RESUMEN
Age-related macular degeneration (AMD) is a progressive, chronic disease of the central area of the retina, which, if untreated, leads to blindness. This study aimed to compare the effectiveness of therapy using anti-VEGF drugs, namely brolucizumab and aflibercept, in patients with neovascular AMD (nAMD) during a monitoring period lasting around 20 weeks. The analysis consisted of 40 patients diagnosed with neovascular age-related macular degeneration, with 20 patients receiving aflibercept (Eylea, Bayer) at a dose of 2 mg/50 µL into the vitreous chamber at the following intervals-3 doses, 4 weeks apart, followed by a fourth dose after 8 weeks. The remaining 20 patients received brolucizumab (Beovu, Novartis) at a dose of 6 mg/50 µL, administered in the following schedule-3 initial doses, 4 weeks apart, with the administration of a fourth dose decided for each patient individually by the doctor, depending on disease activity, assessed through imaging tests. To evaluate treatment effectiveness, the following measurements were used: 'read distance and near visual acuity' for each eye separately using the Snellen chart; and non-invasive retinal imaging techniques-optical coherence tomography (OCT) and OCT angiography (OCTA). In patients treated using brolucizumab, during the observation period, statistically significant differences were found in the following parameters: flow area (p = 0.0277); select area (p = 0.0277); FOVEA (p = 0.0073); visus (p = 0.0064). In brolucizumab-treated patients, changes in OCT and OCTA, indicating an improvement, were already visible after the first injection of the drug, whereas in the aflibercept-treated group, changes were only visible after the fourth injection. We found a higher effectiveness of brolucizumab therapy compared to aflibercept in patients with nAMD during an observations period lasting 20 weeks. Our observations are significant, although they require further research.
Asunto(s)
Inhibidores de la Angiogénesis , Degeneración Macular Húmeda , Inhibidores de la Angiogénesis/efectos adversos , Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales Humanizados , Estudios de Seguimiento , Humanos , Lactante , Receptores de Factores de Crecimiento Endotelial Vascular , Proteínas Recombinantes de Fusión , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular , Agudeza Visual , Degeneración Macular Húmeda/inducido químicamente , Degeneración Macular Húmeda/tratamiento farmacológicoRESUMEN
This study was performed on 80 spontaneously aborted human fetuses of a gestational period of between 17 and 27 weeks. The procedure was based on latex filled arteries, which were preserved in formalin, and then later dissected. Data collection was accomplished using digital imaging. The specific measurements of the aortic arch diameter, length and volume were obtained using a computer program, written solely for the purpose of this study. Results indicated that the collected figures correlated with the fetal age through 3 sets of 4-week intervals. Diameter and length of the aortic arch varied from 2.5 to 4.1 mm and from 6.7 to 10.3 mm, respectively. Both parameters showed statistically significant (p<0.05) linear growth and differences between age groups. The volumetric growth of the aortic arch followed a square root function with its values ranging from 35.7 to 136.8 mm3, which were also statistically significant (p < 0.05). The diameter of the aortic isthmus was measured and compared to the diameters of the ascending and descending aorta thus allowing an estimation ratio between those parameters. Concluding analyses suggest that the aortic isthmus becomes narrower during fetal development.
Asunto(s)
Aorta Torácica/embriología , Aborto Espontáneo/patología , Aorta Torácica/anatomía & histología , Femenino , Edad Gestacional , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del EmbarazoRESUMEN
The study was performed on 103 human foetuses (58 female, 45 male) spontaneously aborted at between 14 and 30 weeks of gestation. The arteries were filled with latex, preserved in formalin and then dissected under the microscope and digitalised using a camera system. The following measurements were taken with the use of special computer software: the external diameter, the length and the volume of the arch of the aorta. The increase in diameter and length in relation to age corresponded to a linear function with values ranging from 1.77 mm to 4.09 mm for the diameter and from 4.94 mm to 13.31 mm for the length. The increase in volume corresponded to a square root function with values ranging from 13.42 mm3 to 173.96 mm3. Analysis of arch of the aorta variations revealed 11 cases of a common trunk for the brachiocephalic trunk and the left common carotid artery and 7 cases with the left vertebral artery arising directly from the arch of the aorta. In 2 cases the brachiocephalic trunk was absent, the right subclavian artery branching directly from the arch of the aorta at the level of the left subclavian artery or from the descending aorta just below the arterial duct ostium.