Intravitreal Injection of Corticosteroid Attenuates Leukostasis and Vascular Leakage in Experimental Diabetic Retina

Tamura, Hiroshi; Miyamoto, Kazuaki; Kiryu, Junichi; Miyahara, Shinya; Katsuta, Hideto; Hirose, Fuyuki; Musashi, Kunihiro; Yoshimura, Nagahisa

doi:10.1167/iovs.04-0905

Cited by 222 publications

(139 citation statements)

References 20 publications

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“…[17][18][19] IVD delivers sustained release of corticosteroid and has proven to be an effective treatment modality for DMO. [9][10][11][12] Corticosteroids block production of inflammatory cytokines and VEGF, 27 inhibit leukostasis, 28 improve the barrier function of vascular endothelial cell tight junctions, 29 inhibit endothelial nitric oxide synthase, 30 reduce tissue oedema, and decrease the release of prostaglandins and histamines, 31 all of which could cause vasodilation and choroidal thickening, potentially affecting ocular perfusion pressure. 32 IVD, therefore, could exert its therapeutic effect not only on the retina, but also on the choroid, by decreasing the production of inflammatory cytokines and factors that could increase CT.…”

Section: Discussionmentioning

confidence: 99%

Effect of intravitreal dexamethasone implant on retinal and choroidal thickness in refractory diabetic macular oedema after multiple anti-VEGF injections

Kim

Cho

Lee

et al. 2016

Eye

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Aims To investigate the effect of intravitreal dexamethasone implant (IVD) on central foveal thickness (CFT), choroidal thickness (CT) and its correlation with visual acuity in eyes with refractory diabetic macular oedema (DMO). Methods This was a retrospective interventional case-series. Thirty-five eyes of 35 patients were treated with a single injection of IVD because of refractory DMO with CFT over 300 μm, and persistent intraretinal and subretinal fluid despite of multiple intravitreal bevacizumab injections. Patients were followed-up for 6 months for the evaluation of CFT and subfoveal CT by spectral-domain optical coherence tomography. Results All eyes (mean age: 59.4 ± 12.35 years; 18 males, 17 females) had been previously treated with multiple bevacizumab injections and showed persistent DMO (mean number of injections 4.08 ± 2.98) The preoperative logMAR BCVA was 0.49 ± 0.24, which gradually improved to 0.46 ± 0.32 at 6 months (P = 0.652) and 26% gained two or more lines of Snellen visual acuity. At baseline, the mean CFT was 526.29 ± 123.48 μm, which significantly improved to 316.15 ± 100.09 μm at 3 months (Po0.001). However, CFT deteriorated to 457.07 ± 136.53 μm at 6 months (P = 0.051). Similarly, the mean preoperative subfoveal CT was 288.91 ± 36.47 μm and it decreased to 266.85 ± 30.93 μm at 3 months (Po0.01), but increased to 278.63 ± 32.55 μm at 6 months (P = 0.137). The reduction of CFT from baseline showed significant correlation with that of subfoveal CT at 3 months (P = 0.041) and at 6 months (P = 0.008). Conclusions In DMO refractory to multiple bevacizumab injections, IVD significantly reduced CFT and subfoveal CT, with BCVA improvement in one-fourth of the patients. The reduction of CFT showed significant correlation with reduction of subfoveal CT.

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Section: Discussionmentioning

confidence: 99%

Effect of intravitreal dexamethasone implant on retinal and choroidal thickness in refractory diabetic macular oedema after multiple anti-VEGF injections

Kim

Cho

Lee

et al. 2016

Eye

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“…Mechanisms of intravitreal corticosteroids include reduction of retinal capillary permeability by increasing the activity and/or density of tight junctions in the retinal capillary endothelium, 64 inhibition of the VEGF gene expression, inhibition of the VEGF metabolic pathway, 65 and suppression of intracellular adhesion molecule-1 (ICAM-1)-mediated leucocyte adhesion to vessel walls. 66 Corticosteroids help keep vision stable, but increase the incidence of cataracts and glaucoma.…”

Section: Anti-inflammatory and Immunosuppressive Agentsmentioning

confidence: 99%

Intravitreal bevacizumab for choroidal neovascularisation secondary to causes other than age-related macular degeneration

Gupta

Elagouz

Sivaprasad

2009

Eye

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Choroidal neovascularisation (CNV) is characterised by new blood vessel growth under the retina that usually results in significant visual impairment when the fovea is involved. Though CNV is more commonly associated with age-related macular degeneration (AMD), it can occur secondary to a variety of other diseases. Recent successes with anti-angiogenic therapies suggest that they may outperform other therapies for all types of CNV. As non-AMD-related CNV cases are rare, randomised controlled trials are often not possible. This review compares the less prevalent reports of non-AMD CNV and pools evidence on the success and limitations of a variety of therapies.

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“…7,8 We hypothesised that the CMO developed in this patient because of non-VEGF-driven inflammation generated by Coats'-like exudation. This hypothesis is supported by the lack of improvement with an antivascular endothelial growth factor drug (Bevacizumab) and the immediate improvement with an intravitreal injection of a dexamethasone implant.…”

Section: Discussionmentioning

confidence: 96%

Coat’s-like exudation in rhodopsin retinitis pigmentosa: successful treatment with an intravitreal dexamethasone implant

Patil

Lotery

2014

Eye

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Purpose Role of intravitreal injection of dexamethasone implant (Ozurdex) for refractory macular thickening. Methods A case report of a 13-year-old boy with Rhodopsin-positive, CRB1-negative retinitis pigmentosa presenting with Coat's-like exudative vitreoretinopathy and treatment-resistant cystoid macular oedema. Results A reduction in the macular thickening following a single injection of Ozurdex. Conclusion We present our experience in successful treatment of refractory macular oedema with intravitreal injection of dexamethasone implant resulting in clinically significant resolution of macular thickening.

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Intravitreal Injection of Corticosteroid Attenuates Leukostasis and Vascular Leakage in Experimental Diabetic Retina

Abstract: Intravitreal injection of corticosteroids improves diabetic retinal edema through inhibiting leukocyte recruitment in the diabetic retina.

Cited by 222 publications

References 20 publications

Effect of intravitreal dexamethasone implant on retinal and choroidal thickness in refractory diabetic macular oedema after multiple anti-VEGF injections

Effect of intravitreal dexamethasone implant on retinal and choroidal thickness in refractory diabetic macular oedema after multiple anti-VEGF injections

Intravitreal bevacizumab for choroidal neovascularisation secondary to causes other than age-related macular degeneration

Coat’s-like exudation in rhodopsin retinitis pigmentosa: successful treatment with an intravitreal dexamethasone implant

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