1.Reversal of Early Central Retinal Vein Occlusion by Alleviating Optic Nerve Edema with an Intravitreal Dexamethasone Implant.
Young Joo CHO ; Dong Hyun LEE ; Hae Min KANG ; Min KIM ; Hyoung Jun KOH
Korean Journal of Ophthalmology 2014;28(2):192-193
This case describes the reversal of early central retinal vein occlusion (CRVO) with disc swelling after intravitreal dexamethasone implant (Ozurdex) injection. A 44-year-old female presented with sudden-onset intermittent blurred vision in her left eye. Fundus examination revealed multiple retinal hemorrhages without macular edema (ME). Two weeks later, an increased number of retinal hemorrhages with severe disc swelling were noted with still no sign of ME. An intravitreal dexamethasone implant was injected. Five days later, there were improvements in disc swelling and retinal hemorrhage. One month later, her subjective visual symptoms were completely improved, and fundus examination revealed marked improvement along with almost complete resolution of disc swelling. Intravitreal dexamethasone implant injection may potentially change the natural course of CRVO progression and its various subsequent complications.
Adult
;
Dexamethasone/*administration & dosage
;
Drug Implants
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Female
;
Glucocorticoids/*administration & dosage
;
Humans
;
Intravitreal Injections
;
Papilledema/*drug therapy
;
Retinal Vein/*drug effects
;
Retinal Vein Occlusion/*drug therapy
;
Treatment Outcome
2.Preparation and evaluation of Shedan in situ forming gel based on ocular characteristics.
Guo-hua WANG ; Qi-xia NIE ; Chen ZANG ; Bao-xian ZHANG ; Qiong ZHU
China Journal of Chinese Materia Medica 2015;40(15):2982-2987
To develop an ophthalmic preparation of Shedan, an in situ forming gel was prepared with the formulation containing 18% of poloxamer 407 and 5% of poloxamer 188 by response surface designs plus central composite designs. The rheology results showed that LVE range gamma should limited within 0.5%, Shedan high-frequency region, and the thixotropy recovery time is less than 5 seconds. The phase transition temperature was 33.25 °C according to curve of storage modulus and loss modulus determined by temperature scanning. Surface tension and osmometer of it determined by surface tension meter and dew point osmometer were 36.43 mN · m(-1), and 320.6 mOsm · kg(-1), respectively. Fluorescein sodium was selected as the marker to monitor the corneal residence time, and the results showed that Shedan gel could prolong drug residence for 180 min. In line with zero-order kinetics, releases of muscone and salvianolic acid B in vitro depends on gels erosion. The results of rabbit ocular irritation experiments suggested that Shedan in situ forming gel was biocompatible and nonirritant. In conclusion, a novel Shedan in situ forming gel was developed and characterized for potential drug treatment of retinal vein occlusion.
Animals
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Benzofurans
;
chemistry
;
Cycloparaffins
;
chemistry
;
Female
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Gels
;
chemistry
;
Male
;
Ophthalmic Solutions
;
Poloxamer
;
chemistry
;
Rabbits
;
Retinal Vein Occlusion
;
drug therapy
;
Viscosity
3.Network pharmacology study of mechanism on xuesaitong injection against retinal vein occlusion.
Lin-Li WANG ; Xiao-Ping ZHAO ; Zhuan-You ZHAO ; Xiao-Hui FAN ; Zheng LI
China Journal of Chinese Materia Medica 2014;39(12):2322-2325
Retinal vein occlusion (RVO) is a common clinical disease causing vision loss. Risk factors such as diabetes, atherosclerosis are closely associated with RVO. Xuesaitong injection is used extensively in clinical treatment of RVO, however the mechanism is still unclear. In this study, we investigated the protective effect of Xuesaitong injection on RVO rat model. Using a compound-target network of Xuesaitong on anti-RVO constructed by literature mining, we aim to elucidate the multi-compound, multi-target effect of Xuesaitong injection. Fifteen potential targets of Xuesaitong injection associated with inflammation, angiogenesis, apoptosis, and coagulation were identified in this study. VEGF, IL-1beta and IL-6, three important targets in the compound-target network were further experimentally validated. This study provided experimental evidence for Xuesaitong injection being effective in treating RVO and a network view on its anti-RVO mode of action through a multi-compound and multiple-target mechanism.
Animals
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Drugs, Chinese Herbal
;
administration & dosage
;
Gene Regulatory Networks
;
drug effects
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Humans
;
Interleukin-6
;
genetics
;
metabolism
;
Male
;
Rats
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Rats, Sprague-Dawley
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Retinal Vein Occlusion
;
drug therapy
;
genetics
;
metabolism
4.Treatment of retinal vein occlusion in rabbits with traditional Chinese medicine Fufang XueShuan Tong.
Dan ZHOU ; Wen-Bin WEI ; Cheng-Xun YANG ; Ning DING ; Yan LIU ; Man-Lin HE ; Zhi-Jia HOU ; Jin-Qiong ZHOU
Chinese Medical Journal 2010;123(22):3293-3298
BACKGROUNDRetinal vein occlusion (RVO) is one of the most common causes of visual loss. Many approaches have been tried to treat central retinal vein occlusion (CRVO), and branch retinal vein occlusion (BRVO) with various results. However, there is no defined protocol and limited evidence to support the interventions currently used. The aim of this study was to assess the efficacy of the traditional Chinese medicine Fufang XueShuan Tong (FXST) in treating experimentally created RVO.
METHODSRVO model was first induced in forty-four pigmented rabbits through photocoagulation following injection of rose Bengal. The rabbits were divided into four groups based on the dose of FXST administered (212 mg/kg, 424 mg/kg, 848 mg/kg and control group). The rabbits were observed for four weeks after the procedure, using color fundus photography, fundus fluorescein angiography and electroretinogram examination. Vascular endothelial growth factor (VEGF), interleukin-6 and nitric oxide (NO) levels in the vitreous and histopathologic evaluation were monitored.
RESULTSThe obstructed vessels in the treatment groups reopened or anastomosed faster than those in the control group (P < 0.05). The amplitude of maximum b wave and the oscillatory potential were significantly higher in the treatment groups than in the control group (P < 0.01). At both two weeks and four weeks, VEGF and IL-6 levels in the vitreous were significantly decreased in the treatment groups (P < 0.01), while NO levels were significantly elevated (P < 0.01). At the same time, histopathologic evaluation showed different retinal neuroepithelium structures in the different groups. Immunoreactivity of VEGF was greater in the control group than in the treatment groups.
CONCLUSIONFXST was helpful in reconstructing retinal vessels in the RVO model, protecting retinal structures and improving visual function, and could inhibit the neovascular factor.
Animals ; Drugs, Chinese Herbal ; therapeutic use ; Interleukin-6 ; metabolism ; Nitric Oxide ; metabolism ; Rabbits ; Retinal Vein Occlusion ; drug therapy ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism
5.Systemic lupus erythematosus presenting earlier as retinal vaso-occlusion.
Yong Ho SONG ; Chae Gi KIM ; Si Dong KIM ; Yoon Young KIM ; Jung Yoon CHOE
The Korean Journal of Internal Medicine 2001;16(3):210-213
Retinal vascular lesions are the most common ophthalmologic manifestation of systemic lupus erythematosus (SLE), occurring in 3% to 29% of cases, generally late in the disease. More rare is the severe vaso-occlusive disease, often termed "retinal vasculitis", which includes central retinal artery occlusion, multifocal arteriolar occlusions, extensive capillary nonperfusion and central venous occlusion. Patients with SLE and raised serum concentrations of anticardiolipin antibodies (ACA) have a higher risk of developing occlusive ocular vascular disease. We report a case in which retinal involvement was an earlier manifestation of SLE in a patient without ACA.
Adolescent
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Adrenal Cortex Hormones/administration & dosage
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Angiography
;
Case Report
;
Diagnosis, Differential
;
Female
;
Follow-Up Studies
;
Human
;
Lupus Erythematosus, Systemic/*diagnosis/drug therapy
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Ophthalmoscopy
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Retinal Vein Occlusion/*diagnosis/drug therapy
;
Treatment Outcome
;
Visual Acuity
6.Effects on the contralateral eye after intravitreal bevacizumab and ranibizumab injections: a case report.
Annals of the Academy of Medicine, Singapore 2008;37(7):591-593
INTRODUCTIONWe report a case in which intravitreal bevacizumab and ranibizumab appeared to have effects in the contralateral, uninjected eye.
CLINICAL PICTUREAn 83-year-old man with macular oedema from branch retinal vein occlusion (BRVO) in the right eye developed neovascular macular degeneration in the left eye. Intravitreal bevacizumab in the left eye improved macular oedema in the right eye temporarily before it recurred. Subsequently, intravitreal ranibizumab in the left eye also resulted in significant reduction of macular oedema in the right eye.
OUTCOMEVision and macular oedema in the right eye improved.
CONCLUSIONBevacizumab and ranibizumab may have therapeutic effects in the uninjected eye, possibly because they may escape from the eye into the systemic circulation.
Aged, 80 and over ; Angiogenesis Inhibitors ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Eye ; drug effects ; Humans ; Injections ; Macular Edema ; drug therapy ; etiology ; Male ; Ranibizumab ; Retinal Vein Occlusion ; complications ; Treatment Outcome ; Vitreous Body
7.Bevacizumab and Triamcinolone for Branch Vein Occlusion.
Korean Journal of Ophthalmology 2010;24(3):192-193
No abstract available.
Aged
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Angiogenesis Inhibitors/*administration & dosage
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Antibodies, Monoclonal/*administration & dosage
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Female
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Glucocorticoids/*administration & dosage
;
Humans
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Injections, Intraocular
;
Macular Edema/*drug therapy/etiology
;
Male
;
Middle Aged
;
Retinal Vein Occlusion/*complications
;
Triamcinolone Acetonide/*administration & dosage
;
Vitreous Body
8.Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection.
Mete GULER ; Burak BILGIN ; Musa CAPKIN ; Ali SIMSEK ; Semsettin BILAK
Korean Journal of Ophthalmology 2015;29(3):190-194
PURPOSE: To compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures. METHODS: Seventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/worst pain). The average of these scores was used as the primary outcome. RESULTS: The VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 +/- 0.91 (range, 0 to 3) and 1.94 +/- 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and > or =65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients > or =65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078). CONCLUSIONS: Thirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.
Aged
;
Aged, 80 and over
;
Angiogenesis Inhibitors/*administration & dosage
;
Antibodies, Monoclonal, Humanized/*administration & dosage
;
Bevacizumab/*administration & dosage
;
Diabetic Retinopathy/drug therapy/physiopathology
;
Female
;
Humans
;
*Intravitreal Injections
;
Macular Degeneration/drug therapy/physiopathology
;
Macular Edema/drug therapy/physiopathology
;
Male
;
Middle Aged
;
Pain Measurement
;
Ranibizumab/*administration & dosage
;
Retinal Vein Occlusion/drug therapy/physiopathology
9.Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection.
Mete GULER ; Burak BILGIN ; Musa CAPKIN ; Ali SIMSEK ; Semsettin BILAK
Korean Journal of Ophthalmology 2015;29(3):190-194
PURPOSE: To compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures. METHODS: Seventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/worst pain). The average of these scores was used as the primary outcome. RESULTS: The VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 +/- 0.91 (range, 0 to 3) and 1.94 +/- 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and > or =65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients > or =65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078). CONCLUSIONS: Thirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.
Aged
;
Aged, 80 and over
;
Angiogenesis Inhibitors/*administration & dosage
;
Antibodies, Monoclonal, Humanized/*administration & dosage
;
Bevacizumab/*administration & dosage
;
Diabetic Retinopathy/drug therapy/physiopathology
;
Female
;
Humans
;
*Intravitreal Injections
;
Macular Degeneration/drug therapy/physiopathology
;
Macular Edema/drug therapy/physiopathology
;
Male
;
Middle Aged
;
Pain Measurement
;
Ranibizumab/*administration & dosage
;
Retinal Vein Occlusion/drug therapy/physiopathology
10.Progression of Impending Central Retinal Vein Occlusion to the Ischemic Variant Following Intravitreal Bevacizumab.
Korean Journal of Ophthalmology 2010;24(3):179-181
A 60-year-old woman who had experienced two episodes of amaurosis fugax in her right eye presented with vision loss. Two weeks earlier, at a private clinic, she was diagnosed with impending central retinal vein occlusion (CRVO) of the right eye and received an intravitreal injection of bevacizumab. Two weeks after this injection she was diagnosed with ischemic CRVO. At 11-weeks post-presentation, extremely ischemic features were observed with fluorescein angiographic findings of severe vascular attenuation and extensive retinal capillary obliteration. At 22-weeks post-presentation she was diagnosed with neovascular glaucoma; she experienced no visual improvement over the following several months.
Antibodies, Monoclonal/*administration & dosage
;
Disease Progression
;
Female
;
Fluorescein Angiography
;
Glaucoma, Neovascular/complications
;
Humans
;
Injections, Intraocular
;
Ischemia/diagnosis/*etiology/physiopathology
;
Middle Aged
;
Retinal Vein Occlusion/*complications/*drug therapy/physiopathology
;
*Retinal Vessels
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Vascular Endothelial Growth Factor A/antagonists & inhibitors
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Visual Acuity/drug effects
;
Vitreous Body