Asunto(s)
Dexametasona/efectos adversos , Glaucoma Neovascular/inducido químicamente , Glucocorticoides/efectos adversos , Oclusión de la Vena Retiniana/tratamiento farmacológico , Dexametasona/administración & dosificación , Implantes de Medicamentos , Angiografía con Fluoresceína , Glaucoma Neovascular/diagnóstico , Glucocorticoides/administración & dosificación , Gonioscopía , Humanos , Presión Intraocular , Iris/irrigación sanguínea , Iris/patología , Masculino , Neovascularización Patológica/inducido químicamente , Neovascularización Patológica/diagnóstico , Estudios Retrospectivos , Agudeza Visual/fisiología , Cuerpo Vítreo/efectos de los fármacosRESUMEN
PURPOSE: To evaluate a variable frequency regimen with intravitreal bevacizumab for treatment of neovascular age-related macular degeneration (AMD) in eyes that have not received any previous treatment. METHODS: Retrospective review of patients with neovascular AMD who were treated with three consecutive monthly intravitreal injections of bevacizumab (1.25 mg) and retreated based on the PrONTO study criteria. Outcome measures included visual acuity (VA) and central retinal thickness. Subgroup analysis was conducted to identify pretreatment characteristics that could determine visual outcome with treatment. RESULTS: A total of 109 eyes of 109 patients were treated. The mean age was 82 years, and the mean follow-up period was 9.4 months (range 6-12 months). At baseline, the mean VA was 45.6 letters (6/37.5) and mean central retinal thickness 343 microm. This improved to 51 letters (6/30) (P < 0.001)) and 231 microm (P < 0.001) at 6 months. At 6 months, VA was improved by at least five letters in 50%, remained stable in 30% and worsened by at least five letters in 20% of patients. Patients with large intraretinal cysts on optical coherence tomography before treatment had an increased risk of worse vision (odds ratio 10.5, 95% confidence interval 1.69-64.99; P = 0.018). CONCLUSIONS: The majority of patients had improvement or stability of VA regardless of the angiographic type of choroidal neovascularization. Intravitreal bevacizumab with this tailored regimen is beneficial in the treatment of neovascular AMD in the short term. The presence of large intraretinal cysts on optical coherence tomography is a poor prognostic factor for visual improvement with this treatment.
Asunto(s)
Inhibidores de la Angiogénesis/administración & dosificación , Anticuerpos Monoclonales/administración & dosificación , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/tratamiento farmacológico , Degeneración Macular/diagnóstico , Degeneración Macular/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados , Bevacizumab , Neovascularización Coroidal/complicaciones , Femenino , Humanos , Inyecciones , Degeneración Macular/complicaciones , Edema Macular/complicaciones , Masculino , Pronóstico , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual , Cuerpo VítreoRESUMEN
PURPOSE: To report the prevalence of intraocular lens (IOL) opacification and related clinical features in patients implanted with Hydroview IOL. SETTING: Gloucestershire Eye Unit, Gloucestershire, United Kingdom. METHODS: A total of 1330 eyes of 1265 patients who had cataract surgery with Hydroview IOL implantation between September 2000 and April 2001 were reviewed between April and October 2004. The visual acuity, visual symptoms, IOL status, and associated ocular comorbidity were recorded. RESULTS: One hundred ninety-three (14.5%) of 1330 eyes had evidence of IOL opacification. A total of 56 (4.2%) had visually significant opacification and had IOL exchange. The prevalence of IOL opacification ranged from 1.1% in patients who had surgery in September 2000 to 36.3% in the December 2000 group. In eyes with IOL opacification, the visual symptoms were decreased vision (57%), glare (32%), and mistiness of vision (27%). One hundred forty-four eyes (75%) with IOL opacification had visual acuity of 6/12 or better; 21.5% of diabetic eyes had IOL opacification compared with 14.3% of nondiabetic eyes (P =.06); 20.5% of glaucomatous eyes had IOL opacification compared with 14.0% of nonglaucomatous eyes (P = .033). CONCLUSIONS: This is the first large sample recall of patients implanted with the Hydroview H60M IOL. The overall prevalence of IOL opacification was 14.5%, with peak prevalence in patients who had surgery in December 2000.