1,720,986 research outputs found
From the analysis of pharmacologic vitreolysis to the comprehension of ocriplasmin safety
No full textIntroduction: Pharmacologic vitreolysis is a strategy used to treat anomalous posterior vitreous detachment, by weakening vitreoretinal adhesion with an intravitreal drug. Pharmacologic vitreolysis facilitates surgery, and abnormalities of the vitreoretinal interface including vitreomacular traction (VMT) and early stage macular hole (MH) could be resolved. Ocriplasmin is a recombinant protease, active against fibronectin and laminin, which are important components of the vitreoretinal interface. Ocriplasmin has been approved for symptomatic treatment of VMT and MH with visible traction, and it functions by dissolving the proteins that link the vitreous to the macula, thereby creating a complete posterior vitreous detachment (PVD). Areas covered: This paper reviews the current knowledge and status of investigations regarding the use of ocriplasmin for pharmacologic vitreolysis and its safety. Expert opinion: Ocriplasmin is a non-specific enzyme; therefore, it dissolves vitreal proteins as well as possibly proteins associated with visual function in the retina, choroid, and lens. Ocular adverse events (OAEs) of ocriplasmin include transient visual loss, intraocular inflammation, vitreous floaters, lens opacification, zonular instability of the lens, and intraocular hemorrhage. The prevalence of the OAEs is very low; however, on rare occasions, they can result in widespread retinal dysfunction. Research into the acute and long-term safety of ocriplasmin is required
Pseudo-Foster Kennedy syndrome in a young woman with meningioma infiltrating the superior sagittal sinus
No full textSystemic thromboembolic adverse events in patients treated with intravitreal anti-VEGF drugs for neovascular age-related macular degeneration: an overview
No full textAnti-VEGF therapy improved the quality of life for millions of patients suffering from wet age-related macular degeneration (wet-AMD); unfortunately, this therapy involves multiple injections over many years. The administration of anti-VEGF can overcome the blood-retinal barrier with agents entering the systemic circulation and causing a significant decrease in VEGF serum concentration. Although circulating VEGF protects the integrity and patency of vessels, prolonged anti-VEGF treatment has the potential to increase the risk of thromboembolic events
Comparison of visual and anatomical outcomes of half-dose photodynamic therapy and 689 nm laser treatment (pseudo-PDT) in eyes with chronic central serous chorioretinopathy
No full textPurpose : Acute central serous chorioretinopathy (CSC) is a common disorder in middle-aged patients, characterized by serous retinal detachment in the macular region. We evaluated half-dose verteporfin photodynamic therapy (hd-PDT) versus 689 nm laser treatment in chronic CSC.
Methods : This was a pilot study of eyes with chronic CSC. A total of 20 patients were enrolled consecutively and randomized in a 1:1 ratio to receive hd-PDT (group 1) or 689 nm laser treatment delivering 95 J/cm2 by application of an intensity of 805 mW/cm2 over 118 seconds, using a spot size with a 3000 μm diameter (group 2). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) findings were compared between groups.
Results : The baseline characteristics were similar, and no significant differences between the groups were found. Both groups had significant BCVA improvements (7.3 ± 1.3 vs 7.6 ± 1.5 ETRDS letters in group 1 and 2, respectively; P = 0.64), as well as CMT reductions (-102.5 ± 13.6 vs -96.1 ± 20.5 μm in group 1 and 2, respectively; P = 0.42) at 16 weeks. Measured parameters were not significantly different between groups at any time point examined. Complete photoreceptor recovery, defined as a continuous ellipsoid zone with a discernible interdigitation zone, was observed at 16 weeks in 7 and 6 patients in group 1 and 2, respectively.
Conclusions : Both hd-PDT and 689 nm laser treatment were effective in treating chronic CSC. No significant differences in visual or anatomical outcomes were observed. Additional larger studies are warranted to corroborate our results
Efficacy and vitreous levels of topical NSAIDs
No full textINTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medications and are routinely used for their analgesic, antipyretic, and anti-inflammatory properties. Because of their potent cyclooxygenase-inhibitory activity, they can inhibit pro-inflammatory prostaglandin synthesis, leading to complex inflammatory cascades. NSAIDs have been broadly used systemically for many decades and have recently become commercially available in the form of topical ophthalmic formulations. NSAIDs are weak acids with pKa values mostly between 3.5 and 4.5 and are poorly water-soluble. New, aqueous ophthalmic solutions of NSAIDs that afford better tissue penetration have recently been developed. In ophthalmological practice, topical NSAIDs are mostly used to stabilize pupillary dilation during intraocular surgery, manage postoperative pain and inflammation, and treat pseudophakic cystoid macular edema.
AREAS COVERED: This review focuses on the vitreous penetration of topical NSAIDs and their potential clinical applications in the treatment of retinal diseases.
EXPERT OPINION: A growing body of evidence suggests that NSAIDs may be beneficial in the treatment of age-related macular degeneration, diabetic retinopathy, and ocular tumors. Recent studies from our group and other authors have shown that the vitreous levels of NSAID exceed the median inhibitory concentration, which can significantly decrease vitreous PGE2 levels
Functional and Morphological Changes Following Macular Pucker Surgery After Topical Administration of Indomethacin 0.5%, Bromfenac 0.09%, Nepafenac 0.1%, or Placebo
No full textPurpose : Nonsteroidal antiinflammatory drugs (NSAIDs) are reported to penetrate the vitreous and lower basal prostaglandin E2 level. We investigated the functional and morphological changes in patients treated with NSAIDs before vitrectomy for macular pucker.
Methods : A prospective, investigator-masked, randomized study was performed in 64 patients scheduled to undergo 25-gauge vitrectomy. The patients were randomized 1:1:1:1 to receive indomethacin 0.5%, bromfenac 0.09%, nepafenac 0.1%, or placebo three times a day one week before surgery. Main outcome measures were best-corrected visual acuity (BCVA) and central macular thickness (CMT) findings.
Results : Mean BCVA improvement was 0.24 ± 0.15 LogMAR for indomethacin, 0.26 ± 0.13 LogMAR for bromfenac, 0.23 ± 0.1 LogMAR for nepafenac, and 0.23 ± 0.1 LogMAR for placebo (P = 0.87). Mean CMT reduction was 50.2 ± 85 μm for indomethacin, 122.4 ± 63 μm for bromfenac, 65.6 ± 100 μm for nepafenac, and 117.2 ± 164.3 for placebo (P = 0.3). No statistical differences among the different NSAID groups were noticed in either BCVA or CMT.
Conclusions : Despite the antiinflammatory activity of the NSAIDs in the vitreous, no functional or morphological improvements were observed after macular pucker surgery
Systemic thromboembolic adverse events in patients treated with intravitreal anti-VEGF drugs for neovascular age-related macular degeneration: an update
No full textIntroduction: Intravitreal anti-VEGF is the most effective therapy for wet AMD, although systemic effects on the endothelium cannot be excluded. Areas covered: The purpose of this review was to evaluate risk of thromboembolic events associated with intravitreal anti-VEGF. Expert opinion: Current data are insufficient to confirm the safety of these compounds, due to the paucity of specific studies. Thus, pharmacovigilance for all anti-VEGF should be improved to verify the true role of anti-VEGF in the occurrence of systemic adverse events
Pharmacokinetic and Pharmacodynamic Properties of Anti-VEGF Drugs After Intravitreal Injection
No full textSubretinal neovascularization and pathologic ocular angiogenesis are common causes of progressive, irreversible impairment of central vision, and dramatically affect quality of life. Anti-vascular endothelial growth factor (anti-VEGF) therapy has improved the quality of life for many patients with age-related macular degeneration, diabetic retinopathy, and other ocular diseases involving neovascularization and edema. In these pathologies, the inhibition of intraocular VEGF is the only therapy that can preserve vision. Four anti-VEGF drugs are currently used to treat ocular neovascularization; pegaptanib, ranibizumab, and aflibercept have been approved for this condition, while bevacizumab can be used off-label. Anti-VEGF therapy is administered regularly for many months or years because its suspension or discontinuation may cause recurrence of neovascularization. On the other hand, VEGF is necessary for the survival of retinal and choroidal endothelial cells. Experimental studies in animal models have shown that local inhibition of VEGF causes thinning and atrophy of the choriocapillaris and degeneration of photoreceptors, primarily cones. These studies combined with clinical experience indicated that prolonged VEGF inhibition could impair retinal function. Moreover, anti-VEGF compounds can cross the blood-retina barrier, enter the systemic circulation, and inhibit serum VEGF. Since circulating VEGF protects blood vessel integrity, prolonged anti-VEGF treatment could induce thromboembolic adverse events from vascular causes such as heart attack and stroke, and even death. The ocular dosing regimen and systemic toxicity of anti-VEGF compounds are therefore central concerns. A better understanding of this topic requires knowledge of the metabolism, tissue distribution, and clearance of anti-VEGF compounds. This manuscript reviews the properties of anti-VEGF compounds following intravitreal administration
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
