These data suggest that transvitreal endoresection of posterior uveal melanoma is an acceptable management option to conserve the globe and functional vision in selected patients. Distant metastasis is an infrequent event in this modality of treatment.

Bevacizumab, an anti-VEGF antibody, has demonstrated trustworthy effects in treatment of retinal and choroidal neovascularization that both are crucial sight threatening conditions. However, the weak point is the short half-life of the drug in vitreous which necessitates frequent intravitreal injections. Accordingly employing controlled-release drug delivery systems such as polymeric nanoparticles (NPs) has been suggested. In this study albuminated-PLGA-NPs containing bevacizumab were prepared and studied intended for reducing the number of injections. NPs were formulated by double-emulsion method and a single dose of NPs was intravitreally injected to rabbits. The drug concentrations in vitreous and aqueous humor were assayed in different time intervals using ELISA and intraocular pharmacokinetic parameters were calculated. Moreover, coumarin-6 loaded albuminated-PLGA-NPs were employed to evaluate the distribution and persistence of the NPs in the posterior segment. Results revealed that the bevacizumab vitreous concentration maintained above 500 ng mL(-1) for about 8 weeks and 3.3 times elevation was observed in the drug vitreous MRT compared with the control. According to coumarin-6 NP tests, fluorescence emissions in posterior tissues were observed for 56 days which confirmed the nanoparticles persistence in ocular tissues during the test span. Therefore our prepared formulation may offer improvements in treatment of eye posterior segment neovascularization.

The authors observed a relatively high incidence of ROP in this series, especially its severe form affecting relatively more mature infants, which merits further investigation. GA, BW and oxygen therapy were independent ROP determinants.

BackgroundTo evaluate the efficacy of triple therapy consisting of single-session photodynamic therapy (PDT), intravitreal bevacizumab (IVB) and intravitreal triamcinolone (IVT) as initial pulse therapy followed by repeat intravitreal bevacizumab injections for maintenance treatment in neovascular age-related macular degeneration (AMD).MethodsIn a prospective interventional case series, patients with subfoveal choroidal neovascularization (CNV) secondary to AMD underwent pulse therapy with single-session PDT according to the standard protocol followed by 1.25 mg IVB and 2 mg IVT 48 hours later. Best corrected visual acuity (BCVA) was assessed and optical coherence tomography (OCT) and fluorescein angiography (FA) were performed prior to treatment. BCVA and OCT measurements were repeated at 6 week intervals and FA was obtained after 12 weeks and when necessary thereafter. Repeat injections of IVB were performed based on fluorescein angiographic evidence of CNV leakage.ResultsThis series included 17 eyes of 17 patients with mean age of 67.6 ± 7.2 years. Mean follow up duration was 50.4 ± 15.5 weeks. Mean BCVA prior to treatment was 0.74 ± 0.33 logMAR which improved to 0.52 ± 0.36 logMAR after 12 weeks (P = 0.012) and 0.41 ± 0.38 logMAR after 24 weeks (P = 0.001). Mean pretreatment central macular thickness (CMT) was 395 ± 181μ which was significantly reduced to 217 ± 69μ (P = 0.005), 231 ± 79μ (P = 0.028) and 221 ± 87μ (P = 0.05) six, twelve and twenty-four weeks after initial treatment respectively. Visual acuity improvement and CMT reduction was maintained during the follow-up period. IVB injections were repeated once, twice and three times in 10, 7 and 2 eyes at a mean interval of 20.2 ± 10.1, 19 ± 13.7 and 15 ± 1.4 weeks after initial therapy, respectively.ConclusionInitial pulse triple therapy consisting of single-session PDT combined with IVB and IVT improves vision and reduces CMT in neovascular AMD. Repeat IVB injections maintain the visual gain from the initial combination therapy.

<H4>BACKGROUND AND OBJECTIVE</H4> <P>To evaluate the efficacy and safety of the pars plana Ahmed glaucoma valve (New World Medical, Inc., Rancho Cucamonga, CA) implant combined with pars plana vitrectomy and panretinal photocoagulation for the management of neovascular glaucoma in patients with vitreous hemorrhage.</P> <H4>PATIENTS AND METHODS</H4> <P>The records of 18 eyes of 17 consecutive patients with neovascular glaucoma who had undergone pars plana vitrectomy and pars plana Ahmed valve implant were evaluated. The patients were observed for a mean time of 14.2 months (range, 6 to 28 months).</P> <H4>RESULTS</H4> <P>Mean preoperative intraocular pressure with oral and two or three topical antiglaucoma medications was 53.3 ± 10 mm Hg, and mean postoperative intraocular pressure without oral antiglaucoma medications was 16.3 ± 7.1 mm Hg (<I>P</I> < .0001) at the final visit. Overall success rate was 72.2%, defined as an intraocular pressure of 5 to 21 mm Hg with or without antiglaucoma medication. A postoperative hypertensive phase occurred in 7 patients (38.8%), of which all but one responded to medical therapy. Visual acuity was stabilized or improved in 77.7% of the eyes. There was one case of each of the following adverse events: mild vitreous cavity hemorrhage, hypotony, choroidal effusion, epiretinal membrane, corneal edema, and corneal ulcer. Two cases developed phthisis bulbi and lost light perception.</P> <H4>CONCLUSIONS</H4> <P>Pars plana vitrectomy and Ahmed valve implantation seems to be a viable surgical modality in the management of neovascular glaucoma and coexisting posterior segment pathology with a relatively low rate of serious permanent postoperative complications.</P> <P>[<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:292- 300.]</P> <H4>AUTHORS</H4> <P>From the Eye Research Center (HF, FH, S-FM, AK, MR-E), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; and the Department of Ophthalmology (GAP), University of Arizona College of Medicine, Tucson, Arizona.</P> <P>Accepted for publication January 20, 2007.</P> <P>Address correspondence to Gholam A. Peyman, MD, University of Arizona College of Medicine, 655 N. Alvernon Way, Suite 108, Tucson, AZ 85711.</P>

Mandated therapy with IVB improved best-corrected visual acuity and decreased central macular thickness in neovascular age-related macular degeneration. The addition of low-dose IVT temporarily increased the therapeutic efficacy in the early postinjection period and resulted in fewer requirements for repeat IVB injections at 6 months; however, final levels of visual improvement were comparable in the 2 study groups.

No abstract

No abstract