Intravitreal anti-VEGF therapy as an adjunct to laser photocoagulation for severe aggressive posterior retinopathy of prematurity

AbstractPurposeThe aim of the study was to evaluate the role of anti-VEGF therapy as an adjunct to laser ablation therapy in severe aggressive posterior retinopaty of prematurity (AP-ROP).MethodsMedical records of premature infants with a primary diagnosis of AP-ROP treated with 0.625mg/0.025ml intravitreal bevacizumab (IVB) in addition to standard laser photocoagulation as a salvage therapy or primarily combined with laser in a university clinic were reviewed, retrospectively. The anatomical results and complications were evaluated after treatment.Results15 eyes of 9 patients with a mean gestational age of 28.3 weeks (range, 26–31w) and mean birth weight of 1090g (range, 860–1330g) were included in the study. They all had Zone 1 or posterior Zone 2 plus disease staging between severe 3 and 4a. Twelve eyes were treatment naive at the beginning. The mean follow-up was 19.5±11.8 months (range, 11–40 months). The disease regressed totally in 6 eyes (40%), stayed stable as stage 4a in 1 eye (6.7%), progressed to and stabilized at stage 4a in 3 eyes (20%) and progressed to stage 5 in 3 eyes (20%) within 7–10 days. Two eyes (13.3%) developed hypotony and cataract.ConclusionThe association of IVB and laser ablation might decrease the progression rate in severe AP-ROP. Prompt regression of iris neovascularization encourages its use in cases with pupillary rigidity to allow for laser treatment. When used as a salvage therapy it may not change the overall result dramatically

Trabeculectomy with large area mitomycin-C application as a first-line treatment in advanced glaucoma:retrospective review

<b>AIM:</b>To evaluate the outcomes of trabeculectomy with large area mitomycin-C (MMC) application as a first line treatment in advanced glaucoma.<b>METHODS:</b>The records of 55 patients with severe visual field defects undergoing trabeculectomy were retrospectively reviewed. The patients were classified as first-line therapy to either early trabeculectomy (initial trabeculectomy-Group 1) or long term medical therapy followed by trabeculectomy (primary trabeculectomy-Group 2). Trabeculectomy was performed with large-area MMC application. Intraocular pressure (IOP) values, visual acuities, mean deviations, morphology and function of the blebs, necessity for anti-glaucomatous medications and surgical complications were reported.<b>RESULTS:</b>There were 20 eyes of 18 patients in Group 1 and 37 eyes of 37 patients in Group 2<b>.</b> The mean preoperative IOPs in Groups 1 and 2 were 40.2±10.0mmHg (27-68mmHg) and 29.0±4.4mmHg (21-41mmHg), respectively (<i>P</i>=0.001). Average preoperative mean deviations (MD) in Groups 1 and 2 were 17.4±2.8dB (13.3-23dB) and 17.9±2.4 dB (13.7-23.2dB), respectively (<i>P</i>=0.441). Postoperative IOPs significantly decreased and were comparable in both Groups. The mean number of medications was significantly higher in Group 2 (<i>P</i>=0.005)<i><b>.</b></i> No cystic bleb formation was observed in Group 1, whereas 4 patients from Group 2 (10.8 %) developed cystic bleb (<i>P</i>=0.040). No visually devastating complication has occurred in both Groups.<b>CONCLUSION:</b>Initial trabeculectomy with large area MMC application might be applied in patients with advanced glaucoma with low complication rates. Long-term topically applied anti-glaucomatous medications seem to increase the risk of cystic bleb formation

Retinal vessel diameters and their correlation with retinal nerve fiber layer thickness in patients with pseudoexfoliation syndrome.

To compare retinal artery-vein diameters (RAVDs) of patients with pseudoexfoliation (PSX) syndrome with healthy controls and investigate the correlations between retinal nerve fiber layer (RNFL) thickness parameters and RAVDs

Neuroprotective effect of systemic and/or intravitreal rosuvastatin administration in rat glaucoma model.

To evaluate the neuroprotective effect of rosuvastatin, in a rat experimental glaucoma model