Effectiveness of sub-tenon’s administration of an angiogenesis inhibitor in treatment of wet age-related macular degeneration
- Authors: Gaybaryan RV1, Epikhin AN1, Bondarenko Y.F1
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Affiliations:
- Rostov State Medical University
- Issue: Vol 97, No 5 (2016)
- Pages: 705-709
- Section: Theoretical and clinical medicine
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/5565
- DOI: https://doi.org/10.17750/KMJ2016-705
- ID: 5565
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Full Text
Abstract
Aim. To study the clinical results of the administration of an angiogenesis inhibitor into sub-Tenon’s space on the viscous carrier.
Methods. The study was conducted in two stages. At the first stage, analysis of examination and treatment of 32 patients (34 eyes) with the wet age-related macular degeneration was conducted. Patients were injected the angiogenesis inhibitor (bevacizumab 12.5 mg) on the viscous carrier (1.0 ml of 2% hydroxypropylmethylcellulose solution) into the posterior sub-Tenon’s space. At the second stage, a retrospective analysis of the treatment results of 30 patients (30 eyes) with the wet age-related macular degeneration, who received the standard monotherapy in the form of 3 monthly intravitreal injection of angiogenesis inhibitor (0.5 mg ranibizumab), and then according to indications, was conducted. The best-corrected visual acuity and optical coherence tomography data over the period of 12 months were evaluated.
Results. When comparing the effectiveness of treatment, the mean best-corrected visual acuity significantly improved in both groups after treatment, and its final values were not significantly different. Also central retinal thickness, length, height and volume of lesions significantly decreased as a result of the treatment, and final values were not significantly different between the groups. The duration of the achieved clinical effect in sub-Tenon’s administration was 2-2.5 months, in intravitreal administration - 1-1.5 months.
Conclusion. Administration of angiogenesis inhibitors into the posterior sub-Tenon’s space in wet age-related macular degeneration has an equivalent effectiveness to intravitreal introduction and at the same time provides more prolonged effect of medications.
About the authors
R V Gaybaryan
Rostov State Medical University
Author for correspondence.
Email: frolova1985@rambler.ru
A N Epikhin
Rostov State Medical University
Email: frolova1985@rambler.ru
Yu F Bondarenko
Rostov State Medical University
Email: frolova1985@rambler.ru
References
- Байбородов Я.В., Балашевич Л.И. Оптимизация техники витрэктомии при поздних стадиях пролиферативной диабетической ретинопатии. Сахарн. диабет. 2008; 11 (3): 16-17.
- Басинский С.Н., Красногорская В.Н., Басинский А.С. Методы введения лекарственных препаратов к заднему отделу глаза. Клин. офтальмол. 2008; 2: 54-57.
- Егоров Е.А., Астахов Ю.С., Ставицкая Т.В. Офтальмофармакология: руководство для врачей. М.: ГЭОТАР-Медиа. 2005; 72-84.
- Халикова М.А., Фадеева Д.А., Жилякова Е.Т. и др. Исследование физико-химических показателей растворов гидроксипропилметилцеллюлозы. Научн. ведомости Белгород. гос. ун-та. 2010; (22): 86-88.
- Ambati J., Canakis C.S., Miller J.W. Diffusion of high molecular weight compounds through sclera. Invest. Ophthalmol. Vis. Sci. 2000; 41; (5): 1181-1185.
- Chakravarthy U., Harding S., Rogers C. et al. Alternative treatments to inhibit VEGF in age-related choroidal neovascularisation: 2-year findings of the IVAN randomised controlled trial. Lancet. 2013; 382: 1258-1267. http://dx.doi.org/10.1016/S0140-6736(13)61501-9
- Cunningham M.A., Edelman J.L., Kaushal S. Intravitreal steroids for macular edema: the past, the present, and the future. Surv. Ophthalmol. 2008; 53; (2): 139-149. http://dx.doi.org/10.1016/j.survophthal.2007.12.005
- Jonas J.B., Kreissing I., Spandau U.H., Harder B. Infectious and noninfectious endophthalmitis after intravitreal high-dosage triamcinolone acetonide. Am. J. Ophthalmol. 2006; 141; (3): 579-580. http://dx.doi.org/10.1016/j.ajo.2005.10.007
- Martin D.F., Maguire M.G., Fine S.L. et al. (CATT Research Group). Ranibizumab and bevacizumab for neovascular age-related macular degeneration: two-year results. Ophthalmology. 2012; 119; (7): 1388-1398. http://dx.doi.org/10.1016/j.ophtha.2012.03.053
- O’Shea J.G. Response to replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us. Clin. Exp. Optom. 2012; 95 (5): 541-543. http://dx.doi.org/10.1111/j.1444-0938.2012.00736.x
- Tatar O., Adam A., Shinoda K. et al. Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy. Am. J. Ophthalmol. 2006; 142; (1): 95-104. http://dx.doi.org/10.1016/j.ajo.2006.01.085
- Velez G., Whitcup S.M. New developments in sustained release drug delivery for the treatment of intraocular disease. Br. J. Ophthalmol. 1999; 83; (11): 1225-1229. http://dx.doi.org/10.1136/bjo.83.11.1225
- Ventrice P., Leporini C., Aloe J.F. et al. Anti-vascular endothelial growth factor drugs safety and efficacy in ophthalmic diseases. J. Pharmacol. Pharmacother. 2013; 4: 38-42. http://dx.doi.org/10.4103/0976-500X.120947