Effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve implantation: A randomized control trial

Importance: The effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve (AGV) implantation. Background: Evaluation of efficacy and safety of subconjunctival Bevacizumab injection adjunctive to AGV implantation. Design: Prospective and randomized clinical trial. Participants: Fifty eyes of 50 patients with diagnosis of glaucoma that were candidate for AGV surgery were included. Methods: In 25 eyes, conventional AGV surgery (group 1) and in 25 eyes AGV surgery with subconjunctival Bevacizumab (group 2) was performed by block randomization Main Outcome Measures: The primary outcome measure was surgical success. Outcome measures were compared at postoperative month 3, 6 and 12. Results: Mean age of patients was 58.76 ± 12.11 and 51.36 ± 15.44 years in group 1 and 2 respectively (P = 0.06). Mean intraocular pressure (IOP) at baseline was 24.88± 7.62mmHg in group 1 and 27.52± 8.57mmHg in group 2 which decreased to15.4 ± 4.4 mmHg in group 1 and 13.42± 2.9 mmHg in group 2 (P < 0.00) at last follow up. Surgical success was defined in two level: postoperative IOP �21mmHg with at least 20 reduction in IOP (Criterion A), either with no medication (complete success) or with no more than two medications (qualified success) and criterion B with the same definition but the IOP �18mmHg The cumulative success according to criterion A and B was 77.8, 72.2 in group 1 and 89.5 in group 2, respectively, at the end of follow-up. Conclusions and Relevance: Subconjunctival injection of Bevacizumab adjunctive to AGV implantation leads to higher success rate compared with AGV alone in one year follow-up. © 2018 Royal Australian and New Zealand College of Ophthalmologists

Effects of statins on myocarditis: A review of underlying molecular mechanisms

Myocarditis refers to the clinical and histological characteristics of a diverse range of inflammatory cellular pathophysiological conditions which result in cardiac dysfunction. Myocarditis is a major cause of mortality in individuals less than 40 years of age and accounts for approximately 20% of cardiovascular disease (CVD) events. Myocarditis contributes to dilated cardiomyopathy in 30% of patients and can progress to cardiac arrest, which has a poor prognosis of <40% survival over 10 years. Myocarditis has also been documented after infection with SARS-CoV-2. The most commonly used lipid-lowering therapies, HMG-CoA reductase inhibitors (statins), decrease CVD-related morbidity and mortality. In addition to their lipid-lowering effects, increasing evidence supports the existence of several additional beneficial, ‘pleiotropic’ effects of statins. Recently, several studies have indicated that statins may attenuate myocarditis. Statins modify the lipid oxidation, inflammation, immunomodulation, and endothelial activity of the pathophysiology and have been recommended as adjuvant treatment. In this review, we focus on the mechanisms of action of statins and their effects on myocarditis, SARS-CoV-2 and CVD

Effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve implantation: A randomized control trial

Importance: The effect of subconjunctival Bevacizumab injection on the outcome of Ahmed glaucoma valve (AGV) implantation. Background: Evaluation of efficacy and safety of subconjunctival Bevacizumab injection adjunctive to AGV implantation. Design: Prospective and randomized clinical trial. Participants: Fifty eyes of 50 patients with diagnosis of glaucoma that were candidate for AGV surgery were included. Methods: In 25 eyes, conventional AGV surgery (group 1) and in 25 eyes AGV surgery with subconjunctival Bevacizumab (group 2) was performed by block randomization Main Outcome Measures: The primary outcome measure was surgical success. Outcome measures were compared at postoperative month 3, 6 and 12. Results: Mean age of patients was 58.76 ± 12.11 and 51.36 ± 15.44 years in group 1 and 2 respectively (P = 0.06). Mean intraocular pressure (IOP) at baseline was 24.88± 7.62mmHg in group 1 and 27.52± 8.57mmHg in group 2 which decreased to15.4 ± 4.4 mmHg in group 1 and 13.42± 2.9 mmHg in group 2 (P < 0.00) at last follow up. Surgical success was defined in two level: postoperative IOP �21mmHg with at least 20 reduction in IOP (Criterion A), either with no medication (complete success) or with no more than two medications (qualified success) and criterion B with the same definition but the IOP �18mmHg The cumulative success according to criterion A and B was 77.8, 72.2 in group 1 and 89.5 in group 2, respectively, at the end of follow-up. Conclusions and Relevance: Subconjunctival injection of Bevacizumab adjunctive to AGV implantation leads to higher success rate compared with AGV alone in one year follow-up. © 2018 Royal Australian and New Zealand College of Ophthalmologists