Fixed combination brimonidine-timolol versus brimonidine for treatment of intraocular pressure elevation after neodymium: YAG laser posterior capsulotomy

WOS: 000311827800005PubMed: 22809091Purpose: To evaluate the efficacy of fixed combination brimonidine-timolol (FCBT) in comparison with brimonidine tartrate 0.2% and control for the treatment of intraocular pressure (IOP) spikes after neodymium:YAG (Nd:YAG) laser posterior capsulotomy. Methods: One hundred five eyes of 105 patients were enrolled in the study. Patients were randomized to 3 groups (each group, including 35 patients): the FCBT group that received 1 drop of FCBT, the brimonidine group that received 1 drop of brimonidine tartrate 0.2%, and the control group that received 1 drop of artificial tear, 1 h before the laser procedure. Postoperative IOP measurements were performed at 1st, 2nd, 3rd, 24th hours, and seventh day. Results: the mean IOP changes from baseline were statistically different between the study groups at first, second, and third hours (all P 0.05), the IOP levels of the brimonidine group were less reduced from baseline than the FCBT group at second and third hours (P = 0.01 and P = 0.03, respectively). the differences among the study groups concerning the incidence of IOP elevations of >= 5 or >= 10 mmHg were statistically significant (P = 0.007, P = 0.04, respectively). However, the differences between the treatment groups were not statistically significant (both P > 0.05). Conclusion: This study has shown that preoperative instillation of 1-drop FCBT was safe and effective for preventing IOP spikes after Nd: YAG laser posterior capsulotomy. FCBT may be a better option than brimonidine tartrate 0.2%, which is one of the current standard prophylaxes for these spikes

Effects of Photodynamic Therapy With Verteporfin for the Treatment of Chronic Central Serous Chorioretinopathy: An Uncontrolled, Open-Label, Observational Study

KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000280083100004PubMed: 24683263BACKGROUND: Central serous chorioretinopathy is an idiopathic disorder that leads to serous neurosensory retinal detachment. The disorder is usually self-limited and resolves spontaneously; however, sometimes neurosensory retinal detachment persists. This form of the disorder is called chronic central serous chorioretinopathy (CCSC). OBJECTIVE: The aim of this study was to assess the effects of photodynamic therapy (PDT) on visual acuity with full-dose verteporfin for CCSC. METHODS: The eyes of patients with CCSC were included in the study. Ophthalmic examination including best-corrected visual acuity (BCVA), fundus examination, fluorescein angiography, and optical coherence tomography was performed before treatment and at 1, 3, 6, 9, and 12 months. PDT with full-dose verteporfin (6 mg/m(2) of body surface area) was applied only to areas of active leakage. BCVA was converted to a log of the minimum angle of resolution (logMAR) equivalent for statistical analysis. Central foveal thickness and BCVA between baseline and follow-up were compared. RESULTS: Seventeen eyes of 16 patients (13 males, 3 females; mean [SD] age, 39.75 [7.51] years; mean duration of follow-up, 13.06 [1.82] months) were used in the study. The mean (SEM) logMAR BCVA was 0.26 (0.07) at baseline and 0.04 (0.02) at 12 months. Mean logMAR BCVA values at baseline (0.259) and after treatment (0.112, 0.053, 0.047, 0.041, and 0.041 at 1, 3, 6, 9, and 12 months, respectively) differed significantly (P = 0.006, P = 0.005, P = 0.005, P = 0.005, and P = 0.005). There was a significant difference in the mean central foveal thickness at the final visit (169 pm) compared with the baseline value (383 pm; P < 0.001). BCVA decreased in one eye (20/20 vs 20/25) and persisted during follow-up; in the other 16 eyes, BCVA either increased (n = 10) or remained stable (n = 6). CONCLUSIONS: In this small, open-label study, patients with CCSC treated with a single course of PDT with full-dose verteporfin had significant improvement from baseline in BCVA and resolution of subretinal fluid accumulation and active leakage. Treatment was generally well tolerated, but one patient had worsening in BCVA. (Curr Thor Res Clin Exp. 2010;71:173-185) (C) 2010 Excerpta Medica Inc

Fakoemülsifikasyon sonrası göz içi basıncı artışı tedavisinde brimonidin-timolol ile dorzolamide-timolol’ün karşılaştırılması

Amaç: Fakoemülsifikasyon cerrahisi sonrası göz içi basıncı (GİB) yükselmesinin önlenmesinde dorzolamide-timolol sabit kombinasyonu (DTSK) ile brimonidine-timolol sabit kombinasyonu (BTSK)’nun etkinliklerinin karşılaştırılması. Gereç ve Yöntem: Fakoemülsifikasyon cerrahisine giden 150 hastanın 150 gözü bu çalışmaya dahil edildi. Hastalar cerra- hiden hemen sonra damlatılan damlalara göre rastgele üç gruba ayrıldı; DTSK grubuna 1 damla DTSK, BTSK grubuna 1 damla BTSK ve kontrol grubuna 1 damla suni gözyaşı damlatıldı. GİB her hasta için ameliyattan hemen önce ve ameliyat sonrası 6. saat, 24. saat ve 7. günlerde ölçüldü. Bulgular: Ortalama GİB değerleri 6. ve 24. saatlerde DTSK ve BTSK gruplarında kontrol grubuna göre anlamlı derecede düşüktü (p<0.001). Ancak her iki tedavi grubunda takip süresi boyunca anlamlı bir fark yoktu. Sonuç: Bu çalışma, işlem sonrası damlatılan bir damla DTSK veya BTSK’nın her ikisinin de fakoemulsifiakasyon cerrahisi sonrası GİB artışının önlenmesinde etkin olduğu ve benzer etkiye sahip olduklarını gösterdi.Purpose: To compare the efficacies of fixed combination dorzolamide-timolol (FCDT) and fixed combination brimonidine- timolol (FCBT) for preventing intraocular pressure (IOP) spikes after phacoemulsification surgery. Materials and Methods: One hundred and fifty eyes of 150 patients undergoing phacoemulsification surgery were enrolled in this study. Patients were randomly divided preoperatively into three groups according to the drug that instilled immedi- ately after surgery; FCDT group that receiving one drop of FCDT, FCBT group that receiving one drop of FCBT and control group that receiving one drop of artificial tear. IOP was recorded immediately before surgery (baseline), at the 6th hour, 24th hour and 7th day postoperatively. Results: Mean IOP levels were significantly lower in the treatment groups than in the control group at the 6th and 24th hours (both p<0.001) after surgery whereas there was no significant difference between the treatment groups during the follow-up period. Conclusion: Our study has demonstrated that both FCDT and FCBT, each one drop administered immediately after proce- dure, were effective and both had similar efficacy for preventing IOP elevation after phacoemulsification surgery

Single injection of triamcinolone versus three repeated injections of bevacizumab for treatment of diabetic macular edema

WOS: 000321249500008PubMed: 23334618To compare the effect of a single intravitreal injection of triamcinolone acetonide versus three consecutive monthly intravitreal injections of bevacizumab for the treatment of diabetic macular edema (DME). Forty patients treated with a single intravitreal injection of 4 mg triamcinolone acetonide (triamcinolone group) were compared with 40 patients treated with three consecutive monthly intravitreal injections of 1.25 mg bevacizumab (bevacizumab group). the triamcinolone group showed a significant decrease in mean central retinal thickness (CRT) from 472.5 mu m +/- A 120.35 to 374.0 mu m +/- A 152.31 after 3 months (p < 0.001). the bevacizumab group also showed a significant reduction in CRT from 464.5 mu m +/- A 115.3 to 370.0 mu m +/- A 142.31 (p < 0.001). the triamcinolone group displayed an increase in best-corrected visual acuity (BCVA) following a single intravitreal triamcinolone acetonide injection from a mean of +0.70 +/- A 0.17 logMAR to a mean of +0.54 +/- A 0.38 logMAR after 3 months (p < 0.05). the bevacizumab group also showed an increase in BCVA following three injections of bevacizumab from a mean of +0.73 +/- A 0.28 logMAR to a mean of +0.57 +/- A 0.33 logMAR (p < 0.05). Statistical analysis showed no significant difference between both groups at 3 months. Our study showed that a single intravitreal injection of triamcinolone is as effective as three consecutive monthly intravitreal injections of bevacizumab for treatment of DME with regard to BCVA and CRT measured by optical coherence tomography. Despite the recent popularity of bevacizumab, three injections are no more effective than a single injection of triamcinolone for the treatment of DME