Lucedex

Ranchod, Tushar M.; Ray, Swapna; Daniels, Stewart A.; Leong, Craig J.; Ting, T. D.; Verne, Allen Z.

doi:10.1097/iae.0b013e318285cb71

Cited by 28 publications

(8 citation statements)

References 16 publications

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“…In particular, it has been shown that intravitreal combination of triamcinolone and bevacizumab is highly efficient in decreasing the amount of subretinal fluid, limiting neovascularization and preserving or increasing visual acuity32. Similar positive results were obtained in a recent study of combined intravitreal ranibizumab and dexamethasone33.…”

Section: Discussionsupporting

confidence: 88%

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

Vakalis

Echiadis

Pervena

et al. 2015

Sci Rep

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The purpose of this study is to investigate the efficacy and safety of intravitreal dexamethasone sodium phosphate (DSP) combined with bevacizumab for the treatment of neovascular age-related macular degeneration (AMD). In this non comparative case study, 30 eyes of 27 patients with CNV due to AMD received intravitreal DSP (0.2 mg) and bevacizumab (1.25 mg) during a 6-month PRN (pro re nata) dosing regimen. Visual acuity, macular thickness and intraocular pressure (IOP) were monitored and recorded. After 6 months, mean retinal thickness decreased from 423.5 ± 75.3 to 228.2 ± 34.5 and mean visual acuity improved from 0.9 ± 0.39 logMAR to 0.53 ± 0.34 (p = 0.001) logMAR. During the trial period, 81 intravitreal injections were performed in 30 eyes, thus the mean number of injections per eye was 2.7 ± 1.1. 86.7% of the eyes required 3 or less injections while only 13.3% needed 4 or more injections. None of the patients, phakic or pseudophakic, manifested an elevation of IOP during the treatment, ranging between 12 and 22 mmHg. Combined DSP and bevacizumab offers encouraging results in the challenge of AMD treatment, providing immediate response of macular edema, reduced number of intravitreal injections and stabilization or improvement of visual acuity.

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Section: Discussionsupporting

confidence: 88%

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

Vakalis

Echiadis

Pervena

et al. 2015

Sci Rep

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“…The LuceDex study 21 was the first study using the IV DEX injections (500 mg in 0.05 mL), followed by IV ranibizumab (4 monthly injections of 0.5 mg in 0.05 mL) that was compared with IV ranibizumab monotherapy (Group 2; total 37 patients). After 4 consecutive months, in both groups, ranibizumab pro re nata treatment was administered if signs of lesion activity were present.…”

Section: Namdmentioning

confidence: 99%

Widening use of dexamethasone implant for the treatment of macular edema

Bonfiglio¹,

Reibaldi²,

Fallico³

et al. 2017

DDDT

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Sustained-release intravitreal 0.7 mg dexamethasone (DEX) implant is approved in Europe for the treatment of macular edema related to diabetic retinopathy, branch retinal vein occlusion, central retinal vein occlusion, and non-infectious uveitis. The implant is formulated in a biodegradable copolymer to release the active ingredient within the vitreous chamber for up to 6 months after an intravitreal injection, allowing a prolonged interval of efficacy between injections with a good safety profile. Various other ocular pathologies with inflammatory etiopathogeneses associated with macular edema have been treated by DEX implant, including neovascular age-related macular degeneration, Irvine–Gass syndrome, vasoproliferative retinal tumors, retinal telangiectasia, Coats’ disease, radiation maculopathy, retinitis pigmentosa, and macular edema secondary to scleral buckling and pars plana vitrectomy. We undertook a review to provide a comprehensive collection of all of the diseases that benefit from the use of the sustained-release DEX implant, alone or in combination with concomitant therapies. A MEDLINE search revealed lack of randomized controlled trials related to these indications. Therefore we included and analyzed all available studies (retrospective and prospective, comparative and non-comparative, randomized and nonrandomized, single center and multicenter, and case report). There are reports in the literature of the use of DEX implant across a range of macular edema-related pathologies, with their clinical experience supporting the use of DEX implant on a case-by-case basis with the aim of improving patient outcomes in many macular pathologies. As many of the reported macular pathologies are difficult to treat, a new treatment option that has a beneficial influence on the clinical course of the disease may be useful in clinical practice.

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“…Certainly, many reports have suggested that switching patients to Aflibercept which blocks multiple angiogenic growth factors including VEGF-A, VEGF-B and PIGF (placental growth factor) have better treatment outcomes than anti-VEGF monotherapy78. In addition, combination therapy with anti-VEGF and corticosteroid has better treatment outcomes than anti-VEGF monotherapy910. There is currently great research interest in discovering new angiogenic pathways that may serve as therapeutic targets to achieve better outcomes in the treatment of nAMD in the future.…”

mentioning

confidence: 99%

Elevated angiopoietin 2 in aqueous of patients with neovascular age related macular degeneration correlates with disease severity at presentation

Yip

Bakthavatsalam

et al. 2017

Sci Rep

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Angiopoietin 2 (ANG2) is a proangiogenic cytokine which may have an implication in neovascular age related macular degeneration (nAMD). In 24 eyes of 24 subjects presenting with treatment naïve nAMD and 26 eyes of 26 control patients, aqueous humor samples were collected at the time of intervention (intravitreal injection of anti-vascular endothelial growth factor or cataract extraction). Best corrected visual acuity (BCVA) with and central macular thickness (CMT) using optical coherence tomography (OCT) were measured before each injection in the nAMD group. Aqueous cytokine levels were determined by immunoassay using a multiplex array (Quansys Biosciences, Logan, UT). Levels of ANG2 in the aqueous were significantly higher in nAMD patients than those of the control group (p < 0.0001), so were hepatocyte growth factor (HGF), interleukin-8 (IL-8) and tissue inhibitor of metalloproteinase 1 (TIMP 1), all with p < 0.001. ANG2 correlated with worse BCVA (r = 0.44, p-value = 0.027) and greater CMT (r = 0.66, p-value < 0.0001) on optical coherence tomography (OCT). ANG2 is upregulated in patients with nAMD and correlates with severity of disease at presentation.

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Lucedex

Abstract: The LuceDex pilot study suggested a possible benefit of adding intravitreal dexamethasone to treatment of neovascular age-related macular degeneration with intravitreal ranibizumab. A larger study is needed to further identify and define possible benefits of this combination therapy.

Cited by 28 publications

References 16 publications

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

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

Widening use of dexamethasone implant for the treatment of macular edema

Elevated angiopoietin 2 in aqueous of patients with neovascular age related macular degeneration correlates with disease severity at presentation

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