Management of Myopic Choroidal Neovascularization: Focus on Anti-VEGF Therapy

Teo, Kelvin Yi Chong; Lee, Shu Yen; Cheung, Chui Ming Gemmy

doi:10.1007/s40265-016-0605-0

Cited by 9 publications

(4 citation statements)

References 106 publications

(155 reference statements)

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“…Due to the good efficacy of anti-VEGF biological agents, including bevacizumab, ranibizumab and aflibercept, these have been proposed as a first-line treatment for mCNV ( 10 ). The visual prognosis and natural progression of mCNV are more favourable than those of CNV secondary to age-related macular degeneration (AMD) and patients with mCNV have shown a good response to anti-VEGF therapy ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

High‑dose aflibercept injection has striking effects on myopic choroidal neovascularization

et al. 2023

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The aim of the present study was to evaluate the 1-year outcomes of a high-dose aflibercept injection [4 mg 2+ pro re nata (PRN) scheme] for individuals with myopic choroidal neovascularization (mCNV) through optical coherence tomography (OCT) follow-ups. A total of 16 consecutive patients (7 males and 9 females; sixteen eyes) with mCNV were enrolled in this retrospective study. The mean age was 30.5±3.35 years and mean spherical equivalent was -7.31±0.90 D. Subjects received 4 mg aflibercept intravitreal injection on the day of diagnosis and 35 days later. Further injections of aflibercept were required when the following were detected by OCT and fluorescein angiography: i) Decrease in best corrected visual acuity (BCVA); ii) aggravation of metamorphopsia; iii) macular oedema; iv) macular haemorrhage; v) increase in retinal thickness; and vi) leakage. Ophthalmic examination and OCT were performed at the baseline, as well as at 1, 2, 4, 6, 8, 10 and 12 months after the initial aflibercept injection. BCVA and central retinal thickness (CRT) were evaluated at each follow-up. The results showed that the vision of all subjects improved following the aflibercept intravitreal injection. The mean BCVA improved from 0.35±0.15 logarithm of the minimal angle of resolution (logMAR) at the baseline to 0.12±0.05 logMAR at final follow-up (P<0.05). A reduction in metamorphopsia was observed and the mean CRT was reduced from 345.38±34.69 µm of pre-treatment levels to 222.75±8.98 µm at the last postoperative visit (P<0.05). The mean number of injections in the present study was 2.13±0.5. Out of all patients, 13 received two injections and 3 subjects received three injections. The mean follow-up was 13.41±1.17 months. Based on the outcomes, it was found that an intravitreal injection of high-dose aflibercept (4 mg 2+PRN scheme) is effective for vision improvement and stabilization. In addition, it also significantly alleviated metamorphopsia and reduced the CRT in patients treated with mCNV. During the follow-up, the eyesight of the patients was stable.

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Section: Introductionmentioning

confidence: 99%

High‑dose aflibercept injection has striking effects on myopic choroidal neovascularization

et al. 2023

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“…It plays a central role in cancer and various ischemic diseases [2,3]. Vascular endothelial growth factor (VEGF) is upregulated by hypoxia during ischemia [4] and is a major stimulatory factor for choroidal neovascularization (CNV) in age-related macular degeneration [5,6] and high myopia [7], as well as retinal neovascularization in diabetic retinopathy [6]. Retinal and choroidal endothelial cells play key roles in the development of retinal and choroidal neovascularization, and subsequent fibrosis.…”

Section: Introductionmentioning

confidence: 99%

The Inhibitory Effects of Gold Nanoparticles on VEGF-A-Induced Cell Migration in Choroid-Retina Endothelial Cells

Chan

Hsiao

et al. 2019

IJMS

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Background: Vascular endothelial growth factor (VEGF) is upregulated by hypoxia and is a crucial stimulator for choroidal neovascularization (CNV) in age-related macular degeneration and pathologic myopia, as well as retinal neovascularization in proliferative diabetic retinopathy. Retinal and choroidal endothelial cells play key roles in the development of retinal and CNV, and subsequent fibrosis. At present, the effects of gold nanoparticles (AuNPs) on the VEGF-induced choroid-retina endothelial (RF/6A) cells are still unknown. In our study, we investigated the effects of AuNPs on RF/6A cell viabilities and cell adhesion to fibronectin, a major ECM protein of fibrovascular membrane. Furthermore, the inhibitory effects of AuNPs on RF/6A cell migration induced by VEGF and its signaling were studied. Methods: The cell viability assay was used to determine the viability of cells treated with AuNPs. The migration of RF/6A cells was assessed by the Transwell migration assay. The cell adhesion to fibronectin was examined by an adhesion assay. The VEGF-induced signaling pathways were determined by western blotting. Results: The 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay revealed no cytotoxicity of AuNPs on RF/6A cells. AuNPs inhibited VEGF-induced RF/6A cell migration in a concentration-dependent manner but showed no significant effects on RF/6A cell adhesion to fibronectin. Inhibitory effects of AuNPs on VEGF-induced Akt/eNOS were found. Conclusions: These results suggest that AuNPs are an effective inhibitor of VEGF-induced RF/6A cell migration through the Akt/eNOS pathways, but they have no effects on their cell viabilities and cell adhesion to fibronectin.

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“…Previous therapies such as photodynamic therapy with Verteporfin showed limited success [ 9 ]. Due to the similarities in pathogenesis of CNV, anti-vascular endothelial growth factor therapy (anti-VEGF) has been shown to be effective and has become the first choice for the treatment of CNV [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmacogenomic study on anti-VEGF medicine in treatment of macular Neovascular diseases: a study protocol for a prospective observational study

Jin¹,

Shen²,

Xia³

et al. 2018

BMC Ophthalmol

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BackgroundMacular neovascular diseases can cause severe vision loss. A newly approved anti—VEGF drug Conbercept has shown good efficacy and safety in rigorous random controlled trials (RCT), however, it cannot fully reflect the clinical application of Conbercept in real world clinical practice. Moreover, anti-VEGF drugs are expensive and often require multiple treatments, and some patients have poor or even no response to the drugs,this resulted enormous waste of medical resources. Therefore, how to find out those patients who have good response, and how to develop individualized therapeutic regimen in real world need to be urgently investigated in the aspect of pharmacogenomics and pharmacometabolomics.MethodsThis study is a multicenter, prospective, observational study of Conbecept treating macular neovascular diseases in China. Patients suffered from age-related macular degeneration, polypoidal choroidal vasculopathy, and pathological myopia who already planned to receive Conbercept treatment will be recruited. We aimed to enroll more than 5000 patients from 43 ophthalmic centers in China. Patients’ clinical data and blood samples will be collected during the one-year follow-up period. Finally, the safety and efficacy of Conbercept, and the potential predictors of patients’ response to Conbercept will be investigated by pharmacogenomics and pharmacometabolomics analysis.DiscussionThis study will provide important data of Conbercept in treating macular neovascular diseases in real world. Besides, finding the predictor of patients’ response will help doctor make more precise individualized therapeutic regimens.Trial registrationClinicalTrials.gov, NCT03128463. Registered on 9 March 2017.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0812-4) contains supplementary material, which is available to authorized users.

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Management of Myopic Choroidal Neovascularization: Focus on Anti-VEGF Therapy

Cited by 9 publications

References 106 publications

High‑dose aflibercept injection has striking effects on myopic choroidal neovascularization

High‑dose aflibercept injection has striking effects on myopic choroidal neovascularization

The Inhibitory Effects of Gold Nanoparticles on VEGF-A-Induced Cell Migration in Choroid-Retina Endothelial Cells

Pharmacogenomic study on anti-VEGF medicine in treatment of macular Neovascular diseases: a study protocol for a prospective observational study

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