TY - JOUR T1 - COMBINED VITRECTOMY AND INTRAVITREAL DEXAMETHASONE (OZURDEX) SUSTAINED-RELEASE IMPLANT. JF - Retina Y1 - 2016 A1 - Zheng, Andrew A1 - Chin, Eric K A1 - Almeida, David R P A1 - Tsang, Stephen H A1 - Mahajan, Vinit B KW - Adult KW - Aged KW - Aged, 80 and over KW - Combined Modality Therapy KW - Dexamethasone KW - Drug Implants KW - Female KW - Glucocorticoids KW - Humans KW - Intraocular Pressure KW - Intravitreal Injections KW - Macular Edema KW - Male KW - Middle Aged KW - Retinal Vein Occlusion KW - Retrospective Studies KW - Tomography, Optical Coherence KW - Uveitis, Posterior KW - Visual Acuity KW - Vitrectomy KW - Wet Macular Degeneration AB -

PURPOSE: To evaluate the safety and efficacy of combining intravitreal dexamethasone implantation (Ozurdex) with pars plana vitrectomy (PPV).

METHODS: A retrospective review was conducted on cases where Ozurdex injection was performed in the operating room in conjunction with pars plana vitrectomy. Our primary outcome measure was the presence of surgical complications in the perioperative and 3-month postoperative window. We also measured visual acuity, intraocular pressure (IOP), and macular edema at baseline, one, and 3 months after surgery.

RESULTS: Fifteen eyes in 14 cases were reviewed. There were no complications intraoperatively or at 1-month postoperatively. Two patients (2 eyes) with prior retinal detachment developed proliferative vitreoretinopathy and redetachment at 3 months. Visual acuity improved in 7 of 15 eyes, and an average improvement of 2 lines was achieved for the entire cohort. There was no overall change in intraocular pressure although 1 patient developed an increase in intraocular pressure >5 mmHg. Five of 9 patients with baseline macular edema experienced improvement or resolution at 3 months.

CONCLUSION: Intraoperative Ozurdex in combination with PPV may be safe and effective in treating macular edema caused by many different underlying diseases.

VL - 36 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27148836?dopt=Abstract ER - TY - JOUR T1 - Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab. JF - Am J Ophthalmol Y1 - 2013 A1 - Bakall, Benjamin A1 - Folk, James C A1 - Boldt, H Culver A1 - Sohn, Elliott H A1 - Stone, Edwin M A1 - Russell, Stephen R A1 - Mahajan, Vinit B KW - Aged KW - Aged, 80 and over KW - Angiogenesis Inhibitors KW - Antibodies, Monoclonal, Humanized KW - Bevacizumab KW - Drug Resistance KW - Drug Substitution KW - Exudates and Transudates KW - Female KW - Humans KW - Intravitreal Injections KW - Male KW - Middle Aged KW - Postoperative Complications KW - Ranibizumab KW - Receptors, Vascular Endothelial Growth Factor KW - Recombinant Fusion Proteins KW - Retina KW - Retreatment KW - Retrospective Studies KW - Subretinal Fluid KW - Tomography, Optical Coherence KW - Treatment Outcome KW - Vascular Endothelial Growth Factor A KW - Visual Acuity KW - Wet Macular Degeneration AB -

PURPOSE: To evaluate the outcome of intravitreal injection of aflibercept in cases with exudative age-related macular degeneration, (AMD) resistant to injections of bevacizumab or ranibizumab.

DESIGN: Retrospective observational case series.

METHODS: A retrospective chart review at a single institution was conducted to identify patients with exudative AMD and choroidal neovascularization (CNV) in 1 or both eyes resistant to treatment with ranibizumab or bevacizumab who were switched to treatment with at least 3 monthly injections of aflibercept. In total, 36 eyes from 31 patients were included. The demographic data, visual acuities, central macular thickness on optical coherence tomography (OCT), complications, and number of injections were reviewed.

RESULTS: The mean patient age was 79 years (range 60-88). There were 13 male and 18 female patients. The number of prior injections with either bevacizumab or ranibizumab ranged from 6-74. After 3 monthly injections of aflibercept, there was a reduction of either subretinal or intraretinal fluid in 18 of 36 (50.0%) of the treated eyes; the amount of fluid remained stable in 15 eyes (41.7%) and worsened in 3 eyes (8.3%). A significant average decrease was observed for the central macular thickness after 3 injections of 65 μm (P = 2.9 × 10(-6)), with no significant change in visual acuity.

CONCLUSIONS: Aflibercept therapy appears to be beneficial in a subset of patients with neovascular age-related macular degeneration who exhibit recurrent or resistant intraretinal or subretinal fluid following multiple injections with either bevacizumab or ranibizumab.

VL - 156 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23706500?dopt=Abstract ER -