Aqueous humor levels of cytokines and growth/inflammatory factors were measured in 38 patients with macular edema who had major branch retinal vein occlusion (BRVO) or macular BRVO and were treated with intravitreal ranibizumab injection (IRI). Patients with recurrence of macular edema received further IRI as needed. Aqueous humor levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor-1 (sVEGFR-1), and other cytokines/factors were measured. Compared with major BRVO, macular BRVO was associated with lower aqueous humor levels of sVEGFR-1, its ligands (VEGF and placental growth factor), and other growth/inflammatory factors (platelet-derived growth factor-AA, monocyte chemotactic protein-1, soluble intercellular adhesion molecule-1, interleukin-6, and interleukin-8). The mean number of IRI over 6 months was significantly lower in the macular BRVO group than in the major BRVO group. These findings suggest that macular BRVO requires fewer IRI than major BRVO and is associated with lower aqueous humor levels of various growth/inflammatory factors and cytokines.
To investigate the relationship between retinal blood flow and the presence or absence of macular edema (ME) recurrence after intravitreal ranibizumab injection (IRI) in patients with central retinal vein occlusion (CRVO).We reviewed the medical records of 16 eyes with ME associated with CRVO. All eyes had received pro re nata IRI. Repeat IRI was performed if the central macular thickness was ≥300 µm. At 12 months, patients without additional IRI in the past 6 months were assigned to the resolved group, and those with additional IRI, to the recurrence group. We used laser speckle flowgraphy (LSFG) to measure the mean blur rate (MBR) of the optic disc before and after IRI.Ten of the 16 eyes were assigned to the resolved group, and the other 6 eyes to the recurrence group. At several visits in the 12 months after IRI, MBR was significantly higher in the resolved group than in the recurrence group. Percent change of MBR (%Δ MBR) from baseline was significantly higher in the resolved group than in the recurrence group at 1 month (initial %Δ MBR) and 11 and 12 months. Multivariate stepwise analysis showed that the initial %Δ MBR was significantly and negatively correlated with the number of IRIs.These findings suggest that determining %Δ MBR in LSFG may be a useful way to determine the likelihood of ME recurrence in CRVO patients.
Correlations among functional–morphological parameters, the aqueous flare value (an indicator of inflammation) and aqueous humour levels of cytokines/inflammatory factors were investigated in patients with branch retinal vein occlusion (BRVO) and macular oedema who received intravitreal ranibizumab injection (IRI) and were followed for 6 months.
Methods
Aqueous humour levels of 11 cytokines or growth inflammatory/factors were measured in 45 patients with BRVO and macular oedema who received IRI. Patients with recurrent macular oedema were given further IRI as needed. Aqueous humour levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor (sVEGFR) and other cytokines/inflammatory factors were measured by the suspension array method. Aqueous flare values were measured with a laser flare metre and macular oedema was examined by optical coherence tomography.
Results
There were significant correlations between the aqueous flare and the aqueous levels of sVEGFR-1, placental growth factor, monocyte chemoattractant protein 1, soluble intercellular adhesion molecule-1, interleukin (IL)-6 and IL-8. There were also significant correlations between the change of the aqueous flare and improvement of central macular thickness after 1 month, after 6 months and at the 1st recurrence. Furthermore, a significant correlation was noted between the change of the aqueous flare and improvement of best-corrected visual acuity at 6 months after IRI, but not at 1 month or at the 1st recurrence.
Conclusions
These findings suggest that the aqueous flare is associated with inflammatory factors/cytokines, and that the change of the aqueous flare value may influence the long-term prognosis in patients with BRVO receiving IRI therapy for macular oedema.
To prospectively evaluate the efficacy of subtenon injection of triamcinolone acetonide (TA) before laser grid pattern photocoagulation (G-PC) for the treatment of diffuse diabetic macular oedema (DDME).42 eyes of 37 consecutive patients with DDME were studied. 1 week before G-PC, 21 eyes received TA subtenon injection, and the other eyes served as control. The clinical course of visual acuity (VA) and foveal thickness (FT) was monitored for up to 24 weeks after G-PC. Mean deviation (MD) of perimetry with 30-2 program on Humphrey Perimeter (Zeiss-Humphrey, Dublin, California, USA) was also measured. The average laser intensity was recorded.After TA injection, FT and VA were improved, and subsequent G-PC maintained the improvement for up to 24 weeks without recurrence of diffuse diabetic macular oedema. In contrast, G-PC without TA injection induced transient worsening of FT and VA, then both were gradually improved. At 24 weeks after G-PC, MD in the TA-injected eyes was better than those in control. The required laser intensity in TA-injected eyes was less than that for control.Subtenon injection of TA prior to G-PC allows for treatment with a lower intensity of laser spots and also prevents the decrease in central visual field sensitivity, all of which have clinical advantages for G-PC.
To evaluate the effectiveness of topical bromfenac during treatment with intravitreal injections of bevacizumab (IVB) in eyes with macular oedema (ME) secondary to branch retinal vein occlusion (BRVO).
Methods
Prospective interventional case–control study. 48 eyes of 44 patients with ME-BRVO who received 1.25 mg/0.05 mL of IVB showed temporary regression of ME. Additional IVB were given when ME recurred. 24 eyes received topical bromfenac, and the other 24 eyes received topical saline as control, four times a day during the clinical course of 48 weeks. The clinical course of foveal thickness (FT) as measured by optical coherence tomography, logarithm of the minimum angle of resolution visual acuity (VA), was monitored. The number of IVB was also recorded.
Results
There were no significant differences in FT, VA between the bromfenac-treated eyes and the control eyes at the initial and final examinations. The number of injections in bromfenac-treated eyes of 3.8±1.1 times was significantly less than in the control eyes of 4.8±1.2 times.
Conclusions
Although topical bromfenac during IVB therapy in eyes with ME secondary to BRVO did not affect the visual prognosis, it had the advantage of reducing the number of injections.
<b><i>Purpose:</i></b> To investigate dynamic changes in aqueous humor levels of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and inflammatory factors in patients receiving intravitreal ranibizumab injection (IRI) or intravitreal aflibercept injection (IAI) to treat central retinal vein occlusion (CRVO) with macular edema. <b><i>Methods:</i></b> In<i></i> 22 CRVO patients scheduled to receive 3 doses of ranibizumab (11 eyes) or aflibercept (11 eyes) at monthly intervals, aqueous samples were collected at the time of intravitreal injection. The concentrations of VEGF, PlGF, soluble intercellular adhesion molecule-1, monocyte chemotactic protein (MCP)-1 (CCL2), platelet-derived growth factor-AA, interleukin (IL)-6, IL-8 (CXCL8), IL-12(p70) (IL12B), and IL-13 in aqueous samples were measured by the suspension array method. <b><i>Results:</i></b> Visual acuity and foveal thickness improved significantly in both the IRI group and the IAI group. In addition, aqueous levels of VEGF and PlGF as well as MCP-1 and IL-6 decreased significantly over time in both groups. These parameters did not significantly differ between both groups. <b><i>Conclusions:</i></b> In CRVO patients, both ranibizumab and aflibercept achieved similar improvement in clinical parameters and similar reductions in aqueous VEGF, PlGF, MCP-1, and IL-6 levels.
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