Triple Therapy for Anti-Vascular Endothelial Growth Factor Nonresponders in Neovascular Age-Related Macular Degeneration: Impact of Different Photodynamic Therapy Parameters

Veritti, Daniele; Lanzetta, Paolo

doi:10.1159/000351651

Cited by 11 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Often combined with other chemotherapy, it improves response and survival in certain cancer types, including advanced cervical cancer [6]. Given the inhibitory effects on neovascularization, intraocular diseases associated with the formation of new vessels, such as age-related macular degeneration and diabetic retinopathy, may also benefit from bevacizumab intervention [7]. In addition to bevacizumab, there are many other drugs that target the VEGF pathway and angiogenesis, including other VEGF ligands, VEGFR blockers, and tyrosine kinase inhibitors, such as sunitinib and sorafenib, that block VEGF-induced cellular signaling [8].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous thrombogenic vasculopathy associated with bevacizumab therapy

Kiuru

Schwartz

Magro

2014

Dermatology Online Journal

View full text Add to dashboard Cite

Bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), is an angiogenesis inhibitor used to treat a variety of cancers, including lung, colon, cervical, ovarian, and renal cancers as well as glioblastoma. A significant adverse effect associated with its use is one of thromboembolic events. We report a case of a 74-year-old male with diagnosis of glioblastoma multiforme treated with partial resection, radiation, temozolomide, and bevacizumab. He presented to a plastic surgeon with a several week history of asymptomatic crusted hemorrhagic ulcers and purpuric patches on the lower legs shortly following the initiation of bevacizumab. A biopsy showed an occlusive pauci-inflammatory thrombogenic vasculopathy associated with ischemic epidermal and dermal changes and accompanied by extensive vascular C5b-9 (complement C5b-9 membrane attack complex) deposition. Bevacizumab has been associated with thrombotic complications including atypical hemolytic uremic syndrome and arterial and venous thrombosis. C5b-9 may be the factor most important in the mechanism of vascular thrombosis given the extent of deposition in our index case. Thrombotic events in the skin associated with bevacizumab therapy are without precedent and dermatologists should be aware of this potential complication.

show abstract

Section: Discussionmentioning

confidence: 99%

Cutaneous thrombogenic vasculopathy associated with bevacizumab therapy

Kiuru

Schwartz

Magro

2014

Dermatology Online Journal

View full text Add to dashboard Cite

show abstract

“…It found that both standard fluence and standard irradiance produced visual decline at 6 months (change of 0.29 logMAR, p < 0.05), possibly due to choroidal ischaemia. Reduced fluence/standard irradiance and reduced fluence/reduced irradiance were associated with no significant visual change (Veritti & Lanzetta ). Single dosage combination intravitreal triamcinolone, intravitreal bevacizumab and oscillatory thermotherapy in conjunction with ICGA for resistant nAMD has been evaluated in one series.…”

Section: Methodsmentioning

confidence: 99%

Treating the untreatable patient: current options for the management of treatment‐resistant neovascular age‐related macular degeneration

Broadhead

Hong²,

Chang

2014

Acta Ophthalmologica

View full text Add to dashboard Cite

ABSTRACT. Anti-vascular endothelial growth factor (anti-VEGF) agents represent the current standard of care for neovascular age-related macular degeneration (nAMD). Although effective in a majority of cases, a significant proportion of patients have persisting retinal exudation despite regular anti-VEGF therapy. This exudation is considered to produce poorer visual outcomes in these patients. Some of these patients may have misdiagnosed nAMD variants such as polypoidal choroidal vasculopathy; however, the majority of these eyes have what has been termed treatment-resistant nAMD. Currently, the best way to care for these patients is uncertain. Here, we review the evidence for different approaches to the management of treatment-resistant nAMD, including high-dose anti-VEGF therapy, combination regimes and switching of anti-VEGF agents, and discuss possible therapeutic approaches for patients with treatment-resistant nAMD.

show abstract

“…10 “Triple therapy,” in which patients with AMD receive intravitreal dexamethasone or triamcinolone acetonide injections, intravitreal bevacizumab or other anti-VEGF injections, and photodynamic therapy, has been described to stabilize and sometimes improve VA in eyes with neovascular AMD that does not respond to anti-VEGF treatment alone. 11,12…”

Section: Resultsmentioning

confidence: 99%

Prompt Improvement of an Enlarging Pigment Epithelial Detachment Following Intravitreal Dexamethasone in Neovascular Age-Related Macular Degeneration

Powers

Wisely

Sastry

et al. 2019

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

Purpose: This report discusses a case of neovascular age-related macular degeneration with mixed serous pigment epithelial detachment (PED) that was unresponsive to antivascular endothelial growth injections but responded to the addition of intravitreal steroid injection. Methods: We report a case. Results: A 75-year-old woman with neovascular age-related macular degeneration developed a mixed serous PED in her right eye. Three monthly aflibercept (Eylea, Regeneron) treatments led to resolution of associated intraretinal fluid; however, the mixed serous and fibrovascular PED significantly increased in size. The addition of intravitreal dexamethasone (Ozurdex, Allergan) to monthly aflibercept led to prompt flattening of the PED. Three months later, the PED recurred despite continued administration of monthly aflibercept. Conclusions: This case supports a growing body of research that PEDs unresponsive to antivascular endothelial growth injections may respond to intravitreal steroid injections.

show abstract

Triple Therapy for Anti-Vascular Endothelial Growth Factor Nonresponders in Neovascular Age-Related Macular Degeneration: Impact of Different Photodynamic Therapy Parameters

Cited by 11 publications

References 16 publications

Cutaneous thrombogenic vasculopathy associated with bevacizumab therapy

Cutaneous thrombogenic vasculopathy associated with bevacizumab therapy

Treating the untreatable patient: current options for the management of treatment‐resistant neovascular age‐related macular degeneration

Prompt Improvement of an Enlarging Pigment Epithelial Detachment Following Intravitreal Dexamethasone in Neovascular Age-Related Macular Degeneration

Contact Info

Product

Resources

About