PURPOSE: To report the results of switching treatment to vascular endothelial growth factor (VEGF) Trap-Eye (aflibercept) in neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) refractory to anti-VEGF (ranibizumab and bevacizumab). METHODS: This is a retrospective study involving 32 eyes from 29 patients; 18 were cases of neovascular AMD and 14 were cases of PCV. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of spectral-domain optical coherence tomography were evaluated. RESULTS: BCVA and CMT improved from 0.58 to 0.55 (p = 0.005) and from 404 to 321 microm (p < 0.001), respectively, after switching to aflibercept. The 14 eyes that received 6 or more aflibercept injections remained stable at 0.81 to 0.81 and 321 to 327 microm (p = 1.0, 0.29), respectively, after 3 aflibercept injections. The 10 eyes that received 3 or more bevacizumab injections after 3 or more aflibercept injections worsened, from 0.44 to 0.47 and from 332 to 346 microm (p = 0.06, 0.05), respectively. The results showed similar improvement of BCVA and CMT in neovascular AMD and PCV. CONCLUSIONS: Aflibercept seems to be effective for improvement and maintenance of BCVA and CMT for neovascular AMD and PCV refractory to anti-VEGF. Switching from aflibercept back to bevacizumab treatment may not be a proper strategy.
Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/administration & dosage ; Choroid/*blood supply ; Choroid Diseases/complications/diagnosis/*drug therapy ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Ranibizumab/administration & dosage ; Receptors, Vascular Endothelial Growth Factor/*administration & dosage ; Recombinant Fusion Proteins/*administration & dosage ; Retinal Neovascularization/complications/diagnosis/*drug therapy ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; *Visual Acuity ; Wet Macular Degeneration/diagnosis/*drug therapy/etiology

PURPOSE: To compare the surgical outcomes between sequential -and simultaneous combined vitrectomy and Ahmed valve implantation (AVI) in neovascular glaucoma (NVG) patients with vitreous hemorrhage. METHODS: The medical records of 22 eyes of 22 patients, who had NVG with vitreous hemorrhage treated with vitrectomy and AVI, were retrospectively reviewed. Surgical success was defined as 6 mm Hg < or = IOP < or = 21 mm Hg, with or without the use of antiglaucoma medications and failure was defined as cases that had no light perception during the study period and which required additional surgery. The authors of the present study evaluated the surgical success rates and factors affecting surgical success between sequential and simultaneous combined vitrectomy and AVI. RESULTS: The cumulative surgical success rate by the Kaplan-Meier survival analysis was 45% in sequential combined vitrectomy and AVI (group1), and 18% in combined vitrectomy and AVI (group 2), at 1 year, a significant difference. Preoperative panretinal photocoagulation was related to surgical success rate by Cox's regression model analysis. CONCLUSIONS: Simultaneous combined vitrectomy and AVI is considered as a primary procedure in a patient who has NVG with vitreous hemorrhage. Panretinal photocoagulation in the preoperative periods, is thought to increase the surgical success rate.
Eye ; Glaucoma, Neovascular ; Glycolates ; Humans ; Light ; Light Coagulation ; Medical Records ; Preoperative Period ; Retrospective Studies ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. METHODS: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. RESULTS: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. CONCLUSIONS: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.
Cholangitis ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Drainage ; Gallstones* ; Humans ; Immunosuppression ; Kidney Transplantation* ; Medical Records ; Mortality ; Organ Transplantation ; Retrospective Studies ; Transplants ; Ultrasonography