المؤلفون: Wirth MA; City hospital Triemli, Zurich, Switzerland., Freiberg F; City hospital Triemli, Zurich, Switzerland., Pfau M; City hospital Triemli, Zurich, Switzerland., Wons J; City hospital Triemli, Zurich, Switzerland., Becker MD; City hospital Triemli, Zurich, Switzerland.; University of Heidelberg, Heidelberg, Germany., Michels S; City hospital Triemli, Zurich, Switzerland.; University of Zurich, Zurich, Switzerland.

المصدر: Acta ophthalmologica [Acta Ophthalmol] 2017 Jun; Vol. 95 (4), pp. 428-430. Date of Electronic Publication: 2016 Sep 23.

نوع المنشور: Journal Article; Review

بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE

مواضيع طبية MeSH: Choroid/*pathology , Choroidal Neovascularization/*diagnosis , Fluorescein Angiography/*methods , Macula Lutea/*pathology , Retinal Vessels/*pathology , Tomography, Optical Coherence/*methods , Wet Macular Degeneration/*diagnosis, Fundus Oculi ; Humans

المؤلفون: Leydolt C; Department of Ophthalmology, Medical University of Vienna, Austria., Michels S, Prager F, Garhoefer G, Georgopoulos M, Polak K, Schmidt-Erfurth U

المصدر: Acta ophthalmologica [Acta Ophthalmol] 2010 Aug; Vol. 88 (5), pp. 594-600. Date of Electronic Publication: 2009 May 22.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE

مواضيع طبية MeSH: Angiogenesis Inhibitors/*therapeutic use , Antibodies, Monoclonal/*therapeutic use , Choroidal Neovascularization/*drug therapy , Macular Degeneration/*drug therapy , Vascular Endothelial Growth Factor A/*antagonists & inhibitors, Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/adverse effects ; Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Choroidal Neovascularization/diagnosis ; Choroidal Neovascularization/etiology ; Female ; Follow-Up Studies ; Humans ; Injections ; Macular Degeneration/complications ; Macular Degeneration/diagnosis ; Male ; Middle Aged ; Retreatment ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity/physiology ; Vitreous Body

مستخلص: Purpose: To study the effect of intravitreal bevacizumab therapy on visual and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) within a follow-up period of 6 and 12 months.
Methods: A retrospective analysis of 102 eyes of 102 consecutive patients with neovascular AMD evaluated repeated intravitreal bevacizumab (1 or 2.5 mg) injections. Retreatment was performed following an optical coherence tomography (OCT)-based regimen. Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging. Data were analysed at baseline, 6 months (24 weeks) and 12 months (48 weeks) after treatment initiation.
Results: BCVA remained stable at 6 months (mean: 0.00+/-0.41 logMAR; p=0.95) and 12 months (mean: +0.02+/-0.43 logMAR; loss of approximately 1 letter; p=0.70) after the first treatment. OCT retinal thickness decreased by a mean of -37.8+/-101.6 microm (p<0.05) compared to baseline at month 6 and -38.6+/-93.3 microm (p<0.05) at month 12. A mean of 2.6+/-1.2 injections were needed to obtain absence of fluid by OCT, and the time to recurrence was 23+/-11 weeks thereafter. There was no difference in BCVA and OCT outcomes between treatment-naive eyes and eyes that had undergone prior treatment.
Conclusion: The 6- and 12-month follow-up of repeated intravitreal bevacizumab therapy in eyes with neovascular AMD demonstrated stabilization of vision and no safety concerns. An OCT-based retreatment strategy appears appropriate in the management of patients treated with intravitreal bevacizumab.

المؤلفون: Geitzenauer W; Department of Ophthalmology, Medical University of Vienna, Austria., Michels S, Prager F, Rosenfeld PJ, Kornek G, Vormittag L, Schmidt-Erfurth U

المصدر: Retina (Philadelphia, Pa.) [Retina] 2008 Nov-Dec; Vol. 28 (10), pp. 1375-86.

نوع المنشور: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8309919 Publication Model: Print Cited Medium: Internet ISSN: 1539-2864 (Electronic) Linking ISSN: 0275004X NLM ISO Abbreviation: Retina Subsets: MEDLINE

مواضيع طبية MeSH: Angiogenesis Inhibitors/*administration & dosage , Antibodies, Monoclonal/*administration & dosage , Choroidal Neovascularization/*drug therapy , Macular Degeneration/*drug therapy, Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/adverse effects ; Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Blood Pressure ; Choroidal Neovascularization/etiology ; Female ; Fluorescein Angiography ; Humans ; Infusions, Intravenous ; Macular Degeneration/complications ; Male ; Middle Aged ; Prospective Studies ; Time Factors ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

مستخلص: Background: To compare safety, visual acuity (VA), and anatomic outcomes of 2.5 mg/kg and 5 mg/kg intravenous bevacizumab in patients with neovascular age-related macular degeneration.
Methods: In an institutional cohort study, 16 patients (2 cohorts, 27 eyes) with neovascular age-related macular degeneration were treated with 5 mg/kg intravenous bevacizumab and 2.5 mg/kg, respectively. All patients received 3 initial intravenous infusions at 2-week intervals. The main outcome measures were VA, optical coherence tomography, and fluorescein angiography.
Results: No serious systemic or ocular adverse events were identified. By Day 7, mean VA increased from 56 letters (20/80(+1)) at baseline to 60 letters (20/63) in the 5 mg/kg group and mean central retinal thickness decreased by 83 microm. In the 2.5 mg/kg group, mean VA increased from 55 letters (20/80) to 66 letters (20/50(+1)) and mean central retinal thickness decreased by 93 microm. By Month 3, VA improved by 10 letters compared to baseline in the 5 mg/kg group and by 9 letters in the 2.5 mg/kg group. Central retinal thickness was reduced by 128 microm in the 5 mg/kg group and by 127 microm in the 2.5 mg/kg group. These benefits were sustained through 6 months. No statistically significant difference was found between both treatment groups regarding safety, VA, and anatomic outcomes.
Conclusion: Similar VA, optical coherence tomography, and angiographic improvements were observed in both treatment groups up to 6 months. Further follow-up is required to evaluate the long-term durability and safety of both treatment regimens.

المؤلفون: Prager F; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Michels S, Simader C, Geitzenauer W, Schmidt-Erfurth U

المصدر: Retina (Philadelphia, Pa.) [Retina] 2008 May; Vol. 28 (5), pp. 682-8.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8309919 Publication Model: Print Cited Medium: Print ISSN: 0275-004X (Print) Linking ISSN: 0275004X NLM ISO Abbreviation: Retina Subsets: MEDLINE

مواضيع طبية MeSH: Angiogenesis Inhibitors/*administration & dosage , Antibodies, Monoclonal/*administration & dosage , Choroidal Neovascularization/*physiopathology , Macular Degeneration/*physiopathology , Retina/*physiology, Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Choroidal Neovascularization/drug therapy ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Macular Degeneration/drug therapy ; Male ; Prospective Studies ; Retreatment ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vision, Ocular/physiology ; Visual Acuity ; Visual Field Tests ; Visual Fields/drug effects

مستخلص: Objective: To evaluate changes in central retinal sensitivity in patients with neovascular age-related macular degeneration after systemic bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) therapy.
Methods: For all eyes, the central 12 x 12 degrees visual field was recorded using the MP 1 Microperimeter (Nidek, Gamagori, Japan) at baseline and 1 week, 1 month, 3 months, and 6 months after initial treatment. Patients received systemic anti-vascular endothelial growth factor (VEGF) therapy with three initial bevacizumab infusions at 2-week intervals. Retreatment during follow-up was performed only in cases of choroidal neovascularization recurrence. Seven patients (12 eyes) received bevacizumab infusions at a dose of 5 mg/kg, and 7 patients (9 eyes), at a dose of 2.5 mg/kg.
Results: Of 41 stimulation points, a mean absolute scotoma of 15 missed stimulation points was measured at baseline, which decreased to 10 missed stimulation points at month 3 (-5; P = 0.005) and to 11 stimulation points at month 6 (-4; P = 0.106). The mean absolute scotoma size (in % of total tested area) decreased from 33% to 22% (-11%; P = 0.011) at month 3 and to 23% (-10%, P = 0.123) at month 6. Mean differential light threshold increased significantly throughout the observation period from 3.8 dB at baseline to 5.5 dB (+1.7 dB; P = 0.012) at month 6.
Conclusions: Systemic bevacizumab therapy induced a significant increase in mean retinal sensitivity at month 6 of follow-up and a significant decrease of mean absolute scotoma size at month 3. The MP 1 Microperimeter proved to be a valuable tool in the evaluation of functional benefits and retinal safety of anti-VEGF therapy with systemic bevacizumab.

المؤلفون: Prager F; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Michels S, Geitzenauer W, Schmidt-Erfurth U

المصدر: Acta ophthalmologica Scandinavica [Acta Ophthalmol Scand] 2007 Dec; Vol. 85 (8), pp. 904-6. Date of Electronic Publication: 2007 Apr 13.

نوع المنشور: Case Reports; Journal Article

بيانات الدورية: Publisher: Blackwell Country of Publication: Denmark NLM ID: 9507578 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-0420 (Electronic) Linking ISSN: 13953907 NLM ISO Abbreviation: Acta Ophthalmol Scand Subsets: MEDLINE

مواضيع طبية MeSH: Genes, Dominant*, Choroidal Neovascularization/*etiology , Retinal Diseases/*complications , Retinal Diseases/*genetics, Adult ; Angiogenesis Inhibitors/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Choroidal Neovascularization/drug therapy ; Choroidal Neovascularization/physiopathology ; Female ; Fundus Oculi ; Humans ; Retinal Diseases/diagnosis ; Retinal Diseases/physiopathology ; Visual Acuity

مستخلص: Purpose: A case of choroidal neovascularization (CNV) secondary to Sorsby fundus dystrophy (SFD) treated with systemic bevacizumab (Avastin).
Methods: A 41-year-old woman presented with CNV secondary to SFD in her better eye. The patient received three initial infusions of bevacizumab at a dose of 5 mg/kg at 2 week intervals and one additional infusion because of CNV recurrence at the 7 month follow-up.
Results: At 16 month follow-up, visual acuity had improved from 20/50 at baseline to 20/25; optical coherence tomography and fluorescein angiography showed no evidence of CNV activity.
Conclusion: Systemic bevacizumab seems to be a promising treatment option for CNV secondary to SFD.

المؤلفون: Stifter E; Department of Ophthalmology, Medical University of Vienna, Austria., Michels S, Prager F, Georgopoulos M, Polak K, Hirn C, Schmidt-Erfurth U

المصدر: American journal of ophthalmology [Am J Ophthalmol] 2007 Dec; Vol. 144 (6), pp. 886-892. Date of Electronic Publication: 2007 Oct 04.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0370500 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0002-9394 (Print) Linking ISSN: 00029394 NLM ISO Abbreviation: Am J Ophthalmol Subsets: MEDLINE

مواضيع طبية MeSH: Angiogenesis Inhibitors/*therapeutic use , Antibodies, Monoclonal/*therapeutic use , Choroidal Neovascularization/*drug therapy , Macular Degeneration/*drug therapy , Retinal Hemorrhage/*drug therapy, Aged ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Choroidal Neovascularization/etiology ; Female ; Follow-Up Studies ; Humans ; Injections ; Macular Degeneration/complications ; Male ; Retina/pathology ; Retinal Hemorrhage/etiology ; Retrospective Studies ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Vitreous Body

مستخلص: Purpose: To evaluate functional and anatomic effects of intravitreal bevacizumab (Avastin; Roche Pharma, Vienna, Austria) in patients with neovascular age-related macular degeneration (AMD) with large submacular hemorrhages.
Design: Retrospective, clinical study.
Methods: Twenty-one eyes of 19 AMD patients with choroidal neovascularization and large submacular hemorrhage involving the fovea comprising more than 50% of the total lesion area were evaluated. All patients completed at least four months of follow-up; 12 patients fulfilled 12 months or more of follow-up. Patients were treated with up to six intravitreal bevacizumab injections (1 mg/0.04 ml) at a minimum of four-week intervals. Changes from baseline visual acuity (VA) scores, retinal measurements by optical coherence tomography (OCT), angiographic lesion characteristics, and hemorrhage size were analyzed. A safety assessment was performed at all visits.
Results: Intravitreal bevacizumab injections were well tolerated in all patients. At month 4, VA was stable or improved (visual loss of 3 acuity lines or fewer) in 100% and improved by at least 3 lines in 9.5%. Comparable results were found at month 12. On average, the central foveal thickness decreased significantly by 55 microm four weeks after the first injection (P < .001) and by 52 microm at month 4 (P = .002). A significant anatomic improvement also was found for maximum retinal thickness, minimum retinal thickness, and foveal volume (P < .05) and was maintained during four months of follow-up. Mean size of hemorrhage was significantly reduced from 19.7 mm(2) at baseline to 2.5 mm(2) at the four-month follow-up (P < .001).
Conclusions: Intravitreal bevacizumab seems to be a promising therapeutic option in eyes with neovascular AMD and large submacular hemorrhages, with a stabilization in VA and anatomic improvement.

المؤلفون: Fung AE; Pacific Eye Associates, California Pacific Medical Center, San Francisco, California, USA., Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW Jr, Esquiabro M

المصدر: American journal of ophthalmology [Am J Ophthalmol] 2007 Apr; Vol. 143 (4), pp. 566-83.

نوع المنشور: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0370500 Publication Model: Print Cited Medium: Print ISSN: 0002-9394 (Print) Linking ISSN: 00029394 NLM ISO Abbreviation: Am J Ophthalmol Subsets: MEDLINE

مواضيع طبية MeSH: Tomography, Optical Coherence*, Angiogenesis Inhibitors/*administration & dosage , Antibodies, Monoclonal/*administration & dosage , Choroidal Neovascularization/*drug therapy , Macular Degeneration/*drug therapy, Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized ; Choroidal Neovascularization/diagnosis ; Female ; Fluorescein Angiography ; Humans ; Injections ; Macular Degeneration/diagnosis ; Male ; Prospective Studies ; Ranibizumab ; Retreatment ; Treatment Outcome ; Visual Acuity ; Vitreous Body

مستخلص: Purpose: To evaluate an optical coherence tomography (OCT)-guided, variable-dosing regimen with intravitreal ranibizumab for the treatment of patients with neovascular age-related macular degeneration (AMD).
Design: Open-label, prospective, single-center, nonrandomized, investigator-sponsored clinical study.
Methods: In this two-year study, neovascular AMD patients with subfoveal choroidal neovascularization (CNV) (n = 40) and a central retinal thickness of at least 300 microm as measured by OCT were enrolled to receive three consecutive monthly intravitreal injections of ranibizumab (0.5 mg). Thereafter, retreatment with ranibizumab was performed if one of the following changes was observed between visits: a loss of five letters in conjunction with fluid in the macula as detected by OCT, an increase in OCT central retinal thickness of at least 100 microm, new-onset classic CNV, new macular hemorrhage, or persistent macular fluid detected by OCT at least one month after the previous injection of ranibizumab.
Results: At month 12, the mean visual acuity improved by 9.3 letters (P < .001) and the mean OCT central retinal thickness decreased by 178 microm (P < .001). Visual acuity improved 15 or more letters in 35% of patients. These visual acuity and OCT outcomes were achieved with an average of 5.6 injections over 12 months. After a fluid-free macula was achieved, the mean injection-free interval was 4.5 months before another reinjection was necessary.
Conclusion: This OCT-guided, variable-dosing regimen with ranibizumab resulted in visual acuity outcomes similar to the Phase III clinical studies, but required fewer intravitreal injections. OCT appears useful for determining when retreatment with ranibizumab is necessary.

المؤلفون: Moshfeghi AA; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA., Rosenfeld PJ, Puliafito CA, Michels S, Marcus EN, Lenchus JD, Venkatraman AS

المصدر: Ophthalmology [Ophthalmology] 2006 Nov; Vol. 113 (11), pp. 2002.e1-12. Date of Electronic Publication: 2006 Oct 05.

نوع المنشور: Case Reports; Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE

مواضيع طبية MeSH: Antibodies, Monoclonal/*therapeutic use , Choroidal Neovascularization/*drug therapy , Choroidal Neovascularization/*etiology , Macular Degeneration/*complications , Vascular Endothelial Growth Factor A/*antagonists & inhibitors, Aged ; Aged, 80 and over ; Antibodies, Monoclonal/adverse effects ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Blood Pressure/drug effects ; Choroidal Neovascularization/diagnosis ; Choroidal Neovascularization/physiopathology ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Male ; Retina/pathology ; Retreatment ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity/drug effects

مستخلص: Purpose: To evaluate the safety, efficacy, and durability of bevacizumab for the treatment of subfoveal choroidal neovascularization (CNV) in patients with neovascular age-related macular degeneration (AMD).
Design: Open-label, single-center, uncontrolled clinical study.
Participants: Age-related macular degeneration patients with subfoveal CNV (n = 18) and best-corrected visual acuity (VA) letter scores of 70 to 20 (approximate Snellen equivalent, 20/40-20/400).
Methods: Patients were treated at baseline with an intravenous infusion of bevacizumab (5 mg/kg) followed by 1 or 2 additional doses given at 2-week intervals. Safety assessments were performed at all visits. Ophthalmologic evaluations included protocol VA measurements, ocular examinations, and optical coherence tomography (OCT) imaging at each visit. Retreatment with bevacizumab was performed if there was evidence of recurrent CNV.
Main Outcome Measures: Assessments of safety and changes from baseline in VA scores and OCT measurements were performed through 24 weeks.
Results: No serious ocular or systemic adverse events were identified through 24 weeks. The only adverse event identified was a mild elevation of mean systolic and diastolic blood pressure measurements (+11 mmHg, P = 0.004; +8 mmHg, P<0.001) evident by 3 weeks and easily controlled with antihypertensive medications. By 24 weeks, the systolic and diastolic mean blood pressures were at or below baseline measurements. Visual acuity in the study eyes improved within the first 2 weeks, and by 24 weeks, the mean VA letter score increased by 14 letters in the study eyes (P<0.001), and the mean OCT central retinal thickness measurement decreased by 112 microm (P<0.001). By 24 weeks, retreatment was needed for only 6 of the 18 study eyes, and after retreatment, the recurrent leakage was eliminated, with restoration of any lost VA.
Conclusions: Systemic bevacizumab therapy for neovascular AMD was well tolerated and effective for all 18 patients through 24 weeks. By 6 months, most patients did not require any additional treatment beyond the initial 2 or 3 infusions. Despite these impressive results, it is unlikely that systemic bevacizumab will be studied in a large clinical trial because of the potential risks associated with systemic anti-VEGF therapy and the perception that intravitreal therapy is safer.

المؤلفون: Kiss C; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Michels S, Prager F, Weigert G, Geitzenauer W, Schmidt-Erfurth U

المصدر: Retina (Philadelphia, Pa.) [Retina] 2006 Oct; Vol. 26 (8), pp. 877-81.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8309919 Publication Model: Print Cited Medium: Print ISSN: 0275-004X (Print) Linking ISSN: 0275004X NLM ISO Abbreviation: Retina Subsets: MEDLINE

مواضيع طبية MeSH: Angiogenesis Inhibitors/*therapeutic use , Anterior Chamber/*immunology , Antibodies, Monoclonal/*therapeutic use , Choroidal Neovascularization/*drug therapy , Inflammation/*diagnosis , Macular Degeneration/*drug therapy , Vascular Endothelial Growth Factor A/*immunology, Anterior Chamber/pathology ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Cell Count ; Choroidal Neovascularization/etiology ; Diagnostic Techniques, Ophthalmological ; Humans ; Injections ; Macular Degeneration/complications ; Microscopy ; Uveitis, Anterior/diagnosis

مستخلص: Purpose: To evaluate the effect of intravitreal bevacizumab on anterior chamber inflammatory activity.
Methods: Sixty-one consecutive patients with neovascular age-related macular degeneration were examined before, 1 day, and 1 week after intravitreal administration of 1 mg of bevacizumab (0.04 mL) for neovascular age-related macular degeneration. The intravitreal injection was performed under sterile conditions. Twenty-one fellow eyes served as controls. The anterior chamber inflammatory activity was evaluated using biomicroscopy and the laser flare meter (Kowa FM-500, Kowa Company, Ltd., Tokyo, Japan).
Results: None of the 61 consecutive patients had a significant, clinically detectable inflammatory response within 1 week of follow-up. Anterior chamber inflammatory activity measured by the laser flare meter ranged from 1.9 counts/ms to 70.0 counts/ms (mean +/- SD, 13.2 +/- 16.9 counts/ms; 95% confidence interval [CI], 7.8-18.6) before treatment. One day and 1 week after injection, values were between 3.2 counts/ms and 30.0 counts/ms (mean +/- SD, 9.1 +/- 6.2 counts/ms; 95% CI, 7.2-11.1) and 2.0 counts/ms and 25.1 counts/ms (mean +/- SD, 7.3 +/- 4.6 counts/ms; 95% CI, 5.8-8.8), respectively. There was a significant reduction of anterior chamber flare at 1 week compared with baseline (P = 0.031). The control eyes had constantly low flare measures.
Conclusion: No inflammatory response was detected clinically and by the laser flare meter after intravitreal bevacizumab administration. The slight reduction in anterior chamber flare could be due to the known antiinflammatory effect of anti-vascular endothelial growth factor therapy.

المؤلفون: Michels S; University Eye Hospital Vienna, Vienna, Austria. stephan.michels@meduniwien.ac.at, Hansmann F, Geitzenauer W, Schmidt-Erfurth U

المصدر: Investigative ophthalmology & visual science [Invest Ophthalmol Vis Sci] 2006 Jan; Vol. 47 (1), pp. 371-6.

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Association For Research In Vision And Ophthalmology (Arvo) Country of Publication: United States NLM ID: 7703701 Publication Model: Print Cited Medium: Print ISSN: 0146-0404 (Print) Linking ISSN: 01460404 NLM ISO Abbreviation: Invest Ophthalmol Vis Sci Subsets: MEDLINE

مواضيع طبية MeSH: Photochemotherapy*, Choroidal Neovascularization/*drug therapy , Macular Degeneration/*drug therapy , Photosensitizing Agents/*therapeutic use , Porphyrins/*therapeutic use, Capillary Permeability ; Choroid/blood supply ; Choroidal Neovascularization/etiology ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Macular Degeneration/complications ; Tomography, Optical Coherence ; Treatment Outcome ; Verteporfin ; Visual Acuity

مستخلص: Purpose: To improve selectivity of verteporfin therapy (PDT) in neovascular age-related macular degeneration (AMD) using modified treatment parameters.
Methods: Nineteen consecutive patients with predominantly classic choroidal neovascularization (CNV) in AMD were treated with 6 mg/m2 verteporfin given as bolus infusion. Patients received PDT with a fluence of either 25 or 50 J/cm2. Choroidal perfusion changes were evaluated by indocyanine green angiography (ICGA) at baseline, day 1, week 1, week 4, and month 3. Secondary outcomes were CNV closure rate and therapy-induced leakage documented by fluorescein angiography (FA). The safety of the treatment was assessed with ETDRS visual acuity.
Results: Complete CNV closure was achieved in all patients at day 1. Choroidal hypoperfusion was minimal in eyes treated with a reduced fluence of 25 J/cm2. Most patients treated with 50 J/cm2 showed significant choriocapillary nonperfusion at week 1, lasting as long as 3 months. A transient PDT-induced increase in leakage area in FA at day 1 was found to be more extensive in the 50-J/cm2 group.
Conclusions: Bolus administration of verteporfin combined with a reduced light dose achieved improved selectivity of photodynamic effects, avoiding collateral alteration of the physiologic choroid while obtaining complete CNV closure. An increased selectivity with decreased effect on the surrounding choroid should be of advantage in verteporfin monotherapy as well as in combination strategies.