Complications of Ziv-Aflibercept in Choroidal and Retinal Vascular Diseases

Introduction: The modern ophthalmology trends are changing rapidly every day with the introduction of much newer studies and research. Numerous anti-vascular endothelial growth factors (VEGF) are utilized as the mainstay in the treatment of intraocular vascular pathologies. The rationale of this study is to add to the literature regarding the safety and efficacy profile of the ziv-aflibercept as there is insubstantial data in patients with intraocular vascular pathologies being treated with this injection with prime focus on the complications of the injection. Materials and Methods: A prospective observational study was conducted at Opthalmology Department, Lahore General Hospital, Lahore between 14 August 2018 and 23 December 2019. Patients with choroidal and retinal vascular diseases like diabetic macular edema (DME), age-related macular degeneration (AMD) and retinal vein occlusion (RVO) who had no active infection of eye and had no history of myocardial infarction or cerebrovascular accident were added in this study. Results: Best-corrected visual acuity was significantly improved at 4, 8, and 12 weeks as compared to the baseline (p Conclusion: The use of ziv-aflibercept injection via intravitreal route under aseptic conditions for choroidal and retinal vascular diseases is effective as well as safe with mild and treatable ocular side effects.

The choroid plexus-cerebrospinal fluid interface in Alzheimer's disease:more than just a barrier

The choroid plexus is a complex structure which hangs inside the ventricles of the brain and consists mainly of choroid plexus epithelial（CPE） cells surrounding fenestrated capillaries.These CPE cells not only form an anatomical barrier,called the blood-cerebrospinal fluid barrier（BCSFB）,but also present an active interface between blood and cerebrospinal fluid（CSF）.CPE cells perform indispensable functions for the development,maintenance and functioning of the brain.Indeed,the primary role of the choroid plexus in the brain is to maintain homeostasis by secreting CSF which contains different molecules,such as nutrients,neurotrophins,and growth factors,as well as by clearing toxic and undesirable molecules from CSF.The choroid plexus also acts as a selective entry gate for leukocytes into the brain.Recent findings have revealed distinct changes in CPE cells that are associated with aging and Alzheimer＇s disease.In this review,we review some recent findings that highlight the importance of the CPE-CSF system in Alzheimer＇s disease and we summarize the recent advances in the regeneration of brain tissue through use of CPE cells as a new therapeutic strategy.

Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound

Background Choroidal melanoma is the most common intraocular malignant tumor in adults. It threatens not only the visual function but also the patient＇s life. Therefore, it is important to find a non-traumatic, quantitative and repetitive diagnostic method. This study investigated the value of quantitative analysis of contrast-enhanced ultrasound （CEUS） in the diagnosis of choroidal melanoma. Methods CEUS were performed in 51 cases of choroidal melanoma, which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma. The characteristics of the time-intensity curve of the contrast agent were analyzed. For the quantitative analysis, the following parameters of the contrast agent in the lesion were included： rising time （RT）, time to peak （TTP）, maximum intensity （MI） and the mean transit time （MTT）. Results Choroidal melanoma had the following characteristics on CEUS： Choroidal lesions were completely filled with contrast agent. The typical filling pattern was centripetal, with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion. In some cases, areas with contrast agent filling defect were obseved in the lesions. The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion. Quantitative analysis showed that in choroidal melanoma, MI of contrast agent （191.31%±146.90%） was significantly more than that of the normal tissue （100.00%±0.00%） （P 〈0.05） and MTT （（63.56±26.04） seconds） was significanly less than that of the normal tissue （（149.87±182.68）seconds） （P 〈0.05）. TTP （22.80±9.85） was less than that of the normal tissue （（29.57±24.76） seconds） and RT （（18.52±7.09） seconds） was less than that of the normal tissue （（26.45±21.83） seconds）. Both the differences of TTP and RT were not statistically significant though. Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT, the sensitivity was 90.5% and the specific degrees was 85.7%. Conclusions CEUS is a new method to diagnose tumors in the eye. Choroidal melanoma may be diagnosed objectively and accurately by combining the graphic characteristics on CEUS and the time-intensity curve quantitative analysis.