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1.
Yunoki T Miyakoshi A Nakamura T Fujita K Fuchizawa C Hayashi A 《Japanese journal of ophthalmology》2012,56(2):159-164
Purpose
We examined the predictive factors for final visual acuity (VA) with macular edema of branch retinal vein occlusion (BRVO) treated by intravitreal injection of bevacizumab (IVB) and examined the differences between patients without recurrent macular edema due to BRVO after a single IVB and patients treated with multiple IVB because of recurrent macular edema. 相似文献2.
Purpose
To retrospectively study the efficacy of intravitreal bevacizumab (IVB) for exudative age-related macular degeneration (AMD) in patients with good visual acuity (VA). 相似文献3.
Alaa E. Radwan Cheryl A. Arcinue Paul Yang Pichaporn Artornsombudh Esam M. Abu Al-Fadl C. Stephen Foster 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(7):1801-1806
Purpose
To evaluate the efficacy of bromfenac drops alone or with a single intravitreal injection of bevacizumab (IVB) or triamcinolone acetonide (IVTA) in the treatment of uveitic macular edema (UME).Design
Comparative case series.Study Participant
Sixty-seven eyes (of 55 patients) with UME that received either bromfenac drops alone (n?=?34), IVB plus bromfenac (n?=?21) or IVTA plus bromfenac (n?=?12).Methods
Chart review of patients at the Massachusetts Eye Research and Surgery Institution (MERSI) was done. Eyes that received either bromfenac drops alone (Br), IVB plus bromfenac (IVB/Br) or IVTA plus bromfenac (IVTA/Br), with follow-up of up to 3 months, were included.Main Outcome Measure
Visual acuity.Results
There was no statistically significant effect seen in VA or CMT in the Br group, with 17 of 34 eyes (50 %) needing re-injection before 3 months of follow-up. Mean change in CMT at 4 weeks for the Br group was 5.06 µm. Compared to baseline, both the IVTA/Br and IVB/Br groups showed significant decrease in CMT and improvement in VA at 1 and 3 months follow-up. There was also a continuous decrease in CMT up to 3 months of follow-up with the IVTA/Br group, which was found to be significant in comparison with the IVB/Br group; this trend was not seen in the IVB/Br group at 3 months. The greatest mean change in CMT at 1 month was seen in the IVTA/Br group (154.33 ±178.22 µm), and this was statistically significant in comparison with the other groups (p?=?<0.0001). However, in terms of mean change in VA, there was no change in the Br group (0.01?±?0.11 VA logMAR), and only 0.12?±?0.19 and 0.15?±?0.20 in the IVB/Br and IVTA/Br groups, respectively.Conclusion
IVB and IVTA are both effective in improving VA and decreasing CMT up to 3 months. Bromfenac is ineffective alone for UME treatment, but may have a synergistic effect with IVTA in reducing CMT up to 3 months of follow-up. 相似文献4.
Use of bevacizumab for macular edema secondary to branch retinal vein occlusion: a systematic review
Yilmaz T Cordero-Coma M 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2012,250(6):787-793
Introduction
This systematic review assesses the effectiveness of intravitreal bevacizumab (IVB) versus a comparison group in the treatment of branch retinal vein occlusion (BRVO)-associated macular edema, and explores its effects on visual acuity (VA) and central macular thickness (CMT).Methods
The authors searched the following databases: Medline (1950–October week 3, 2011), The Cochrane Library (Issue 10, 2011), EMBASE (up to 24 October 2011), and the TRIP Database (up to 24 October 2011), using no language or other limits. Trials that were included consisted of patients with BRVO-associated macular edema, those comparing a 1.25?mg IVB injection with a comparison group, those reporting both VA and CMT outcomes, and those having a minimum follow-up of 4?weeks.Results
In the four trials comparing IVB with a comparison group, IVB was effective in improving VA and CMT values in the long-term (12?weeks) in patients with BRVO-associated macular edema. Furthermore, statistically significant improvements in VA in the short-term (4?weeks) could also be seen.Discussion
Clinicians should use this review as an indicator that IVB is effective in improving VA and CMT values in the long-term in patients with BRVO-associated macular edema. It is important to note, however, that statistically significant improvements in VA in the short term could be seen. This review's main aim was to serve as an evidence base for potentially using other modalities, such as IVB, which seems to be reserved for certain cases. 相似文献5.
Purpose
To assess the efficacy and safety of preoperative intravitreal bevacizumab (IVB) before vitrectomy for diabetic tractional retinal detachment (TRD).Methods
Using ICD-9 codes, we located all patients with diabetic TRD who underwent 3-port 20-gauge vitrectomy primarily performed by one surgeon between January 2004 and January 2009. Eyes receiving IVB were compared with those not. The following outcomes were compared: visual acuity (VA), duration of surgery, and complication rates.Results
A total of 99 eyes of 90 patients were included in the analysis. In all, 34 patients received IVB on an average of 11.5 (range, 3–30) days previtrectomy. Age was 46.5 and 51.6 in the IVB and non-IVB groups, respectively. VA was improved significantly in both groups: from 20/617 to 20/62 in the IVB group, and from 20/443 to 20/86 in the non-IVB group (P=0.11 between groups). Operating time and postoperative complications (glaucoma, RD, and revitrectomy rate) were similar in both groups. On comparing IVB and non-IVB eyes in younger patients (≤40), operating time was shorter (P=0.02) and a trend to better VA in the IVB group was seen.Conclusions
Preoperative IVB may be a useful adjunct to vitrectomy for severe PDR complicated by TRD, particularly in younger diabetics. 相似文献6.
Nakata I Yamashiro K Nakanishi H Tsujikawa A Otani A Yoshimura N 《Japanese journal of ophthalmology》2011,55(5):435-443
Purpose
To investigate the association between the vascular endothelial growth factor (VEGF) gene and response to either intravitreal bevacizumab (IVB) or photodynamic therapy with intravitreal triamcinolone acetonide and IVB (triple therapy) for neovascular age-related macular degeneration (AMD).Methods
The study consisted of 94 patients with neovascular AMD who underwent IVB and 79 patients with neovascular AMD who underwent triple therapy. Genotypes were determined for four selected tagging single-nucleotide polymorphism (SNP)s of the VEGF gene.Results
Of the four SNPs studied, one SNP (rs699946) was associated significantly with visual acuity (VA) changes 12 months after treatment??irrespective of whether they received IVB alone (P = 0.044) or triple therapy 0.010). Baseline VA was not significantly different among the three genotypes of rs699946 in either treatment group. There were no significant differences in the number of treatments, incidence of recurrence, or the period until the recurrence according to VEGF rs699946 genetic variant.Conclusions
The VEGF gene SNP rs699946 was associated with response to IVB alone and to triple therapy in this study. The G allele in SNP rs699946 can thus be applied as a marker for better visual prognosis in patients with neovascular AMD who receive either IVB or triple therapy. 相似文献7.
Mustafa Ozsutcu Gokhan Gulkilik Emre Ayintap Muhammed Altinisik Goktug Demirci Cengiz Aras 《Case reports in ophthalmology》2013,4(1):7-10
Purpose
To report 2 eyes of a patient which developed vitreomacular traction (VMT) 1 month after intravitreal bevacizumab (IVB) injection.Materials and Methods
A 45-year-old female with bilateral diffuse diabetic macular edema (DME) received bilateral IVB.Results
Her initial visual acuity (VA) was 0.15 and 0.2 in OD and OS, respectively. Central foveal thickness (CFT) was 568 and 662 µm in OD and OS, respectively, without any sign of VMT. Both eyes responded well initially but developed VMT at 1 month. This time, intravitreal triamcinolone (IVTA) injection was performed. One month after IVTA injection, VMT was released and CFT decreased to 163 and 181 µm in OD and OS, respectively. Six months after IVTA injection, CFT was 163 and 153 µm, and VA was 0.7 and 0.9 in OD and OS, respectively.Conclusion
In eyes with DME and attached posterior vitreous, VMT may develop after IVB injection and increase edema. IVTA injection might be an option to release VMT before considering vitrectomy.Key Words: Bevacizumab, Diabetic macular edema, Posterior vitreous, Vitreomacular traction 相似文献8.
Intravitreal triamcinolone versus intravitreal bevacizumab for diabetic macular edema:a meta-analysis 下载免费PDF全文
AIM: To compare the efficacy of the sole intravitreal triamcinolone (IVT) versus intravitreal bevacizumab (IVB) alone or IVB combined with IVT in the treatment of diabetic macular edema (DME).METHODS: Pertinent publications were identified through systematic searches of database and manually searching. Methodological quality of the literatures was valuated according to the Jadad Score. RevMan 5.1.0 was used to do the meta-analysis. Heterogeneity was determined and sensitivity was conducted.RESULTS: Six studies were ultimately included in the meta-analysis. The results of our analysis showed IVT had a statistically significant improvement in vision over the IVB at 1 month and 3 months (P<0.01=. However, the reduction was not significant regarding central macular thickness (CMT) during the earlier (1 month and 3 months) follow-up period (P=0.12, P=0.41, respectively). At later visit (6 months), IVT had a significant decrease in CMT when compared to IVB (P<0.01) while no significant improvement in visual acuity (VA) was observed (P=0.14). The incidence of intraocular hypertension was 13/102 in IVT group during follow-up period while 0/103 in IVB group. The difference was significant (P<0.01). With regards to IVT versus IVB combined with IVT, there were no significant differences in CMT at 1 month (P=0.86) and 3 months (P=0.06). The incidence of intraocular hypertension was 6/67 in IVT group during follow-up period while 4/66 in IVB+IVT group. But the difference was not significant (P=0.53).CONCLUSION:Current evidence shows IVT is superior in improving VA at earlier follow-up (1 month and 3 months) and in reducing CMT at later follow-up (6 months) for DME. At other time, it is in favor of IVT treatment but there are no statistically significances. However, IVT has the side-effect of ocular hypertension. There is no adequate evidence of the benefit adding IVB to IVT in contrast to IVT alone. 相似文献
9.
Morteza Entezari Alireza Ramezani Hamid Ahmadieh Hassan Ghasemi 《Indian journal of ophthalmology》2014,62(4):468-471
Background:
To report a series of patients with sterile endophthalmitis after intravitreal bevacizumab (IVB) injection from 2 different batches of bevacizumab.Materials and Methods:
Records of 11 eyes with severe inflammation after IVB injections from two different batches (7 eyes from one and 4 from the other) on two separate days were evaluated. Fifteen eyes of 15 patients in one day were treated with one batch and 18 eyes of 17 patients were treated another day using another batch injected for different retinal diseases. Each batch was opened on the day of injection. We used commercially available bevacizumab (100 mg/4 ml) kept at 4°C. Severe cases with hypopyon were admitted to the ward and underwent anterior chamber and vitreous tap for direct smear and culture.Results:
Pain, redness and decreased vision began after 11-17 days. All had anterior chamber and vitreous reactions and 5 had hypopyon. Antibiotics and corticosteroids were initiated immediately, but the antibiotics were discontinued after negative culture results. Visual acuity returned to pre-injection levels in 10 eyes after 1 month and only in one eye pars plana vitrectomy was performed. Mean VA at the time of presentation with inflammation (1.76 ± 0.78 logMAR) decreased significantly (P =0.008) compared to the initial mean corrected VA (1.18 ± 0.55 logMAR); however, final mean corrected VA (1.02 ± 0.48 logMAR) improved in comparison with the baseline but not to a significant level (P =0.159).Conclusions:
We report a cluster of sterile endophthalmitis following intravitreal injection of bevacizumab from the same batch of bevacizumab that has a favorable prognosis. 相似文献10.
Rasha I Ali Kapil G Kapoor Adeel N Khan Syed K Gibran 《Indian journal of ophthalmology》2014,62(4):396-399
Purpose:
To evaluate the efficacy of combined treatment with intravitreal bevacizumab (IVB) and triamcinolone acetate (IVT) for patients with macular edema secondary to branch retinal vein occlusion (BRVO).Materials and Methods:
Retrospective analysis of 20 eyes injected with 1.25 mg IVB and 2 mg IVT for clinically identified BRVO within 8 weeks of onset. All patients lacked concomitant ocular pathology and completed 6 months’ follow-up. Clinical examination including LogMAR visual acuity (VA) and central macular thickness (CMT) by spectralis optical coherence tomography (OCT) was performed preoperatively and at 1, 3 and 6 months post-operatively.Results:
Mean patient age was 61.3 years with a mean BRVO diagnosis time of 3 weeks at presentation. VA improved from logMAR 1.08 preoperatively to Mean logMAR VA of 0.55 ± 0.17 at 1 month (P < 0.001), 0.56 ± 0.21 at 3 months (P < 0.001), and 0.38 ± 0.1 at 6 months (P < 0.001) Mean CMT improved from 482 ± 107 μm preoperatively to 319 ± 53 μm at 1 month (P < 0.001), 344 ± 89 μm at 3 months (P < 0.001), and 241 ± 29 μm at 6 months (P < 0.001). Mean IOP preoperatively was 16.5 mmHg, 21 mmHg at 1 month, and 15 mmHg at 6 months. Six out of 20 patients (30%) were re-injected with IVB and IVT at 3 months.Conclusions:
Early combined treatment with IVB and IVT is effective in improving anatomic and functional outcomes in patients with macular edema secondary to BRVO. 相似文献11.
Yukari Shirakata Chieko Shiragami Ayana Yamashita Eri Nitta Atsushi Fujiwara Fumio Shiraga 《Japanese journal of ophthalmology》2012,56(6):599-607
Purpose
Our aim was to study the efficacy of combined triple therapy with intravitreal bevacizumab injections (IVB), posterior sub-Tenon injection of triamcinolone acetonide (STTA), and reduced laser fluence photodynamic therapy (RFPDT) in Japanese patients with retinal angiomatous proliferation (RAP).Design
This was a retrospective, observational, consecutive case series.Methods
Fifteen consecutive RAP treatment-na?ve eyes were treated with triple therapy of IVB, STTA, and RFPDT (25?J/cm2 of laser fluence). Whenever there was a recurrence of retinal–retinal anastomosis (RRA) or retinal–choroidal anastomosis (RCA) and marked leakage from subretinal neovascularization, the triple therapy was reapplied. When there were only intraretinal exudative and/or hemorrhagic changes without distinct RRA or RCA, IVB alone was applied.Results
The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at baseline improved significantly (from 0.489 to 0.294 12 months) (paired t test, p?=?0.043). LogMAR BCVA at 12?months was stable or improved by ≥0.2 in 14 eyes (93.3?%). Mean number of triple therapy instituted during the 12-month study period was 1.2, and mean number of IVB treatments was 1.4.Conclusion
Combined IVB, STTA, and RFPDT for RAP was effective in maintaining or improving VA at 1?year. In addition, the number of treatments could be markedly reduced. 相似文献12.
Macular detachment after successful intravitreal bevacizumab for myopic choroidal neovascularization
Shimada N Ohno-Matsui K Hayashi K Yoshida T Tokoro T Mochizuki M 《Japanese journal of ophthalmology》2011,55(4):378-382
Purpose
To determine the incidence and features of macular retinal detachment (RD) after successful intravitreal injection of bevacizumab (IVB) for the treatment of myopic choroidal neovascularizations (CNVs). 相似文献13.
Yeo Jue Byun Mi In Roh Sung Chul Lee Hyoung Jun Koh 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2010,248(7):963-971
Purpose
To compare visual outcomes after intravitreal triamcinolone acetonide (IVTA) injection and intravitreal bevacizumab (IVB) administration for treatment of macular edema associated with branch retinal vein occlusion (BRVO). 相似文献14.
Purpose
To clarify the efficacy of a combination of intravitreal anti-vascular endothelial growth factor (VEGF) injections and photodynamic therapy (PDT), over 24 months, for patients with symptomatic retinal angiomatous proliferation (RAP).Methods
We retrospectively reviewed 13 treatment-naïve eyes of 12 patients (7 men, 5 women; age range (mean), 63–92 (77) years) treated with intravitreal bevacizumab (IVB) plus PDT as initial treatment. Retreatment was performed with IVB plus PDT until February 2009 or intravitreal ranibizumab and PDT from March 2009.Results
Mean best-corrected visual acuity (BCVA) significantly improved from 0.26 at baseline to 0.40 at 24 months (P = 0.013). The mean improvement in BCVA at 24 months from baseline was 1.79 lines. The central retinal thickness decreased significantly from 431 to 142 microns at 24 months (P < 0.0001). Complete occlusion of the retinal–retinal anastomosis was achieved in seven of the 10 eyes at 24 months. The mean number of PDT treatments during 24 months was 2.8 and the mean number of injections was 3.4. Geographic atrophy was seen in four eyes without significant decline of VA at 24 months.Conclusion
Combined anti-VEGF and PDT for RAP patients effectively maintained or improved VA and reduced exudation, without severe adverse events, over 24 months. 相似文献15.
Tomoaki Tatsumi Shuichi Yamamoto Juntaro Uehara Takeshi Sugawara Takayuki Baba Masayuki Inoue Hiroko Hata Yoshinori Mitamura 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(5):1355-1360
Background
To compare the therapeutic effects of panretinal photocoagulation (PRP) combined with intravitreal bevacizumab (IVB) and cryoretinopexy (CR-IVB) to that of PRP combined with IVB alone in eyes with neovascular glaucoma (NVG).Design
Retrospective, consecutive, case-control study.Methods
The medical records of 102 eyes of 96 patients with NVG due to proliferative diabetic retinopathy, central retinal vein occlusion, and ocular ischemic syndrome were reviewed. The mean age of the patients was 59.6?±?11.5 years, with a range of 34 to 84 years. Patients received either 1.25 mg/0.05 ml of IVB combined with 360° of cryotherapy of the peripheral retina (CR-IVB subgroup) or IVB alone (IVB alone subgroup) as adjunctive treatments to PRP. The patients were followed for at least 12 months. Fifty-four eyes of 49 patients had open-angle NVG; 30 of these eyes were treated by CR-IVB, and 24 eyes by IVB alone. Forty-eight eyes of 48 patients had angle-closure NVG; 22 of these eyes were treated by CR-IVB, and 26 eyes were by IVB alone. Failure was defined as a postoperative intraocular pressure (IOP) >21 mmHg for two consecutive follow-up visits, or the need of additional surgery such as trabeculectomy or diode laser cycloablation. The differences in the success rates between the CR-IVB and IVB alone subgroups for the eyes with open-angle and closed-angle NVG were compared.Results
The success rate at 12 months in eyes with open-angle NVG was 80.0 % in the CR-IVB subgroup and 41.7 % in the IVB alone subgroup (P?=?0.0096). In eyes with angle-closure NVG, the success rate at 12 months was 22.7 % in the CR-IVB subgroup and 0 % in the IVB-alone subgroup (P?=?0.030).Conclusion
The significantly better IOP control after PRP combined with cryotherapy and IVB than after PRP with IVB alone indicates that cryotherapy enhances the effectiveness of PRP for neovascular glaucoma for at least 1 year. 相似文献16.
Dong Ho Park Jae Pil Shin Si Yeol Kim 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2010,248(5):641-650
Background
To study the clinical outcome and complications of intravitreal bevacizumab (IVB) versus triamcinolone acetonide (IVT) injections at the end of vitrectomy in patients with diabetic vitreous hemorrhage. 相似文献17.
Yoshifumi Okamoto Fumiki Okamoto Takahiro Hiraoka Tetsuro Oshika 《Japanese journal of ophthalmology》2014,58(4):369-374
Purpose
To investigate the vision-related quality of life (VR-QOL) and visual function in patients undergoing intravitreal injection of bevacizumab (IVB) for persistent diabetic macular edema (DME) after vitrectomy.Methods
This institutional study enrolled 20 consecutive patients (20 eyes) who had received 1.25 mg IVB for persistent macular edema after vitrectomy for DME at least 3 months previously. Visual function and VR-QOL were measured before, and 1 and 3 months after IVB. Measurements included the logarithm of the minimum angle of resolution (logMAR), best corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia using M-CHARTS, central retinal thickness using optical coherence tomography, and VR-QOL with the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25).Results
One month after IVB, statistically significant improvements were observed in central retinal thickness, letter contrast sensitivity, and the VFQ-25 “mental health” subscale score (P < 0.05, Dunnett test). LogMAR BCVA, metamorphopsia, and the VFQ-25 composite score did not improve significantly. Three months after IVB, there were no significant improvements in any parameters examined.Conclusions
Intravitreal bevacizumab injection for persistent DME after vitrectomy temporarily improved central retinal thickness, contrast sensitivity, and the psychometric aspect of the VR-QOL, but these effects did not last for over 3 months. 相似文献18.
Sarah Moussa Siamak Ansari-Shahrezaei Eva Smretschnig Stefan Hagen Kerstin Steindl-Kuscher Ilse Krebs Susanne Binder 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2010,248(8):1087-1090
Background
To evaluate contrast sensitivity (CS) using Pelli-Robson charts after intravitreal ranibizumab (IVR) (Lucentis, Novartis, Basel, Switzerland) or bevacizumab (IVB) (Avastin, Genentech, South San Francisco, California, USA) in eyes with myopic choroidal neovascularization (mCNV). 相似文献19.
Mihoko Suzuki Fumi Gomi Miki Sawa Motokazu Tsujikawa Hirokazu Sakaguchi 《Japanese journal of ophthalmology》2010,54(2):124-128
Purpose
To assess intravitreal bevacizumab (IVB) for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) in Japanese patients. 相似文献20.