The role of posterior vitreous detachment on the efficacy of anti-vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration

Neudorfer, Meira; Fuhrer, AudeliaEshel; Zur, Dinah; Barak, Adiel

doi:10.4103/ijo.ijo_373_18

Cited by 7 publications

(6 citation statements)

References 39 publications

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“…Furthermore, when comparing studied parameters between eyes with complete PVD and eyes without it, there were no significant differences in baseline and 1-year logMAR BCVA. A previous report using ultrasonography showed the similar results [ 23 ]. Taken together, although VMT obviously affects treatment outcome of anti-VEGF therapy in AMD [ 5 , 15 ], PVD and VMA has remained controversial.…”

Section: Discussionsupporting

confidence: 79%

Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration

et al. 2021

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Background To quantitatively evaluate the vitreomacular interface of eyes with neovascular age-related macular degeneration (AMD) and to investigate its association with the 1-year treatment outcome following intravitreal injections of aflibercept (IVA). Methods This prospective observational case series included 59 eyes of 59 consecutive patients with treatment-naïve neovascular AMD who were treated with three monthly IVA and subsequent four bi-monthly IVA and were followed up for 1 year. We estimated posterior vitreous detachment at 1, 9, and 25 macular points within an area of 6 × 6 mm2 at the center of the fovea using the built-in enhanced vitreous visualization mode of swept-source optical coherence tomography. One year after the initial IVA, we classified the eyes into either wet or dry groups. Results The wet and dry groups included 12 and 47 eyes, respectively. The resistance rate against IVA was 20.3%. The 25-point interface score was higher in the wet group than in the dry group (23.0 ± 4.3 vs. 18.6 ± 9.8, P = 0.03), whereas there were no significant between-group differences in the 9-point and 1-point scores (P = 0.21, and 0.47, respectively) or in the other studied parameters. Multivariable analysis revealed that the 25-point vitreomacular interface score was strongly correlated with subfoveal choroidal thickness (P = 0.02, β = − 0.31). Conclusions Our findings suggest that wide-ranged separation of the posterior vitreous membrane from the retina induces poor response to IVA.

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Section: Discussionsupporting

confidence: 79%

Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration

et al. 2021

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“…In a clinical setting, posterior hyaloid status has been found not to affect the efficacy of intravitreal injection courses for diabetic macular edema or age-related macular degeneration. [10][11][12] However, in patients who have received therapy with intravitreal ocriplasmin for symptomatic vitreoretinal adhesion, 13 ellipsoid zone disruption has been suggested to be a preexisting finding of the disease, leading to lack of visual improvement after treatment.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Posterior Hyaloid Assessment Using Preoperative Optical Coherence Tomography and Intraoperative Triamcinolone Acetonide Staining During Vitrectomy

Albabtain

Mura

Schatz

et al. 2021

OPTH

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Purpose To compare the specificity of diagnosing posterior vitreous detachment (PVD) using preoperative optical coherence tomography (OCT) versus intraoperative triamcinolone acetonide (TA) staining in patients undergoing vitrectomy. Patients and Methods This retrospective cohort study included patients undergoing pars plana vitrectomy for diverse retinal pathologies. Intraoperatively, surgeons evaluated the posterior hyaloid status with TA staining and compared it with preoperative OCT findings. Results One hundred six patients underwent intraoperative assessments of posterior hyaloid status, with 72% (76/106) of the eyes showing positive staining. Sixty-two patients had also undergone preoperative OCT. Of the patients diagnosed with PVD on preoperative OCT, 50% (15/30) showed positive TA staining intraoperatively. The sensitivity of preoperative OCT assessment was 83.3%, and its specificity was 65.9%. Conclusion Preoperative OCT imaging is associated with lower sensitivity and specificity for diagnosing PVD when compared to intraoperative TA staining.

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“…Importantly, the effect of PVD on the treatment of anti-VEGF did not show any significant differences when compared with the normal patients. 58…”

Section: Effect Of Vitreous Humour Changes On Intravitreal Drug Deliverymentioning

confidence: 99%

Vitreous Humor: Composition, Characteristics and Implication on Intravitreal Drug Delivery

Mishra

Gade

Glover

et al. 2022

Current Eye Research

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Purpose: Intravitreal administration of drug molecules is one of the most common routes for treating posterior segment eye diseases. However, the properties of vitreous humour changes with the time. A number of ocular complications such as liquefaction of the vitreous humour, solidification of the vitreous humour in the central vitreous cavity and detachment of the limiting membrane due to the shrinking of vitreous humour are some of the factors that can drastically affect the efficacy of therapeutics delivered via intravitreal route. Although significant research has been conducted for studying the properties of vitreous humour and its changes during the ageing process, there have been limited work to understand the effect of these changes on therapeutic efficacy of intravitreal drug delivery systems. Therefore, in this review we discussed both the coomposition and characteristics of the vitreous humour, and their subsequent influence on intravitreal drug delivery. Methods: Articles were searched on Scopus, PubMed and Web of Science up to March 2022. Results: In this review, we discussed the biological composition and biomechanical properties of vitreous humour, methods to study the properties of vitreous humour and the changes in these properties and their relevance in ocular drug delivery field, with the aim to provide a useful insight into these aspects which can aid the process of development of novel intravitreal drug delivery systems. Conclusions: The composition and characteristics of the vitreous humour, and how these change during natural aging processes, directly influence intravitreal drug delivery. This review therefore highlights the importance of understanding the properties of the vitreous and identifies the need to achieve greater understanding of how changing properties of the vitreous affect the therapeutic efficacy of drugs administered for the treatment of posterior eye diseases.

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The role of posterior vitreous detachment on the efficacy of anti-vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration

Cited by 7 publications

References 39 publications

Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration

Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration

Comparison of Posterior Hyaloid Assessment Using Preoperative Optical Coherence Tomography and Intraoperative Triamcinolone Acetonide Staining During Vitrectomy

Vitreous Humor: Composition, Characteristics and Implication on Intravitreal Drug Delivery

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