Age-related macular degeneration (AMD) is characterized as a chronic, multifactorial disease and is the leading cause of irreversible blindness. Advanced AMD is classified as neovascular (wet) AMD and non-neovascular (dry) AMD. Dry AMD can progress to a more advanced form that manifests as geographic atrophy (GA), which significantly threatens vision, leading to progressive and irreversible loss of visual function. There are currently no approved therapeutics commercially available for GA patients. However, data from various clinical trials have demonstrated favorable results with significant reduction in GA lesion growth. This review furthers the understanding of the pathophysiology of GA, as well as current clinical trial data on investigational therapeutics.
Age-related macular degeneration (AMD) represents a leading cause of blindness worldwide. Neovascular AMD (nAMD) is a subtype of AMD most frequently treated with intravitreal anti-vascular endothelial growth factor (aVEGF) injections, which has allowed for patients to maintain vision that would have otherwise been lost. However, the need for frequent intravitreal injections for optimal results poses a risk for undertreatment in nAMD patients due to the high treatment burden associated with current aVEGF therapy. Many novel agents and pathways are being explored and targeted for less burdensome treatment options, one of which is the ranibizumab port delivery system (PDS). The PDS is a surgically implanted, refillable device that allows for the sustained release of ranibizumab, a widely used aVEGF agent, into the vitreous cavity. Positive results non-inferior to monthly ranibizumab injections in both phase II and phase III clinical trials allowed for FDA approval of the device with refill intervals of 6 months, which represents the longest approved treatment interval to date for nAMD therapy. This article reviews the need for a durable nAMD treatment option in real-world practice, the clinical trial and extension study data for the PDS, the risk of adverse events and safety profile of the PDS and the potential clinical role of the PDS in answering the real-world needs of nAMD treatment. In addition, other pipeline sustained-treatment modalities are discussed in the context of ongoing clinical trials.
Postoperative staple line hemorrhage and leakage are major causes of postoperative morbidity after laparoscopic sleeve gastrectomy (LSG). Many staple line reinforcement (SLR) techniques have been innovated in efforts to reduce such complications; these include oversewing/suturing (OS/S), omentopexy/gastropexy (OP/GP), gluing, and buttressing. Therefore, surgeons are often confused of which SLR they should use. Recent high-quality evidence shows that Seamguard buttressing (SGB) and OS/S are associated with better postoperative outcomes when each is compared to no SLR; having said that, it is unknown if one of these 2 methods is superior to the other. The aim of this study is to compare postoperative outcomes between LSG with SGB versus LSG with OS/S. Key points • No significant difference in postoperative bleeding, postoperative leakage, and readmission was observed between SGB and OS/S. • SGB was associated with decreased incidence of reoperations, and without significant heterogeneity which makes the decrease generalizable. However, when compared to OS/S, number need to treat (NNT) with SGB to prevent a case reoperation is 166. • OS/S was associated with shorter LOS, but this isn’t generalizable because of significant heterogeneity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.