1,721,092 research outputs found
Biomarkers in the treatment of retinal vein occlusion
No full textHintergrund
Retinale Venenverschlüsse, subsumiert in Zentralvenen- und Venenastverschluss, gehören zu den häufigsten vaskulären Erkrankungen der Netzhaut. Sowohl bei Erstdiagnose als auch in der Therapie verschlussassoziierter Komplikationen, v. a. des Makulaödems, sind Biomarker der optischen Kohärenztomographie (OCT), OCT-Angiographie und (Ultraweitwinkel‑)Fluoreszeinangiographie von herausragender Bedeutung.
Methoden
Es erfolgte eine systematische Literaturrecherche auf pubmed.gov mit den Keywords „central retinal vein occlusion“, „branch retinal vein occlusion“, „biomarker“, „OCT“, „OCT angiography“, „ultra-widefield fluorescein angiography“ mit Priorisierung der wichtigsten Aspekte zur Umfangsreduktion.
Ergebnisse
Als relevante Biomarker konnten in der OCT Makuladicke („central retinal thickness“ [CRT]), makuläre Flüssigkeit, die Integrität der Photorezeptorbande (Membrana limitans externa [ELM] und „ellipsoid zone“ [EZ]), „disorganization of retinal inner layers“ (DRIL), hyperreflektive Foci, Aderhautdicke sowie Ischämiezeichen wie „prominent middle limiting membrane“ (p-MLM), die „paracentral acute middle maculopathy“ (PAMM) sowie „hyperreflectivity of inner retinal layers“ (HIRL) identifiziert werden. Der Stellenwert der OCT-Angiographie liegt v. a. in der Beurteilung mikrovaskulärer Veränderungen, insbesondere der „vessel density“ im tiefen retinalen Gefäßplexus, der fovealen avaskulären Zone und von Arealen ohne Kapillarperfusion. Bezüglich der Therapieentscheidung zum Netzhautlaser sind Biomarker der Ultraweitwinkelangiographie wie periphere Ischämien („ischemic index“) sowie Neovaskularisationen essenziell.
Schlussfolgerung
Eine Vielzahl simplerer und komplexer Biomarker ermöglicht heute eine effektive individualisierte Therapie- und Prognoseeinschätzung beim retinalen Venenverschluss. Eine Verschiebung von invasiven zu nichtinvasiven Biomarkern wird beobachtet.Background
Retinal vein occlusion, subdivided into central retinal and branch retinal vein occlusion, is one of the most frequent vascular diseases of the retina. Biomarkers of optical coherence tomography (OCT), OCT-angiography and (ultra-widefield) fluorescein angiography are of exceptional importance in the initial diagnosis and also in the treatment of complications associated with retinal vascular occlusion, particularly macular edema.
Methods
A systematic literature review was carried out in PubMed with the keywords central retinal vein occlusion, branch retinal vein occlusion, biomarker, OCT, OCT angiography, ultra-widefield fluorescein angiography with prioritization of the most important aspects.
Results
Relevant biomarkers in OCT include central retinal thickness (CRT), macular fluid, the integrity of the photoreceptor bands (external limiting membrane and ellipsoid zone), disorganization of retinal inner layers (DRIL), hyperreflective foci, choroidal thickness and signs of ischemia, such as a prominent middle limiting membrane (p-MLM), paracentral acute middle maculopathy (PAMM) as well as hyperreflectivity of inner retinal layers (HIRL). The importance of OCT-angiography lies particularly in the assessment of microvascular alterations, especially vessel density in the deep retinal vascular plexus, the foveal avascular zone and of areas with no capillary perfusion. Biomarkers of ultra-widefield angiography, such as peripheral ischemia (ischemic index) and neovascularízation are essential with respect to treatment decisions for retinal laser.
Conclusion
A multitude of simple and complex biomarkers currently enable an effective individualized evaluation of treatment and prognosis in retinal vein occlusion. A shift from invasive to noninvasive biomarkers can be observed
Sektorenübergreifende Augenheilkunde – gemeinsame Kommission von DOG und BVA. Stand Januar 2020
No full textRanibizumab in retinal vein occlusion: treatment recommendations by an expert panel
No full textRetinal vein occlusion (RVO) is a common cause of retinal vascular disease, resulting in potentially irreversible loss of vision despite the existence of several therapeutic options. The humanised monoclonal antibody fragment ranibizumab binds to and inhibits vascular endothelial growth factor, a key driver of macular oedema in RVO. In 2010, ranibizumab was approved in the USA for the treatment of macular oedema in RVO and, in 2011, ranibizumab was approved in the European Union for the treatment of visual impairment caused by macular oedema secondary to RVO in branch and central RVO. Ranibizumab provides an additional therapeutic option for this complex disease: an option that was not fully considered during the preparation of current international guidelines. An expert panel was convened to critically evaluate the evidence for treatment with ranibizumab in patients with visual impairment caused by macular oedema secondary to RVO and to develop treatment recommendations, with the aim of assisting physicians to optimise patient treatment
Ranibizumab in retinal vein occlusion: Treatment recommendations by an expert panel
Full text linkRetinal vein occlusion (RVO) is a common cause of retinal vascular disease, resulting in potentially irreversible loss of vision despite the existence of several therapeutic options. The humanised monoclonal antibody fragment ranibizumab binds to and inhibits vascular endothelial growth factor, a key driver of macular oedema in RVO. In 2010, ranibizumab was approved in the USA for the treatment of macular oedema in RVO and, in 2011, ranibizumab was approved in the European Union for the treatment of visual impairment caused by macular oedema secondary to RVO in branch and central RVO. Ranibizumab provides an additional therapeutic option for this complex disease: an option that was not fully considered during the preparation of current international guidelines. An expert panel was convened to critically evaluate the evidence for treatment with ranibizumab in patients with visual impairment caused by macular oedema secondary to RVO and to develop treatment recommendations, with the aim of assisting physicians to optimise patient treatment
Auswirkungen der SARS-CoV-2-Pandemie auf die ophthalmologische Versorgung in Deutschland
No full textAuswirkungen der SARS-CoV-2-Pandemie auf die ophthalmologische Versorgung in Deutschland
No full textRanibizumab Pro Re nata versus Dexamethasone in the Management of Ischemic Retinal Vein Occlusion: Post-hoc Analysis from the COMRADE Trials
No full textPurpose: To compare ischemia-related clinical outcomes in patients treated with either ranibizumab pro re nata (PRN) or single dexamethasone implant in the Branch Retinal Vein Occlusion (COMRADE-B) or Central Retinal Vein Occlusion (COMRADE-C) trials.Methods: A post-hoc analysis of the Phase IIIb, 6-month, multicenter, double-masked, randomized, COMRADE-B and COMRADE-C trials. Change over 6 months in retinal ischemia status (central avascular [CA] zone and peripheral nonperfusion [PNP]), mean best-corrected visual acuity (BCVA), the development of shunt vessels and neovascularization, and frequency of laser therapy were assessed in retinal vein occlusion (RVO) patients treated with either ranibizumab 0.5 mg PRN or single dexamethasone 0.7 mg implant, as per European labels, in the COMRADE-B (N = 244; ranibizumab, 126, dexamethasone, 118) or COMRADE-C (N = 243; ranibizumab, 124, dexamethasone, 119) trials. BCVA progression in ischemic vs. non-ischemic patients based on the ischemia assessment at month 6 was carried out.Results: Visual acuity (VA) gains from baseline to month 6 were higher with ranibizumab than with dexamethasone in both patients with central ischemia and those with peripheral retinal nonperfusion, independent of the type of RVO (branch or central). The presence of CA and PNP had a significant impact on VA gain over 6 months in CRVO patients (p Conclusions: VA gain over six months in ranibizumab-treated RVO patients is not affected by ischemia, and is associated with less development of new ischemia during the first 6 months of treatment and equal or fewer laser treatments than dexamethasone implant
White-dot-syndromes: Birdshot-Retinochoroiditis & Punctate Inner Choroidopathy: Immunology, Imaging, Therapy and Patient Care
No full textIntraokulare Entzündungen sind die dritthäufigste Erblindungsursache im mittleren Alter, darunter fällt die schwerwiegende und funktionell relevante Uveitis posterior, u.a. White-dot-Syndrome (WDS). WDS, übersetzt „Weißfleckenkrankheiten“ umfasst eine Gruppe von Erkrankungen mit charakteristischen entzündlichen Veränderungen der Netzhaut (Retina), des retinalen Pigmentepithels (RPE) und der Aderhaut (Choroidea). In dieser Habilitationsschrift sind die Schwerpunkte auf zwei Erkrankungen, die Birdshot-Retinochoroiditis und die punktförmige innere Choroidopathie gelegt
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
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