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Comparison of intravitreal aflibercept and dexamethasone implant in the treatment of macular edema associated with diabetic retinopathy or retinal vein occlusion:a Meta-analysis and systematic review

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International Journal of Ophthalmology(English edition) 2022年第9期15卷 1511-1519页

作者： Xuan-Yu Qiu Xiao-Fei Hu Ya-Zhou Qin Ji-Xian Ma Qiu-Ping Liu Li Qin Jing-Ming Li Department of Ophthalmology First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina Vitreoretinal Department Affiliated Eye Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina

·AIM:To compare the efficacy and safety of intravitreal aflibercept with dexamethasone implant in the treatment of macular edema(ME)associated with diabetic retinopathy(DR)or retinal vein occlusion(RVO).·METHODS:A comprehensive search of studies comparing dexamethasone and aflibercept in patients with ME was conducted at PubMed,Embase,and Cochrane central Register of Controlled Trials from the beginning of library to April 16,*** the data including bestcorrected visual acuity(BCVA),central retinal thickness(CRT),number of injections and serious adverse events(SAEs)from the final qualified *** 5.3 software was used for Meta-analysis of the included studies.·RESULTS:Totally 7 studies with 369 eyes were *** causes of ME in the final screening study included RVO and *** with the aflibercept treatment group,the BCVA of the dexamethasone implant treatment group showed no significant difference in the follow-up for 3 mo[mean difference(MD):-0.05,95%confidence interval(CI):-0.11,0.02;P=0.17]and 12 mo(MD:-0.01,95%CI:-0.38,0.37;P=0.98),but it was slightly worse than the aflibercept group at 6 mo(MD:0.12.95%CI:0.03,0.21;P=0.008).In terms of CRT reduction,there was no significant difference between the two groups at 3 mo(MD:-28.14,95%CI:-79.95,23.67;P=0.29),6 mo(MD:27.67,95%CI:-84.89,140.24;P=0.63),and 12 mo(MD:-59.00,95%CI:-127.37,9.37;P=0.09).However,dexamethasone implant had fewer injections,but more adverse events such as elevated intraocular pressure(IOP)and cataract.·CONCLUSION:Intravitreal injection of aflibercept and dexamethasone implant can both effectively increase BCVA and reduce *** with aflibercept,dexamethasone implant is not inferior in improving vision and reducing CRT in the initial treatment period(3 mo)and long-term treatment period(12 mo).Besides,it has fewer injections and more likely to cause elevated IOP and cataract.

关键词： Meta-analysis macular edema dexamethasone aflibercept best-corrected visual acuity central retinal thickness

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Various configuration types of the foveal avascular zone with related factors in normal Chinese adults with or without myopia assessed by swept-source OCT angiography

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International Journal of Ophthalmology(English edition) 2022年第9期15卷 1502-1510页

作者： Yan-Min Dong Hai-Yan Zhu Zhen-Hui Liu Shu-Ying Fu Ke Wang Li-Ping Du Xue-Min Jin Department of Ophthalmology the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina

·AIM:To describe the morphological characteristics of foveal avascular zone(FAZ)in normal Chinese adults with or without myopia by swept-source optical coherence tomography angiography(SS-OCTA)and analyze the possible associated factors.·METHODS:Normal Chinese adults with or without myopia aged between 18 and 60 y were recruited into the *** eye in each individual was randomly selected for scanning using *** parameters,central retinal thickness(CRT)and central choroidal thickness(CCT)were then *** between systemic and ocular variables and FAZ parameters were subsequently *** subgroup analysis based on refractive error was also carried out.·RESULTS:In total,127 eyes out of 127 normal subjects were finally included in the study(mean age29.5±8.22 y,61 males and 66 females).The pattern of FAZ was variable:round configuration in 28 eyes(22%),quadrilateral configuration in 23 eyes(18%),pentagonal configuration in 20 eyes(16%),oval configuration in 15 eyes(12%),triangular configuration in 6 eyes(5%)and irregular configuration in 35 eyes(28%).The mean area of FAZ was0.37±0.12 mm^(2).Females had a larger FAZ(0.41±0.11 mm^(2)vs0.32±0.11 mm^(2))compared with that of males(P<0.01).All myopic individuals showed smaller FAZ area and perimeter compared with that of normal individuals(P<0.01).There was no obvious correlation between age and *** the univariate regression analysis,both axial length(AL)and refractive error were significantly related to FAZ ***,only CRT showed negative correlation with FAZ in the multivariate regression analysis.·CONCLUSION:The pattern of FAZ configuration in normal Chinese adults with or without myopia is highly *** quantitative parameters of FAZ would not only provide details of macular pathophysiology but could possibly contribute as a biomarker in disease staging.

关键词： foveal avascular zone swept-source optical coherence tomography angiography central retinal thickness myopia

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Intravitreal dexamethasone implant in naive and previously treated patients with diabetic macular edema:a retrospective study

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International Journal of Ophthalmology(English edition) 2020年第10期13卷 1597-1605页

作者： Marta Medina-Baena Olga Cejudo-Corbalán Juan Ignacio García-Pulido María Jesús Huertos-Carrillo Eloy Girela-López Hospital Universitario Puerto Real Puerto Real 11510CadizSpain University of Cordoba Cordoba 14004Spain

AIM:To assess the effect of the intravitreal dexamethasone implant(DEX)Ozurdex on the best corrected visual acuity(BCVA)and central retinal thickness(CRT)in patients with diabetic macular edema(DME).METHODS:Totally 43 eyes(24 naive and 19 previously treated)were included in the *** and single-center study involved patients with a clinical diagnosed of DME,who received treatment with DEX implant and had a follow-up of at least 12 *** endpoints included changes in BCVA and ***:At month 12,mean improvement in BCVA from baseline was 20.4±20.8 letters and 6.8±6.9 letters in naive and previously treated patients,respectively(P=0.0132).The naive patients achieved the BCVA improvement significantly faster(2.4±1.5 mo)than the previously treated ones(3.5±2.4 mo,P=0.0298;MannWhitney test).The proportion of eyes gaining≥15 letters was 54.2%and 21.1%in the non-previously treated and previously treated groups,respectively(P=0.0293).CRT was significantly reduced from 484.0±119.8 and 487.5±159.9μm to 272.0±39.2 and 233.5±65.7μm in the naive and previously treated patients,respectively;Pretinal fluid was significantly associated with the proportion of patients achieving a BCVA improvement≥5 letters[HR(95%CI),1.23(1.04 to 1.45),P=0.0145];≥10 letters[HR(95%CI),1.75(1.10 to 2.77),P=0.0182];and≥15 letters[HR(95%CI),2.04(1.03 to 4.02),P=0.0407].Naive patients received less DEX implants throughout the study than the previously treated ones(1.8±0.6 vs 2.3±0.6,P=0.0172,respectively).Totally 9 patients(20.9%)have developed ocular hypertension,which was successfully controlled with topical hypotensive *** the 23 phakic eyes at baseline,5 eyes(21.7%)either had new onset lens opacity or progression of an existing opacity during the study *** of them(2 in the naive group and 2 in the previously treated one)required cataract surgery at months 4,6,6,and 6,***:The results obtained in this

关键词： diabetic macular edema dexamethasone implant Ozurdex visual acuity central retinal thickness naive patients

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Six-year outcomes in neovascular age-related macular degeneration with ranibizumab

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 81-90页

作者： Julie Jacob Heidi Brié Anita Leys Laurent Levecq Filip Mevgaerts Kris Denhaerynck Stefaan Vancayzeele Eline Van Craeyveld Ivo Abraham Karen MacDonald Leuven University Eye Hospital Kapucijnenvoer 33Leuven B-3000Belgium Novartis Pharma Medialaan 40Vilvoorde B-1800Belgium Catholic University of Louvain CHU UCL NamurYvoirB-5530Belgium Medisch Centrum Aarschot Langdorpsesteenweg 129Aarschot B-3200Belgium Matrix45 6159 W Sunset RdTucsonAZ 85743USA Center for Health Outcomes and Pharmacoeconomic Research University of ArizonaTucsonAZ 85721USA

AIM： To evaluate the outcomes of （6y ranibizumab therapy in neovascular age-related macular degeneration （AMD）.METHODS： HELIX was a retrospective, observational effectiveness study using medical records of patients treated in three clinics in Belgium. Patients had neovascular AMD and were initially treated with intravitreal ranibizumab （0.5 mg） between November 1, 2007 and October 31, 2008, had （6y of data available, and were treated on an ongoing, as-needed basis. Outcomes included best-corrected visual acuity （BCVA） and central retinal thickness （CRT）.RESULTS： The sample consisted of 88 eyes from 69 patients. Mean age was 76.4±6.5y, most patients were female （62.3%）. Most eyes （62.5%） were treatment-naive, 33 previously treated eyes had received predominantly other anti-vascular endothelial growth factor agents and verteporfin. Mean baseline BCVA was 57.4±12.7 ETDRS letters and CRT was 291.5±86.1 （m. On average, patients received 20.6±11.9 ranibizumab injections over the （6y. Intervals between injections were on average 12.7±16.1wk. Mean change in BCVA from baseline to last observation for the sample was less than one letter （-0.9±17.3 letters）, with an average loss of -3.2±15.6 letters in previously treated eyes versus a gain of 0.6±18.4 letters in treatment-na？ve eyes. When considering a loss of 〈15 letters over 6y as stabilization of disease, 75.9% of all eyes showed a positive （improvement or stabilization） outcome. Mean change in CRT from baseline to last observation for the sample was -26.9±148.4 （m with the greatest reduction observed in treatment-naive ***： This retrospective study of 69 neovascular AMD patients treated for （6y with ranibizumab demonstrates long-term visual stabilization. In light of the natural evolution of the disease, these data confirm that ranibizumab is effective long-term under real-world conditions of heterogeneity of patients, clinicians, and centers.

关键词： ranibizumab age-related macular degeneration visual acuity central retinal thickness optical coherence tomography visual function, long-term outcome

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