Intravitreal Combination of Dexamethasone Sodium Phosphate and Bevacizumab in The Treatment of Exudative AMD

Vakalis, Nikolaos; Echiadis, George; Pervena, A.; Deligiannis, Ioannis; Kavalarakis, E.; Giannikakis, S.; Papaefthymiou, Ioannis

doi:10.1038/srep08627

Cited by 17 publications

(8 citation statements)

References 38 publications

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“…More recently, GCs has been used in combination with anti-VEGF (Vakalis et al, 2015; Calvo et al; and 2015, Lim et al 2015) or photodynamic monotherapy (Selım et al, 2014). These combinations have been shown to have superior results than either treatment alone.…”

Section: Introductionmentioning

confidence: 99%

Glucocorticoid therapy and ocular hypertension

Dibas

Yorio

2016

European Journal of Pharmacology

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The projected number of people who will develop age-related macular degeneration in estimated at 2020 is 196 million and is expected to reach 288 million in 2040. Also, the number of people with Diabetic retinopathy will grow from 126.6 million in 2010 to 191.0 million by 2030. In addition, it is estimated that there are 2.3 million people suffering from uveitis worldwide. Because of the anti-inflammatory properties of glucocorticoids (GCs), they are often used topically and/or intravitreally to treat ocular inflammation conditions or edema associated with macular degeneration and diabetic retinopathy. Unfortunately, ocular GC therapy can lead to severe side effects. Serious and sometimes irreversible eye damage can occur as a result of the development of GC-induced ocular hypertension causing secondary open-angle glaucoma. According to the world health organization, glaucoma is the second leading cause of blindness in the world and it is estimated that 80 million will suffer from glaucoma by 2020. In the current review, mechanisms of GC-induced damage in ocular tissue, GC-resistance, and enhancing GC therapy will be discussed.

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Section: Introductionmentioning

confidence: 99%

Glucocorticoid therapy and ocular hypertension

Dibas

Yorio

2016

European Journal of Pharmacology

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“…; Vakalis et al. ). A combination of anti‐VEGF injection and PDT could be an option, at least in some special cases (Wang et al.…”

Section: Discussionmentioning

confidence: 97%

Anti‐vascular endothelial growth factors treatment of wet age‐related macular degeneration: from neurophysiology to cost‐effectiveness

Vottonen

2018

Acta Ophthalmologica

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“…The intravitreal implant with a sustained release of dexamethasone was applied to cull intraocular inflammations [26]. The combination of corticosteroids and anti-VEGF has been reported to perform efficiently in recent AMD studies [27,28].…”

Section: Discussionmentioning

confidence: 99%

Establishing Liposome-Immobilized Dexamethasone-Releasing PDMS Membrane for the Cultivation of Retinal Pigment Epithelial Cells and Suppression of Neovascularization

Lin

Chien

Lin³

et al. 2019

IJMS

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Age-related macular degeneration (AMD) is the eye disease with the highest epidemic incidence, and has great impact on the aged population. Wet-type AMD commonly has the feature of neovascularization, which destroys the normal retinal structure and visual function. So far, effective therapy options for rescuing visual function in advanced AMD patients are highly limited, especially in wet-type AMD, in which the retinal pigmented epithelium and Bruch’s membrane structure (RPE-BM) are destroyed by abnormal angiogenesis. Anti-VEGF treatment is an effective remedy for the latter type of AMD; however, it is not a curative therapy. Therefore, reconstruction of the complex structure of RPE-BM and controlled release of angiogenesis inhibitors are strongly required for sustained therapy. The major purpose of this study was to develop a dual function biomimetic material, which could mimic the RPE-BM structure and ensure slow release of angiogenesis inhibitor as a novel therapeutic strategy for wet AMD. We herein utilized plasma-modified polydimethylsiloxane (PDMS) sheet to create a biomimetic scaffold mimicking subretinal BM. This dual-surface biomimetic scaffold was coated with laminin and dexamethasone-loaded liposomes. The top surface of PDMS was covalently grafted with laminin and used for cultivation of the retinal pigment epithelial cells differentiated from human induced pluripotent stem cells (hiPSC-RPE). To reach the objective of inhibiting angiogenesis required for treatment of wet AMD, the bottom surface of modified PDMS membrane was further loaded with dexamethasone-containing liposomes via biotin-streptavidin linkage. We demonstrated that hiPSC-RPE cells could proliferate, express normal RPE-specific genes and maintain their phenotype on laminin-coated PDMS membrane, including phagocytosis ability, and secretion of anti-angiogenesis factor PEDF. By using in vitro HUVEC angiogenesis assay, we showed that application of our membrane could suppress oxidative stress-induced angiogenesis, which was manifested in decreased secretion of VEGF by RPE cells and suppression of vascularization. In conclusion, we propose modified biomimetic material for dual delivery of RPE cells and liposome-enveloped dexamethasone, which can be potentially applied for AMD therapy.

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Intravitreal Combination of Dexamethasone Sodium Phosphate and Bevacizumab in The Treatment of Exudative AMD

Cited by 17 publications

References 38 publications

Glucocorticoid therapy and ocular hypertension

Glucocorticoid therapy and ocular hypertension

Anti‐vascular endothelial growth factors treatment of wet age‐related macular degeneration: from neurophysiology to cost‐effectiveness

Establishing Liposome-Immobilized Dexamethasone-Releasing PDMS Membrane for the Cultivation of Retinal Pigment Epithelial Cells and Suppression of Neovascularization

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