Intravitreal triamcinolone, bevacizumab and pegaptanib for occult choroidal neovascularization

Abstract

ABSTRACT.Purpose: To evaluate best-corrected visual acuity (BCVA) and foveal thickness (FT) changes in occult subfoveal choroidal neovascularization (CNV) from agerelated macular degeneration (AMD) after intravitreal bevacizumab (IVB, 1.25 mg ⁄ 0.05 ml), pegaptanib (IVP, 0.3 mg ⁄ 0.09 ml) and triamcinolone acetonide (IVTA, 4 mg ⁄ 0.1 ml) injected on an as needed basis. Methods: Retrospective, interventional, comparative study. BCVA (Early Treatment Diabetic Retinopathy Study LogMAR) and FT by optical coherence tomography (OCT) were evaluated during 12 months from first treatment. Patients were retreated if signs of neovascular activity were still present on angiography or OCT. Results: Forty-eight eyes received IVB, 43 eyes received IVP, 52 eyes received IVTA. BCVA and FT at baseline were 1.22 ± 0.49 LogMAR and 410.2 ± 41.83 lm in the IVB group, 1.25 ± 0.43 LogMAR and 452.3 ± 44.83 lm in the IVP group and 1.31 ± 0.4 LogMAR and 456.6 ± 48.27 lm in the IVTA group. BCVA and FT improved in the three groups during follow-up. A significantly greater improvement of BCVA was present at month-3, month-6 and at month-12 in the IVB and IVP groups (p = 0.01). Improvement of FT was greater in the IVTA group at month-3 (p = 0.02), while it was greater in the anti-Vascular Endothelial Growth Factor (VEGF) groups at month-6 and month-12 (p = 0.01). A postoperative increase of intraocular pressure was detected in 9 ⁄ 52 (17.3%) eyes treated with IVTA, and in two cases it was resistant to topical therapy. Conclusion: Intravitreal injection of anti-VEGF drugs administered on an as needed basis for AMD-related occult CNVs provided functional and anatomic improvement during 12 months of follow-up.

Bilateral Intravitreal Bevacizumab Injection for Exudative Age-Related Macular Degeneration: Effect of Baseline Visual Acuity

“…This conclusion, however, should not lead to a delay in the treatment of the better-seeing eye, as the therapeutic efficacy of the intravitreal anti-vascular endothelial growth has been proved. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] …”

“…1 After the introduction of intravitreally applied bevacizumab into clinical ophthalmology by Rosenfeld and colleagues, 2 intravitreal bevacizumab has become one of the pillars in the therapy of exudative AMD. [3][4][5][6][7][8][9][10] Despite numerous studies on the effect of intravitreal bevacizumab on visual outcome in patients with exudative AMD, studies based on clinical practice with a consecutive inclusion of patients and an analysis of factors influencing the postinjection outcome have been mostly missing so far. It was, therefore, the purpose of our study to evaluate, in an intraindividual intereye comparison, whether baseline visual acuity and baseline anatomic macular changes influence visual outcome in patients bilaterally receiving intravitreal bevacizumab as treatment of exudative AMD in clinical practice.…”

Low luminance visual acuity in patients with central serous chorioretinopathy

“…Recent advances in OCT have provided some correlations of the foveal microstructure with visual function in several retinal diseases . Sekine, Imasawa and Iijima reported that the thickness of the serous retinal detachment and not neurosensory retinal thickness, was significantly correlated with visual sensitivity measured by automated static perimetry in eyes with central serous chorioretinopathy.…”

Natural History of Age-Related Retinal Lesions That Precede AMD in Mice Fed High or Low Glycemic Index Diets

“…Only 10% of AMD cases are the neovascular form. [2][3][4][5][6][7][8][9][10] The remaining 90% of AMD cases (approximately 7 million patients in the United States) are nonneovascular, for which treatment options are limited and disease progression is inexorable. 10 The best strategy to alleviate the personal and public financial burden of this disease is to prevent the onset and progression of AMD pathology.…”