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[PMID]:29292948
[Au] Autor:Bro T
[Ad] Endereço:Region Jönköpings län - Ögonmottagningen Höglandssjukhuset Eksjö, Sweden Region Jönköpings län - Ögonmottagningen Höglandssjukhuset Eksjö, Sweden.
[Ti] Título:Öga för öga? - Olika syn på förskrivning ¼off label« ger stora regionala skillnader i behandling vid sjukdom i gula fläcken..
[So] Source:Lakartidningen;114, 2017 Nov 28.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:An eye for an eye? Lack of consensus in off-label use of medications leads to major regional differences in medical costs for the treatment of wet AMD in Sweden. The three ocular VEGF inhibitors available in Sweden have similar efficacy and safety. Only two are however registered for wet AMD. The remaining, Avastin, is developed for oncological indications, but used for wet AMD in many parts of the world. Major regional differences exist in the use of Avastin in Sweden. In the three largest cities, it is not used at all. As a consequence, the yearly drug cost for a patient with wet AMD differs from 2 000 to 44 000 SEK. As this difference is not compatible with the Swedish law of "care on equal terms", increased efforts should be made to obtain a national consensus.
[Mh] Termos MeSH primário: Inibidores da Angiogênese/uso terapêutico
Bevacizumab/uso terapêutico
Degeneração Macular Exsudativa
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/administração & dosagem
Inibidores da Angiogênese/economia
Bevacizumab/administração & dosagem
Bevacizumab/economia
Custos de Medicamentos
Seres Humanos
Injeções Intravítreas
Uso Off-Label/economia
Suécia
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Degeneração Macular Exsudativa/tratamento farmacológico
Degeneração Macular Exsudativa/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A); 2S9ZZM9Q9V (Bevacizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29378528
[Au] Autor:Elwes F; Borooah S; Aspinall P; Sim PY; Loo CY; Armbrecht AM; Dhillon B; Cackett P
[Ad] Endereço:Royal Infirmary of Edinburgh, Edinburgh, UK.
[Ti] Título:Clinical outcomes of switching to aflibercept using a pro re nata treatment regimen in patients with neovascular age-related macular degeneration who incompletely responded to ranibizumab.
[So] Source:BMC Ophthalmol;18(1):20, 2018 Jan 30.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To assess the effect of switching patients previously incompletely treated with ranibizumab (RBZ) to aflibercept (AFL) using a pro re nata (PRN) treatment strategy in neovascular age-related macular degeneration (nvAMD). METHODS: A retrospective case series was conducted on patients who had persistent or recurrent intra- and/or sub-retinal fluid treated initially with RBZ and subsequently switched to AFL. The main outcome measures were best corrected visual acuity (BCVA) and central retinal thickness (CRT) measured at different stages of the study. Friedman analysis of variance and Wilcoxon test were used to examine differences in BCVA and CRT. RESULTS: Two hundred and seven eyes from 182 patients were included. BCVA and CRT improved significantly initially following 3 RBZ injections with a mean gain of 3.7 letters (p < 0.001) and a mean loss of 69 µm (p < 0.001) respectively. Following PRN RBZ therapy and immediately prior to switching to AFL (mean 129 weeks), there was a mean loss of 6.7 letters (p < 0.001) BCVA and a mean gain of 24 µm (p < 0.001) CRT. AFL loading resulted in a mean improvement of 0.7 letters (p = 0.28) BCVA and 55 µm (p < 0.001) CRT. At final follow-up following AFL PRN therapy (mean 85 weeks), there was a mean loss of 8.9 letters (p < 0.001) BCVA and a mean gain of 12 µm (p < 0.05) CRT. CONCLUSION: AFL loading resulted in a significant anatomical improvement but no significant change in visual acuity. However, the benefits of switching were gradually lost over time with AFL PRN dosing despite an increased injection rate when compared with RBZ PRN treatment. TRIAL REGISTRATION: Not applicable.
[Mh] Termos MeSH primário: Protocolos Clínicos
Substituição de Medicamentos/métodos
Ranibizumab/administração & dosagem
Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem
Proteínas Recombinantes de Fusão/administração & dosagem
Acuidade Visual
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Inibidores da Angiogênese/administração & dosagem
Feminino
Seguimentos
Seres Humanos
Injeções Intravítreas
Masculino
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Estudos Retrospectivos
Fatores de Tempo
Tomografia de Coerência Óptica
Resultado do Tratamento
Degeneração Macular Exsudativa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0688-3


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[PMID]:29184013
[Au] Autor:Mackenzie JW
[Ad] Endereço:Royal Berkshire Hospital, Reading RG1 5AN, UK.
[Ti] Título:Time to ask patients about drugs for macular degeneration.
[So] Source:BMJ;359:j5426, 2017 11 28.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Inibidores da Angiogênese/economia
Bevacizumab/economia
Degeneração Macular/tratamento farmacológico
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/administração & dosagem
Inibidores da Angiogênese/uso terapêutico
Bevacizumab/administração & dosagem
Bevacizumab/uso terapêutico
Análise Custo-Benefício/legislação & jurisprudência
Seres Humanos
Injeções Intravítreas
Degeneração Macular/economia
Degeneração Macular Exsudativa/economia
[Pt] Tipo de publicação:LETTER
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 2S9ZZM9Q9V (Bevacizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5426


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[PMID]:29390407
[Au] Autor:Gao M; Liu L; Liang X; Yu Y; Liu X; Liu W
[Ad] Endereço:Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University.
[Ti] Título:Influence of vitreomacular interface on anti-vascular endothelial growth factor treatment outcomes in neovascular age-related macular degeneration: A MOOSE-compliant meta-analysis.
[So] Source:Medicine (Baltimore);96(50):e9345, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to evaluate the influence of vitreomacular interface configuration on treatment outcomes after intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (AMD).The Pubmed, Embase, and Cochrane Central Register of Controlled Trials databases were searched to identify relevant prospective or retrospective studies that evaluate the influence of vitreomacular adhesion (VMA) or vitreomacular traction (VMT) on functional and anatomical outcomes in neovascular AMD patients treated with anti-VEGF agents. The outcome measures were the mean change in best corrected visual acuity (BCVA) from baseline, the mean change in central macular thickness (CMT) from baseline, and the mean injection numbers of anti-VEGF treatment from baseline.In total, 9 studies were selected for this meta-analysis, including 2156 eyes (404 eyes in the VMA/VMT group and 1752 eyes in the non-VMA/VMT group). In neovascular AMD patients treated with anti-VEGF agents, the VMA/VMT group was associated with poorer visual acuity gains and CMT reductions at 1 year (WMD [95% CI], -6.17 [-11.91, -0.43] early treatment diabetic retinopathy study (ETDRS) letters, P = .04; WMD [95% CI], 22.19 [2.01, 42.38] µm, P = .03, respectively). There was no significant difference between 2 groups in the mean BCVA change and the CMT change over 2 years (WMD [95% CI], -5.59 [-21.19, 10.01] ETDRS letters, P = .48; WMD [95% CI], 6.56 [-24.78, 37.90] µm, P = .68, respectively). There was no significant difference in the mean injection numbers between 2 groups at 1 year (WMD [95% CI], 0.36 [-0.19, 0.90], P = .21), whereas the VMA/VMT group had a significantly higher mean injection numbers over 2 years (WMD [95% CI], 1.14 [0.11, 2.16], P = .03).The limited evidence suggests that vitreomacular interface configuration have a significant influence on the visual acuity gain and CMT reduction at 1 year, injection numbers at 2 years in neovascular AMD patients treated with anti-VEGF agents. However, the results of this meta-analysis should be interpreted with caution because of the heterogeneity among study designs. Eyes with VMA/VMT on optical coherence tomography at baseline may require more intensive treatment with decreased response to anti-VEGF agents.
[Mh] Termos MeSH primário: Macula Lutea/patologia
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Corpo Vítreo/patologia
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Fatores Etários
Barreira Hematorretiniana
Seres Humanos
Injeções Intravítreas
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Vascular Endothelial Growth Factor A)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009345


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[PMID]:29385989
[Au] Autor:Giocanti-Aurégan A; Chbat E; Darugar A; Morel C; Morin B; Conrath J; Devin F
[Ad] Endereço:Department Ophthalmology, Avicenne Hospital, DHU Vision and Handicaps, 125 rue de Stalingrad, 93000, Bobigny, France. audreygiocanti@yahoo.fr.
[Ti] Título:Influence of new societal factors on neovascular age-related macular degeneration outcomes.
[So] Source:BMC Ophthalmol;18(1):22, 2018 Feb 01.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To assess the impact of unstudied societal factors for neovascular age-related macular degeneration (nAMD) on functional outcomes after anti-VEGFs. METHODS: Charts of 94 nAMD patients treated in the Monticelli-Paradis Centre, Marseille, France, were reviewed. Phone interviews were conducted to assess societal factors, including transportation, living status, daily reading and social security scheme (SSS). Primary outcome was the impact of family support and disease burden on functional improvement in nAMD. RESULTS: Between baseline and month 24 (M24), 42.4% of the variability in best-corrected visual acuity (BCVA) was explained by the cumulative effect of the following societal factors: intermittent out-patient follow-up, marital status, daily reading, transportation type, commuting time. No isolated societal factor significantly correlated with ETDRS BCVA severity at M24. A trend to correlation was observed between the EDTRS score at M24 and the SSS (P = 0.076), economic burden (P = 0.075), time between diagnosis and treatment initiation (P = 0.070). A significant correlation was found for the disease burdensome on the patient (P = 0.034) and low vision rehabilitation (P = 0.014). CONCLUSIONS: Societal factors could influence functional outcomes in nAMD patients treated with anti-VEGFs. They could contribute to the healing process or sustain disease progression.
[Mh] Termos MeSH primário: Efeitos Psicossociais da Doença
Cobertura do Seguro
Qualidade de Vida/psicologia
Degeneração Macular Exsudativa/economia
Degeneração Macular Exsudativa/psicologia
[Mh] Termos MeSH secundário: Idoso
Inibidores da Angiogênese/administração & dosagem
Feminino
Seres Humanos
Injeções Intravítreas
Masculino
Ranibizumab/administração & dosagem
Estudos Retrospectivos
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Baixa Visão/reabilitação
Acuidade Visual/fisiologia
Degeneração Macular Exsudativa/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); ZL1R02VT79 (Ranibizumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0690-9


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[PMID]:29177891
[Au] Autor:Ioanna Z; Christian S; Christian G; Daniel B
[Ad] Endereço:Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
[Ti] Título:Plasma levels of hypoxia-regulated factors in patients with age-related macular degeneration.
[So] Source:Graefes Arch Clin Exp Ophthalmol;256(2):325-332, 2018 Feb.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Various hypoxia-related proteins are differentially expressed in the retina and secreted to the vitreous and/or aqueous humor of patients affected by dry or neovascular age-related macular degeneration (nAMD). To determine whether these conditions alter concentrations of cytokines also in the systemic circulation, we measured plasma levels of six hypoxia-related proteins. METHODS: Plasma was prepared from EDTA blood that was collected from patients affected by dry AMD (n = 5), nAMD (n = 11), proliferative diabetic retinopathy (PDR; n = 9), and patients with an epiretinal membrane (ERM; n = 11). ERM samples served as negative controls, PDR samples as positive controls. Protein concentrations of vascular endothelial growth factor (VEGF), erythropoietin (EPO), angiopoietin-like 4 (ANGPTL4), placental growth factor (PlGF), tumor necrosis factor alpha (TNF-α), and pigment epithelium-derived factor (PEDF) were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: The concentration of PlGF was significantly increased in plasma of patients affected by nAMD. Although no statistically significant differences were found for EPO, ANGPTL4, PlGF, TNF-α, and PEDF, the mean concentration of VEGF was lowest in the nAMD group. Plasma concentrations of the six factors did not correlate with gender or age of patients. CONCLUSIONS: nAMD may increase plasma concentrations of PlGF, making it a candidate as a biomarker for the neovascular form of AMD. Other factors, however, were not differentially regulated, suggesting that their systemic concentrations are not generally increased in hypoxia-related retinal diseases.
[Mh] Termos MeSH primário: Proteína 4 Semelhante a Angiopoietina/sangue
Citocinas/sangue
Eritropoetina/sangue
Proteínas do Olho/sangue
Hipóxia/sangue
Proteínas de Membrana/sangue
Fatores de Crescimento Neural/sangue
Serpinas/sangue
Degeneração Macular Exsudativa/sangue
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Hipóxia/etiologia
Macula Lutea/patologia
Masculino
Meia-Idade
Tomografia de Coerência Óptica
Fator A de Crescimento do Endotélio Vascular/sangue
Degeneração Macular Exsudativa/complicações
Degeneração Macular Exsudativa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (ANGPTL4 protein, human); 0 (Angiopoietin-like 4 Protein); 0 (Biomarkers); 0 (Cytokines); 0 (Eye Proteins); 0 (Membrane Proteins); 0 (Nerve Growth Factors); 0 (PIGF protein, human); 0 (Serpins); 0 (Vascular Endothelial Growth Factor A); 0 (pigment epithelium-derived factor); 11096-26-7 (Erythropoietin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3846-z


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[PMID]:28465248
[Au] Autor:Klingeborn M; Dismuke WM; Bowes Rickman C; Stamer WD
[Ad] Endereço:Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC 27710, USA.
[Ti] Título:Roles of exosomes in the normal and diseased eye.
[So] Source:Prog Retin Eye Res;59:158-177, 2017 Jul.
[Is] ISSN:1873-1635
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Exosomes are nanometer-sized vesicles that are released by cells in a controlled fashion and mediate a plethora of extra- and intercellular activities. Some key functions of exosomes include cell-cell communication, immune modulation, extracellular matrix turnover, stem cell division/differentiation, neovascularization and cellular waste removal. While much is known about their role in cancer, exosome function in the many specialized tissues of the eye is just beginning to undergo rigorous study. Here we review current knowledge of exosome function in the visual system in the context of larger bodies of data from other fields, in both health and disease. Additionally, we discuss recent advances in the exosome field including use of exosomes as a therapeutic vehicle, exosomes as a source of biomarkers for disease, plus current standards for isolation and validation of exosome populations. Finally, we use this foundational information about exosomes in the eye as a platform to identify areas of opportunity for future research studies.
[Mh] Termos MeSH primário: Exossomos/fisiologia
Retina/metabolismo
Degeneração Macular Exsudativa/metabolismo
[Mh] Termos MeSH secundário: Comunicação Celular
Diferenciação Celular
Seres Humanos
Retina/patologia
Degeneração Macular Exsudativa/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:29177890
[Au] Autor:Sakurada Y; Kikushima W; Sugiyama A; Yoneyama S; Tanabe N; Matsubara M; Iijima H
[Ad] Endereço:Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi Prefecture, Japan. sakurada@yamanashi.ac.jp.
[Ti] Título:AREDS simplified severity scale as a predictive factor for response to aflibercept therapy for typical neovascular age-related macular degeneration.
[So] Source:Graefes Arch Clin Exp Ophthalmol;256(1):99-104, 2018 Jan.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate whether the severity of the condition in the untreated fellow eye is a predictive factor for the response to intravitreal aflibercept injection (IAI) for exudative age-related macular degeneration (AMD). METHODS: A retrospective medical chart review was conducted for 88 patients with treatment-naïve neovascular AMD, who were initially treated with three monthly IAIs, followed by monthly monitoring and re-injection as needed for at least 12 months. Subjects were classified into three groups according to the severity of the condition in their untreated eye, based on the severity scale in the Age-Related Eye Disease Study (AREDS): group 0, AREDS severity level 1 (no drusen); group 1, AREDS severity level 2 or 3 (any drusen); group 2, AREDS severity level 4 (advanced AMD). Genotyping was performed in all cases for ARMS2 A69S and CFH I62V. RESULTS: Fellow-eye severity was associated with age and the risk variant of ARMS2 A69S (P = 0.005 and 0.001, respectively). Although best-corrected visual acuity (BCVA) had improved significantly after 12 months in all groups, this improvement was significantly greater in group 0 than in the other groups (P = 0.008). The retreatment-free period was also significantly longer for group 0 than for the other groups (P = 0.016), and the number of additional injections was significantly associated with fellow-eye severity (P = 0.007). CONCLUSIONS: Fellow-eye severity was associated with treatment response in terms of visual improvement and retreatment and may be a predictive factor for response to IAI for neovascular AMD.
[Mh] Termos MeSH primário: Macula Lutea/patologia
Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem
Proteínas Recombinantes de Fusão/administração & dosagem
Tomografia de Coerência Óptica/métodos
Acuidade Visual
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Injeções Intravítreas
Masculino
Prognóstico
Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores
Retratamento
Estudos Retrospectivos
Índice de Gravidade de Doença
Fatores de Tempo
Degeneração Macular Exsudativa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Recombinant Fusion Proteins); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3847-y


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[PMID]:29177712
[Au] Autor:Querques G; Cicinelli MV; Rabiolo A; de Vitis L; Sacconi R; Querques L; Bandello F
[Ad] Endereço:Department of Ophthalmology, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy. giuseppe.querques@hotmail.it.
[Ti] Título:Laser photocoagulation as treatment of non-exudative age-related macular degeneration: state-of-the-art and future perspectives.
[So] Source:Graefes Arch Clin Exp Ophthalmol;256(1):1-9, 2018 Jan.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To give an updated review of laser approaches to non-exudative age-related macular degeneration (AMD). METHODS: PubMed and Medline database searches were carried out using the terms "laser" and "photocoagulation" associated with "age-related macular degeneration", and latest publications up to May 2017 have been reviewed. Moreover, the design of an ongoing single-center, non-randomized, phase I-II, pilot study, the PASCAL-GA trial, coordinated by F. Bandello, MD and G. Querques, MD from the IRCCS Ospedale San Raffaele, is described. RESULTS: Either standard or subthreshold laser strategies have been tried to induce regression of distinct phenotypes of AMD, as reticular pseudodrusen (RPD), nascent geographic atrophy (nGA), and drusen-associated geographic atrophy (DAGA), with heterogeneous results. The aim of the PASCAL-GA protocol is to assess if subthreshold laser can restore the retinal pigment epithelium function in eyes with RPD and nGA offering a protective effect against extensive GA. CONCLUSIONS: New-generation medical and surgical approaches, including subthreshold laser photocoagulation, may have some success in downstaging AMD.
[Mh] Termos MeSH primário: Fotocoagulação a Laser/métodos
Acuidade Visual
Degeneração Macular Exsudativa/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Projetos Piloto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3848-x


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[PMID]:29220371
[Au] Autor:Hanemoto T; Hikichi Y; Kikuchi N; Kozawa T
[Ad] Endereço:Department of Ophthalmology, Kozawa Eye Hospital, Ibaraki, Japan.
[Ti] Título:The impact of different anti-vascular endothelial growth factor treatment regimens on reducing burden for caregivers and patients with wet age-related macular degeneration in a single-center real-world Japanese setting.
[So] Source:PLoS One;12(12):e0189035, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the burden associated with different anti-vascular endothelial growth factor (VEGF) treatment strategies for wet age-related macular degeneration (wAMD) in a real-word setting in Japan. METHODS: Single-center, cross-sectional survey of caregivers of patients with wAMD performed in a hospital in Mito-City, a rural area in Japan. Caregiver burden was evaluated using the Burden Index of Caregivers (BIC-11), and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale. Retrospective medical chart review was conducted to monitor resource use and visual acuity outcomes in patients. The productivity loss of caregivers accompanying patients on hospital visits was estimated using the human capital method. RESULTS: Seventy-one patient-caregiver pairs were included. Most caregivers were female (74.6%), spouse/partner (54.9%), employed (46.5%), and the primary caregiver (85.9%). Patients received anti-VEGF treatment as follows: treat-and-extend (T&E; n = 42), switch (from as-needed [PRN] to T&E; n = 18), PRN (n = 10), and other (n = 1). Caregiver-related burden (total BIC-11 scores) were 4.29 (T&E) 4.60 (PRN), and 5.33 (switch) (p = NS). The mean number of hospital visits was lower with T&E than PRN (7.88 vs. 14.0 [p = 0.00674] in year 1 and 5.68 vs. 9.0 in year 2). For patients who switched from PRN to T&E, the mean number of hospital visits decreased from 13.21 to 7.43 (p<0.0001) in the first year after switch. The productivity loss associated with accompanying patients to the hospital was lower for caregivers of patients receiving T&E than PRN (mean differences: 74,456.04 JPY [p = 0.00284] in year 1 and 40843.14 JPY in year 2), and was also reduced for caregivers of patients who switched from PRN to T&E. CONCLUSION: wAMD treatment with anti-VEGF agents via T&E reduced hospital visits compared with PRN, where associated monitoring visits are necessary to provide good patient outcomes. T&E was associated with a reduction trend in caregiver burden, including time and costs.
[Mh] Termos MeSH primário: Inibidores da Angiogênese/uso terapêutico
Cuidadores
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
Degeneração Macular Exsudativa/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Estudos Transversais
Feminino
Seres Humanos
Japão
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189035



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