Refractory Intraretinal or Subretinal Fluid in Neovascular Age-Related Macular Degeneration Treated With Intravitreal Ranizubimab

Gianniou, Christina; Dirani, Ali; Jang, Liuna; Mantel, Irmela

doi:10.1097/iae.0000000000000465

Cited by 60 publications

(50 citation statements)

References 28 publications

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“…7 In addition, some small retrospective studies found that SRF is compatible with good VA after anti-VEGF therapy. 8,9 It would be of interest to learn whether data from large, randomized, comparative ranibizumab versus bevacizumab neovascular AMD treatment trials, such as Inhibition of VEGF in Age-related Choroidal Neovascularization (IVAN), 10 similarly showed that eyes with SRF had better VA after 2 years of anti- VEGF treatment.…”

Section: Discussionmentioning

confidence: 99%

Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

et al. 2016

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Purpose To describe the association between morphologic features on fundus photography (FP), fluores-cein angiography (FA), and optical coherence tomography (OCT) and visual acuity (VA) in the second year of the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Design Prospective cohort study within a randomized clinical trial. Participants Participants in the CATT. Methods Study eye eligibility required angiographic and OCT evidence of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and VA between 20/25 and 20/320. Treatment was assigned randomly to ranibizumab or bevacizumab with 3 different dosing regimens over a 2-year period. Main Outcome Measures Fluid type, location, and thickness; retina and subretinal tissue complex thickness on OCT; size and lesion composition on FP and FA; and VA. Results Among 1185 CATT participants, 993 (84%) had fluid on OCT at baseline and completed 2 years of follow-up. At 2 years, intraretinal fluid (IRF), subretinal fluid (SRF), sub–retinal pigment epithelium (RPE) fluid, and subretinal tissue complex thickness decreased in all treatment groups. Ranibizumab monthly was best able to resolve each type of fluid. Eyes with SRF in the foveal center on OCT had better mean VA than eyes with no SRF (72.8 vs. 66.6 letters; P = 0.006). Eyes with IRF in the foveal center had worse mean VA than eyes without IRF (59.9 vs. 70.9 letters; P < 0.0001). Eyes with retinal thickness <120 µm had worse VA compared with eyes with retinal thickness 120 to 212 and >212 µm (59.4 vs. 71.3 vs. 70.3 letters; P < 0.0001). At 2 years, the mean VA (letters) of eyes varied substantially by the type of subfoveal pathology on FP and FA: 70.6 for no pathology; 74.1 for fluid only; 73.3 for CNV or pigment epithelial (RPE) detachment; 68.4 for nongeographic atrophy; and 62.9 for geographic atrophy, hemorrhage, RPE tear, or scar (P < 0.0001). Conclusions The associations between VA and morphologic features identified through year 1 were maintained or strengthened during year 2. Eyes with foveal IRF, abnormally thin retina, greater thickness of the subretinal tissue complex on OCT, and subfoveal geographic atrophy or scar on FP/FA had the worst VA.

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Section: Discussionmentioning

confidence: 99%

Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

et al. 2016

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“…W badaniach klinicznych wykazano, że płyn podsiatkówkowy jest jednym z objawów cho-roby, który paradoksalnie nie wiąże się z gorszym rokowaniem. Zaobserwowano, że gdy był obecny na początku terapii, to zarówno ostrość wzroku, jak i odpowiedź na leczenie były lepsze [2, 30,39,40]. Przebieg choroby był też bardziej stabilny i wymagana była mniejsza liczba iniekcji.…”

Section: Płyn Podsiatkówkowyunclassified

“…Dirani i wsp. stwierdzili pozytywny wpływ trzech pierwszych comiesięcznych iniekcji anty-VEGF na stan anatomiczny i czynnościowy oczu z PED w przebiegu AMD [40].…”

Section: Odwarstwienie Nabłonka Barwnikowegounclassified

Jak skutecznie leczyć wysiękową postać zwyrodnienia plamki związanego z wiekiem według schematu PRN? Rola biomarkerów widocznych w obrazach optycznej koherentnej tomografii

Matysik-Woźniak

Rękas²,

Ręjdak³

2018

Ophthalmology J

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STRESZCZENIEOptymalizacja leczenia uwzględniająca indywidualny przebieg choroby nadal pozostaje jednym z podstawowych problemów w leczeniu wysiękowej postaci zwyrodnienia plamki związanego z wiekiem (AMD). W niniejszej pracy autorzy zawarli wskazówki, które mogą być pomocne podczas terapii według schematu pro-re-nata (PRN). Obecnie ma on zastosowanie u większości pacjentów będących w programie lekowym. Jednym z podstawowych problemów jest właściwa ocena aktywności choroby, która stanowi podstawę decyzji o wykonaniu kolejnej iniekcji leków blokujących czynnik wzrostu śródbłonka naczyń (anty-VEGF). Określenie parametrów, takich jak stan fotoreceptorów czy nabłonka barwnikowego siatkówki (RPE), lokalizacja płynu, zachowanie prawidłowego układu warstw siatkówki, obecność schorzeń pogranicza szklistkowo-siatkówkowego, wpływa na ocenę stanu klinicznego i rokowanie chorych.SŁOWA KLUCZOWE: zwyrodnienie plamki związane z wiekiem; aflibercept; ranibizumab; schemat PRN; biomarkery; optyczna koherentna tomografia ABSTRACT Optimisation of a treatment which takes into consideration the individual course of a disease remains an essential issue in the treatment of the exudative form of AMD. The authors of this study offer guidance, which may facilitate the use of pro-re-nata (PRN) regimen, which is employed for most patients covered by therapeutic program. One of the basic problems still concerns a proper assessment of disease activity, which is crucial for administration of another anti-VEGF injection. Such parameters as, for example, the state of photoreceptors, retinal pigment epithelium (RPE), location of the fluid, the maintenance of the normal organisation of retinal layers, are all relevant to clinical condition and prognosis.

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“…Three pathologic changes affecting central retinal morphology have been described in nAMD patients; intraretinal cystoid fluid, subretinal fluid, and pigment epithelial detachment [35, 36]. The presence of exudative cystoid fluid is an important finding on OCT as cysts are associated with a higher risk for visual loss associated with fibrosis and atrophy [37]. Therefore, intraretinal cystoid fluid is considered the most relevant prognostic biomarker in nAMD [38].…”

Section: Biomarkers In Age Related Macular Degenerationmentioning

confidence: 99%

The potential of spectral domain optical coherence tomography imaging based retinal biomarkers

et al. 2017

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BackgroundBiomarker”, a merged word of “biological marker”, refers to a broad subcategory of medical signs that objectively indicate the state of health, and well-being of an individual. Biomarkers hold great promise for personalized medicine as information gained from diagnostic or progression markers can be used to tailor treatment to the individual for highly effective intervention in the disease process. Optical coherence tomography (OCT) has proved useful in identifying various biomarkers in ocular and systemic diseases.Main bodySpectral domain optical coherence tomography imaging-based biomarkers provide a valuable tool for detecting the earlier stages of the disease, tracking progression, and monitoring treatment response. The aim of this review article is to analyze various OCT based imaging biomarkers and their potential to be considered as surrogate endpoints for diabetic retinopathy, age related macular degeneration, retinitis pigmentosa and vitreomacular interface disorder. These OCT based surrogate markers have been classified as retinal structural alterations (macular central subfield thickness and cube average thickness); retinal ultrastructural alterations (disruption of external limiting membrane and ellipsoid zone, thinning of retinal nerve fiber layer and ganglion cell layer); intraretinal microangiopathic changes; choroidal surrogate endpoints; and vitreoretinal interface endpoints.ConclusionOCT technology is changing very quickly and throughout this review there are some of the multiple possibilities that OCT based imaging biomarkers will be more useful in the near future for diagnosis, prognosticating disease progression and as endpoint in clinical trials.

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Refractory Intraretinal or Subretinal Fluid in Neovascular Age-Related Macular Degeneration Treated With Intravitreal Ranizubimab

Cited by 60 publications

References 28 publications

Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

Macular Morphology and Visual Acuity in the Second Year of the Comparison of Age-Related Macular Degeneration Treatments Trials

Jak skutecznie leczyć wysiękową postać zwyrodnienia plamki związanego z wiekiem według schematu PRN? Rola biomarkerów widocznych w obrazach optycznej koherentnej tomografii

The potential of spectral domain optical coherence tomography imaging based retinal biomarkers

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