration Clinicaltrials.gov, NCT03470103. Registered February 5, 2018, https://clinicaltrials.gov/ct2/show/NCT03470103.

An unusual case of nine cilia embedded in the retina after a perforating ocular injury.

PURPOSE: To report an extremely rare case involving a 41-year-old man with nine intraocular cilia embedded in the retina after a perforating ocular injury caused by a metal wire. This case is particularly rare because of the number and location of the cilia. OBSERVATIONS: The patient underwent an uneventful corneal suturing and extracapsular extraction of the damaged lens of his right eye. Intraocular foreign bodies were discovered following surgery and were removed at a later date. Following lens extraction and ocular repair, the patient's best-corrected visual acuity (BCVA) was counting fingers. Fundus examination during follow-up revealed several eyelashes embedded in the retina. Thirty-two days after the injury, the patient showed signs of ocular inflammation. Therefore, the patient underwent vitrectomy and intraocular foreign body removal. Nine cilia were embedded in the retina at the posterior perforation site. At the final follow-up visit, his BCVA was 20/25. CONCLUSION AND IMPORTANCE: This report describes an unusual case where intraocular cilia were embedded in the retina after a perforating ocular injury. The eyelashes caused an intraocular inflammatory reaction that subsided after their removal.

Hemangioma capilar da retina associado a descolamento de retina: relato de caso / Retinal capillary hemangioma with tractional retinal detachment: case rerpot

Os autores descrevem um caso de uma paciente portadora de hemangioma capilar da retina que evoluiu com descolamento de retina tradicional, após crioterapia. A vitrectomia via pars plana foi efetiva nessa complicaçäo do hemangioma e a retina apresentou-se colada após 1 ano e 6 meses de seguimento. Säo feitas consideraçöes a respeito das manifestaçöes clínicas e oftalmológicas, complicaçöes e tratamento.

Estudo e classificaçäo das membranas neovasculares subretinianas na degeneraçäo macular relacionada à idade pela angiografia digital com indocianina verde / Study and classification of subretinal neovascularization in age-related macular degeneration by digital angiography with indocyanine green

Objetivo: analisar por meio da angiografia digital com indocianina verde (ICV) casos de membrana neovascular subretiniana (MNSR) oculta ou mal definida, diagnosticada pela angiofluoresceinografia (AF) em degeneraçäo macular relacionada à idade. Material e método: pacientes com MNSR oculta ou mal definida, diagnosticada pela AF foram analisados por meio do ICV, excluindo-se olhos com tratamento prévio com raio laser ou outra doença ocular. Resultados: trinta e quatro olhos foram estudados. Foi encontrada placa com hiperfluorescência difusa em 18 olhos (52,9 por cento) em 11 olhos (32,3 por cento) a existência de um ponto focal hiperfluorescente, sendo que estas alteraçöes näo foram detectadas pela angiofluoresceinografia. Conclusäo: a ICV em alguns casos detecta a presença de membrana neovascular subretiniana presumível näo-evidenciada ao exame