Anti-VEGF therapy resistance in neovascular age-related macular degeneration

Budzinskaya, M.V.; Plyukhova, A.A.; Sorokin, P A

doi:10.17116/oftalma20171334103-108

Cited by 7 publications

(6 citation statements)

References 43 publications

(62 reference statements)

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“…As previous studies have shown, blockage of VEGF by Ranibizumab is expected to cause regression of neovascularization. [31,32] Therefore, IVR given at the end of air-fluid exchange can eliminate neovascularization either at the optic disc or retina. Due to the use of the endolaser during the procedures performed after the PPV, the neovascularization of the retina is limited, which in turn reduces the probability of bleeding after surgery.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study)

Zhang

Wang

et al. 2019

Medicine

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To evaluate the outcomes and complications of intravitreal injections of ranibizumab in patients during pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. This retrospective, observational, comparative study included 103 patients (103 eyes) who underwent pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. Sixty-six patients received an intravitreal injection of 0.05 mg (0.05 cc) of ranibizumab at the end of surgery. Main outcome measures were the occurrence of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, best corrected visual acuity. Mean follow-up time was 6 months. The rate of rebleeding in the intravitreal ranibizumab (IVR) group was 6.1% (4 eyes), which is significantly lower than the control group (24.3%, 9 eyes, P < .01). The incidence of postoperative diabetic vitreous hemorrhage (PDVH) was significantly lower in the IVR group than the control group, OR=0.26, 95% CI= (0.06, 0.95). Visual acuity 6 months after operation was better in IVR group ( P <.01) There was no difference in mean intraocular pressure between the 2 groups ( P =.56). The present clinical study suggests that intravitreal injection of ranibizumab is effective in the prevention of postoperative diabetic vitreous hemorrhage in eyes undergoing pars plana vitrectomy for the treatment of diabetic vitreous hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study)

Zhang

Wang

et al. 2019

Medicine

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“…Ocular in ammation, increased intraocular pressure, uveitis or less frequently endophthalmitis, retinal detachment and retinal or vitreous hemorrhage are all serious ocular adverse events to anti-VEGF treatment [13][14]. Others reported a lack (down to complete lack) of response with standard treatment patterns and even a decrease in treatment e cacy after repeated intravitreal injections [15].…”

Section: Read Full Licensementioning

confidence: 99%

Mingjing Granule, a Traditional Chinese Medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

Liang

Snellingen

et al. 2020

Preprint

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BackgroundNeovascular age-related macular degeneration (nAMD) is the most common cause of irreversible vision loss and blindness among the elderly people aged 50 and over. Although anti-vascular endothelial growth factor(anti-VEGF) therapies have resulted in improving patient outcomes, there are limitations associated with these treatments. In China, Traditional Chinese medicine(TCM) has been used to treat eye diseases for more than 2000 years. Previous studies have shown that TCM may be beneficial for nAMD patients. However, explicit evidence has not been obtained. The purpose of the present trial is to examine the efficacy and safety of the Mingjing Granule, a compound Chinese herbal medicine, for nAMD patients. Methods/DesignThis is a double-blind, placebo-controlled, randomized trial of Mingjing Granule as an add-on to intravitreous ranibizumab for nAMD. 180 nAMD patients from six hospitals in China will be enrolled according to the inclusion and exclusion criteria, and randomly allocated into two groups, 90 in each. All participants will receive a 24-week treatment and then be followed-up for another 24 weeks. The primary outcome is the mean change of best-corrected visual acuity at week 24 and 48 as compared to the baseline. The secondary outcomes include mean change in central retinal thickness, area of retinal hemorrhage and exudation, and TCM syndrome score, mean number of intravitreal ranibizumab injection and total cost of the treatment. Indexes of safety include blood regular test, urine regular test, liver function test, renal function test and electrocardiogram from baseline to week 24 and 48. Qualitative control and some standard operating processes will be formed throughout the trial. Any ocular or systemic adverse events will be treated suitably and related data will be recorded accurately and completely in the case report form.DiscussionBased on previous empirical and animal laboratory studies, this study will address the question of whether Mingjing Granule could contribute to improving efficacy, safety and efficiency with need for fewer intravitreal injections of anti-VEGF, improving compliance and visual outcomes in the management of persons with nAMD.Trial registrationChinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000035990. Registered on 21 August 2020.

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“…Ocular inflammation, increased intraocular pressure, uveitis or less frequently endophthalmitis, retinal detachment, and retinal or vitreous hemorrhage are all serious ocular adverse events to anti-VEGF treatment [ 13 , 14 ]. Others reported a lack (down to complete lack) of response with standard treatment patterns and even a decrease in treatment efficacy after repeated intravitreal injections [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Mingjing granule, a traditional Chinese medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

Liang

Snellingen³

et al. 2021

Trials

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Background Neovascular age-related macular degeneration (nAMD) is the most common cause of irreversible vision loss and blindness among the older people aged 50 and over. Although anti-vascular endothelial growth factor (anti-VEGF) therapies have resulted in improving patient outcomes, there are limitations associated with these treatments. In China, traditional Chinese medicine (TCM) has been used to treat eye diseases for more than 2000 years. Previous studies have shown that TCM may be beneficial for nAMD patients. However, explicit evidence has not been obtained. The purpose of the present trial is to examine the efficacy and safety of the Mingjing granule, a compound Chinese herbal medicine, for nAMD patients. Methods/design This is a double-blind, placebo-controlled, randomized trial of Mingjing granule as an add-on to intravitreous ranibizumab for nAMD. One hundred eighty nAMD patients from six hospitals in China will be enrolled according to the inclusion and exclusion criteria and randomly allocated into two groups, 90 in each. All participants will receive a 24-week treatment and then be followed up for another 24 weeks. The primary outcome is the mean change of best-corrected visual acuity at week 24 and 48 as compared to the baseline. The secondary outcomes include mean change in central retinal thickness, area of retinal hemorrhage and exudation, and TCM syndrome score, mean number of intravitreal ranibizumab injection, and total cost of the treatment. Indexes of safety include blood regular test, urine regular test, liver function test, renal function test, and electrocardiogram from baseline to weeks 24 and 48. Qualitative control and some standard operating processes will be formed throughout the trial. Any ocular or systemic adverse events will be treated suitably, and related data will be recorded accurately and completely in the case report form. Discussion Based on previous empirical and animal laboratory studies, this study will address the question of whether Mingjing granule could contribute to improving efficacy, safety, and efficiency with need for fewer intravitreal injections of anti-VEGF, improving compliance and visual outcomes in the management of persons with nAMD. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000035990. Registered on 21 August 2020.

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Anti-VEGF therapy resistance in neovascular age-related macular degeneration

Cited by 7 publications

References 43 publications

Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study)

Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study)

Mingjing Granule, a Traditional Chinese Medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

Mingjing granule, a traditional Chinese medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

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