Aim: To evaluate the efficacy and safety of triple therapy consisting single-session photodynamic therapy (PDT), intravitreal bevacizumab (IVB) and intravitreal triamcinolone (IVTA) for treatment of neovascular age-related macular degeneration (AMD) Methods: Consecutive patients with subfoveal choroidal neovascularisation (CNV) secondary to AMD were treated with PDT using a standard protocol immediately followed by 1.25 mg of IVB and 4 mg of IVTA. 1.25 mg of IVB was given at 3 months for residual leakage. Best-corrected Snellen visual acuity (BCVA) and fluorescein angiography (FA) were performed prior to treatment. BCVA, intraocular pressure (IOP) and presence of vitritis were documented at 1 and 6 weeks, 3 and 6 months. FA was repeated at 3 and 6 months. Outcome measures included visual improvement measured by logMAR equivalent, angiographic evident of leakage and safety profile. Results: 36 eyes of 33 patients, aged 76.4 (SD 10.5) years with mean follow-up of 14.7 (6.9-19.2) months were analysed. Baseline logMAR acuity was 1.22 (0.71). The mean logMAR acuity was 1.14 (0.62) and 1.18 (0.63) at 3 and 6 months respectively. At 6 months, 61.1% (22/36) showed stable or gaining vision, and 27.8% (10/36) gained three or more lines. Twentyeight eyes (77.8%) achieved CNV resolution by single session of triple therapy. One eye lost more than six lines due to retinal pigment epithelium rip, three eyes showed a significant cataract requiring surgery, and two showed persistent raised IOP at 6 months. None resulted in endophthalmitis or reported thromboembolic event. Conclusions: Short-term results of single session triple therapy suggested that it might be a useful treatment option for neovascular AMD based on its low retreatment rates, sustainable CNV eradication result and visual gain achievement. However, the risk and benefits of using intravitreal triamcinolone in addition to combined PDT and IVB warrant further evaluation.Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. It can be classified into non-neovascular (dry) and neovascular (wet) form. The neovascular form of AMD is characterised by the development of choroidal neovascularisation (CNV). It contributed to a minority of cases, approximately 10% to 20% but associated with 80% to 90% of visual loss.
Polymerase chain reaction might have a higher sensitivity and similar specificity in diagnosing neonatal chlamydial conjunctivitis compared to conventional methods, and it has an additional advantage as a diagnostic tool in mild disease.
We report a case of methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis after phacoemulsification in a continuous ambulatory peritoneal dialysis (CAPD) patient with a history of MRSA infection. This case raised the problem of preoperative identification and subsequent management of MRSA carrier status, which might reduce the risk for sight- or life-threatening infection.
Brolucizumab is a next-generation anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration. It is highly potent and thus appropriate for those unresponsive to other anti-VEGF agents and those undertreated owing to the low adherence or the heavy burden of repeated injections. An expert panel of 10 retina specialists from Hong Kong and Germany convened in February 2021 to discuss the benefit-risk profile and clinical use of brolucizumab. Evidence suggests that brolucizumab provides comparable visual outcomes to aflibercept at a more relaxed injection schedule. Brolucizumab is superior to aflibercept in resolving intraretinal and subretinal fluids and decreasing disease activity. Brolucizumab is suitable for patients unresponsive to other anti-VEGF agents, especially for those with persistent intraretinal and subretinal fluids or disease activity. Injection intervals of brolucizumab can be extended to 8 to 12 weeks. However, brolucizumab has higher risk of adverse events such as intraocular inflammation, retinal vasculitis, and retinal occlusion, compared with aflibercept. Thus, regular monitoring for signs of intraocular inflammation and prompt management are important before and during treatment.
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.