The effect and safety of intravitreal injection of ranibizumab and bevacizumab on the corneal endothelium in the treatment of diabetic macular edema

Güzel, Hüseyin; Bakbak, Berker; Koylu, Mehmet Talay; Gonul, Saban; Öztürk, Bayram; Gedik, Şansal

doi:10.3109/15569527.2016.1140177

Cited by 13 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In rabbit, IC injection with aflibercept and ranibizumab affects cornea endothelial cells viability, but it did not induce apoptotic pathways in the cornea when IVT was administrated. This observation may justify the apparent contrasting data reported by several clinical reports showing no relevant corneal side effects in patients treated with IVT anti-VEGF injection (Guzel et al, 2017;Perez-Rico et al, 2010a, 2010b. Clinical and experimental studies investigating the effects of IC injection of anti-VEGF agents reported mild or no changes in endothelial morphology (Ari et al, 2015;H.Y.…”

Section: Discussionmentioning

confidence: 93%

In vivo antivascular endothelial growth factor treatment induces corneal endothelium apoptosis in rabbits through changes in p75NTR–proNGF pathway

Gharbiya

Sacchetti

Rosso

et al. 2018

Journal Cellular Physiology

View full text Add to dashboard Cite

Intravitreal injection (IVT) of antivascular endothelial growth factor (anti-VEGF) agents is widely used for the treatment of retinal vascular diseases. Recently, the injection of anti-VEGF agents in the ocular anterior chamber has been proposed for the treatment of neovascular glaucoma and potential side effects on the corneal structures have been investigated with contrasting results. Increasing evidence has demonstrated that VEGF inhibition is associated with cellular apoptotic changes and that this effect may be mediated by alterations in nerve growth factor (NGF) pathway. In this study, we demonstrated that anterior chamber injection (IC), but not IVT injection of two different anti-VEGF agents, aflibercept and ranibizumab, affects rabbit corneal endothelium in terms of survival and apoptosis and is associated with changes in endothelial expression of NGF precursor (proNGF) and p75 neurotrophin receptor (p75NTR) receptor. We observed an increase in corneal endothelial cell incorporation of trypan blue and expression of cleaved-caspase 3 (c-Casp3), p75NTR, and RhoA after IC injection of both anti-VEGF drugs when compared with the vehicle. Our results showed that apoptosis induction by aflibercept was more pronounced when compared with that of ranibizumab. Aflibercept also mediated a significant increase in endothelial expression of proNGF when compared with the vehicle. In line with these data, IC administration of both anti-VEGF agents induced the activation of apoptotic signals in endothelial cells, including an increase in c-Casp3, decrease in Bad Ser 112 phosphorylation, and unbalance of AKT phosphorylation. These results demonstrated that administration of anti-VEGF in the anterior chamber of rabbit affects endothelial cell survival by inducing apoptosis through alteration of NGF pathway.

show abstract

Section: Discussionmentioning

confidence: 93%

In vivo antivascular endothelial growth factor treatment induces corneal endothelium apoptosis in rabbits through changes in p75NTR–proNGF pathway

Gharbiya

Sacchetti

Rosso

et al. 2018

Journal Cellular Physiology

View full text Add to dashboard Cite

show abstract

“…Çalışmamızda aflibercept uygulanan gözler, kontrol gözler ile karşılaştırıldığında, 3 aylık ardışık aflibercept uygulamasının kornea endotel sayısı, CV nunun da kornea endoteli üzerine toksik etkisi bildirilmemiştir. 11,12 Ari ve ark. tarafından, daha yüksek ön kamara konsantrasyonlarının oluştuğu ön kamaraya uygulanan anti-VEBF enjeksiyonlarında dahi tavşan kornea endotelinde toksik etkinin olmadığı bildirilmiştir.…”

Section: Discussionunclassified

“…Nitekim, literatürde bildirilen çalışmalarda, intravitreal anti-VEBF tedavilerinin MKK'yi değiştirmediği, düzensiz kan şekerinin ve yüksek HbA1c düzeyinin yüksek MKK ile ilişkili olduğu bildirilmiştir. 11,12,15,16 Her iki çalışma grubunda, tedavi edilen gözler ve kontrol gözler arasında enjeksiyon öncesi ve son-rası dönemde ÖKD, ÖKH, İKA ve HÖKÇ parametreleri açısından anlamlı bir fark izlenmemiştir. Literatürde bu konu ile ilgili benzer sonuçlar bildiren yayınlar mevcuttur.…”

Section: Discussionunclassified

The Effect of Intravitreal Injection of Aflibercept and Ranibizumab on Cornea Endothelium and Anterior Chamber in Patients with Diabetic Macular Edema

Cankurtaran¹,

Özateş²

2020

Turkiye Klinikleri J Ophthalmol

View full text Add to dashboard Cite

Vasküler endotelyal büyüme faktörü (VEBF), dokulardaki anjiyogenezi düzenlemektedir ve diyabetik retinopati gibi göz hastalıklarının patogene-zinde temel bir rol oynamaktadır. 1,2 VEBF neovaskülarizasyonu ve endotelyal geçirgenliği artırıcı etkileri nedeni ile göz hastalıklarının tedavisinde en çok ÖZET Amaç: İntravitreal ranibizumab ve aflibercept enjeksiyonu yapılan gözlerdeki kornea endotel sayısı ve morfolojisinin ve ön kamara anatomisinin incelenmesidir. Gereç ve Yöntemler: Bu prospektif ve kesitsel çalışmaya, diyabetik makuler ödem nedeni ile tedavi edilen 51 hastanın 102 gözü dâhil edildi. Hastaların tek gözüne 1 ay ara ile üç doz intravitreal ranibizumab ya da aflibercept enjeksiyonu uygulandı. Ranibizumab enjeksiyonu yapılan hastalar ranibizumab grubuna (n=26), aflibercept enjeksiyonu yapılan hastalar aflibercept grubuna (n=25) dâhil edildi. Her iki grupta da hastaların tedavi edilmeyen gözleri kontrol grubu olarak alındı. Hastaların endotel hücre sayısı (EHS), hücre alanı değişim katsayısı (CV), altıgen şekilli hücre (HKZ) yüzdesi, merkezi kornea kalınlığı (MKK), ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), iridokorneal açı (İKA) ve horizontal ön kamara çapı (HÖKÇ) değerlendirmeleri yapıldı. Bulgular: Aflibercept ve ranibizumab grubunda hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesi ve sonrasında ortalama korneal endotel hücre sayısı, CV ve HKZ yüzdesi bakımından istatistiksel olarak anlamlı fark yoktu. Her iki gruptaki ortalama MKK değeri hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesinde tedavi sonrasına göre anlamlı olarak daha fazla idi (p<0,05). Her iki grupta, tedavi edilen ve kontrol gözlerde ortalama ÖKD, ÖKH, İKA ve HÖKÇ değerleri arasında tedavi öncesi ve sonrası anlamlı bir fark izlenmedi. Sonuç: Çalışmamız, intravitreal aflibercept ve ranibizumab enjeksiyonunun kornea endotelinde ve ön kamara yapısında herhangi bir değişikliğe sebep olmadığını göstermiştir. Anah tar Ke li me ler: Aflibercept; ranibizumab; makuler ödem;kornea; endotel ABS TRACT Objective: To assess the effect of intravitreal injection of aflibercept and ranibizumab on cornea endothelium and anterior chamber structure in patients with diabetic macular edema. Material and Methods: One hundred and two eyes of the 51 patients with diabetic macular edema were included in this prospective and cross-sectional clinical study. Intravitreal aflibercept or ranibizumab injection was administered for three times with one-month intervals to only one eye of the patients. Patients formed ranibizumab group (n=26) and aflibercept group (n=25) according to administered drug. Contralateral eyes, which were not treated, in both groups formed the control group. Main outcomes were endothelial cell density (ECD), coefficient of variation of cell area (CV), percentage of hexagonal cells (HEX), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), horizontal anterior chamber diameter (HACD). Results: Mean ECD, CV and HEX before and after treatment...

show abstract

“…Güzel et al proposed that endothelial cell density and morphology did not change after intravitreal ranibizumab and bevacizumab injections [21]. Peraz Rico et al showed that ranibizumab had no harmful effect on corneal endothelium [22].…”

Section: Discussionmentioning

confidence: 99%

Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients

Güler

Örnek

et al. 2018

BMC Ophthalmol

View full text Add to dashboard Cite

BackgroundTo assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO).MethodsTwenty-two eyes of 22 patients were assessed prospectively after intravitreal 0.7 mg DEX implant injection. Twenty-two eyes of 22 healthy volunteers served as control group. Corneal endothelial cell parameters including endothelial cell density (ECD), coefficient of variation of cell size (CV), percentage of hexagonality (Hex) and central corneal thickness (CCT) were analyzed before and 1 and 3 months after injection by specular microscopy. The results of the study were compared statistically.ResultsThere were 17 (77.3%) patients with branch RVO and 5 (22.7%) patients with central RVO. Mean intraocular pressure (IOP) was 14.73 mmHg before injection, 17.05 mmHg at 1 month and 17.15 mmHg at 3 months after injection. Mean IOP at 1 and 3 months were significantly higher than pre-injection value (p = 0.002 and p = 0.003, respectively). There was a statistically significant reduction in mean ECD at 3 months after injection compared to pre-injection and 1 month (p = 0.013, p = 0.009, respectively) in the injected eyes. Mean ECD showed no significant difference in the uninjected fellow eyes during the follow up (p>0.05). Mean CV and Hex did not reveal a statistically significant difference in injected and uninjected fellow eyes (p > 0.05). No significant change was observed in mean CCT values during the follow up (p = 0.8).ConclusionIntravitreal dexamethasone implant may cause a transient reduction in corneal endothelial cell density in short term without changing cell morphology.

show abstract

The effect and safety of intravitreal injection of ranibizumab and bevacizumab on the corneal endothelium in the treatment of diabetic macular edema

Abstract: Monthly 1.25 mg/0.05 ml IVIs of bevacizumab or 0.5 mg/0.05 ml of ranibizumab for three consecutive months in the treatment of diabetic macular edema does not affect corneal morphology and has no harmful effects on the endothelium.

Cited by 13 publications

References 19 publications

In vivo antivascular endothelial growth factor treatment induces corneal endothelium apoptosis in rabbits through changes in p75NTR–proNGF pathway

In vivo antivascular endothelial growth factor treatment induces corneal endothelium apoptosis in rabbits through changes in p75NTR–proNGF pathway

The Effect of Intravitreal Injection of Aflibercept and Ranibizumab on Cornea Endothelium and Anterior Chamber in Patients with Diabetic Macular Edema

Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients

Contact Info

Product

Resources

About