Safety review of anti-VEGF therapy in patients with myopic choroidal neovascularization

Ng, David C.; Ho, Mary; Iu, Lawrence P.; Lai, Timothy Y Y

doi:10.1080/14740338.2021.1952979

Cited by 17 publications

(12 citation statements)

References 106 publications

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“…However, the long-term safety and e cacy of anti-VEGF drugs still remain unclear. Although anti-VEGF drugs are targeted at the etiological treatment, there are di erences in individual responses to anti-VEGF therapy, and neovascularization usually requires repeated multiple injections [20][21][22][23]. Moreover, the high price of anti-VEGF drugs brings a serious economic burden to patients and the whole society, which is difficult for ordinary patients to bear [24].…”

Section: Discussionmentioning

confidence: 99%

Clinical Effect of Tongmai Fuming Decoction on Neovascular Ophthalmopathy

Yang

Zhou

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. The incidence of neovascular eye disease is increasing year by year, seriously threatening human vision health and becoming an urgent public health problem. Tongmai fuming decoction as an experienced prescription can treat ischemic eye disease. Objective. To investigate the therapeutic effect of Tongmai fuming decoction combined with anti-VEGF therapy on neovascular ophthalmopathy. Methods. 52 patients (62 eyes) with neovascular ophthalmopathy who met the inclusion criteria from January 2018 to July 2020 were randomly divided into the control and observation groups. The control group was given an intravitreal injection of antivascular endothelial growth factor (VEGF) drugs once a day combined with on-demand treatment. The observation group was treated with traditional Chinese medicine Tongmai fuming decoction in addition to the treatment of anti-VEGF drugs. The best-corrected visual acuity (BCVA) was examined before and after treatment, and optical coherence tomography angiography (OCTA) was used to examine the mean retinal thickness and neovascularization in the macular area. Patients were followed for one year and the number of anti-VEGF injections was recorded. Results. After treatment, the average thickness of BCVA and macular retina in the two groups significantly improved. The BCVA of the control group was 0.59 ± 0.39 3 months after treatment, and that of the experimental group was 0.42 ± 0.25 3 months after treatment. The average thickness of the macular retina in the control group was 304.8 ± 79.7 3 months after treatment, and that in the experimental group was 267.7 ± 64.6 3 months after treatment; The average number of injections of anti-VEGF therapy in the control group was 2.32 ± 1.15 times, and that in the experimental group was 1.74 ± 0.76 times. There was a significant difference between the two groups. Conclusion. Tongmai fuming decoction and anti-VEGF therapy have a synergistic effect in the treatment of neovascular ophthalmopathy, which can reduce the treatment times of anti-VEGF drugs.

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Section: Discussionmentioning

confidence: 99%

Clinical Effect of Tongmai Fuming Decoction on Neovascular Ophthalmopathy

Yang

Zhou

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Patients with neovascular ARMD require long-term repeated intravitreal injections during anti-VEGF therapy [ 4 , 13 ]. Repeated injections may lead to complications such as uveitis, endophthalmitis, subconjunctival haemorrhage, elevated intraocular pressure, retinal detachment, retinal pigment epithelium tears, corneal nerve fibres and sensitivity loss [ 14 , 15 ]. As a common complication of ocular surgery, VMIA has been discussed as an influencing factor of anti-VEGF efficacy in previous studies [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of vitreomacular interface in neovascular age-related macular degeneration treated with intravitreal injection of anti-VEGF

et al. 2022

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Background The purpose of this study is to study the effect of repeated intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs on vitreomacular interface. Methods Neovascular age-related macular degeneration patients who received intravitreal injections of anti-VEGF drugs were included. Eyes with severe vitreous opacity, uveitis, complicated cataract surgery and previous vitrectomy were excluded. Vitreomacular interface, best corrected visual acuity (BCVA) and central retinal thickness (CRT) assessment were performed once a month for at least 3 months. The nature and time of the change event are recorded. Groups were divided according to whether vitreomacular interface change events occurred. To analyse the risk factors of vitreomacular interface changes and their influence on treatment effect. Results A total of 87 eyes were evaluated. Vitreomacular interface change event occurred in 9 eyes. Pre-existing vitreomacular interface abnormality (VMIA) was a risk factor for the VMI change (P = 0.033, OR = 16.518, 95% CI: 1.258 to 216.939). 60% of interface events occurred in the first 3 months of treatment. The final BCVA of eyes with vitreomacular interface unchanged was significantly higher than that at baseline (P = 0.001), and the final CRT was also significantly lower than that at baseline (P < 0.001). The final CRT of eyes vitreomacular interface changed was significantly lower than that at baseline (P = 0.015), however, there was no statistical significance in BCVA (P = 0.468). Conclusion Intravitreal injection of anti-VEGF drugs has a certain probability to cause changes in the vitreomacular interface, and the risk is higher in eyes with pre-existing vitreomacular interface abnormality. The effect of intravitreal injections on the vitreomacular interface was concentrated in the first three injections, and subsequent increases in the number of injections did not significantly increase the risk of vitreomacular interface abnormality. Ophthalmologists should increase attention to the vitreomacular interface in the early stages of anti-VEGF therapy and counsel patients accordingly.

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“…The safety and efficacy of these anti-VEGF agents have been proved in many studies. Similar visual gains and morphological improvements of mCNV patients were achieved by each of these anti-VEGF agents [94][95][96] .…”

Section: Anti-vegf Therapymentioning

confidence: 95%

Stem cell-based therapy for myopic maculopathy: a new concept

Ying¹,

Li²

2022

J Transl Genet Genom

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Myopia has reached epidemic proportions in the world, especially in East Asia. Pathologic myopia is an extreme type of high myopia that can cause irreversible blindness. Myopic maculopathy is one of the characteristics of pathologic myopia. Nowadays, limited treatments can preserve the visual outcome of these patients. We review the current treatment in practice for myopic maculopathy. Furthermore, based on the current stem cell-based therapy used in degenerative ocular diseases, we discuss a new concept of stem cell therapy for myopic maculopathy.

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Safety review of anti-VEGF therapy in patients with myopic choroidal neovascularization

Cited by 17 publications

References 106 publications

Clinical Effect of Tongmai Fuming Decoction on Neovascular Ophthalmopathy

Clinical Effect of Tongmai Fuming Decoction on Neovascular Ophthalmopathy

The effect of vitreomacular interface in neovascular age-related macular degeneration treated with intravitreal injection of anti-VEGF

Stem cell-based therapy for myopic maculopathy: a new concept

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