Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Ikeda, Tsunehiko; Sawa, Hiroshi; Koizumi, Keigo; Yasuhara, Toru; Yamasaki, Toshihide

doi:10.1034/j.1600-0420.2000.078004460.x

Cited by 34 publications

(25 citation statements)

References 25 publications

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“…The authors concluded that the persistent attachment of the posterior vitreous cortex to the macula may be a risk factor for developing exudative AMD, and that vitrectomy to create a PVD may have prophylactic benefits. Relevant to our case, a regression of a CNV in eyes with AMD has been described after vitrectomy to create a PVD 5. We found a firmly adherent vitreous cortex around the macula, which may have caused the development of a CNV after the cataract surgery in the fellow eye.…”

Section: Discussionsupporting

confidence: 77%

Combined vitreous and cataract surgeries in highly hyperopic eye

Inoue

Shinoda²,

Matsuda-Yamamitsu³

et al. 2010

OPTH

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We report a case of a patient with a highly hyperopic eye who underwent cataract surgery combined with vitreous surgery to create a posterior vitreous detachment (PVD) to prevent choroidal neovascularization (CNV). A 78-year-old man noticed a decrease in his vision due to a cataract in his right eye. The patient had a severe visual loss in his left eye because of a CNV 2 years after a cataract surgery. His visual acuities were 20/30 OD and 20/600 OS, and funduscopic examination showed an orange-colored lesion OD and degenerative subretinal fibrosis OS. The posterior vitreous was attached to the retina in both eyes. The axial length was 18.9 mm OD and 19.0 mm OS. Cataract surgery combined with vitreous surgery to create PVD was performed on the right eye, and the vision improved to 20/20 with no signs of developing CNV after 5 years. We conclude that cataract surgery combined with vitreous surgery to create a PVD may prevent the development of CNV in highly hyperopic eyes.

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Section: Discussionsupporting

confidence: 77%

Combined vitreous and cataract surgeries in highly hyperopic eye

Inoue

Shinoda²,

Matsuda-Yamamitsu³

et al. 2010

OPTH

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“…Furthermore, these tractional forces may antagonize the effects of anti-VEGF treatments and cause pharmacological resistance in those patients [29, 30]. Unfortunately, no published study has investigated whether there is an increase in vitreous VEGF levels in the presence of vitreoretinal interface pathologies or an alteration in the penetration of anti-VEGF drugs through the ERM in eyes with nAMD.…”

Section: Discussionmentioning

confidence: 99%

The Role of Epiretinal Membrane on Treatment of Neovascular Age‐Related Macular Degeneration with Intravitreal Bevacizumab

Alkın

Özkaya

Osmanbaşoğlu

et al. 2013

The Scientific World Journal

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Purpose. To determine the effect of epiretinal membranes (ERM) on the treatment response and the number of intravitreal bevacizumab injections (IVB) in patients with neovascular age-related macular degeneration (nAMD). Methods. A retrospective chart review was performed on 63 eyes of 63 patients. The patients were divided into AMD group (n = 35) and AMD/ERM group (n = 28). Best corrected visual acuity (BCVA) and central retinal thickness (CRT), as well as the number of injections, were evaluated. Results. There was a significant improvement in BCVA at 3 months for the AMD and AMD/ERM groups (P = 0.02, P = 0.03, resp.). At 6, 12, and 18 months, BCVA did not change significantly in either of the groups compared to baseline (P > 0.05 for all). At 3, 6, 12, and 24 months, the AMD group had an improvement in BCVA (logMAR) of 0.09, 0.06, 0.06, and 0.03 versus 0.08, 0.07, 0.05, and 0.03 for the AMD/ERM group (P = 0.29, P = 0.88, P = 0.74, P = 0.85, resp.). A significant decrease in CRT occurred in both groups for all time points (P < 0.001 for all). The change in CRT was not statistically different between the two groups at all time points (P > 0.05 for all). The mean number of injections over 24 months was 8.8 in the AMD group and 9.2 in the AMD/ERM group (P = 0.76). Conclusion. During 24 months, visual and anatomical outcomes of IVB in nAMD patients were comparable with those in nAMD patients with ERM with similar injection numbers.

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“…23 It has also been shown that vitrectomy to detach the posterior vitreous cortex could improve CNV regression. 24 In 2 In contrast to other variable-dosing regime studies showing better outcomes, the presence of VMT often leads to poorer visual and anatomical outcomes during anti-VEGF therapy for wet AMD. Surgical intervention to address VMT is an option to be considered in managing this difficult group of patients when the expected response is not achieved.…”

Section: Discussionmentioning

confidence: 99%

Vitreomacular Traction Affects Anti-Vascular Endothelial Growth Factor Treatment Outcomes for Exudative Age-Related Macular Degeneration

Krishnan

Arora

Salvo

et al. 2015

Retina

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Abstract:Purpose: To evaluate the effect of vitreomacular traction (VMT) on the visual acuity outcomes and central retinal thickness measurements following intravitreal antivascular endothelial growth factor (anti-VEGF) therapy for the treatment of exudative AMD.Methods: In this retrospective series, we evaluate the clinical records and optical coherence tomography (OCT) scans of 34 eyes of 32 patients, with VMT confirmed on OCT scanning at baseline, to assess the effects of VMT on anti-VEGF therapy for newly diagnosed exudative wet AMD. Best corrected visual acuity (BCVA) at baseline, 1, 3, 6, 9 and 12 months and central retinal thickness (CRT) at baseline, 3, 6, and 12 months were assessed. Comparison was made with a control group of 29 eyes of 28 patients with wet AMD and no VMT on OCT and with key variable dosing studies for anti-VEGF in exudative AMD (CATT, HARBOR, PrONTO, SUSTAIN and Gupta et al).Results: BCVA results showed a visual acuity improvement that peaked at 3 months with 2.47 letters, well below other variable dosing studies for anti-VEGF therapy in exudative AMD. This was then followed by a steady decline with mean BCVA at 12 months ending below the baseline level (-1.00 letters) compared to a gain of 9.39 letters in the control group at 12 months. Comparison of the mean CRT in the VMT Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationgroup between baseline and 12 months showed no significant difference (P=0.67), while the PrONTO study and control group showed a highly significant difference at 12 months compared to baseline (P< 0.001).Mean CRT values at 6 and 12 months were essentially at baseline levels (0.26 um, -0.62 um respectively).Conclusion: VMT at baseline, existing concurrently with newly diagnosed exudative AMD treated with intravitreal anti-VEGF therapy on a variable dosing regime, was associated with poorer visual outcomes and a decreased response to reduction in CRT, compared to a control group of wet AMD without VMT treated with intravitreal anti-VEGF and compared to major variable dosing studies for intravitreal anti-VEGF in exudative AMD. While change in letter score is fine, the visual acuities should be provided with their Snellen equivents. This needs to be done in Table 1. Otherwise the manuscript should be accepted. Amendments:I have added the Snellen equivalents to the ETDRS visual acuities in Table 1 as requested above. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Key words:Age-related macular degeneration; anti-vascular endothelial growth factor; exudative; vitreomacular traction 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 Summary statement:In patients with AMD treated with anti-VEGF therapy on a variable dosing regime, concurrent vitreomacular traction was associated with a less favourable visual outcome and less ...

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Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration

Cited by 34 publications

References 25 publications

Combined vitreous and cataract surgeries in highly hyperopic eye

Combined vitreous and cataract surgeries in highly hyperopic eye

The Role of Epiretinal Membrane on Treatment of Neovascular Age‐Related Macular Degeneration with Intravitreal Bevacizumab

Vitreomacular Traction Affects Anti-Vascular Endothelial Growth Factor Treatment Outcomes for Exudative Age-Related Macular Degeneration

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