subretinal fluid Dotaz Zobrazit nápovědu
- Klíčová slova
- RETINAL DETACHMENT/pathology *,
- MeSH
- lidé MeSH
- mukoproteiny * MeSH
- odchlípení sítnice patologie MeSH
- subretinální tekutina * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- mukoproteiny * MeSH
- Klíčová slova
- ELECTROPHORESIS *, RETINAL DETACHMENT/pathology *,
- MeSH
- elektroforéza * MeSH
- lidé MeSH
- odchlípení sítnice patologie MeSH
- subretinální tekutina * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The aim of the study was to compare the effect of three initial doses of the anti-VEGF ranibizumab and aflibercept medication on serous pigment epithelial detachment (PED), subretinal fluid (SRF) and intraretinal fluid (IRF) in the macula of treatment naive neovascular AMD (nvAMD) patients. MATERIAL AND METHODS: The cohort consists of 148 patients, of which 74 patients were treated with ranibizumab (51 females and 23 males) and 74 with aflibercept (46 females and 28 males). The data was recorded prospectively from the moment of diagnosis and start of treatment for a period of 3 months. At the moment of diagnosis and 3 months later, an OCT examination (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) was performed. The OCT examination included a macular scan with 25 scans. Using the OCT instrument software, we measured the maximum anterior-posterior elevation of serous PED, the highest thickness of SRF and the largest diameter of the intraretinal cystic space. The statistical significance of differences between groups was evaluated using the t-test for continuous data and the Fisher exact test for categorical data. Changes in values of continuous variables over time were evaluated using the Wilcoxon paired test. Paired comparisons of binary parameters were determined by the McNemar test. RESULTS: Full regression of PED, SRF and IRF occurred in 3 (4.1%), 25 (39%) and 20 (51%) patients treated with ranibizumab, and in 5 (7.9%, p = 0.470), 28 (47%, p = 0.470) and 25 (57%, p = 0.827) patients treated with aflibercept, respectively. The average regression of PED, SRF and IRF was -60.4 μm (median -37.5 μm), -84.3 μm (median -85 μm) and -109.3 μm (median -81 μm) in patients treated with ranibizumab, and -46.3 μm (median -30 μm, p = 0.389), -127.7 μm (median -104 μm, p = 0.096) and -204.4 μm (median -163 μm, p = 0.005) in patients treated with aflibercept, respectively. We did not show a statistically significant difference in the regression rates of PED, SRF and IRF between the ranibizumab and aflibercept groups. (in patients with IRF after adjustment of the higher baseline IRF volumes in patients treated with aflibercept, p = 0.891). CONCLUSION: We are convinced that ranibizumab and aflibercept have the same effect on serous PED, SRF and IRF in the macula in patients with treatment naive nvAMD during the initial loading phase.
- Klíčová slova
- aflibercept, age related macular degeneration, age-related macular degeneration, intraretinal fluid, pigment epithelium detachment, ranibizumab, subretinal fluid,
- MeSH
- inhibitory angiogeneze farmakologie terapeutické užití MeSH
- injekce intravitreální MeSH
- lidé MeSH
- odchlípení sítnice * diagnóza MeSH
- optická koherentní tomografie MeSH
- ranibizumab terapeutické užití MeSH
- receptory vaskulárního endoteliálního růstového faktoru MeSH
- rekombinantní fúzní proteiny terapeutické užití MeSH
- retinální pigmenty terapeutické užití MeSH
- retrospektivní studie MeSH
- vaskulární endoteliální růstový faktor A MeSH
- vlhká makulární degenerace * diagnóza farmakoterapie MeSH
- zraková ostrost MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- aflibercept MeSH Prohlížeč
- inhibitory angiogeneze MeSH
- ranibizumab MeSH
- receptory vaskulárního endoteliálního růstového faktoru MeSH
- rekombinantní fúzní proteiny MeSH
- retinální pigmenty MeSH
- vaskulární endoteliální růstový faktor A MeSH
PURPOSE: To determine if optical coherence tomography (OCT) measurements of retinal thickness at the fixation point (RTFP) can be used to confirm the effectiveness of photodynamic therapy (PDT) with verteporfin in the treatment of symptomatic circumscribed choroidal hemangioma (CCH). METHODS: Nine eyes of nine patients with subretinal fluid under foveal centre were treated by PDT with a dose of 6 mg/m2 of intravenous verteporfin administered 5 minutes before a laser irradiation at 689 nm. Visual outcomes, initial, and final findings were evaluated using biomicroscopy, OCT, ultrasound, fluorescein angiography, and indocyanine green angiography. RESULTS: After a mean follow-up of 8 months (range, 3-18 months) OCT showed absorption of subretinal fluid in all cases (100%). Maximal decrease of RTFP was seen within first month after treatment. Average RTFP decreased from 378 microm (range, 221 microm-849 microm) preoperatively to 190 microm (range, 118 microm-321 microm) postoperatively (p=0.017, paired t-test). Mean best corrected visual acuity (BCVA) improved from 4/16 (range, 4/5-1/20) preoperatively to 4/8 (range, 4/3-1/15) postoperatively (p=0.0046, paired t-test). An improvement in BCVA was observed in all cases (100%, one to seven lines on Early Treatment Diabetic Retinopathy Study charts). BCVA returned to 4/5 or better in six patients (67%). Mean tumor height decreased from 3.2 mm (range, 1.5 mm-4.0 mm) preoperatively to 0.9 mm (range, 0 mm-2.4 mm) postoperatively (p=0.00003, paired t-test). There was no measurable tumor height in four cases (44%), there were marked reduction in the other five cases (56%) on ultrasound. CONCLUSIONS: OCT appears to be useful method for evaluation of subretinal fluid absorption after the treatment of CCH by PDT with verteporfin. RTFP value can be used for quantification of subretinal fluid under the foveal centre. Functional results of PDT with verteporfin in CCH are limited in pre-existing retinal alterations. Randomised trial with single versus repeated sessions of PDT with verteporfin is needed.
- MeSH
- dospělí MeSH
- fotochemoterapie škodlivé účinky metody MeSH
- fotosenzibilizující látky škodlivé účinky terapeutické užití MeSH
- fovea centralis účinky léků patologie MeSH
- hemangiom farmakoterapie metabolismus patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory choroidey farmakoterapie metabolismus patologie MeSH
- optická koherentní tomografie metody MeSH
- porfyriny škodlivé účinky terapeutické užití MeSH
- retina účinky léků metabolismus patologie MeSH
- senioři MeSH
- tělesné tekutiny metabolismus MeSH
- verteporfin MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- Názvy látek
- fotosenzibilizující látky MeSH
- porfyriny MeSH
- verteporfin MeSH
Degenerative disorders of the retina (including age-related macular degeneration), which originate primarily at or within the retinal pigmented epithelial (RPE) layer, lead to a progressive disorganization of the retinal anatomy and the deterioration of visual function. The substitution of damaged RPE cells (RPEs) with in vitro cultured RPE cells using a subretinal cell carrier has shown potential for re-establishing the anatomical structure of the outer retinal layers and is, therefore, being further studied. Here, we present the principles of a surgical technique that allows for the effective subretinal transplantation of a cell carrier with cultivated RPEs into minipigs. The surgeries were performed under general anesthesia and included a standard lens-sparing three-port pars plana vitrectomy (PPV), subretinal application of a balanced salt solution (BSS), a 2.7 mm retinotomy, implantation of a nanofibrous cell carrier into the subretinal space through an additional 3.0 mm sclerotomy, fluid-air exchange (FAX), silicone oil tamponade, and closure of all the sclerotomies. This surgical approach was used in 29 surgeries (18 animals) over the past 8 years with a success rate of 93.1%. Anatomic verification of the surgical placement was carried out using in vivo fundus imaging (fundus photography and optical coherence tomography). The recommended surgical steps for the subretinal implantation of RPEs on a carrier in minipig eyes can be used in future preclinical studies using large-eye animal models.
- MeSH
- lidé MeSH
- miniaturní prasata MeSH
- pooperační péče MeSH
- prasata MeSH
- retina chirurgie MeSH
- retinální pigmentový epitel * chirurgie MeSH
- vitrektomie * metody MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- audiovizuální média MeSH
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- imunoelektroforéza MeSH
- králíci MeSH
- oční proteiny analýza klasifikace imunologie MeSH
- odchlípení sítnice metabolismus MeSH
- retina analýza MeSH
- specificita protilátek MeSH
- techniky in vitro MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- oční proteiny MeSH
- MeSH
- albuminy metabolismus MeSH
- časové faktory MeSH
- lidé MeSH
- odchlípení sítnice metabolismus chirurgie MeSH
- tělesné tekutiny metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- albuminy MeSH
- MeSH
- časové faktory MeSH
- imunoelektroforéza MeSH
- lidé MeSH
- oční proteiny analýza MeSH
- odchlípení sítnice metabolismus patofyziologie chirurgie MeSH
- prognóza MeSH
- retina metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- oční proteiny MeSH
- MeSH
- časové faktory MeSH
- izoenzymy MeSH
- kreatinkinasa krev metabolismus MeSH
- lidé MeSH
- odchlípení sítnice metabolismus MeSH
- retina enzymologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- izoenzymy MeSH
- kreatinkinasa MeSH
- MeSH
- bilirubin analýza MeSH
- časové faktory MeSH
- exsudáty a transsudáty analýza MeSH
- lidé MeSH
- odchlípení sítnice diagnóza metabolismus MeSH
- sklivec analýza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- bilirubin MeSH