Bevacizumab in Wet AMD treatment: A tribute to the thirteen years of experience from the beginning of the anti‑VEGF era in Romania

Stanca, Horia Tudor; Stanca, Simona; Tăbăcaru, Bogdana; Borugă, Mădălina; Baltă, Florian

doi:10.3892/etm.2019.7858

Cited by 17 publications

(14 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Iris manipulation during anterior segment procedures presents an additional risk of inflammation with high levels of IL-1, IL-8, IL-0, IL-6 and TNF-α, cytokines that are proven to be involved in the development of proliferative vitreoretinopathy (12). Also, in vitrectomized eyes, the inflammatory cytokines are present many months after PPV (13)(14)(15)(16)(17). These factors are known to promote fibrosis development under the form of proliferative vitreoretinopathy and posterior capsule opacification, which explains why there is a higher inflammatory risk when the procedures are accomplished simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of simultaneous vs. sequential pars plana vitrectomy and cataract surgery

Moraru

Costin

Moraru³

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

The coexistence of cataract and vitreoretinal diseases is common in clinical practice. The technological achievements of the last decade in both types of surgeries, allow simultaneous interventions on lens and retina. This retrospective study assessed the morphofunctional results obtained after performing simultaneous surgeries in a series of 87 patients presenting with both pathologies. The cases were retrospectively reviewed from their clinical records from 2017 to 2019. The patients were divided into two groups: group 1 comprising 41 cases underwent the combined procedure and group 2 comprising 46 patients underwent vitrectomy, followed by cataract surgery after 3-10 months. The functional and anatomical outcomes and the complications were assessed pre-and post-operatively. The statistical analysis was carried out by MaxStat software. The final best corrected visual acuity (BCVA), in group 1 was <0.1 in 4.88% of the cases, 0.1 to 0.3 in 17.07%, 0.3 to 0.5 in 51.22% and >0.5 in 26.83% eyes. In group 2, the final BCVA, after both surgeries were completed was <0.1 in 8.7% cases, 0.1 to 0.3 in 30.43%, 41.3% were 0.3 to 0.5 and 19.57% were >0.5. During the cataract surgery, the most common intraoperative complication was miosis, followed by posterior capsule rupture. Postoperative, 12.2% cases from group 1 developed an immediate inflammatory reaction in the anterior chamber, and 17.07% presented with posterior capsular opacification (PCO). Simultaneous surgery is safe and effective in obtaining a good morphological and functional result and offers the advantage of a clear eye media that allows a safer vitrectomy and thus a quicker rehabilitation of the patient. The analysis of the risks and benefits of each procedure should be taken into account and the cases selected individually for either simultaneous or sequential surgery in order to obtain the best outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of simultaneous vs. sequential pars plana vitrectomy and cataract surgery

Moraru

Costin

Moraru³

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…In some cases, a quick dislocation of the clot through the injected site was observed. After total fluid-air exchange, 1.25 mg/0.05 ml bevacizumab (Avastin ® , Roche, Switzerland) injection was intravitreally injected in all patients ( 12 ). Face-down position was recommended in all cases for the next 24 h. Patients were evaluated on the first day, 1 week and 1 month after surgery.…”

Section: Case Reportsmentioning

confidence: 99%

Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series

et al. 2020

Self Cite

View full text Add to dashboard Cite

This report describes a series of cases with massive subretinal hemorrhage (SRH) due to age-related macular degeneration (AMD) treated by subretinal alteplase injections. In all cases, the surgical technique consisted in 25-gauge pars plana vitrectomy (PPV) and alteplase injection under the retina using a 38-gauge cannula. After the fluid-gas exchange, bevacizumab injection was performed in all patients. Three cases of SRH in which this technique was used, as well as their evolution at one week and one month postoperatively are described. Visual acuity was hand motion in all three cases at presentation. After surgery, a significant anatomical and functional improvement was noted in all cases. One month postoperatively, none of the patients had blood under the macula, and visual acuities significantly improved to 0.8, 0.2 and 0.16 (decimal fraction). A consistent reduction of central retinal thickness was observed on optical coherence tomography (OCT) from the first week postoperatively. No intra and postoperative complications were noted. Subretinal alteplase injection proved as a viable solution in these severe SRH with early presentation. There was no need to change the systemic anticoagulant and antiaggregant therapy. Bevacizumab intravitreal injection at the end of surgery has an important role in preventing further bleeding.

show abstract

“…However, the off-label therapy represents a jurisdictional ambiguity, and physicians treating patients with bevacizumab face a substantial legal risk. Nevertheless, within study protocols, bevacizumab has been proven to be an efficient and safe drug for wet AMD patients, both in short and medium term [33].…”

Section: Romaniamentioning

confidence: 99%

Off-label use of bevacizumab for wet age-related macular degeneration in Europe

Bro

Derebecka

Jørstad

et al. 2019

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose To analyse current off-label use of bevacizumab for wet age-related macular degeneration (AMD) in Europe. Methods The study was conducted as a combined survey and literature review. It included the 22 most populous countries in Europe. In each country, ophthalmologists with particular knowledge about off-label treatment responded to a questionnaire. Results Answers were obtained from twenty European countries. The off-label use of bevacizumab for wet AMD greatly differed between nations; the bevacizumab proportion varied from non-existent (0%) to very high (97%). There were also large disparities within single countries (e.g. 0-80%), which were attributable to differences in regional decision-making. Both governmental institutions and national ophthalmological societies expressed highly diverging opinions on the use of off-label treatment. Intravitreal administration of bevacizumab had been a matter of legal dispute in several countries. The question about responsibility for off-label therapy mainly remained unanswered. Conclusions There was a highly varying utilization of bevacizumab between European countries. Despite an intention of a consistent approach to medical regulations, Europe has not yet reached a professional or political consensus on the ophthalmic off-label use of bevacizumab.

show abstract

Bevacizumab in Wet AMD treatment: A tribute to the thirteen years of experience from the beginning of the anti‑VEGF era in Romania

Cited by 17 publications

References 35 publications

Outcomes of simultaneous vs. sequential pars plana vitrectomy and cataract surgery

Outcomes of simultaneous vs. sequential pars plana vitrectomy and cataract surgery

Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series

Off-label use of bevacizumab for wet age-related macular degeneration in Europe

Contact Info

Product

Resources

About