Podcasts about ranibizumab

Prof. Zohar Habot-Wilner (Tel Aviv University) chairs a rich discussion with Prof. Sofia Androudi (University of Thessaly, Greece) and Prof. Sarah Touhami (University of Sorbonne) on managing retinal and uveitic diseases during pregnancy. They explore safe diagnostic tools, therapeutic dilemmas like Ranibizumab vs. Ozurdex, and the effects of pregnancy-related hormonal shifts—highlighting the importance of multidisciplinary collaboration in high-risk cases

Interview with Arshad M. Khanani, MD, author of Continuous Ranibizumab via Port Delivery System vs Monthly Ranibizumab for Treatment of Diabetic Macular Edema: The Pagoda Randomized Clinical Trial. Hosted by Neil Bressler, MD. Related Content: Continuous Ranibizumab via Port Delivery System vs Monthly Ranibizumab for Treatment of Diabetic Macular Edema

Interview with Arshad M. Khanani, MD, author of Continuous Ranibizumab via Port Delivery System vs Monthly Ranibizumab for Treatment of Diabetic Macular Edema: The Pagoda Randomized Clinical Trial. Hosted by Neil Bressler, MD. Related Content: Continuous Ranibizumab via Port Delivery System vs Monthly Ranibizumab for Treatment of Diabetic Macular Edema

Drs. David Eichenbaum and Priya Vakharia share their insights on biosimilars in the treatment of retinal disease in the United States.

Dr. Regillo describes the results of the phase 3 prospective study of Ranibizumab Port Delivery System (PDS) for the treatment of neovascular AMD.  Reference Article: Regillo C, Berger B, Brooks L, Clark WL, Mittra R, Wykoff CC, Callaway NF, DeGraaf S, Ding HT, Fung AE, Gune S, Le Pogam S, Smith R, Willis JR, Barteselli G. Archway Phase 3 Trial of the Port Delivery System with Ranibizumab for Neovascular Age-Related Macular Degeneration 2-Year Results. Ophthalmology. 2023 Jul;130(7):735-747. doi: 10.1016/j.ophtha.2023.02.024. Epub 2023 Mar 2. PMID: 36870451.

Too busy to read The Lens? Listen to our weekly summary here! In this week's issue: A majority of ophthalmology researchers have incomplete financial disclosures with underreported physician-industry relationships.  Risk of retinal vascular occlusion after mRNA COVID-19 vaccination is extremely low and commensurate with historically used vaccines for influenza and Tdap. Ranibizumab and bevacizumab showed different risks for intraocular pressure increase compared to aflibercept in a nondiabetic cohort in Tuscany, Italy.

Drs. Lediana Goduni, Safa Rahmani, and Marianeli Rodriguez join to discuss four recent publications in major ophthalmology journals.Posterior Vitreous Detachments and Complications (https://ophthalmologyretina.org/article/S2468-6530(22)00575-9/fulltext)Tractional Retinal Detachments, Treatment Type, and Follow-up (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2799232)Ranibizumab versus Bevacizumab for ROP (https://www.aaojournal.org/article/S0161-6420(22)00904-6/fulltext)Patient Satisfaction Metrics (https://jamanetwork.com/journals/jama/article-abstract/2798954)Relevant Financial Disclosures: None relevantYou can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audi

Josh Mali, MD, of The Eyes Associates, joins HCPLive to review the key news and developments coming out of the American Society of Retina Specialists 2021 Scientific Meeting.

In this podcast, expert clinicians will discuss best practices regarding the use of Port Delivery System with ranibizumab.

Episode 44: Diabetic Retinopathy. Dr Carranza explains the effect of diabetes on the retina, domestic abuse among female doctors, jokes.Today is March 15, 2021.Domestic Abuse among Female DoctorsThere are topics which are very sensitive, but we need to talk about them.Such is the case of domestic abuse among doctors. Do you know what is the most important risk factor to be a victim of domestic abuse? Yes, being female, and doctors are not an exception. Recently, in February 2021, the British Journal of General Practice (BJGP) posted an article addressing this topic.  The aim of the article was to understand the experience of female doctors as victims of domestic abuse, the barriers they faced to find help, and the impact that domestic abuse had on their work. The study was limited to doctor mothers because the author had access to this group and she was a member of the online forum and a single doctor herself. 114 doctors expressed interest in the study but a total of 21 participants were interviewed. The criteria to be included in the study were being a single mother working as a doctor and having previously left an abusive relationship. Each interview lasted between 44 and 113 minutes and were conducted from August 2019 and March 2020. The interviews were recorded. The principal author of the study can be seen and heard in an interview on the BJGP’s podcast.  The doctors felt that stress of domestic abuse affected their quality of work but were unable to participate in seeking help because of the social stigma. One of the barriers for seeking help included lack of confidentiality when the other partner was a doctor as well. One of the participants expressed that the social services did not treat her with respect when the abuser was a doctor himself. Also, the participants expressed embarrassment and shame because of their status as a doctor as she stated that doctors “should know better.”  Another negative connotation going through domestic abuse as a doctor is that the particular individual “is not capable of taking care of the patients if she cannot take care of her personal life.” The barriers to find help included “owning up” to domestic abuse, not seeking help from social services and work hours. The doctors feel socially and professionally isolated because they are not able to talk about abuse and fear the consequences of reporting. One of the most helpful thing for victims of domestic abuse was an online social group. The author added that domestic abuse training should be taught in medical school as doctors can be victims as well.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. Question of the Month: Polyarthralgiaby Valerie Civelli (written by Claudia Carranza)  This is match week! congrats to everyone, and we hope you matched to your dream residency.  This is the question of the month. This is the last week you have to answer this question. We have received very interesting answers but we are hoping to receive yours. A 49-year-old female comes to clinic reporting bilateral wrist and ankle pain for 1 month. The pain responds well to ibuprofen. She denies joint swelling, warmth, or morning stiffness. She reports feeling very fatigued. You note on her chart that she was diagnosed with COVID-19 six weeks ago that did not require hospitalization. She denies any relevant past medical history. She denies trauma, bleeding, headaches, chest pain, SOB, or dizziness. Exam is remarkable for a “tired look” and tenderness to palpation to bilateral wrist and ankle. No signs of inflammation on joints are noted. What do you think is the etiology of this patient’s symptoms and what workup would you order (if any)? Let’s repeat the question: What do you think is the etiology of the symptoms in a 49-year-old female who complains of symmetrical ankle and wrist pain with fatigue for 1 month. What workup would you order? Clue: Listen carefully to the history of the patient. Send us your answer to rbresidency@clinicasierravista.org before March 22, 2021. The winner will receive a prize.Diabetic Retinopathy  A lot of us send out referrals for diabetic retinopathy screenings every day. Now we all learned about this topic in med school but it is important to do an overview as to what diabetic retinopathy entails. These will help us, providers, to be able to explain it to your patients better and also for all listeners to have a better understanding of a much-unwanted complication of diabetes.  Basics on Diabetes. So for all of our listeners I wanted to do a quick review on diabetes. A lot of us have heard about “high sugars” and diabetes but what is it really? It is a disease in which carbohydrates are not processed correctly in our body leading to an increase of glucose in our blood. Insulin is made in the pancreas and its job is to regulate carbs by sending them to the liver, fat, skeletal muscle. You need glucose to function and not in your blood vessels but in your organs. For the listeners, what should they look out for with regards to symptoms?Lots of urination, also called polyuria and nocturia, increased thirst, weight loss, increased appetite, blurred vision, UTIs, fatigue, numbness and tingling of extremities. In other words, think of any symptoms you would have if honey was running through your bloodstream.  Hemoglobin A1c is the number people hear when they have diabetes. I tell this to all my patients, this number is a way to measure the sugar coating of your RBCs over the last 3 months. If your cells are exposed to higher amounts of glucose then the number will be higher. Prediabetes is 5.8-6.4, and diabetes is >6.5.   Diabetic Retinopathy (DR).   The main targets of diabetes are the eyes, kidneys and nerves since the first things to get damaged are the smallest blood vessels and those feed these organs. Today you are going to tell us more about the damage diabetes can do to your eyes or as we call it Diabetic Retinopathy. DR is actually one of the most important causes of visual loss worldwide and the main reason for impaired vision in patients 25-74 as the retina becomes damaged. An issue is that people will not develop symptoms until they are in late stages of DR. 1 in 5 patients with newly diagnosed diabetes will have signs of DR.  In patients with diabetes, glucose runs through the circulatory system. Glucose and the protein at the walls of blood vessels react and overtime damage the collagen. Collagen keeps the blood vessels plump. When damaged, the capillaries thicken and the walls break down.  The timing of your diabetes is a good predictor for DR. After 10 years 50%, 15 yrs 90% but it all really depends on your A1c. The more uncontrolled, the quickest you will have side effects and damage and will end up with DR. Proliferative and non-proliferative diabetic retinopathy.   Non-proliferative diabetic retinopathy is also known as “background retinopathy” meaning it just kinda sits in the background for years. 95% of people with DR have Non-Proliferative Diabetic Retinopathy (NPDR). Usually it is at an early stage and the progression is very slow. It is the result of capillary breakdown with leakage of fluid into retina, aneurysms at the blood vessels that can burst and show “blot and dot” hemorrhages that are small and round and can be seen on fundoscopic exam.When it worsens, there is decreased blood flow to the retina causing ischemia of superficial retinal nerve fibers. This can also be seen in fundoscopic exam as the infamous “cotton wool spots”. Worsening capillary break down can also lead to beading of larger retinal veins.  The other type of DR is the Proliferative retinopathy. The way this one occurs is that when vessels are very damaged they occlude completely and you end up with no blood supply.  Our bodies are smart and usually try to fix themselves. How does the retina reacts to this lack of blood flow? It sends chemicals, like VEGF (vascular endothelial growth factor) that stimulate growth of new vessels. This process is called “neovascularization”. This sounds pretty great, right? The problem is that these new vessels are not top notch. They are abnormal, friable and prone to leaking. On top of that they grow in the wrong places. For example, if it grows in the vitreous jelly, which has framework of proteins, it tugs at these proteins and you end up with retinal detachment. These vessels can also bleed into the eye and cause vision loss. And if they grow into the iris, they can block the trabecular meshwork and cause Neovascular Glaucoma. Proliferative retinopathy (PR) can advance quickly and ½ of the patients can go blind if it is left untreated.   Macular edema. The macula is the functional center of the retina which has a high concentration of photoreceptors, it’s basically the center of high-definition and color vision. It’s the center of the retina.  Macular edema it occurs in 10% of patients with diabetic retinopathy, more commonly with severe retinopathy. The leakage of capillaries and microaneurysms cause macular retina to swell with fluid. Once this swelling goes away, on fundoscopic exam you will see the “hard exudates”. These hard exudates are fatty lipids that are left behind after the swelling stops. I highly encourage all of our listeners to google the images for the findings mentioned today as they are quite impressive when you compare them to a healthy retina.  I think it is best for us as physicians to recommend to our patients and try our best to work with them to control their A1c so they don’t end up with diabetic retinopathy and also have yearly eye checkups.  Treatments. Laser treatment is one of the options. The laser seals the leaking vessels and microaneurysms; which can be done when there is only a few and they are well defined. If the area is too large then PRP (Pan-retinal photocoagulation) can be done. What is does is that it burns thousands of spots around the peripheral retina in a way to decrease the stimulus to form new vessels. The side effects are decreased peripheral vision and night vision as you end up with less peripheral rods receptors.  Another treatment is with anti-VEGF agents. These are used to treat proliferative diabetic retinopathy. They are injected into the vitreous. There are 3; Ranibizumab, bevacizumab, and aflibercept. Interesting fact; Bevacizumab is used “off-label” for retinopathy and it has to be repackaged to a strength of 1:500th of the dose used for cancer treatment.  Vitrectomy. For progressive disease, vitrectomy can be performed and it is the removal of the vitreous humor. At this point the vitreous humor would be filled with blood, inflammatory cells and debris. I had read that it is usually replaced with saline but learned from an ophthalmologist that you don’t always have to replace with saline but can also be replaced with air or gas. Conclusion: Diabetic retinopathy is a consequence of poor glycemic control. The consequences can be serious and cause severe physical, mental and social dysfunctions in our patients. Keep an eye on your care gaps, and order an annual retinopathy screening in all your patients with diabetes. But do not limit yourself to order annual screening, always ask about vision changes in your patients, and if there is any concern about worsening vision, send your patients promptly to ophthalmology.____________________________For your Sanity: Jokesby Anonymous Medical Assistants-There is a lot of people with 20/20 vision. How come none of them warned us about corona?-I'm beginning to think adult supervision is a myth. In fact, my vision just seems to be getting worse.-What do you call a fish without an eye? A fsh.-Why did the cross-eyed teacher quit her job? She couldn’t control her pupils. Now we conclude our episode number 44 “Diabetic Retinopathy.” We learned that high glucose is very harmful to the retina. Let’s teach our patients the importance of glycemic control to prevent blindness. Remember to order a retinopathy screening at least once a year, or whenever your patients reports changes in their vision. This is the last week to answer our question about polyarthralgia and fatigue in a 49 year-old-female who has a key element in her history. Send us your answer this week and you will receive a prize. Remember, even without trying, every night you go to bed being wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Claudia Carranza, Steven Saito, Udayveer Brar, Valerie Civelli, and anonymous Medical Assistants. Audio edition: Suraj Amrutia. See you next week! _____________________References:Donovan, Emily; Miriam Santer; Sara Morgan; Gavin Daker-White; and Merlin Willcox, Domestic abuse among female doctors: thematic analysis of qualitative interviews in the UK, British Journal of General Practice, February 8, 2021; BJGP.2020.0795. DOI: https://doi.org/10.3399/BJGP.2020.0795.  Fraser, Claire E; Donald J D'Amico; et al, Diabetic retinopathy: Prevention and treatment, UpToDate, Last updated: Oct 29, 2019, accessed on March 4, 2021. https://www.uptodate.com/contents/diabetic-retinopathy-prevention-and-treatmentRoot, Timothy, MD, OphthoBook, Chapter 4: Retina (47-53), published on July 20, 2009. 

Drs. Nicolas Farber, Priya Vakharia, and Yoshihiro Yonekawa join for a journal club examining four publications in major ophthalmology journals.Financial Disclosures: Dr. Sridhar is a consultant for Regeneron, Alcon, Dorc, and Oxurion. Dr. Yonekawa is a consultant for Alcon, Alimera, Allergan, and Genentech. Dr. Farber and Dr. Vakharia have no disclosures.Retinal Detachment Presentation During COVID-19 Pandemic (https://www.aaojournal.org/article/S0161-6420(20)31006-X/fulltext)Racial and Socioeconomic Disparities in Visual Impairment (https://www.aaojournal.org/article/S0161-6420(20)31044-7/fulltext)Hormone Therapy Association with Retinal Vascular Occlusion (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2772809)Ranibizumab Biosimilar Head-to-Head (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2772987)

Drs. M. Ali Khan, Priya Sharma, and Yoshihiro Yonekawa join the program for a traditional journal club episode. Articles covered are listed below: Online Physician Reviews (https://www.aaojournal.org/article/S0161-6420(19)32150-5/fulltext) Systematic Review Reliability (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2752550) SCORE2 24 month Data (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2752549) Ranibizumab versus Aflibercept (https://www.aaojournal.org/article/S0161-6420(19)32137-2/fulltext) Dr. Sridhar has received consulting fees from Alimera, Alcon, and Oxurion. Dr. Khan has received consulting fees from Allergan. Dr. Sharma has no financial disclosures. Dr. Yonekawa receives consulting fees from Alcon. You can now claim CME credits via the AAO website. Visit https://www.aao.org/browse-multimedia?filter=Audio&sub=ONE.ContentTypes.Audio.

Drs. Muni and Juncal discuss their case series on the level of anti-VEGF drugs and VEGF-A levels on lactating mothers who had received intravitreal anti-VEGF injections.   Reference for the article: Ranibizumab and Aflibercept Levels in Breast Milk after Intravitreal Injection; Verena R. Juncal,Quratulain Paracha,Motaz Bamakrid, ,Carolina L.M. Francisconi, Julia Farah, Amin Kherani ,Rajeev H. Muni;  Ophthalmology, published on line Sep.11, 2019 https://doi.org/10.1016/j.ophtha.2019.08.022

Dr. Anne Fung is the Global Development Lead for the Port Delivery System with Ranibizumab and Lucentis at Genentech. She is also a practicing retina specialist and researcher at Pacific Eye Associates and California Pacific Medical Center in San Francisco. Macular degeneration is a degenerative condition of a portion of the retina in the eye. This disease generally affects older adults. While there are some amazing medicines that can help people with macular degeneration, these medicines must be injected into the eye every 4-6 weeks. Anne is working on a tiny implant that serves as a reservoir for medicine so it can be slowly released over 6 months or more. They are currently investigating how long this implant can effectively treat the disease. Outside of science, Anne loves practicing yoga, as well as reading, listening to podcasts, and listening to audiobooks on a variety of topics including business, organizations, and psychology. Anne received her undergraduate degree from Wellesley College and her Medical Degree from Cornell University. She completed her residency in ophthalmology at Stanford University School of Medicine and then pursued a Medical Retina Fellowship at the Bascom Palmer Eye Institute and the University of Miami Miller School of Medicine. Anne worked in clinical practice for ten years before joining the team at Genentech in 2014. Anne is a Board Certified Ophthalmologist and is a Fellow of the American Academy of Ophthalmology. In our interview she shares more about her life and science.

Dr. Mark Gillies from Sydney, Australia discusses 2-year results of the RIVAL Study which investigated rates of geographic atrophy and visual acuity changes in patients with wet AMD.   Full reference:  Gillies, M. C., Hunyor, A. P., Arnold, J. J., Guymer, R. H., Wolf, S., Ng, P., . . . McAllister, I. L. (2019). Effect of Ranibizumab and Aflibercept on Best-Corrected Visual Acuity in Treat-and-Extend for Neovascular Age-Related Macular Degeneration: A Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.6776  

Dr. Peter Kertes discusses the publication of the first year results of the CANTREAT study that investigates monthly vs treat-and-extend dosing of ranibizumab for wet AMD.    Full reference: Kertes, P. J., Galic, I. J., Greve, M., Williams, R. G., Rampakakis, E., Scarino, A., & Sheidow, T. (2019). Canadian Treat and Extend Analysis Trial with Ranibizumab in Patients with Neovascular Age-related Macular Disease: 1-Year Results of the Randomized CANTREAT Study. Ophthalmology. doi:10.1016/j.ophtha.2019.01.013  

Interview with Ian Leslie. Mcallister, FRANZCO, author of Two-Year Efficacy of Ranibizumab Plus Laser-Induced Chorioretinal Anastomosis vs Ranibizumab Monotherapy for Central Retinal Vein Occlusion: A Randomized Clinical Trial

Interview with Ian Leslie. Mcallister, FRANZCO, author of Two-Year Efficacy of Ranibizumab Plus Laser-Induced Chorioretinal Anastomosis vs Ranibizumab Monotherapy for Central Retinal Vein Occlusion: A Randomized Clinical Trial

Dr. Jennifer Sun discusses 5-year results of DRCR.net Protocol S that investigated outcomes of treatment of proliferative diabetic retinopathy using traditional PRP laser vs intravitreal ranibizumab injections.  Full reference: Gross, J. G., Glassman, A. R., Liu, D., Sun, J. K., Antoszyk, A. N., Baker, C. W., . . . Diabetic Retinopathy Clinical Research, N. (2018). Five-Year Outcomes of Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.3255   Please leave your comments in iTunes or send them to theretinachannel@gmail.com   

Dr. Jonathan Chang of the University of Wisconsin-Madison and Dr. Ali Khan of the Doheny Eye Institute join the show to discuss three recent articles, the first concerning aqueous biomarkers associated with diabetic macular edema treated with intravitreal ranibizumab, the second regarding systemic VEGF levels after different anti-VEGF intravitreal medications, and the third regarding macular rotation after macular hole surgery. Articles in order: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2674061 http://www.aaojournal.org/article/S0161-6420(17)32232-7/fulltext http://www.ajo.com/article/S0002-9394(18)30096-5/fulltext

Dr. Rajeev Muni describes the results of his research on the correlation of cytokine levels (VEGF, ICAM, etc) and the anatomical response to intravitreal ranibizumab for the treatment of diabetic macular edema. Full reference of the article: Hillier, R. J., Ojaimi, E., Wong, D. T., Mak, M. Y. K., Berger, A. R., Kohly, R. P., . . . Muni, R. H. (2018). Aqueous Humor Cytokine Levels and Anatomic Response to Intravitreal Ranibizumab in Diabetic Macular Edema. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.0179   Please send leave your comments in iTunes or send to theretinachannel@gmail.com

Dr. SriniVas Sadda discusses development of macular atrophy in an analysis of HARBOR Study which investigated treatment of wet AMD using 0.5 mg and 2.0 mg of Ranibizumab dosing.  Full reference of the discussed article: Sadda, S. R., Tuomi, L. L., Ding, B., Fung, A. E., & Hopkins, J. J. (2018). Macular Atrophy in the HARBOR Study for Neovascular Age-Related Macular Degeneration. Ophthalmology. doi:10.1016/j.ophtha.2017.12.026

Dr. Raj Maturi from DRCR.net discusses final results of the DRCR.net protocol U, which investigated addition of Dexamethasone implant to ranibizumab for the treatment of persistent diabetic macular edema. The full reference of the article is: Maturi, R. K., Glassman, A. R., Liu, D., Beck, R. W., Bhavsar, A. R., Bressler, N. M., . . . Diabetic Retinopathy Clinical Research, N. (2017). Effect of Adding Dexamethasone to Continued Ranibizumab Treatment in Patients With Persistent Diabetic Macular Edema: A DRCR Network Phase 2 Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2017.4914   Please send your comments to theretinachannel@gmail.com

Drs. Daniel Chao of University of California-San Diego, M. Ali Khan of University of California-Los Angeles, Ajay Kuriyan of University of Rochester, and Yasha Modi of New York University join the show for a group journal club discussion of two recent publications in Ophthalmology. The first publication reports the results of a randomized prospective clinical trial assessing the efficacy of intravitreal dexamethasone in improving outcomes in eyes with retinal detachment and advanced proliferative vitreoretinopathy (found here, https://www.ncbi.nlm.nih.gov/pubmed/28237428). The second publication reports the efficacy of ranibizumab and pan retinal laser photocoagulation in reducing progression of proliferative diabetic retinopathy (found here, http://www.aaojournal.org/article/S0161-6420(16)31179-4/abstract).

Interview with Lee M. Jampol, MD, author of Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial

Retinale venöse Gefäßverschlüsse (RVV) sind eine der Hauptursachen für einen Visusverlust in den westlichen Industriestaaten. Venenastverschlüsse (VAV) treten häufiger als Zentralvenenverschlüsse (ZVV) auf. Bei beiden Typen ist das Makulaödem der entscheidende Parameter für die funktionelle Einbuße. Zusätzliche Ischämien und Neovaskularisationen, gerade bei ZVV, führen am gesamten Auge zu teils schwerwiegenden Komplikationen, deren es, neben der Makulaödem-behandlung, vorzubeugen gilt. Mittlerweile sind Lucentis® als Anti-VEGF-Inhibitor sowie Ozurdex® als Steroid-Implantat (Dexamethason) zur Behandlung des Makulaödems bei venösen Gefäßverschlüssen zugelassen und stellen in der Therapie von RVV neben der konventionellen Laserbehandlung eine wesentliche Hauptsäule dar. Die vorliegende Arbeit untersucht den Vergleich der intravitrealen Therapie mit Dexamethason-Implantat (Ozurdex®, Gruppe 1) und Anti-VEGF-Injektion (Lucentis®, Gruppe 2) zur Behandlung des Makulaödems bei retinalen venösen Gefäßverschlüssen in einer retrospektiven, nicht randomisierten Fallserie. Gruppe 1 enthielt 60 Patienten (31 mit ZVV und 29 mit VAV) und Gruppe 2 inkludierte 52 Patienten (27 mit ZVV und 25 mit VAV). Im Falle eines Rezidivs wurden beide Gruppen jeweils weiter behandelt. Präoperativ und monatlich wurden die bestkorrigierte Sehschärfe (BKSS) und der intraokulare Druck (IOD) bestimmt, die zentrale Netzhautdicke mittels Spectralis-OCT erhoben, sowie eine Biomikroskopie und Fundusfotodokumentation durchgeführt. Primärer klinischer Endpunkt war die Visusentwicklung 12 Monate nach der ersten intravitrealen Therapie, sekundäre Endpunkte waren die zentrale Netzhautdicke und die Sicherheit der Therapie. Nach 12 Monaten wurde in der Gruppe 1 bei den ZVV-Patienten ein Anstieg der BKSS (± eine Standardabweichung) von 8,4 (± 1,9) Buchstaben, bei den VAV- Patienten ein Gewinn von 10,7 (± 3,8) Buchstaben beobachtet. In Gruppe 2 zeigten die ZVV-Patienten eine Zunahme der BKSS von 6,9 (± 1,9) Buchstaben nach 12 Monaten im Vergleich zu 12,5 (± 3,7) Buchstaben bei den VAV-Patienten. In beiden Gruppen konnte eine signifikante Reduktion der zentralen Netzhautdicke erreicht werden. Der IOD zeigte in knapp der Hälfte aller Fälle in Gruppe 1 einen Anstieg über 5 mmHg, konnte aber durch konservative antiglaukomatöse Therapie in den Fällen mit einem IOD über 21 mmHg (obere Normgrenze) in der Behandlungsphase gut reguliert werden. Allerdings zeigte sich bereits nach zweimaliger Ozurdex®-Injektion (Gruppe 1) in ca. 50% der Fälle eine Progression einer Linsentrübung. Eine Behandlung mit Ozurdex® führt bei den ZVV im Vergleich zu Lucentis® zu einem besseren Sehschärfenanstieg nach 12 Monaten, allerdings nicht signifikant. Bei den VAV ist der Sehschärfengewinn bei beiden Behandlungsformen ähnlich. Unabhängig von den Ergebnissen muss für Ozurdex® der Linsenstatus und das Alter des Patienten berücksichtigt werden.

Guest: Sascha Fauser, MD Professor Department of Ophthalmology University Hospital of Cologne Cologne, Germany

Thu, 21 Mar 2013 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/15569/ https://edoc.ub.uni-muenchen.de/15569/1/Hoffmann_Andrea_Eva.pdf Hoffmann, Andrea Eva

-Occhi, ipovisione: Rimborso terapia ranibizumab (Lucentis*) per Edema maculare diabetico, Occlusione venosa retinica, Degenerazione maculare neovascolare legata all'età la principale paura delle persone con diabete è la cecità. E' quanto emerge da un'indagine condotta su 2.407 pazienti, il 41% teme la cecità e il 34% le complicanze oculari. Il diabete, se non controllato, nel lungo periodo può provocare danni specifici alla retina, mettendo a rischio la funzionalità visiva e determinando una patologia invalidante come l'edema maculare diabetico, una complicanza della retinopatia diabetica, patologia cronica e progressiva a carico dei piccoli vasi retinici che rappresenta nei Paesi industrializzati la principale causa di cecità in età lavorativa. Oggi i pazienti affetti da diminuzione visiva causata da edema maculare diabetico possono avvalersi della terapia con ranibizumab (Lucentis®) che ha recentemente ottenuto la rimborsabilità a carico del Servizio Sanitario Nazionale anche per questa patologia. (Gazzetta Ufficiale n. 285 del 6 dicembre 2012). Ranibizumab è ad oggi l'unico farmaco anti-VEGF (fattore di crescita vascolare endoteliale) approvato per tre indicazioni terapeutiche: degenerazione maculare neovascolare legata all'età (wet-AMD), diminuzione visiva causata da edema maculare diabetico (DME) e da occlusione venosa retinica (RVO). Ha inoltre ricevuto recentemente l'estensione del rimborso a carico del SSN anche nei pazienti con wet-AMD e acuità visiva

-Congresso SIME: Nasce l' Associazione delle società scientifiche di medicina estetica: Nasce il Collegio delle società scientifiche di medicina estetica, una vera e propria associazione che unisce le tre società scientifiche più importanti in Italia a livello nazionale, che avrà finalmente una funzione prevalentemente di tipo 'sindacale'. Obiettivo prioritario di questa Associazione è di difendere la medicina estetica e la figura del medico estetico, cercando di portarla ad ottenere i giusti riconoscimenti da parte delle autorità preposte (dai Ministeri ai Collegi scientifici) equiparandola alle altre specialità scientifiche. Si tratta di una disciplina medica nata da quasi 40 anni, di cui si occupano ormai dai 5 ai 10 mila medici in tutta Italia. -Ipovisione da degenerazione maculare senile AMD e edema maculare diabetico, la terapia con ranibizumab (Lucentis*) In Italia è necessaria maggiore attenzione alle forme di ipovisione e cecità legale derivate dalle malattie della retina, per assicurare più salute al paziente e minori costi sociali legati all'assistenza. La degenerazione maculare legata all'età e la retinopatia diabetica infatti sono tra le principali cause di ipovisione nei paesi industrializzati. Ranibizumab è un trattamento di comprovata efficacia e sicurezza, sia nella degenerazione maculare neovascolare senile che nella diminuzione visiva causata dall'edema maculare diabetico. -Anche in carcere "La Salute non conosce confini": Presentati i primi risultati della Campagna di Informazione sulle patologie virali croniche all'interno degli Istituti Penitenziari Italiani, promossa dalla SIMIT (Società Italiana di Malattie Infettive e Tropicali), dalla SIMSPE (Società Italiana di Medicina e Sanità Penitenziaria), NPS Italia Onlus (Network Persone Sieropositive) e l'Associazione Donne in rete Onlus e, patrocinata dal Ministero della Giustizia e dal Ministero della Salute. La vera novità è stata l'introduzione del peer educator (un rappresentante NPS): tutore alla pari con credibilità e competenza, passato attraverso le stesse esperienze, che ha parlato la stessa lingua e che è stato in grado di comprendere i loro problemi, effettuando 32 incontri nei 20 Istituti penitenziari con 1.546 detenuti. -Campagna 'Epatite B: usa la testa, fai il test': L'epatite B è una delle malattie più diffuse al mondo: colpisce il fegato e quando si cronicizza può causare danni anche molto gravi. Dal 21 maggio al 15 giugno 2012 in 15 capoluoghi italiani, i cittadini avranno la possibilità di eseguire gratuitamente il test dell'epatite B presso uno dei laboratori che aderiscono alla campagna 'Epatite B: usa la testa, fai il test'. Prenotazioni al Numero Verde 800-027.325 o al sito www.epatiteb2012.it.

Host Neil Bressler, MD, interviews Jennifer Lim, MD, and Judy Kim, MD. Dr. Neil Bressler leads a discussion on the management of patients with age-related macular degeneration. The participants consider a range of issues, including their approach to antibiotic use, the real-world implication of the published CATT outcomes, and the challenge of motivating patients who may be discouraged by a long-term regimen of intravitreal injections. (November 2011)

Dr. Susan B. Bressler, The Julia G. Levy, PhD, Professor of Ophthalmology, Division of Ophthalmology at Johns Hopkins University School of Medicine in Baltimore, Maryland will determine the benefits and risks of intravitreal anti-VEGF therapy with prompt or deferred focal/grid laser compared with prompt focal/grid laser alone. Dr. Bressler will also determine the benefits and risks of intravitreal corticosteroids with prompt focal/grid laser compared with prompt focal/grid laser alone.

Drs. Neil and Susan Bressler from Johns Hopkins University School of Medicine will evaluate the different decision-making processes that guide management of macular edema from diabetes at presetntaion and follow-up

A conversation between Judy Kim, MD, and Neil M. Bressler, MD. Dr. Neil Bressler, chair of the Diabetic Retinopathy Clinical Research Network (DRCR.net), discusses this year

Guest: Eric Souied, MD, PhD Head of Department of Ophthalmology  Hopital Intercommunal de Creteil  and Henri Mondor Hospital Creteil, France

This podcast focuses on the diagnosis and management of choroidal neovascularization.

Dr. Bressler presents 3 cases that discuss the management and treatment of age-related acular degeneration.

Guest: Nisha Acharya, MD, MS Assistant Professor, Director of the Uveitis Service Proctor Foundation University of California, San Francisco San Francisco, CA

Guest: Philip J. Rosenfeld, M.D., Ph.D.Professor of OphthalmologyBascom Palmer Eye InstituteUniversity of Miami Miller School of MedicineMiami, Florida