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Anterior uveitis after treatment of age-related macular degeneration with ranibizumab and bevacizumab: uncommon complication  [cached]
Damasceno N,Horowitz S,Damasceno E
Clinical Ophthalmology , 2012,
Abstract: Nadyr Damasceno,1 Soraya Horowitz,2 Eduardo Damasceno31,2Ophthalmology Department, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; 3Department of Ophthalmology, Universidade Federal Fluminense, Niteroi, BrazilAbstract: The authors describe one case of anterior uveitis after treatment of age-related macular degeneration with both antiangiogenic drugs: ranibizumab and bevacizumab. The case is described as a complication of ranibizumab and bevacizumab due to an inflammatory process. Several reasons are suggested to explain this possibility, and the authors conclude that the main cause remains unknown.Keywords: antiangiogenic agent, complications, ocular inflammatory process, ranibizumab, bevacizumab, anterior uveitis
Anterior uveitis after treatment of age-related macular degeneration with ranibizumab and bevacizumab: uncommon complication
Damasceno N, Horowitz S, Damasceno E
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S31239
Abstract: nterior uveitis after treatment of age-related macular degeneration with ranibizumab and bevacizumab: uncommon complication Case report (1487) Total Article Views Authors: Damasceno N, Horowitz S, Damasceno E Published Date July 2012 Volume 2012:6 Pages 1201 - 1205 DOI: http://dx.doi.org/10.2147/OPTH.S31239 Received: 27 February 2012 Accepted: 17 April 2012 Published: 31 July 2012 Nadyr Damasceno,1 Soraya Horowitz,2 Eduardo Damasceno3 1,2Ophthalmology Department, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil; 3Department of Ophthalmology, Universidade Federal Fluminense, Niteroi, Brazil Abstract: The authors describe one case of anterior uveitis after treatment of age-related macular degeneration with both antiangiogenic drugs: ranibizumab and bevacizumab. The case is described as a complication of ranibizumab and bevacizumab due to an inflammatory process. Several reasons are suggested to explain this possibility, and the authors conclude that the main cause remains unknown.
The effect of intravitreal bevacizumab and ranibizumab on cutaneous tensile strength during wound healing
Christoforidis JB, Wang J, Jiang A, Willard J, Pratt C, Abdel-Rasoul M, Roy S, Powell HM
Clinical Ophthalmology , 2013, DOI: http://dx.doi.org/10.2147/OPTH.S40537
Abstract: t of intravitreal bevacizumab and ranibizumab on cutaneous tensile strength during wound healing Original Research (1801) Total Article Views Authors: Christoforidis JB, Wang J, Jiang A, Willard J, Pratt C, Abdel-Rasoul M, Roy S, Powell HM Published Date January 2013 Volume 2013:7 Pages 185 - 191 DOI: http://dx.doi.org/10.2147/OPTH.S40537 Received: 20 November 2012 Accepted: 13 December 2012 Published: 24 January 2013 John B Christoforidis,1 Jillian Wang,2 Angela Jiang,2 James Willard,5 Cedric Pratt,2 Mahmoud Abdel-Rasoul,3 Sashwati Roy,4 Heather Powell5 1Department of Ophthalmology and Vision Science, College of Medicine, The University of Arizona, Tucson, AZ, USA; 2Department of Ophthalmology, College of Medicine, The Ohio State University, Columbus, OH, USA; 3Center for Biostatistics, The Ohio State University, Columbus, OH, USA; 4Center Surgery, The Ohio State University, Columbus, OH, USA; 5Department of Materials Science, College of Engineering, The Ohio State University, Columbus, OH, USA Purpose: To investigate the effect of intravitreal bevacizumab and ranibizumab on wound tension and by histopathology during cutaneous wound healing in a rabbit model and to compare this effect to placebo intravitreal saline controls 1 and 2 weeks following intravitreal injection. Methods: A total of 120 New Zealand white rabbits were randomly assigned to one of three treatment groups each consisting of 40 rabbits. Each group received intravitreal injections of bevacizumab, ranibizumab, or normal saline. Immediately afterwards, each rabbit underwent four 6 mm full-thickness dermatologic punch biopsies. Twenty rabbits from each agent group underwent wound harvesting on day 7 or day 14. The skin samples were stained for CD34 for vascular endothelial cells on day 7, and maximal wound tensile load was measured on days 7 and 14. Quantitative assessment of mean neovascularization (MNV) scores was obtained from 10 contiguous biopsy margin 400× fields of CD34-stained sections by two independent observers. Results: Wound tension reading means (N) with standard error and adjusted P-values on day 7 were: saline placebos, 7.46 ± 0.87; bevacizumab, 4.50 ± 0.88 (P = 0.041); and ranibizumab, 4.67 ± 0.84 (P = 0.025). On day 14 these were: saline placebos, 7.34 ± 0.55; bevacizumab, 6.05 ± 0.54 (P = 0.18); and ranibizumab 7.99 ± 0.54 (P = 0.40). MNV scores in CD34 stained sections were: saline controls, 18.31 ± 0.43; bevacizumab, 11.02 ± 0.45 (P < 0.0001); and ranibizumab, 13.55 ± 0.43 (P < 0.0001). The interobserver correlation coefficient was 0.928. Conclusion: At day 7, both anti–vascular endothelial growth factor (anti-VEGF) agents had significantly suppressed MNV scores and exerted a significant reduction of cutaneous wound tensile strength compared with saline controls. At day 14, neither agent produced a significant effect on tensile wound strength. Since angiogenesis is an integral component of the proliferative phase of wound healing, we encourage clinicians to be
The effect of intravitreal bevacizumab and ranibizumab on cutaneous tensile strength during wound healing  [cached]
Christoforidis JB,Wang J,Jiang A,Willard J
Clinical Ophthalmology , 2013,
Abstract: John B Christoforidis,1 Jillian Wang,2 Angela Jiang,2 James Willard,5 Cedric Pratt,2 Mahmoud Abdel-Rasoul,3 Sashwati Roy,4 Heather Powell51Department of Ophthalmology and Vision Science, College of Medicine, The University of Arizona, Tucson, AZ, USA; 2Department of Ophthalmology, College of Medicine, The Ohio State University, Columbus, OH, USA; 3Center for Biostatistics, The Ohio State University, Columbus, OH, USA; 4Center Surgery, The Ohio State University, Columbus, OH, USA; 5Department of Materials Science, College of Engineering, The Ohio State University, Columbus, OH, USAPurpose: To investigate the effect of intravitreal bevacizumab and ranibizumab on wound tension and by histopathology during cutaneous wound healing in a rabbit model and to compare this effect to placebo intravitreal saline controls 1 and 2 weeks following intravitreal injection.Methods: A total of 120 New Zealand white rabbits were randomly assigned to one of three treatment groups each consisting of 40 rabbits. Each group received intravitreal injections of bevacizumab, ranibizumab, or normal saline. Immediately afterwards, each rabbit underwent four 6 mm full-thickness dermatologic punch biopsies. Twenty rabbits from each agent group underwent wound harvesting on day 7 or day 14. The skin samples were stained for CD34 for vascular endothelial cells on day 7, and maximal wound tensile load was measured on days 7 and 14. Quantitative assessment of mean neovascularization (MNV) scores was obtained from 10 contiguous biopsy margin 400× fields of CD34-stained sections by two independent observers.Results: Wound tension reading means (N) with standard error and adjusted P-values on day 7 were: saline placebos, 7.46 ± 0.87; bevacizumab, 4.50 ± 0.88 (P = 0.041); and ranibizumab, 4.67 ± 0.84 (P = 0.025). On day 14 these were: saline placebos, 7.34 ± 0.55; bevacizumab, 6.05 ± 0.54 (P = 0.18); and ranibizumab 7.99 ± 0.54 (P = 0.40). MNV scores in CD34 stained sections were: saline controls, 18.31 ± 0.43; bevacizumab, 11.02 ± 0.45 (P < 0.0001); and ranibizumab, 13.55 ± 0.43 (P < 0.0001). The interobserver correlation coefficient was 0.928.Conclusion: At day 7, both anti–vascular endothelial growth factor (anti-VEGF) agents had significantly suppressed MNV scores and exerted a significant reduction of cutaneous wound tensile strength compared with saline controls. At day 14, neither agent produced a significant effect on tensile wound strength. Since angiogenesis is an integral component of the proliferative phase of wound healing, we encourage clinicians to be aware of their patients'
Intravitreal ranibizumab in treating extensive traumatic submacular hemorrhage  [cached]
Abdul-Salim I,Embong Z,ST?Khairy-Shamel,Raja-Azmi MN
Clinical Ophthalmology , 2013,
Abstract: Ismail Abdul-Salim,1 Zunaina Embong,1,2 Sonny-Teo Khairy-Shamel,1,2 Mohd-Noor Raja-Azmi,1,21Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia; 2Universiti Sains Malaysia Hospital, Jalan Raja Perempuan Zainab II, Kubang Kerian, MalaysiaAbstract: Herein, we report our experience in treating extensive traumatic submacular hemorrhage with a single dose of intravitreal ranibizumab. A 23-year-old healthy Malay man presented with a progressive reduction of central vision in the left eye of 2 days’ duration following a history of blunt trauma. Visual acuity was reduced to counting fingers. Examination revealed infero-temporal subconjunctival hemorrhage, traumatic anterior uveitis, and an extensive submacular hemorrhage with suspicion of a choroidal rupture in the affected eye. He was initially treated conservatively with topical prednisolone acetate 1%. The subconjunctival hemorrhage and anterior uveitis resolved but his vision remained poor with minimal resolution of the submacular hemorrhage at 1 week follow-up (day 12 post-trauma). In view of the poor resolution of submacular hemorrhage, he was treated with a single dose of 0.5 mg intravitreal ranibizumab at day 20 post-trauma. At 4 weeks post-intravitreal ranibizumab, there was an improvement in visual acuity (from counting fingers to 6/45) and complete resolution of the submacular hemorrhage with presence of a choroidal rupture scar temporal to the fovea, which was not seen clearly at presentation due to obscuration by blood. His visual acuity further improved to 6/18 at 3 months post-trauma. Although this single case had a favorable outcome, a large population cohort study is needed to establish the effectiveness of intravitreal ranibizumab in treating extensive traumatic submacular hemorrhage.Keywords: trauma, choroidal rupture scar, visual acuity, submacular hemorrhage, anterior uveitis
Intravitreal ranibizumab and bevacizumab for the treatment of nonsubfoveal choroidal neovascularization in age-related macular degeneration
Roller, Aaron Brock;Amaro, Miguel Hage;
Arquivos Brasileiros de Oftalmologia , 2009, DOI: 10.1590/S0004-27492009000500016
Abstract: purpose: to investigate the efficacy of vascular endothelial growth factor-specific (vegf) monoclonal antibodies in the treatment of choroidal neovascularization secondary to age-related macular degeneration (amd) that does not extend beneath the foveal center (nonsubfoveal cnv). methods: the study design was a retrospective chart review of consecutive patients over a two-month period under active treatment with bevacizumab and/or ranibizumab for neovascular amd. patients with neovascularization within the macula that did not extend beneath the center of the foveal avascular zone, along with at least one large drusen (>125 μ) or many intermediate size (63-124 μ) drusen were included. best corrected snellen visual acuity and optical coherence tomography (oct) analysis of the central macular thickness was recorded for each visit. serial injections of bevacizumab and/or ranibizumab were administered until there was resolution of subretinal fluid clinically or by oct. data over the entire follow-up period were analyzed for overall visual acuity and oct changes. all patients had follow-up since diagnosis of at least 6 months (mean=9.6 months). results: of the thirteen included patients, eleven had reduction of retinal thickening in the area involved by the cnv. the remaining two patients did not have oct data available but had no fluid or activity on clinical examination at last follow-up. one patient (8%) lost one line of vision; one (8%) remained stable, and eleven (84%) gained one or more lines of visual acuity. three patients (23%) gained three or more lines. the average treatment outcome for all patients was a gain of 1.7 ± 1.3 lines of snellen acuity. both therapeutic agents were effective, with an average gain of 1.6 ± 0.6 lines for patients treated with bevacizumab, 1.5 ± 1.9 lines gained for patients treated with ranibizumab and 2.5 ± 0.7 lines gained in the two patients who received both agents over the course of their treatment. conclusions: the use of intravi
Three Consecutive Monthly Intravitreal Ranibizumab for Choroidal Neovascularization in Central Serous Choriorethinopathy: A Case Report  [PDF]
Kazim Erol, Esin Sogutlu Sari, Arif Koytak, A Kara?or, D. T. ?oban, M. Bulut
Open Journal of Ophthalmology (OJOph) , 2012, DOI: 10.4236/ojoph.2012.23020
Abstract: Purpose: The author report the result of three consecutive monthly intravitreal ranibizumab injection for choroidal neovascularization (CNV) after bevacizumab injection for chronic central serous rethinopathy (CSR). Methods: A 48 year old man with chronic CSR was treated with intravitreal single dose 2.5 mg bevacizumab. One year after CNV was occurred, and three consecutive monthly intravitreal ranibizumab injections were performed. Results: Four weeks later the first ranibizumab dose, best corrected visual acuity was improved 20/80 to 20/20 and remained stable within one year. Conclusion: Repeat intravitreal ranibizumab injection in CNV after bevacizumab injection for chronic CSR appeared to be an effective treatment option.
Comparative study of 1+PRN ranibizumab versus bevacizumab in the clinical setting  [cached]
Carneiro AM,Mendonça LS,Falcão MS,Fonseca SL
Clinical Ophthalmology , 2012,
Abstract: Angela M Carneiro,1,2 Luis S Mendon a,1 Manuel S Falc o,1,2 Sofia L Fonseca,1 Elisete M Brand o,1 Fernando M Falc o-Reis1,21Department of Ophthalmology of Hospital de S o Jo o, Porto, Portugal; 2Faculty of Medicine of University of Porto, Porto, PortugalPurpose: We compared the efficacy of intravitreal ranibizumab and bevacizumab for treating neovascular age-related macular degeneration using an on-demand regimen.Methods: A total of 186 wet age-related macular degeneration eyes of 186 treatment-na ve patients were compared retrospectively (67 eyes treated with ranibizumab with 91 treated with bevacizumab). At baseline, mean age, best corrected visual acuity, and angiographic lesion types were similar in both groups. Best corrected visual acuity and ocular coherence tomography were evaluated.Results: Sixty eyes treated with ranibizumab and 85 eyes treated with bevacizumab completed a 12-month evaluation. At 12 months, mean best corrected visual acuity increased by +6.65 letters with ranibizumab treatment and by +5.59 with bevacizumab treatment (P = 0.64). Visual acuity improved by ≥15 letters in 15 eyes treated with ranibizumab and in 21 eyes treated with bevacizumab (P = 0.75). An overall reduction in ocular coherence tomography central thickness occurred for all time points. The mean number of injections per eye was 5.97 with ranibizumab and 5.92 with bevacizumab (P = 0.90).Conclusion: Intravitreal therapies with ranibizumab or bevacizumab have similar visual and anatomical results. These results confirm those of comparison of Age-Related Macular Degeneration Treatment Trials in as-needed cohorts in clinical practice. Randomized long-term clinical trials are necessary to examine the systemic safety of these treatments.Keywords: AMD, anti-VEGF therapy, bevacizumab, choroidal neovascularization, ranibizumab, wet AMD
Changing from bevacizumab to ranibizumab in age-related macular degeneration. Is it safe?  [cached]
Dimitrios A Karagiannis,Ioannis D Ladas,Efstratios Parikakis
Clinical Interventions in Aging , 2009,
Abstract: Dimitrios A Karagiannis1, Ioannis D Ladas2, Efstratios Parikakis1, Ilias Georgalas2, Athanasios Kotsolis2, Giorgos Amariotakis1, Vasileios Soumplis1, Panagiotis Mitropoulos11Ophthalmiatrio Eye Hospital of Athens, Athens, Greece; 2First Department of Ophthalmology, Medical School of Athens University, General Hospital of Athens, Athens, GreeceObjective: To report our experiences in changing from intravitreal bevacizumab to ranibizumab in age-related macular degeneration (AMD).Design: Retrospective case series.Participants and methods: We retrospectively reviewed the records of 34 patients (36 eyes) who were treated with monthly injections of intravitreal bevacizumab for six months and then switched to monthly injections of ranibizumab for 12 months. Best-corrected visual acuity measurements (BCVA), contact lens biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography were performed at the baseline examination and then monthly. Chi-square test was used for statistical analysis.Results: Following bevacizumab treatment, retinal thickness decreased (P = 0.033) while BCVA improved (P = 0.040). Changing from bevacizumab to ranibizumab resulted in a transient decrease in BCVA (P = 0.045) and an increase in retinal thickness (P = 0.042). In addition, three eyes presented with a large subretinal hemorrhage. However, final retinal thickness was better than the initial thickness and the value following the bevacizumab course. No major ocular or systemic side effects were noted.Conclusions: Ranibizumab was clinically effective in the long term but the change of treatment from bevacizumab to a half-size molecule with less half-life in the vitreous such as ranibizumab contributed to a transient “instability” in the eye which may have triggered the large subretinal hemorrhage. There is insufficient experience reported in the literature in switching from one agent to another. A prospective study with controls is necessary to determine whether it is safe to change from one medication to another.Keywords: age-related macular degeneration, bevacizumab, ranibizumab, subretinal hemorrhage
Bevacizumab versus Ranibizumab on As-Needed Treatment Regimen for Neovascular Age-Related Macular Degeneration in Turkish Patients  [PDF]
Abdullah Ozkaya,Zeynep Alkin,Yalcin Karakucuk,Dilek Yasa,Ahmet Taylan Yazici,Ahmet Demirok
ISRN Ophthalmology , 2013, DOI: 10.1155/2013/151027
Abstract: Purpose. To compare the efficacy of intravitreal bevacizumab versus ranibizumab in the treatment of neovascular age-related macular degeneration (nAMD). Methods. Retrospective, comparative study. The newly diagnosed nAMD patients who were treated with intravitreal bevacizumab or ranibizumab on an as-needed treatment regimen were included in the study. Main outcome measures were the change in best corrected visual acuity (BCVA), and central retinal thickness (CRT). Secondary outcome measures were the number of injections, and complications. Results. A total of 154 patients were included in the study. Bevacizumab group consisted of 79 patients, and ranibizumab group consisted of 74 patients. Mean follow-up time was 18.9 months, and 18.3 months in the bevacizumab and ranibizumab groups, respectively. There was not a significant difference between the two groups regarding the change in BCVA and CRT at all time points ( for all). The mean number of injections at month 12 was 4.8 and 4.7 in bevacizumab and ranibizumab groups, respectively ( ). No serious complications were detected in any of the groups. Conclusion. Both of the bevacizumab and ranibizumab found to be effective in the treatment of nAMD in regards of functional and anatomical outcomes with similar number of treatments and similar side effects. 1. Introduction Neovascular age-related macular degeneration (nAMD) is a leading cause of visual loss among elderly population [1, 2]. Before the introduction of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for the treatment of nAMD, only prevention from visual acuity loss might have been achieved in a limited number of patients with different treatment options like laser photocoagulation, photodynamic therapy, and vitreoretinal surgery [3–9]. Intravitreal treatments with bevacizumab (full length antibody against VEGF-A) and ranibizumab (Fab part of antibody against VEGF-A) have led the majority of the patients to prevent the baseline visual acuity (VA) and even to achieve visual improvement in some of the patients [10, 11]. The multicenter studies with ranibizumab, like MARINA, ANCHOR, PRONTO, and EXCITE, and the comparative study of ranibizumab and bevacizumab, the CATT study, showed that ranibizumab and bevacizumab were effective to prevent VA loss up to 95% of the patients and is effective to make an improvement in VA up to 40% of the patients [11–15]. Today, the CATT trial answered the questions about the efficacy of bevacizumab versus ranibizumab and showed that both drugs had similar effects in the treatment of nAMD.
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