37 research outputs found
The Role of Anti-VEGF Therapy in the Treatment of Diabetic Macular Edema
No full textDiabetic retinopathy (DR) is the leading cause of blindness among working-age adults. DR often leads to diabetic macular edema (DME), which often goes unnoticed until a patient presents with vision loss. However, treatment options and data for DME are continually improving. We know that vascular endothelial growth factor (VEGF) plays a key role in DME progression; therapies that act by inhibiting VEGF production seem to improve visual acuity in patients with DME. Of the anti-VEGF therapies available, two have been approved by the U.S. Food and Drug Administration to treat DME: ranibizumab (Lucentis; Genentech, South San Francisco, CA) and aflibercept (Eylea; Regeneron, Tarrytown, NY). Bevacizumab (Avastin; Genentech, South San Francisco, CA), which is approved for the treatment of certain types of cancer, is occasionally used off-label to treat DME. Anti-VEGF therapy can stop vision loss and even improve visual acuity. Other treatments remain effective, and these various treatment options fuel a need for new data and discussion. This roundtable discussion, which took place during the 2015 annual meeting of the American Academy of Ophthalmology, outlines the current protocols used to treat DME and provides clinical opinions about selecting and treating with an appropriate anti-VEGF therapy. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:S5-14.]
A NOVEL SURGICAL TECHNIQUE FOR RESCUING A DISLOCATED ACCOMMODATIVE INTRAOCULAR LENS (CRYSTALENS)
No full textRecurrent Vitreous Hemorrhage Secondary to Sulcus Positioning of a One-Piece Acrylic Intraocular Lens Haptic: Report of 3 Cases and Management With Retrocapsular Haptic Repositioning
No full text Three pseudophakic patients presented with recurrent, unilateral vitreous hemorrhage, one of which also had uveitis, glaucoma, and hyphema, consistent with “uveitis–glaucoma–hyphema (UGH)-Plus” syndrome. Arcuate transillumination defects secondary to inadvertent placement of 1 intraocular lens (IOL) haptic in the sulcus were identified in each case. The second haptic and optic were located in the capsular bag. The IOLs were all single-piece foldable acrylic lenses with square-edge haptic design. Surgical repositioning of the malpositioned haptic from the sulcus to the retrocapsular space resulted in the resolution of the recurrent vitreous hemorrhage. This series highlights the fact that recurrent vitreous hemorrhage secondary to iris chafing, with or without UGH, may occur in cases where a square-edge IOL haptic is placed in the sulcus. Vitrectomy with repositioning of the malpositioned IOL is a simple alternative to IOL exchange in these cases. </jats:p
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Long-Term Incidence And Timing Of Intraocular Hypertension After Intravitreal Triamcinolone Acetonide Injection
No full textPurpose: To describe the long-term incidence and timing of steroid-induced ocular hypertension after intravitreal triamcinolone acetonide (IVTA) therapy. Design: Retrospective case series of 929 eyes of 841 patients. Participants: Patients with a variety of posterior segment disorders in a single group practice. Intervention: Pars plana injection of IVTA. Main Outcome Measures: Intraocular pressure (IOP) and requirement for glaucoma surgery. Results: Overall, 929 eyes received ≥1 injections (mean, 1.6) of 4 mg of IVTA. During a mean follow-up period of 14±6.9 months, the Kaplan-Meier cumulative incidences of IOP elevations \u3e21 mmHg at 6, 12, 18, and 24 months post-injection were 28.2%, 34.6%, 41.2%, and 44.6%, respectively; similarly, the incidences of eyes with IOP measurements \u3e25 mmHg were 14.6%, 19.1%, 24.1%, and 28.2%, respectively. At the same time points, lOP-lowering medications were required byl3.0%, 16.9%, 20.7%, and 24.2% of eyes, respectively. Only 3 eyes (0.3%) required lOP-lowering surgery. Preexisting glaucoma, younger age, and a history of an IOP elevation after a previous IVTA injection were risk factors for IOP elevations after IVTA injection. The minimum and maximum follow-up were 3 weeks and 37 months. The mean rate of attrition in this study was 3% per month. Conclusions: Elevations in IOP after IVTA injection are common. Younger patients and eyes with preexisting glaucoma or a history of a steroid response should be monitored more closely for IOP elevations after IVTA therapy
