Effect of lesion size, visual acuity, and lesion composition on visual acuity change with and without verteporfin therapy for choroidal neovascularization secondary to age-related macular degeneration: TAP and VIP report no. 1

Kj, Blinder; Bradley, Scott M.; Bressler, N. M.; Sb, Bressler; Donati, G.; Hao, Yue; C, Ma; Menchini, Ugo; Miller, Joan W.; Potter, MJ; Pournaras, Constantin J.; Reaves, Al; Pj, Rosenfeld; Ha, Strong; Stur, Michael; Xy, Su; Virgili, Gianni

doi:10.1016/s0002-9394(03)00223-x

Cited by 255 publications

(37 citation statements)

References 7 publications

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“…Although these treatments are helpful in reducing the risk of visual deterioration, they only improve vision in 6–33% of patients [3,4]. In addition, patients often exhibit AMD recurrence and require repeated treatments.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats

et al. 2017

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Choroidal neovascularization (CNV) is a major cause of severe visual loss in patients with age-related macular degeneration (AMD). Recently, itraconazole has shown potent and dose-dependent inhibition of tumor-associated angiogenesis. We evaluated the anti-angiogenic effect of itraconazole in a rat model of laser-induced CNV. After laser photocoagulation in each eye to cause CNV, right eyes were administered intravitreal injections of itraconazole; left eyes received balanced salt solution (BSS) as controls. On day 14 after laser induction, fluorescein angiography (FA) was used to assess abnormal vascular leakage. Flattened retinal pigment epithelium (RPE)-choroid tissue complex was stained with Alexa Fluor 594-conjugated isolectin B4 to measure the CNV area and volume. Vascular endothelial growth factor receptor 2 (VEGFR2) mRNA and protein expression was determined 1, 4, 7, and 14 days after intravitreal injection by quantitative RT-PCR or Western blot. VEGF levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Intravitreal itraconazole significantly reduced leakage from CNV as assessed by FA and CNV area and volume on flat mounts compared with intravitreal BSS (p = 0.002 for CNV leakage, p<0.001 for CNV area and volume). Quantitative RT-PCR showed significantly lower expression of VEGFR2 mRNA in the RPE-choroid complexes of itraconazole-injected eyes than those of BSS-injected eyes on days 7 and 14 (p = 0.003 and p = 0.006). Western blots indicated that VEGFR2 was downregulated after itraconazole treatment. ELISA showed a significant difference in VEGF level between itraconazole-injected and BSS-injected eyes on days 7 and 14 (p = 0.04 and p = 0.001). Our study demonstrated that intravitreal itraconazole significantly inhibited the development of laser-induced CNV in rats. Itraconazole had anti-angiogenic activity along with the reduction of VEGFR2 and VEGF levels. Itraconazole may prove beneficial for treating CNV as an alternative or adjunct to other therapies.

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Section: Introductionmentioning

confidence: 99%

Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats

et al. 2017

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“…Another possibility is reduction in laser focus size through reduction of the healthy retina margin to 500 μm, based on a major finding that lesion size is the most important prognostic factor of post-treatment visual acuity, and this closely correlates with laser focus size (in our case the diameter of laser focus was 4900 μm). A lower concentration of verteporfin can be achieved through an extension of the period between drug administration and laser exposure [15]. …”

Section: Discussionmentioning

confidence: 99%

Ostre pogorszenie ostrości wzroku z naczyniówkową hypoperfuzją po terapii fotodynamicznej - opis przypadku

2011

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SummaryBackgroundPhotodynamic therapy (PDT) is considered a selective method of treatment which works in areas of choroidal neovascularization (CNV); however, there are reports of choroidal hypoperfusion after PDT. This paper presents a clinical case of choroidal circulation disturbances caused by PDT, accompanied by CNV progression.Case ReportThe patient, a 75-year-old woman, was qualified for PDT in the right eye – first treatment due to progression of occult CNV. Best corrected visual acuity (BCVA) in the right eye at baseline was +0.3 logMAR. After PDT, a rapid decrease in visual acuity to +0.7 logMAR in the right eye was observed, central choroidal hypoperfusion in fluorescein angiography (FA) with subretinal fluid appeared and, as a consequence, progression of neovascular age-related macular degeneration (AMD). After stabilizing the local state through conservative therapy, a decision was made to treat the right eye with intravitreal injections of vascular endothelial growth factor (VEGF) inhibitor. During a 12-month period of observation, 7 doses of ranibizumab were administered. A regression in activity of wet AMD was observed, with visual acuity of +0.6 logMAR.ConclusionsChoroidal circulation disturbance after PDT is possible and has to be taken into account. Sporadically, it can lead to an acute decrease in visual acuity and local state. After stabilization of AF and optical coherence tomography imaging, further treatment of neovascular AMD with intravitreal injections of anti-VEGF agents should be considered.

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“…PDT was suggested for ARMD patients with predominantly classic CNV [3]. Smaller (≤4.0 disk areas minimally classic and occult CNV with no classic lesions had similar VA outcomes as those observed in predominantly classic lesions [18]. However, until now, government-funded TTT is still one of the options available to ARMD patients with subfoveal CNV, especially for the patients with lower socioeconomic status [19, 20].…”

Section: Discussionmentioning

confidence: 99%

Transpupillary Thermotherapy in Chinese Patients with Choroidal Neovascularization Secondary to Age-Related Macular Degeneration: Emphasis on the Influence of Power Setting

et al. 2008

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Purpose: To perform a safety and efficacy study of transpupillary thermotherapy (TTT) in Chinese patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (ARMD). Methods: In a prospective study, patients with subfoveal or juxtafoveal CNV secondary to ARMD underwent TTT with fixed treatment and follow-up protocols. From August 2002 to December 2004, 26 patients (27 eyes) completed ≧6 months of follow-up and were included in this report. Results: Fourteen eyes (52%) had improved or stable visual acuity (loss of <3 lines) and 13 eyes (48%) had vision loss of ≧3 lines. The serial mean visual acuity initially decreased during follow-up, then stabilized by 6 months. In the subgroup of occult or minimally classic CNV (20 eyes), 13 eyes (65%) had improved or stable vision. The major complication of TTT included laser-related retinal pigment epithelium (RPE) atrophy in 10 eyes (37%). Six eyes had mild RPE atrophy, 4 eyes had severe RPE-choroid atrophy (macular burn). Analysis of possible risk factors for macular burn showed that 3 eyes had to have the power amplified due to nuclear sclerosis, and 1 pseudophakic eye had regular power. Conclusions: TTT in Chinese ARMD patients with occult or minimally classic CNV, according to our protocol, prevented severe vision loss in the majority of patients, but power amplification due to medium lens opacity induced RPE atrophy or burn in some patients.

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Effect of lesion size, visual acuity, and lesion composition on visual acuity change with and without verteporfin therapy for choroidal neovascularization secondary to age-related macular degeneration: TAP and VIP report no. 1

Cited by 255 publications

References 7 publications

Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats

Intravitreal itraconazole inhibits laser-induced choroidal neovascularization in rats

Ostre pogorszenie ostrości wzroku z naczyniówkową hypoperfuzją po terapii fotodynamicznej - opis przypadku

Transpupillary Thermotherapy in Chinese Patients with Choroidal Neovascularization Secondary to Age-Related Macular Degeneration: Emphasis on the Influence of Power Setting

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