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Scleral Thinning After Repeated Intravitreal Injections of Antivascular Endothelial Growth Factor Agents in the Same Quadrant
摘要： PURPOSE. We assessed the effects of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy on scleral architecture using spectral domain anterior segment optical coherence tomography (OCT). METHODS. A total of 35 eyes of 35 patients treated with at least 30 intravitreal injections in one eye in the inferotemporal quadrant with ranibizumab or a?ibercept and 10 or less intravitreal injections in the fellow eye attending the intravitreal injection clinic were included. Enhanced depth imaging anterior segment OCT was used to measure scleral thickness. For each eye the sclera was measured in four quadrants at 3 mm from the limbus. In addition axial eye length was measured in all subjects using partial coherence interferometry. RESULTS. The mean number of intravitreal injections was 42 (range, 30–73) and 1.6 (range, 0–9) in the fellow eyes. In the study eyes with more than 30 injections the average scleral thickness in the inferotemporal quadrant was 568.4 lm (SD 6 66 lm) and 590.6 lm (SD 6 75 lm) in the fellow eyes with 10 or less injections (P ? 0.003). The mean average scleral thickness in the other three quadrants (inferonasal, superotemporal, and superonasal) was 536.6 lm in the study eyes (SD 6 100 lm) and 545.2 lm (SD 6 109 lm) in the fellow eyes (P ? 0.22). There was a borderline association of the total number of injections with scleral thickness change in the inferotemporal quadrant (r ? 0.3, P ? 0.052). CONCLUSIONS. Intravitreal injections may lead to scleral changes when applied repeatedly in the same quadrant. Thus, alternating the injection site should be considered in patients requiring multiple intravitreal injections.
关键词： retina,anterior segment OCT,anti-VEGF,intravitreal injections,sclera
更新于2025-09-23 15:23:52
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Subthreshold laser therapy for macular oedema from branch retinal vein occlusion: focused review
摘要： Retinal vein occlusion is the second- leading cause of vision loss by retinal vascular disease. Subthreshold micropulse laser therapy (SLT) is safer than conventional laser photocoagulation (CLP), yet existing reviews of its use for branch retinal vein occlusion (BRVO) are limited in scope. A literature search of PubMed, Google Scholar, Embase, Cochrane Library and ClinicalTrials.gov databases was conducted in August 2019 without restriction on language or publication date. Outcomes included changes in macular oedema (ME) and visual acuity (VA), and rates of complications or retreatments. Fourteen studies involving 315–405 eyes diagnosed with BRVO were evaluated. Treatment with SLT is associated with significant and durable reduction of ME and VA as early as 1 month. SLT performs comparably with conventional photocoagulation and intravitreal injections (IVIs) of ranibizumab. Subthreshold laser therapy is safer and as effective as CLP for the treatment of ME associated with BRVO. SLT may be used in combination with anti- VEGF IVIs to enhance improvement in VA and ME resolution.
关键词： macular oedema,visual acuity,intravitreal injections,Retinal vein occlusion,subthreshold micropulse laser therapy
更新于2025-09-19 17:13:59
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Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis
摘要： Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.
关键词： Retinopathy of Prematurity,Laser Therapy,Intravitreal Injections
更新于2025-09-11 14:15:04
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Optical coherence tomography and multifocal electroretinography of patients with advanced neovascular age-related macular degeneration before, during, and after treatment with ranibizumab
摘要： Purpose: To evaluate retinal morphology and function of patients with advanced neovascular age-related macular degeneration (AMD) before, during, and after treatment with ranibizumab. Methods: Twenty-one eyes diagnosed with advanced AMD were studied with optical coherence tomography (OCT) and multifocal electroretinography (mfERG). Three intravitreal injections of ranibizumab were administered at 1-month intervals. Evaluations were performed before the first injection (D0) and at 30 (D30), 60 (D60), and 90 days (D90) after the first injection and compared to an age-matched control group (n=21 eyes). Results: The thickness of macular retinal layers increased before treatment due to the presence of intraretinal fluid. A thick retinal pigment epithelium-choriocapillaris complex (RPE-CC) suggested the presence of choroidal neovascular membrane. Intraretinal edema decreased after treatment (P<0.01), but persisting RPE-CC thickness resulted in a subretinal scar. Three different annular retinal areas were studied with mfERG (from center to periphery: rings R1, R2, and R3). The amplitude of the first negative component (N1) decreased in R1, R2, and R3 at D30, D60, and D90 when compared with that in controls (P<0.05); the N1 implicit time was delayed in R3 at D30 (P<0.05). The amplitude of the first positive component (P1) was reduced in R1 and R2 at D30, D60, and D90 when compared with that in controls (P<0.01); the P1 implicit time was delayed in R1 at D0 and D60 (P<0.05), in R2 at D0, D30, and D90 (P<0.01), and in R3 at D30 and D60 (P<0.05). Conclusion: Ranibizumab reduces intraretinal edema, even in advanced cases. Central macular activity appeared to increase after the initiation of treatment, improving over time.
关键词： Electroretinography,optical coherence,Macular degeneration/drug therapy,Antibodies,humanized/therapeutic use,Tomography,monoclonal,Intravitreal injections
更新于2025-09-09 09:28:46