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1.
Alexa Klettner Muhammed Recber Johann Roider 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(10):1593-1598
Purpose
Anti-VEGF treatment is the therapy of choice in age-related macular degeneration and is also applied in diabetic macular edema or retinal vein occlusion. Recently, aflibercept has been approved for therapeutic use. In this study, we investigate the efficacy of aflibercept in comparison with the VEGF-antagonists ranibizumab and bevacizumab in RPE/choroid organ cultures.Methods
RPE/choroid organ cultures were prepared from freshly slaughtered pigs’ eyes. Organ cultures were treated with 125 μg/ml aflibercept, ranibizumab, or bevacizumab, and the VEGF content of the supernatant was evaluated over the course of 7 days. Additionally, the minimal concentration of VEGF inhibition was evaluated in organ cultures, measured after 6 h of application.Results
Aflibercept was able to completely inhibit VEGF detection for 6 h at a minimal concentration of 0.031 μg/ml, in contrast to bevacizumab (3.9 μg/ml) and ranibizumab (0.244 μg/ml). A statistically significant VEGF inhibition compared to control could be found for aflibercept and ranibizumab down to and including 0.031 μg/ml, while bevacizumab was significantly reduced compared to control down to a concentration of 0.244 μg/ml and again at 0.061 μg/ml. Inhibition of VEGF after a single aflibercept application of 125 μg/ml could be found over the course of 7 days, with some VEGF detectable at the 7th day. In contrast, VEGF was detectable after 72 h of ranibizumab treatment and some VEGF could already be found 12 h after bevacizumab treatment.Conclusions
In conclusion, aflibercept displays a prolonged VEGF inhibition, confirming its effectiveness but also raising concerns about possible side effects of long-term usage. 相似文献2.
Izumi Yoshida Tomoaki Shiba Hikari Taniguchi Mao Takahashi Takeyoshi Murano Nobuyuki Hiruta Yuichi Hori Hdieaki Bujo Takatoshi Maeno 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(9):1483-1489
Background
To evaluate the plasma vascular endothelial growth factor (VEGF) levels after one intravitreal injection of aflibercept or ranibizumab in patients with exudative age-related macular degeneration (AMD).Methods
Twenty-four Japanese with exudative AMD, polypoidal choroidal vasculopathy, and retinal angiomatous proliferation were included. Fourteen patients received an intravitreal injection of aflibercept, and ten patients received an intravitreal injection of ranibizumab. Plasma VEGF levels were evaluated within 7 days before the intravitreal injections and 1 day, 1 week, and 1 month after the intravitreal injection.Results
In the ranibizumab group, the mean plasma VEGF levels were 245.7?±?233.4 pg/ml before the injection, 246.6?±?304.8 pg/ml after 1 day, 217.8?±?212.9 pg/ml after 1 week, and 260.0?±?290.1 pg/ml after 1 month. The plasma VEGF levels did not decrease significantly in patients in the ranibizumab group at any time point. In the aflibercept group, the mean plasma VEGF levels were 280.0?±?170.3 pg/ml before the intravitreal injection and 8.2?±?12.9 pg/ml after 1 day, 9.1?±?9.1 pg/ml after 1 week, and 41.9?±?41.4 pg/ml after 1 month (p?0.0001, vs before injection).Conclusion
Intravitreally injected aflibercept reduced plasma VEGF over at least 1 month. In contrast, intravitreal injection of ranibizumab did not cause a significant reduction in the plasma VEGF levels. 相似文献3.
Heidi Fassnacht-Riederle Matthias Becker Nicole Graf Stephan Michels 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(11):1705-1709
Purpose
Evaluation of three aflibercept injections at 4-week intervals in patients with neovascular AMD showing an “insufficient anatomic response” to prior anti-VEGF therapy with ranibizumab or bevacizumab.Methods
The retrospective analysis included 96 eyes that had received at least three intravitreal 0.5 mg ranibizumab or 1.25 mg bevacizumab injections over a period of no more than 4 months prior to switching to aflibercept. In addition, the selected eyes had to have evidence of persisting or increasing sub- or intraretinal fluid, observed in optical coherence tomography (OCT). All patients received a loading dose of three intravitreal 2 mg aflibercept injections at 4-week intervals. Evaluation included central retinal thickness (CRT) and maximum pigment epithelium (PED) height measured by spectral domain OCT and best-corrected visual acuity (BCVA) prior to the switch of therapy and 4 weeks after the third aflibercept injection.Results
A significant reduction of mean CRT (?39 μm; p?0.001) and maximum PED height (?46 μm; p?0.001) as found 4 weeks after the third aflibercept injection. Eighty-two out of 96 eyes (85 %) had a PED just prior to switching to aflibercept. There was an improvement in BCVA of 1.9 letters 4 weeks after the last aflibercept injection; the vision gain, however, did not reach statistical significance (p?=?0.061). The further analysis did not show any correlation of the change in CRT, maximum PED, and BCVA with the number of prior anti-VEGF treatments.Conclusion
Retinal edema and PEDs regressed significantly after switching to aflibercept in patients insufficiently responding to prior therapy with ranibizumab or bevacizumab. No correlation could be found with regard to the number of prior treatments. 相似文献4.
Tae Gon Lee Jae Hui Kim Young Suk Chang Chul Gu Kim Jong Woo Kim 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(10):1573-1579
Purpose
To investigate factors influencing exudation recurrence following cataract surgery in patients already treated with anti-vascular endothelial growth factor (VEGF) agents for exudative age-related macular degeneration (AMD).Methods
A retrospective review of medical records was performed for patients who underwent cataract surgery and had been previously treated with anti-VEGF for exudative AMD. Visual acuity was examined before surgery and 1 and 6 months after surgery. The time between diagnosis and surgery, and the exudation-free period before surgery were examined and compared between patients who had exudation recurrence and those that did not.Results
Thirty-nine eyes of 39 patients were included in analyses. The logarithm of the minimum angle of resolution visual acuity was 1.02?±?0.58 and had significantly improved 1 month (0.81?±?0.62, P?0.001) and 6 months (0.85?±?0.64, P?=?0.001) following surgery. Both the diagnosis-to-surgery period (P?=?0.001) and the preoperative exudation-free period (P?0.001) were significantly longer in patients without recurrence than in patients with recurrence.Conclusions
Cataract surgery was beneficial in patients previously treated with anti-VEGF for exudative AMD. Our data suggests that cataract surgery should be performed after a sufficiently long exudation-free period to minimize exudation recurrence. But larger prospective studies are required to draw definitive clinical guidelines. 相似文献5.
Ulrich Geck Nicole Pustolla Husnia Baraki Abed Atili Nicolas Feltgen Hans Hoerauf 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(7):1691-1695
Background
To evaluate the incidence of posterior vitreous detachment (PVD) induced by intravitreal injection of different intravitreal drugs.Methods
This prospective observational study included 61 patients (61 eyes) with different underlying retinal diseases: exudative age-related macular degeneration (n?=?47), cystoid macular edema (CME) after retinal vein occlusion (n?=?8), and CME of other origin (n?=?6). Bevazicumab (1.25 mg) was injected into 25 eyes, ranibizumab (0.5 mg) into 27 eyes, triamcinolone (4 mg) into six eyes, and a combination of bevacizumab and triamcinolone into three eyes. Patients with initial PVD were excluded. Patients were followed for at least 4–6 weeks after their last injection by Fourier-domain OCT, fundus biomicroscopy and ultrasound B-examination.Results
Overall, 15 of 61 eyes developed a PVD after intravitreal injection (n?=?6 after ranibizumab, n?=?7 after bevacizumab and n?=?2 after triamcinolon) within a mean follow-up period of 11.1 weeks. PVD occurred in three eyes after the first injection, in three eyes after the second, and in seven eyes after the third injection. Incidence of PVD correlated with increasing age.Conclusion
Intravitreal injection of commonly-used drugs seems to induce posterior vitreous detachment, which may thus influence the outcome of the underlying disease. 相似文献6.
Tomoko Sawada Masashi Kakinoki Xiying Wang Hajime Kawamura Yoshitsugu Saishin Masahito Ohji 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(10):1545-1551
Purpose
To evaluate the efficacy of bimonthly intravitreal injections of ranibizumab for age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) in a pilot study.Methods
This study was a prospective, interventional case series. Thirty eyes of 30 patients received prospectively at least three bimonthly intravitreal injections of ranibizumab (0.5 mg/0.05 ml) without loading doses. The best-corrected visual acuity (BCVA) and the central retinal subfield thickness (CRST) were measured before and monthly after the injections.Results
Twenty-eight patients received the three planned injections; one patient refused the third injection, one patient did not receive the third injection because blood pressure was raised, and one patient received a rescue injection at month 5 because of increased retinal thickness. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 0.44?±?0.37 before treatment and significantly improved to 0.25?±?0.34 at month 6 (p?0.001). The mean CRST was 335?±?85.9 μm before treatment and decreased significantly to 261?±?78.1 μm at month 6 (p?0.001). Nine of 30 patients received six planned injections for 12 months. The mean logMAR BCVA was 0.38?±?0.39 before treatment and significantly improved to 0.18?±?0.33 at month 12 (p?=?0.005). The mean CRST was 360?±?110.8 μm before treatment and decreased significantly to 249?±?57.0 μm at month 12 (p?=?0.025).Conclusions
Bimonthly injections of ranibizumab may be effective for treating AMD and PCV. 相似文献7.
M. Ruppenstein T. Ach A. Höh Prof. Dr. S. Dithmar 《Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft》2010,107(9):827-830
Purpose
This study aimed to investigate the effect of bevacizumab on pigment epithelial detachment (PED) in occult choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) and to determine predictive factors.Methods
73 eyes of patients with AMD and PED due to CNV with subretinal and/or intraretinal fluid were assessed. Patients were treated with 1.25 mg of intravitreal bevacizumab.Results
After 30.6 weeks, the mean visual acuity (VA) increased from 0.53 to 0.49 logMAR (p=0.170). The mean PED height decreased from 354.4 μm to 277.4 μm (p=0.004). Although 53.4% of the eyes showed a reduction in PED, this did not correlate with a significant change in VA. Predictive factors were a high baseline PED and VA <0.32.Conclusion
Half of the patients showed PED flattening. Especially in patients with distinctive PED, a response to intravitreal bevacizumab may be expected. This therapy can stabilize VA, but PED flattening does not essentially correlate with an increase in VA. 相似文献8.
Jagat Ram Vaibhav K. Jain Aniruddha Agarwal Jaidrath Kumar 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(9):1443-1449
Purpose
To evaluate complication rates following implantation of hydrophobic acrylic versus polymethyl methacrylate (PMMA) intraocular lens (IOL) with cataract surgery in infants.Methods
Records of children undergoing cataract surgery with IOL implantation in first year of life were retrospectively reviewed. Infants were divided into two groups—hydrophobic acrylic IOLs were implanted in group A, and PMMA IOLs in group B. Outcome measures included incidence of complications, additional surgical procedures, and refractive error changes.Results
One hundred and thirteen eyes of 113 children (75 males) with mean age of 6.49?±?3.56 months were included. Group A included 62 eyes, and group B included 51 eyes. The two groups did not differ significantly in terms of age and axial length. There was no significant difference between the groups for incidence of posterior capsular opacification (PCO), pupillary membranes, glaucoma, fibrin on IOL surface or IOL malposition (p?=?0.09). Development of PCO was delayed in group A (p?=?0.049). Thirteen eyes of group A and 18 eyes of group B required additional surgical intervention (p?=?0.20) in the follow-up visits.Conclusion
Comparable complications may be expected in infants with PMMA and hydrophobic acrylic lenses. Children implanted with PMMA IOLs may require earlier surgical re-intervention for PCO. 相似文献9.
Yuko Emoto Katsuhiko Yoshizawa Yuichi Kinoshita Takashi Yuri Michiko Yuki Kazutoshi Sayama Nobuaki Shikata Airo Tsubura 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(9):1377-1384
Background
Retinitis pigmentosa (RP) is a group of inherited neurodegenerative human diseases characterized by the loss of photoreceptor cells by apoptosis and eventual blindness. A single intraperitoneal (ip) injection of N-methyl-N-nitrosourea (MNU) causes photoreceptor cell apoptosis within 7 days in rats. Green tea extract (THEA-FLAN 90S; GTE) is a common herbal supplement with pluripotent properties including antioxidant activity. The purpose of the present study was to evaluate the efficacy of GTE against photoreceptor apoptosis in 7-week-old female Sprague-Dawley rats that received a single ip injection of 40 mg/kg MNU.Methods
The oral administration of 250 mg/kg/day GTE was initiated 3 days prior to MNU injection and continued once daily throughout the experiment. Rats were sacrificed at 12, 24, and 72 h and 7 days after MNU injection, and the eyes were examined morphologically and morphometrically. The photoreceptor cell ratio, retinal damage ratio, and retinal preservation ratio were used to determine the structural and functional alterations. The number of apoptotic photoreceptor cells per mm2 was determined in situ by TdT-mediated dUTP-digoxigenin nick end labeling (TUNEL). Our results indicated that oral administration of GTE significantly suppressed the loss of photoreceptor cells morphometrically 7 days after MNU injection. The number of TUNEL-positive cells per mm2 in MNU-exposed rat central retina with or without GTE administration was 981 vs. 2056 at 24 h after MNU injection.Conclusions
GTE structurally and functionally suppressed MNU-induced photoreceptor cell apoptosis. These findings indicate that GTE may help to ameliorate the onset and progression of human RP. 相似文献10.
Xiying Wang Tomoko Sawada Masashi Kakinoki Taichiro Miyake Hajime Kawamura Yoshitsugu Saishin Ping Liu Masahito Ohji 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(7):1033-1039
Purpose
To evaluate vascular endothelial growth factor (VEGF) and ranibizumab concentrations in eyes with age-related macular degeneration (AMD) after monthly and bimonthly intravitreal ranibizumab (IVR) injections.Methods
Aqueous humor samples were obtained from 26 eyes with AMD before and after IVR injections. Nine eyes received three monthly injections and 17 eyes received two bimonthly injections. The VEGF and ranibizumab concentrations were measured by enzyme-linked immunosorbent assay.Results
The aqueous VEGF concentrations in the monthly injection group decreased below the lowest detectable limit in eight of nine eyes 1 month after the first injection and seven of nine eyes 1 month after the second injection (P?<?0.001, mean baseline value, 94.7 pg/ml); the aqueous VEGF concentrations in the bimonthly injection group decreased below the lowest detectable limit in two of 17 eyes 2 months after the first injection (P?<?0.001, mean baseline value, 152.4 pg/ml). The mean aqueous ranibizumab concentrations with monthly injections were 71.2 ng/ml 1 month after the first injection, and 96.3 ng/ml 1 month after the second injection. The mean aqueous ranibizumab concentrations in the bimonthly injection group were 2.5 ng/ml in 15 of 17 eyes, and below the lowest detectable limit in two of 17 eyes 2 months after the first injection.Conclusions
In this pilot study with limited follow-up, intravitreal injection of ranibizumab can suppress aqueous VEGF completely for 1 month in most cases. Its effect does not last for 2 months enough to suppress VEGF completely in most cases, although aqueous VEGF at 2 months after intravitreal injection of ranibizumab is less than that before injection in most cases. 相似文献11.
Philipp S. Muether Robert Hoerster Manuel M. Hermann Bernd Kirchhof Sascha Fauser 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(2):453-458
Background
Intravitreal injections of ranibizumab are the standard of care for neovascular age-related macular degeneration (AMD). In clinical trials, comparable efficacy has been shown for either monthly injections or as needed injections upon monthly controls. Unlike in trial settings, treatment in clinical routine is often delayed by complex approval procedures of health insurance and limited short-term surgical capacities.Methods
Eighty-nine patients with neovascular AMD were followed for 12 months. Early treatment diabetic retinopathy study (ETDRS) visual acuity (VA), Radner reading VA and spectral domain optical coherence tomography were performed monthly, with additional fluorescein angiography if needed. After an initial loading phase of three consecutive monthly intravitreal injections with ranibizumab, re-injections were performed when recurrent activity of choroidal neovascularization (CNV) was detected.Results
After an initial increase to a value of +5.0?±?11.87 ETDRS letters from baseline, VA constantly decreased over 12 months to a value of ?0.66?±?16.82 ETDRS letters below baseline. Central retinal thickness (CRT) decreased from a value of 438.1?±?191.4 μm at baseline to a value of 289.9?±?138.6 μm after initial therapy and stabilized at a value of 322.4?±?199.5 μm. Loss of VA during latency between indication to treat and treatment was significantly greater than re-gain of VA after re-initiation of therapy (?2.2?±?5.0 versus 0.4?±?7.4 letters; p?=?0.046).Conclusions
Latency between indication to treat and treatment is responsible for irreversible VA deterioration. A successful PRN treatment regimen for neovascular AMD requires immediate access to therapy after indication. 相似文献12.
Rachel Dragas Carol Westall Tom Wright 《Documenta ophthalmologica. Advances in ophthalmology》2014,129(2):97-104
Purpose
Vigabatrin (VGB), a treatment for the childhood epilepsy, infantile spasms (IS), is implicated in visual field constriction. Electroretinograms (ERGs) are used as a substitute for visual field testing in infants. We use the VGB-associated ERG reduction (VAER), defined as reduction in age-corrected light adapted 30 Hz flicker amplitude from a pre-treatment measurement in the absence of other retinal defects, as an indicator of retinal toxicity resulting from VGB use. The d-wave ERG response is predominantly the result of OFF-bipolar cell depolarization response to light offset. The purpose of this study is to evaluate the ERG d-wave response as a marker for VAER toxicity in an infant population.Methods
One hundred children with IS treated with VGB (median age at baseline: 7.6 months; range 1.7–38.4) were tested for the cone-OFF response elicited to a 250 cd s m2 flash with 200 ms duration (long flash ERG). Diagnosis of VAER requires baseline testing of the flicker ERG and at least one follow up ERG; Fifty-one patients fulfilled this criteria. Fifty-eight children received the long flash ERG at baseline. Thirteen retinally normal controls with a median age of 32 months (5.7–65) were also tested. Amplitude and implicit time of the d-wave response were measured manually.Results
Longer duration of treatment was associated with reduced d-wave amplitude (ANOVA p < 0.05) in patients taking VGB. Nine patients demonstrated VAER during the course of the study. D-wave amplitude was reduced in the IS group with VAER compared to those without VAER (p < 0.05).Conclusions
Vigabatrin associated retinal defects may be reflected in reduction of the cone d-wave amplitude. 相似文献13.
Yoko Nomura Hidenori Takahashi Xue Tan Shigeto Fujimura Ryo Obata Yasuo Yanagi 《Japanese journal of ophthalmology》2014,58(5):443-447
Purpose
To investigate the effects of vitreomacular adhesion (VMA) on intravitreal ranibizumab treatment in Japanese patients with exudative age-related macular degeneration (AMD).Methods
This was a retrospective comparative study that included 123 eyes from 123 patients with exudative AMD. The presence or absence of VMA was examined by spectral domain optical coherence tomography. The association of VMA with best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at 3, 6, and 12 months after ranibizumab treatment was evaluated.Results
In the group of eyes without VMA [VMA(?)], the mean BCVA was 0.41 logMAR at baseline and significantly improved to 0.28, 0.30, and 0.29 logMAR at 3, 6, and 12 months following the initiation of treatment (P < 0.0001, <0.0001, <0.0001), respectively. In the group of eyes with VMA [VMA(+)], the mean BCVA was 0.42 logMAR at baseline, and there was no improvement at any of the measurement time-points during the follow-up period [0.39, 0.40, and 0.39 logMAR at 3, 6, and 12 months (P = 0.53, 0.75, 0.67), respectively]. The mean baseline CRT in the VMA(?) and VMA(+) groups was 326 and 370 µm, respectively, decreasing to 195 and 293 µm (P < 0.0001 and P = 0.0070), respectively, at 12 months. A better baseline BCVA was associated with poor visual response to intravitreal ranibizumab.Conclusions
Our study of Japanese patients with AMD managed in real-world clinical practice revealed that both VMA and BCVA at baseline were associated with a poor visual response to intravitreal ranibizumab. These results are in agreement with previously reported findings for other ethnic groups. 相似文献14.
Simone Eperon Marouen Berguiga Pierluigi Ballabeni Catherine Guex-Crosier Yan Guex-Crosier 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(9):1359-1367
Background
To prospectively investigate patients with seasonal allergic conjunctivitis (SAC) during the pollen season and test associations between tears total IgE, eotaxin concentrations, and SAC severity.Methods
Enrolled patients presented ocular symptoms and clinical signs of SAC at the time of presentation. Ocular itching, hyperaemia, chemosis, eyelid swelling, and tearing were scored, and the sum of these scores was defined as the clinical score. Conjunctival papillae were separately graded. We measured eotaxin concentration in tears by an enzyme-linked immunosorbent assay (ELISA) and total tear IgE by Lacrytest strip.Results
Among thirty patients (30 eyes), 11 showed neither tear IgE nor tear eotaxin, while 15 out of 19 patients with positive IgE values presented a positive amount of eotaxin in their tears (Fisher’s test: p?0.001). The mean eotaxin concentration was 641?±?154 (SEM) pg/ml. In patients with no amount of tear IgE, we observed a lower conjunctival papilla grade than in patients whose tears contained some amount of IgE (trend test: p?=?0.032). In the 15 patients whose tear eotaxin concentration was null, tear IgE concentration was 5.3?±?3.5 arbitrary units; in the other 15 patients whose eotaxin was positive, IgE reached 21?±?4.3 arbitrary U (Mann–Whitney: p?0.001). We measured 127?±?47 pg/ml eotaxin in patients with no history of SAC but newly diagnosed as suffering from SAC, and 852?±?218 pg/ml eotaxin in patients with a known SAC (p?=?0.008). In contrast, tear IgE concentrations of both groups did not differ statistically significantly (p?=?0.947).Conclusions
If IgE and eotaxin secreted in tears are major contributors in SAC pathogenesis, they however act at different steps of the process. 相似文献15.
Yusaku Yoshida Takeya Kohno Manabu Yamamoto Tasuku Yoneda Hisashi Iwami Kunihiko Shiraki 《Japanese journal of ophthalmology》2013,57(3):283-293
Purpose
To report the 2-year results of reduced-fluence photodynamic therapy (RF-PDT) combined with intravitreal ranibizumab (IVR) for typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).Methods
Twenty-four previously untreated eyes of 23 AMD patients with decimal best-corrected visual acuity (BCVA) of less than 0.7 received the combined therapy, followed by retreatments as needed over the subsequent 2 years. When the BCVA was better than or equal to 0.7, only 3 monthly IVR injections were performed during the retreatment.Results
The BCVAs were maintained in 7 of 10 typical AMD eyes and in 13 of 14 PCV eyes at month 24. The mean BCVA improved in the PCV group (P < 0.05) but not in the typical AMD group. The central foveal thickness decreased in both groups (P < 0.01, P < 0.001). The mean numbers of the total PDT and IVR injections were 1.8 and 7.2 in the typical AMD group and 1.8 and 6.4 in the PCV group.Conclusion
After RF-PDT combined therapy with administration of retreatments as needed that consisted of either 3 IVR injections alone or combined therapy, the BCVA was maintained in typical AMD and improved in PCV during a 2-year follow-up period. 相似文献16.
Akio Oishi Masataka Shimozono Michiko Mandai Masayuki Hata Akihiro Nishida Yasuo Kurimoto 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(2):435-440
Purpose
To evaluate whether the status of the external limiting membrane (ELM) or inner segment/outer segment junction (IS/OS) improves after intravitreal injection of ranibizumab for age-related macular degeneration (AMD). We also evaluated whether the pre-operative values of these parameters are associated with the visual prognosis.Methods
This was a hospital-based, cross-sectional study. Seventy-six eyes of 76 treatment-naive AMD patients who received three monthly intravitreal injections of ranibizumab followed for more than 6 months with additional as-needed injections were investigated. Spectral domain OCT was used to evaluate the length of ELM, IS/OS, and foveal thickness pre- and post-operatively. Changes of ELM and IS/OS length were evaluated postoperatively. Correlation coefficients between pre-operative parameters and post-operative visual acuity were also analyzed.Results
Significant changes were noted in mean logMAR (0.66 to 0.53), foveal thickness (231.1 to 151.1 μm), and IS/OS length (514.9 to 832.3 μm) after the treatment. ELM length did not improve significantly (1,312.4 to 1,376.7 μm). Restoration of IS/OS occured where ELM is retained. Although pre-operative ELM length, IS/OS length, and foveal thickness showed correlation with post-operative logMAR (R?=?–0.51, –0.39, and 0.46, respectively), the most powerful predictive factor for visual prognosis was pre-operative logMAR (R?=?0.77, p?<?0.001).Conclusions
IS/OS status improves in response to anti-VEGF therapy but ELM seems to have less plasticity. The status of IS/OS and ELM can be used as prognostic factors but the predictive power is inferior to that of baseline visual acuity. 相似文献17.
Xiaozhen Ye Jun Liu Yangtian Wang Lu Bin Jian Wang 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(10):1639-1644
Background
Graves’ ophthalmopathy (GO) is thought to be an inflammatory disorder of autoimmune background. The aim of this study is to investigate the involvement of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF) in patients with Graves’ ophthalmopathy (GO).Methods
Serum concentrations of VEGF and b-FGF of 48 GO patients, 30 Graves’ hyperthyroid disease (GD) patients without ophthalmopathy, and 30 healthy controls were measured by Enzyme-Linked Immunosorbent Assay (ELISA). Patients with GO were subdivided into two groups according to clinical activity scores (CAS): a score of 3 or less is considered as inactive (CAS?≤?3, inactive GO, n?=?14), and 4 or more is considered active eye disease (CAS?≥?4, active GO; n?=?34). All of the patients with active GO underwent corticosteroid therapy.Results
The concentrations of serum VEGF and b-FGF were significantly higher in patients with GO and in those with GD than in controls. The serum levels of VEGF and b-FGF in patients with active GO were higher than those in patients with inactive GO and those in GD patients (P?0.05). Moreover, serum VEGF and b-FGF concentratison were significantly correlated with CAS in GO patients (p?0.01). Mean VEGF and b-FGF levels in corticosteroid-responsive patients (CAS decreases ≥3 after treatment) decreased significantly after corticosteroid treatment (P?0.05), and these changes were accompanied by a decrease of CAS (P?0.05).Conclusion
The results suggest that serum VEGF and b-FGF levels were increased in patients with active GO and could reflect the degree of ocular inflammatory activity. 相似文献18.
Masaaki Saito Tomohiro Iida Mariko Kano Kanako Itagaki 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2013,251(9):2099-2110
Background
To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV).Methods
We retrospectively reviewed 57 treatment-naïve eyes of 57 patients. Thirty-two patients were treated with standard fluence PDT (PDT group), and 25 patients were treated with three consecutive monthly intravitreal injections of ranibizumab and standard fluence PDT (ranibizumab plus PDT group). All patients were followed for at least 24 months.Results
In the ranibizumab plus PDT group, the mean best-corrected visual acuity (BCVA) levels of decimal (logMAR equivalent) significantly improved from 0.30 (0.52) at baseline to 0.55 (0.26) at 24 months (P?<?0.001). In the PDT group, the BCVA levels stabilized from 0.26 (0.58) at baseline to 0.25 (0.60) at 24 months. The mean changes in the BCVA in the ranibizumab plus PDT group and the PDT group were improvement of 2.63 lines and decline of 0.16 lines respectively (P?=?0.010). The mean number of PDTs at 24 months in the ranibizumab plus PDT group and the PDT group were 1.4 and 2.6 respectively. Increased subretinal hemorrhages were seen in eight (18.0 %) eyes, all of which were belonging to the PDT group.Conclusions
Combined intravitreal ranibizumab and PDT was significantly more effective in maintaining and improving VA for PCV patients compared with PDT monotherapy over 24 months. 相似文献19.
Rita Gangwani Wico W. Lai Rita Sum Sarah M. McGhee Catherine W. S. Chan Anthony J. Hedley David Wong 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2014,252(5):723-729
Background
The purpose of this study was to determine the reliability of detecting age-related macular degeneration (AMD) during screening for diabetic retinopathy (DR).Methods
This prospective study included 2,003 subjects with diabetes mellitus who underwent photographic screening for DR. The reliability of detecting AMD lesions was tested by interobserver and intraobserver agreement, and the sensitivity and specificity of diagnosing AMD at different grades of severity were tested using the consensus grading of a group as the reference standard.Results
DR affected 24.7 % of the subjects. The age-standardized prevalence of early AMD was 17.9 %, and late AMD was 0.1 %. The interobserver and intraobserver agreement for grading AMD was substantial (k?=?0.72 and 0.71 respectively, p?<?0.001). It was equally good in those with different severities of DR. There was also no difference in sensitivity and specificity of detecting AMD in those with different levels of DR (sensitivity 62–68 % and specificity 97–98 %).Conclusion
Intermediate- and high-risk AMD that warrant treatment with zinc and anti-oxidant supplements could be reliably detected during screening for diabetic retinopathy. 相似文献20.
Juan Reche-Frutos Cristina Calvo-Gonzalez Juan Donate-Lopez Julian Garcia-Feijoo 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2009,247(10):1427-1430