Ozurdex in the lens is a rare complication of intravitreal injection (clinical case)

2021 ◽  
pp. 90-93
Author(s):  
V.S. Stebnev ◽  
◽  
S.D. Stebnev ◽  
N.I. Skladchikova ◽  
T.Y. Vashchenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Clinical Case ◽  
Rare Complication ◽  
Intravitreal Injections ◽  
Complete Relief ◽  
Long Time ◽  
Irrigation Solution ◽  
The Russian Federation ◽  
Decrease In Visual Acuity

A clinical case of unintentional implantation of the Ozurdex dexamethasone implant (Allergan, Inc., Irvine, CA, USA) into the lens is presented. The patient was treated for a long time with intravitreal injections of Lucentis (5) and Ozurdex (4) in various clinics of the Russian Federation for recurrent macular edema associated with thrombosis of the n/temporal branch of the central retinal vein. After the last injection of Ozurdex, he noted a decrease in visual acuity. I applied to the Eye Surgery clinic after 5 months due to a significant decrease in visual acuity. After the examination, a cataract was diagnosed, an implant in the thickness of the lens. Phacoemulsification was successfully performed with the implantation of an intraocular lens into a capsule bag (UltraSert, Alcon). An attempt during the operation to preserve the Ozurdex implant and move it into the retrolental space failed, which was due to the long period of its stay in the eye and rapid hydrotation and destruction under the action of irrigation solution. High visual acuity was obtained. The optical coherence tomogram revealed complete relief of macular edema. Key words: Ozurdex®, intralenticular implantation Ozurdex®, complications of intravitreal injections, macular edema, iatrogenic cataract.

scholarly journals Subliminal Laser as Additional Therapy to Reduce Intravitreal Injection Number for the Patients with Macular Diseases

2020 ◽  
Vol 18 (1) ◽  
pp. 45-47
Author(s):  
Liene Muceniece ◽  
Dace Markevica
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Systemic Disease ◽  
Alternative Therapy ◽  
Treatment Method ◽  
Macular Thickness ◽  
Intravitreal Injections ◽  
Macular Diseases ◽  
Significant Difference ◽  
Additional Therapy

SummaryIntroductionIntravitreal injections have become one of the most performed surgical procedures in ophthalmology. There is a need to look for an effective alternative therapy for patients with anti-VEGF complications and systemic disease contraindications.Aim of the studyTo evaluate Subliminal laser effectiveness on reducing macular disease edema.Materials and methodsSubliminal laser treatment was done three times with three month intervals for patients with macular edema due to retinal diseases. On 1st, 3rd, 6th and 9th month visit the best corrected visual acuity, intraocular pressure, macular thickness and macular volume were registered.ResultsMean visual acuity before treatment was 0,52 (SD=0,31) that changed to 0,56 after the 9 month treatment (p>0,05). Mean central macular thickness from 326,12 μm reduced to 308,15 (p=0,76). Without significant difference, inner cycle volume changed from 1353,80 mm3 to 1297,57 mm3 (p=0,81) and outer cycle volume from 1179,4 mm3 to 1112,56 mm3 (p=0,51).ConclusionsSubliminal laser controls macular edema level and could be a solution for patients who cannot afford or are emotionally distressed by monthly intravitreal injections. This treatment method can be used as additional therapy to reduce the number of intravitreal injections.

scholarly journals Vitrectomized versus non-vitrectomized eyes in diabetic macular edema response to ranibizumab—retinal layers thickness as prognostic biomarkers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bernardete Pessoa ◽  
João Leite ◽  
João Heitor ◽  
João Coelho ◽  
Sérgio Monteiro ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Nerve Fiber ◽  
Diabetic Macular Edema ◽  
Intravitreal Injections ◽  
Final Visual Acuity ◽  
Foveal Thickness ◽  
Retinal Layers ◽  
Retinal Nerve Fiber

AbstractTo evaluate the role of the vitreous in the management of diabetic macular edema with ranibizumab intravitreal injections in a pro re nata regimen. Prospective study of 50 consecutive eyes with diabetic macular edema treated with ranibizumab and 12 months of follow-up. Primary endpoint: to assess differences between non-vitrectomized and vitrectomized eyes in the number injections needed to control the edema. Secondary endpoints: comparison of groups regarding best corrected visual acuity, central foveal thickness and thickness of seven retinal layers. 46 eyes from 38 patients, 10 vitrectomized and 36 non-vitrectomized, completed the follow-up. At month 12, the two groups achieved an equivalent anatomical outcome and needed a similar number of ranibizumab intravitreal injections. In vitrectomized eyes final visual acuity was worse when baseline retinal nerve fiber layers in the central foveal subfield were thicker, showing a strong correlation (r = − 0.942, p < 0.001). A similar, albeit moderate correlation was observed in non-vitrectomized eyes (r = − 0.504, p = 0.002). A decrease of retinal nerve fiber layers inner ring thickness was correlated with a better final visual acuity only in vitrectomized eyes (r = 0.734, p = 0.016). The effect of diabetic macular edema seems to be worse in vitrectomized eyes, with a thinner inner retina reservoir.Clinicaltrials.govNCT04387604.

Surgical treatment of damage to the posterior capsule of the lens after laser vitreolysis

2021 ◽  
pp. 30-32
Author(s):  
А.А. Kozhukhov ◽  
◽  
О.V. Unguryanov ◽  
О.А. Chukanin ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Key Words ◽  
Clinical Case ◽  
Vitreous Body ◽  
Posterior Capsule ◽  
Surgical Methods ◽  
Initial Injury ◽  
Capsule Material ◽  
Decrease In Visual Acuity

Damage to the posterior capsule of the lens after laser vitreolysis causes the formation of traumatic cataracts and a decrease in visual acuity. The search for surgical methods of treating such complications is relevant. Purpose. To develop and improve the technique of posterior capsulorexis during phacoemulsification and implantation of IOL combined with vitrectomy in the presence of an initial injury of the posterior lens capsule. Material and methods. Clinical case - a patient came to the clinic with complaints about a decrease in visual acuity and quality after laser vitreolysis performed in another clinic. Observed the damage of the posterior capsule of the lens. The operation was performed according to the developed technique. Results. A method of primary posterior capsulorexis during phacoemulsification and implantation of IOL after vitreolysis, combined with vitrectomy, is proposed. Achieved high visual acuity after the operation, OD=1.0. Conclusions. 1) The developed technique of primary posterior capsulorexis is safe and allows partially preserving the posterior capsule of the lens, while forming a «window» in the area of damage, and implanting the IOL into a capsule bag. 2) The installation of scleral ports during primary posterior capsulorexis makes it possible to successfully combine this operation with vitrectomy and prevent the displacement of lens fragments to the fundus. Key words: сataract, posterior capsulorexis, laser vitreolysis, phacoemulsification, pseudophakia, IOL, vitrectomy, vitreous body.

scholarly journals Anatomical and functional responses in eyes with diabetic macular edema treated with “1 + PRN” ranibizumab: one-year outcomes in population of mainland China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kunbei Lai ◽  
Chuangxin Huang ◽  
Longhui Li ◽  
Yajun Gong ◽  
Fabao Xu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Posterior Vitreous Detachment ◽  
Intravitreal Injections ◽  
Functional Responses ◽  
Ellipsoid Zone ◽  
Link Type ◽  
Time Point

Abstract Background To evaluate the anatomical and functional responses in eyes with diabetic macular edema (DME) treated with ranibizumab under “1 + pro re nata (PRN)” regimen. Methods This prospective interventional case series included 69 eyes of 69 patients with DME treated with intravitreal injections of 0.5 mg ranibizumab followed by repeated injections as needed. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and predictive factors for final visual outcomes were assessed. Results Logarithm of minimal angle of resolution (logMAR) BCVA improved from 0.64 ± 0.23 at baseline to 0.56 ± 0.27, 0.53 ± 0.26, 0.47 ± 0.25, 0.44 ± 0.32, 0.47 ± 0.26 and 0.46 ± 0.26 at time-point of months 1, 2, 3, 6, 9, and 12, respectively (P < 0.05 for any follow-up time-point except month 1). CFT decreased from 478.23 ± 172.31 μm at baseline to 349.74 ± 82.21 μm, 313.52 ± 69.62 μm, 292.59 ± 61.07 μm, 284.67 ± 69.85 μm, 268.33 ± 43.03 μm, and 270.39 ± 49.27 μm at above time-points, respectively (P < 0.05). The number of injections was 6.83 times over 12 months’ follow-up under “1 + PRN” regimen. Multivariate analysis showed that the factors including age, BCVA at baseline, disruption of ellipsoid zone, posterior vitreous detachment (PVD), and vitreomacular traction (VMT) were correlated with the final BCVA. Conclusions Intravitreal injections of ranibizumab under “1 + PRN” regimen is a not only effective but also safe way to improve visual acuity of DME patients. And older age, lower baseline BCVA, VMT, and disruption of ellipsoid zone are predictors for final poor BCVA while PVD is a positive predictive factor for good final BCVA. Trial registration The trial was registered retrospectively in ClinicalTrials.gov on 2 June 2019 (NCT03973138).

scholarly journals Intravitreal and Subtenon Depot Triamcinolone as Treatment of Retinitis Pigmentosa Associated Cystoid Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Sidnei Barge ◽  
Renata Rothwell ◽  
Paula Sepúlveda ◽  
Luís Agrelos
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Cystoid Macular Edema ◽  
Treatment Options ◽  
Corrected Visual Acuity ◽  
Anatomic Results ◽  
The Right ◽  
Decrease In Visual Acuity

We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient’s BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.

scholarly journals Intravitreal Ranibizumab Had Limited Effect on Cystoid Macular Edema Due to Albumin-Bound Paclitaxel: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Suna Ye ◽  
Qiqi Fang ◽  
Jinyu Yao ◽  
Jianqiang Xing ◽  
Shibo Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Visual Acuity ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Rare Complication ◽  
Eye Drops ◽  
Intravitreal Ranibizumab ◽  
Limited Effect ◽  
Underlying Pathogenesis ◽  
Ranibizumab Treatment

Angiographically silent cystoid macular edema (CME) is a rare complication from nab-paclitaxel. Here we report a 45-year-old woman with breast cancer who developed CME after several months of treatment with albumin-bound paclitaxel (nab-paclitaxel). Her visual acuity did not improve significantly with the cessation of nab-paclitaxel and intravitreal ranibizumab treatment. Then, brinzolamide eye drops were prescribed. One month later, her vision improved, with the macular edema significantly subsided. Finally, we reviewed other cases of CME induced by nab-paclitaxel that have been reported in the literature and discussed the underlying pathogenesis of nab-paclitaxel-induced CME.

scholarly journals The effect THE EFFECT OF FREQUENCY, DURATION AND TYPES OF GADGETS ON VISUAL ACUITY OF STUDENTS

2019 ◽  
Vol 2 (03) ◽  
pp. 217-221
Author(s):  
Tria Wahyuningrum ◽  
Veryudha Eka Prameswari
Keyword(s):  
Visual Acuity ◽  
Human Life ◽  
Sampling Technique ◽  
Eye Disease ◽  
Measuring Instrument ◽  
Cross Sectional ◽  
Long Time ◽  
Eye Examination ◽  
Modern Era ◽  
Decrease In Visual Acuity

Technology that is increasingly sophisticated is very influential in human life. Countless types of technology can be found in this modern era. One example of a very popular technology is gadgets. Psychologically, gadgets are easy to create addiction, game facilities that exist in the gadget make children always challenged to reach a higher level. Waste and especially on the eyes that are always used to view gadgets for a long time and without rest can result in asthenopia or tired eyes. Namely, the pupils are slow to react to light, so there is a decrease in visual acuity. The design used in this study is an analytic correlation with cross-sectional approach. The population in this study were all 4-5 graders at Mlirip II Elementary School in Mojokerto. The sampling technique is to use total sampling, that is, the entire population is used as a sample, which is 95 respondents. The results of this study are the fit model, namely the model interpreting the influence between duration, frequency and type of gadget on visual acuity. The duration and frequency of gadget usage significantly affect visual acuity. While for this type of gadget is not significant and does not affect visual acuity. If the duration of gadget usage increases, the decrease in visual acuity ratio increases by 5,299 times. If the frequency of gadget usage increases, the ratio of decreased visual acuity increases by 5,986 times. The level of accuracy of the model in this study was 85.3%. Eye disease problems in children can be prevented by early detection to find out the vision status in children supported by eye examination as a measuring instrument, namely snallen card (Snellen card).  

scholarly journals Treatment results of nondamaging retinal laser therapy in diabetic macular edema

2022 ◽  
Vol 14 ◽  
pp. 251584142110632
Author(s):  
Burcu P. Gültekin
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Therapy ◽  
Diabetic Macular Edema ◽  
Intravitreal Injections ◽  
Diabetic Patients ◽  
Efficacy And Safety ◽  
Anti Vegf ◽  
Significant Difference ◽  
The Mean

Background: Subthreshold nondamaging retinal laser therapy (NRT) provides a greater safety profile than conventional laser methods, but more data is needed on the efficacy and safety of subthreshold NRT in diabetic macular edema. Purpose: To evaluate the efficacy and safety of NRT for the treatment of clinically significant macular edema (CSME) that is partially responsive or resistant to intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: This was a retrospective case series study. Fifty eyes of 38 diabetic patients with CSME previously treated with at least 6-monthly intravitreal bevacizumab injections with/without intravitreal Ozurdex therapy were evaluated. The patients received 577-nm yellow wavelength laser therapy with PASCAL laser system (Topcon Medical Laser Systems, Santa Clara, CA, USA). Best-corrected visual acuity (BCVA) and central subfield thickness (CST) were evaluated before and 1, 3, 6, 12 and 24 months after laser treatment. Results: Baseline mean CST was 368.06 ± 86.9 µm. The mean CST values at the 1-, 3-, 6-, 12-, and 24-month visits were 336.93 ± 79.8, 352.40 ± 113.5, 336.36 ± 109.3, 325.10 ± 104 µm, and 310.08 ± 84.7 µm, respectively. The mean CST decreased significantly at the first ( p = 0.002) and second year visits ( p < 0.001) when compared with pretreatment values. Although visual acuity was improved at the first year compared with baseline, this difference was not statistically significant ( p = 0.03). There was no significant difference in visual acuities between pretreatment and posttreatment visits. During 24-month follow-up, while 37 eyes were treated with [mean: 5.7 ± 3.4 (1–14)] intravitreal anti-VEGF injections, 3 eyes were administered single-dose intravitreal steroids. Additional intravitreal injections were not required in 10 (20%) eyes. Conclusion: NRT is effective by itself or in combination with anti-VEGF agents in diabetic macular edema that is partially responsive or resistant to previous intravitreal injections. T role in treating this disorder should be assessed in more detail with prospective controlled studies.

scholarly journals Brentuximab vedotin (Adcetris®) in therapy of system anaplastic large cell lymphoma. Case report

2019 ◽  
Vol 13 (4) ◽  
pp. 54-59
Author(s):  
A. A. Semenova ◽  
P. A. Zeynalova ◽  
M. S. Nikitina ◽  
M. I. Akhmedov
Keyword(s):  
Anaplastic Large Cell Lymphoma ◽  
Clinical Case ◽  
Cell Lymphoma ◽  
Malignant Tumors ◽  
Rare Complication ◽  
Tumor Lysis Syndrome ◽  
Large Cell ◽  
Brentuximab Vedotin ◽  
The Russian Federation ◽  
Large Cell Lymphoma

The introduction of new monoclonal antibodies has become an integral part of the treatment of malignant tumors.Brentuximab vedotin (Adcetris®) – anti-D30 monoclonal antibody conjugated with monomethyluristatin E – has become a new drug registered since February 2016 in the Russian Federation (SGN-35; Adcetris®). The Food and Drug Administration approved the Adcetris® since August 2011 as a therapy for refractory/recurrent Hodgkin’s lymphoma and anaplastic large cell lymphoma.This article describes the clinical case of successful use of Brentuximab vedotin, accompanied by the development of a rare complication – tumor lysis syndrome – in an elderly patient with primary refractory ALK-negative anaplastic large cell lymphoma with massive eosinophilia.

Corneal collagen crosslinking in a child with keratoconus

2021 ◽  
pp. 33-38
Author(s):  
E.Y. Markova ◽  
◽  
G.V. Avakyants ◽  
Keyword(s):  
Visual Acuity ◽  
Clinical Case ◽  
Progressive Decrease ◽  
Collagen Crosslinking ◽  
Modern Methods ◽  
History Of ◽  
Corneal Collagen Crosslinking ◽  
Decrease In Visual Acuity ◽  
Corneal Collagen ◽  
Spectacle Correction

This clinical case describes medical history of the patient who came to the clinic with complaints of progressive decrease in visual acuity and intolerance of spectacle correction. In the following article all methods of diagnostic are fully described. We are also mentioning and discuss aspects of modern methods of diagnostic and treatment of keratoconus in children such as corneal collagen crosslinking. Key words: keratoconus, keratoconus in children, corneal collagen crosslinking.

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