Combination treatment of low fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane secondary to angioid streaks in Paget′s disease - 12 month results

Prabhu, Varsha V; Morris, Rodney J; Shah, Parag K; Narendran, Venkatapathy

doi:10.4103/0301-4738.82000

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Publications by Indian based authors on anti-VEGF agents started in the year 2007, with 69 peer reviewed papers published until September 2013. [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 ] The years between 2007-10, being populated largely by case reports and occasional case series detailing the use of anti-VEGF agents in treating CNVM of other etiology, and retinopathy of prematurity[ 41 ] (2007), AMD[ 3 ] and adjunct to trabeculectomy[ 44 ] (2008). We can see a trend towards randomized case-control studies comparing different anti-VEGF agents, the use of combination treatments in AMD and other diseases si...…”

Section: Resultsmentioning

confidence: 99%

“…Case reports documenting the use of bevacizumab, ranibizumab and combination treatments such as anti-VEGF agents with photodynamic therapy have been published from India for the following indications:[ 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 ]…”

Section: Resultsmentioning

confidence: 99%

“…A prospective and one retrospective case series documenting the use of anti-VEGF monotherapy or in combination with photodynamic therapy in the treatment of pathologic myopia and a retrospective case series documenting anti-VEGF to treat choroidal neovascularization associated with parafoveal telangiectasia have been published. [ 22 23 24 25 26 27 28 29 30 ] In a noncomparative, consecutive, interventional case series, Mandal et al showed that intravitreal bevacizumab resulted in > 3 line vision improvement in 75% of patients with myopic CNVM. [ 27 ] A retrospective comparison between PDT alone vs. PDT + triamcinolone vs. reduced fluence PDT + ranibizumab/bevacizumab to treat myopic CNVM showed visual improvement in all groups at 6 months, particularly in those treated with combination of PDT + anti-VEGF.…”

Section: Resultsmentioning

confidence: 99%

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Changing paradigms of anti-VEGF in the Indian scenario

Shanmugam

2014

Indian J Ophthalmol

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Anti-vascular endothelial growth factors (VEGF) agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Changing paradigms of anti-VEGF in the Indian scenario

Shanmugam

2014

Indian J Ophthalmol

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“…Based on these previous findings in conjunction with the bevacizumab tachyphylaxis and the vitrectomized-pseudophakic condition that was present, we decided to use ranibizumab instead of bevacizumab in all of the subsequent treatments for this patient. Recently, it has been reported that the combination of IVR and reduced-fluence PDT for CNV associated with AS was effective in the regression of CNV and in improving (or stabilizing) the visual acuity [26,27]. Based on the above-mentioned findings, we performed the combined therapy of full-dose PDT and IVR instead of IVR monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Choroidal neovascularization in angioid streaks following microincision vitrectomy surgery: a case report

et al. 2013

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Background: Patients with angioid streaks are prone to developing subretinal hemorrhage after ocular or head injury due to the brittleness of Bruch's membrane. However, there have been no reports of any angioid streak patients in whom choroidal neovascularization occurred after vitrectomy surgery. We report herein a patient with angioid streaks who developed choroidal neovascularization after vitrectomy surgery for epiretinal membrane. Case presentation: A 76-year-old man presented with distorted vision in his left eye, with a best corrected visual acuity of 1.2 and 0.6 in his right and left eyes, respectively. Fundus examination showed angioid streaks in both eyes and epiretinal membrane only in the left eye. The patient underwent 23-gauge three-port pars plana vitrectomy with removal of the epiretinal membrane combined with cataract surgery. Internal limiting membrane in addition to the epiretinal membrane were successfully peeled and removed, with indocyanine green dye used to visualize the internal limiting membrane. His left best corrected visual acuity improved to 0.8. An elevated lesion with retinal hemorrhage due to probable choroidal neovascularization was found between the fovea and the optic disc in the left eye at 7 weeks after surgery. Since best corrected visual acuity decreased to 0.15 and the hemorrhage expanded, posterior sub-Tenon injection of triamcinolone acetonide was performed. However, no improvement was observed. Even though intravitreal bevacizumab injection was performed a total of five times, his best corrected visual acuity remained at 0.1. Subsequently, we performed a combination treatment of a standard-fluence photodynamic therapy and intravitreal ranibizumab injection, with additional intravitreal ranibizumab injections performed 3 times after this combination treatment. Best corrected visual acuity improved to 0.5 and the size of the choroidal neovascularization markedly regressed at 4 months after the combined treatment. Conclusion: Development of choroidal neovascularization could possibly occur in elderly patients with angioid streaks after vitrectomy surgery. In such cases, a combination of photodynamic therapy and intravitreal ranibizumab injection may be considered for initial treatment of the choroidal neovascularization.

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Membrana neovascular subretiniana asociada a estrías angioides tratada con bevacizumab intravítreo

García-López

González-Castaño

2014

Archivos de la Sociedad Española de Oftalmología

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Combination treatment of low fluence photodynamic therapy and intravitreal ranibizumab for choroidal neovascular membrane secondary to angioid streaks in Paget′s disease - 12 month results

Cited by 6 publications

References 8 publications

Changing paradigms of anti-VEGF in the Indian scenario

Changing paradigms of anti-VEGF in the Indian scenario

Choroidal neovascularization in angioid streaks following microincision vitrectomy surgery: a case report

Membrana neovascular subretiniana asociada a estrías angioides tratada con bevacizumab intravítreo

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