1,721,146 research outputs found
Anti-complement intravitreal agents for geographic atrophy: A missed opportunity for European patients?
No full textAnti-VEGF therapies for age-related macular degeneration: a powerful tactical gear or a blunt weapon? The choice is ours
Full text linkPurpose: Blindness and vision loss are still frequent disabilities associated with a relevant impact on health care and quality of life, and a high economic burden. Supranational programs established by the World Health Organization (WHO), International Agency for the Prevention of Blindness (IAPB), and World Health Assembly (WHA) aim at reducing avoidable visual impairment. Age-related macular degeneration (AMD), diabetic retinopathy (DR), and other retinal diseases are well known causes of visual disability. Since more than a decade, intravitreal agents are available for the treatment of these diseases. The aim of this study is to review whether pharmacotherapy with anti-vascular endothelial growth factor (VEGF) drugs has led to a decrease in the prevalence of blindness with emphasis on AMD and different countries. A brief analysis of other factors correlated to changes in the rate of blindness is also presented. Methods: PubMed and Scopus web platforms were used to identify relevant studies on epidemiology of blindness and vision impairment, the influence of intravitreal therapies, and the existence of different vision care models. Additional data and material was searched in web internet accessed by the web browser Firefox. Results: Age-standardized prevalence of blindness secondary to AMD has started to decline as testified by a number of studies in different countries. This is due to the adoption of anti-VEGF therapy and its adequate management. The frequency of treatment and regimens applied are indirect signs of successful treatment. Local rules and regulations may represent an obstacle. Conclusions: This review shows that by implementing existing health care systems and dispensing adequate therapies in the field of retinal diseases, the prevalence of blindness due to these conditions can decline. [Figure not available: see fulltext.
Combined transconjunctival sutureless three-port vitrectomy and scleral fixation of intraocular lens
No full textPurpose: The aim of this article is to describe an innovative and minimally invasive surgical technique for posterior vitrectomy combined with secondary intraocular lens implantation, using a sutureless scleral fixation Carlevale intraocular lens (I71 FIL SSF Carlevale lens. Soleko IOL Division, Italy). Methods: The technique was conducted with only three transconjunctival sclerotomies and a corneal tunnel to perform intraocular lens explantation, posterior vitrectomy and Carlevale intraocular lens implantation. It is easier, quicker, and less invasive than the traditional technique with conjunctival peritomy, two scleral flaps and five sclerotomies. Results: Surgery was performed uneventfully on three eyes of three patients. Two of them presented a luxation of the intraocular lens into the vitreous chamber, while one patient presented an intraocular lens subluxation. No complications were observed after a 5 to 8 months of follow-up. The intraocular lenses were well positioned, no conjunctival erosion was noted, and the intraocular pressure remained normal at all stages. Conclusions: This is the first report of a combined procedure of IOL explantation, posterior vitrectomy and secondary IOL implantation using only three transconjunctival sclerotomies. This appears to be less invasive and it causes less discomfort to the patient. We suggest considering this technique in all those cases requiring a combined procedure in absence of a proper capsular support
Does the presence of vitreo-macular adhesion influence the outcome of antivascular endothelial growth factor therapy in patients with neovascular agerelated macular degeneration? Systematic review and meta-analysis
No full textTwelve-month treatment with intravitreal dexamethasone implant for diabetic macular edema
No full textWhen and how to do a grid laser for diabetic macular edema
No full textMacular edema is a common feature of posterior segment diseases. It is an expression of abnormal permeability in either retinal vessels (inner blood-retinal barrier) or in the retinal pigment epithelium (outer blood-retinal barrier). It occurs in either a diffuse pattern where the macula appears generally thickened or, in more severe cases, as cystoid edema with the typical petaloid appearance. Grid laser treatment may be useful to reduce macular edema. Spots of 100-250 micrometers in diameter are applied to the whole posterior pole, one to two groups apart. The foveal avascular zone remains untouched. In patients treated bilaterally, areas temporal and nasal to the macula must be spared to prevent the development of deep scotomas. The mechanism yielding positive results with the grid technique is still debated. Among the most reliable hypotheses are: Proliferation of pigment epithelial cells, followed by and improved efficiency of the outer blood-retinal barrier; proliferation of endothelial cells in retinal capillaries followed by an improved efficiency of the inner blood-retinal barrier; improvement of the retinochoroidal exchanges, and finally, release by coagulative necrosis of a factor able to improve the efficiency of the blood-retinal barriers. Lasers with long wavelengths, such as krypton red and diode, are the most appropriate ones to perform grid treatment
Noncongenital juvenile-onset bilateral lamellar cataract in 1p36 deletion syndrome
No full textWe report the case of a 16-year-old girl with 1p36 deletion syndrome, who experienced visual loss in both eyes for 2 months because of lamellar cataracts. Mutations on some 1p36 genes in both experimental models and humans may be associated with cataract. This is the first detailed description of acquired juvenile-onset bilateral cataract with 1p36 deletion
From pro-re-nata to fixed-interval regimen: evolving real-world treatment paradigms in anti-VEGF therapy for neovascular AMD
No full textObjective: To evaluate the impact of evolving treatment paradigms for neovascular age-related macular degeneration (nAMD) by comparing outcomes between two patient cohorts treated with different anti-vascular endothelial growth factor (anti-VEGF) regimens over a decade apart. Methods: This retrospective cohort study included 200 treatment-naive nAMD patients divided into two cohorts. Cohort 1 (2009–2010) was treated with a pro re nata (PRN) regimen, involving three initial monthly injections followed by as-needed treatments based on monthly monitoring. Cohort 2 (2019–2021) received a fixed-interval regimen, consisting of three initial monthly injections followed by bimonthly maintenance doses. Primary outcomes included changes in best corrected visual acuity (BCVA) and central retinal thickness (CRT) at 12 months. Secondary outcomes included the number of injections, follow-up visits, and adherence to treatment schedules. Results: Cohort 2 demonstrated significantly greater improvement in BCVA (+5.5 vs −2.0 ETDRS letters, p < 0.001) and CRT reduction (−101.7 vs −26.5 μm, p < 0.001) compared to Cohort 1. Patients in Cohort 2 received more injections (7.7 vs 4.8, p < 0.001) but required fewer monitoring visits (3.2 vs 5.1, p < 0.001). Adherence to treatment schedules was markedly higher in Cohort 2 (78% vs 0%, p < 0.001). Conclusions: The transition from a PRN to a fixed-interval anti-VEGF regimen significantly improved visual and anatomical outcomes in nAMD patients. Fixed-interval regimens not only enhanced treatment efficacy but also optimized resource utilization, suggesting a superior approach for managing nAMD in a real-world clinical setting
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