Intravitreal anti-VEGF therapy in macular oedema secondary to racemose haemangiomatosis of the retina

Racemose haemangiomatosis of the retina is a sporadic, mostly unilateral, congenital arteriovenous malformation (AVM), comprising abnormal junctions between arteries and veins that omit capillaries. Typically, vascular malformations are asymptomatic and incidentally discovered. Advanced changes may be related to the presence of subretinal fluid and exudates, even though these lesions are classified as benign. Many complications can lead to severe or permanent visual impairment. Direct methods of treatment of primary retinal vascular anomalies have not been developed yet. The aim of this case report is to present the anti-VEGF therapy in the treatment macular oedema secondary to racemose haemangioma

Pre- and perioperative prophylaxis of anti-VEGF therapy in patients with exudative macular degeneration

Macular degeneration is one of the leading causes of blindness worldwide. Nowadays, the gold standard treatment for its exudative form is intravitreal injections with vascular growth factor inhibitor preparations performed on a once-daily basis. Great importance is now attached to the appropriate prophylaxis in the pre- and perioperative period in order to minimise the risk of complications, which often lead to irreversible damage to vision

Vitreous floaters - etiology, diagnostics and treatment

Vitreous floaters are one of the most common complain of ophthalmological patients. The aetiology of floaters includes pathological process (vitreous haemorrhages, injuries, diabetics or uveitis) and also natural age-related changes in vitreous body. Diagnosis and treatment depends on the severity of the symptoms. Process of posterior vitreous detachment requires particularly careful monitoring, because of potential complications such as retinal tears or retinal detachment. Supplementation with anti-glycation and antioxidant substances allows to reduce complains of patients with vitreous floaters

Rola zbilansowanej suplementacji w diecie chorych ze zwyrodnieniem plamki związanym z wiekiem

Aim: The aim of the article was to discuss the role of balanced supplementation in diet of age-related macular degeneration patients. Methods: This review was carried out using comprehensive and systematic literature reports on the role of supplementation of vitamin D, vitamin C, vitamin E, vitamin B6, vitamin B12, zinc, lutein, zeaxanthin, omega-3 acid and folic acid in the prevention of AMD. Results: Vitamins, minerals and carotenoids are essential for the proper retinal function over an inflammation and immune response modulation. Conclusions: Vitamins, minerals and carotenoids discussed in the article have anti-inflammatory and antioxidative properties in the management of AMD progression. Accordingly, it is relevant to assure the appropriate level of these nutrients in a diet of AMD patients.Cel: Celem pracy było omówienie roli zbilansowanej suplementacji w diecie chorych ze zwyrodnieniem plamki związanym z wiekiem (AMD, age-related macular degeneration). Metody: Dokonano przeglądu piśmiennictwa z ostatnich lat dotyczącego roli witamin: D, C, E, B6, B12, cynku, luteiny, zeaksantyny, kwasu omega-3 oraz kwasu foliowego w prewencji AMD. Wyniki: Witaminy, składniki mineralne i karotenoidy są niezbędne do prawidłowego funkcjonowania siatkówki, ponieważ modulują odpowiedź zapalną i immunologiczną. Wnioski: Omówione w pracy witaminy, minerały oraz karotenoidy mają właściwości przeciwzapalne oraz przeciwutleniające, dzięki czemu zmniejszają ryzyko progresji AMD. W związku z powyższym należy zapewnić właściwe stężenie tych substancji w diecie pacjentów z AMD

Treating wet form of AMD – pros and cons

Terapia anty-VEGF jest obecnie standardem w przypadku wysiękowej postaci AMD. Stosowane leki to: ranibizumab (Lucentis), aflibercept (Eylea) oraz bewacyzumab (Avastin). Ten ostatni w okulistyce podawany jest off-label. Schematy leczenia są różne. Leki można stosować według sztywnego schematu, w zależności od potrzeby (pro re nata) lub w schemacie treat and extend.Anti-VEGF treatment is a gold standard in exudative AMD. Three drugs are currently used: ranibizumab (Lucentis), aflibercept (Eylea) and off-label bevacizumab (Avastin). Different treatment regimen are used: fixed scheduled treatment, pro re nata and treat and extend

Macular Integrity Assessment and Fixation Analysis in Chronic Central Serous Chorioretinopathy

Purpose. To investigate retinal sensitivity characteristics associated with morphologic changes in the eyes exhibiting chronic central serous chorioretinopathy (CSC), using macular integrity assessment (MAIA) microperimetry. Methods. A retrospective, cross-sectional, observational study was constructed. The eyes of patients classified as chronic CSC, according to the onset of subjective symptoms with serous retinal detachment, as confirmed by optical coherence tomography examination, were included in the study. Retinal sensitivity and fixation were analyzed by performing microperimetry examinations using the MAIA instrument. Results. We reviewed microperimetry examinations of 15 eyes of 15 patients (age: 28–51 years) with chronic CSC and mean best-corrected visual acuity of −0.2 logMAR units. The mean retinal integrity in the chronic CSC group was 49.0 ± 27.6, which was significantly different from the control eyes. The mean average threshold in the eyes with chronic CSC was 24.7 ± 5.8 dB, which also was significantly different from the control eyes. Fixation stability was significantly different between the CSC and control eyes for the P1 parameter (90.1 ± 13.7 versus 99.3 ± 1.5), and for the P2 parameter (97.4 ± 4.0 versus 100.0 ± 0.0). Conclusion. New microperimetry technology may provide valuable information regarding the visual status of chronic CSC cases. Our findings suggest that retinal sensitivity and fixation stability in chronic CSC eyes may serve as useful indicators for assessing the effectiveness of clinical treatments

How do we treat and where do we go in AMD treatment?

Zwyrodnienie plamki żółtej związane z wiekiem dotyczy coraz większej liczby chorych po 50. r.ż., jednakże etiologia tego schorzenia nie została dotychczas dokładnie poznana. Terapie stosowane w wysiękowej postaci AMD, takie jak radioterapia, laseroterapia czy fototerapia dynamiczna, okazały się nieskuteczne i obecnie standardem w leczeniu tego schorzenia jest podawanie doszklistkowe leków z grupy antagonistów VEGF, takich jak ranibizumab, aflibercept czy off-label bewacyzumab. Preparaty powyższe nie likwidują jednak przyczyny AMD, ale mają głównie działanie objawowe. Przypuszczalna wieloczynnikowa etiologia AMD wskazuje na konieczność poszukiwania nowych metod leczenia tego schorzenia. W związku z tym w fazie badań są leki wpływające na układ immunologiczny, substancje neuroprotekcyjne, antyoksydacyjne, terapie genoweThe number of patients with age-related macular degeneration in population over 50 increases constantly, however the exact etiology of that pathology is still not well known. Previously used wet AMD treatment methods such as radiotherapy, laser therapy or photodynamic therapy were not successful. Now the gold standard for wet AMD treatment is the use of intravitreally administered anti-VEGF antagonists such as ranibizumab, aflibercept or off-label bevacizumab. However these medications are directed against the symptoms and not the cause of described pathology. Probable multifactorial etiology of AMD needs further improvement in therapy of that disease. New immunomodulators, neuroprotectors, antioxidants as well as gene therapy is currently under investigations to improve AMD treatment