AIM: To compare the efficacies of subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium injections for the inhibition of corneal neovascularization in an experimental rat model. METHODS: Sixteen corneas of 1...AIM: To compare the efficacies of subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium injections for the inhibition of corneal neovascularization in an experimental rat model. METHODS: Sixteen corneas of 16 rats were chemically cauterized and randomized into four groups: bevacizumab group that treated with 0.05mL/1.25mg bevacizumab, ranibizumab group that treated with 0.05mL/0.5mg ranibizumab, pegaptanib group that treated with 0.05mL/0.15mg pegaptanib sodium, and control group that treated with 0.05mL saline solution. Digital photographs of the corneas were taken and analyzed using an image analysis software program. All corneas were excised and examined histologically on the 15 th day. RESULTS: Each treatment group had significantly less neovascularized corneal areas and fewer blood vessels than the control group (all P 【0.05). In addition, bevacizumab group had significantly less neovascu-larized corneal areas and fewer blood vessels than ranibizumab and pegaptanib groups (both P 【0.05). However, there was no significant difference between the ranibizumab and pegaptanib groups regarding percentage of neovascularized corneal areas and number of blood vessels (both P 】0.05). CONCLUSION: Subconjunctival bevacizumab, ranibiz-umab, and pegaptanib sodium were effective with no corneal epitheliopathy for inhibiting corneal neovascularization after corneal burn in rats .Bevacizumab was more effective than ranibizumab and pegaptanib sodium.展开更多
BACKGROUND: Pegaptanib, an anti-vascular endothelial growth factor therapy, w as evaluated in the treatment of neovascular age-related macular degeneration. METHODS: We conducted two concurrent, prospective, randomize...BACKGROUND: Pegaptanib, an anti-vascular endothelial growth factor therapy, w as evaluated in the treatment of neovascular age-related macular degeneration. METHODS: We conducted two concurrent, prospective, randomized, double-blind, mu lticenter, dose-ranging, controlled clinical trials using broad entry criteria. Intravitreous injection into one eye per patient of pegaptanib (at a dose of 0. 3 mg, 1.0 mg, or 3.0 mg) or sham injections were administered every 6 weeks over a period of 48 weeks. The primary end point was the proportion of patients who had lost fewer than 15 letters of visual acuity at 54 weeks. RESULTS: In the com bined analysis of the primary end point (for a total of 1186 patients), efficacy was demonstrated, without a dose-response relationship, for all three doses of pegaptanib (P< 0.001 for the comparison of 0.3 mg with sham injection;P < 0.001 for the comparison of 1.0 mg with sham injection; and P=0.03 for the comparison of 3.0 mg with sham injection). In the group given pegaptanib at 0.3 mg, 70 per cent of patients lost fewer than 15 letters of visual acuity, as compared with 5 5 percent among the controls (P < 0.001). The risk of severe loss of visual acui ty (loss of 30 letters or more)-was reduced from 22 percent in the sham-inject ion group to 10 percent in the group receiving 0.3 mg of pegaptanib (P < 0.001). More patients receiving pegaptanib (0.3 mg), as compared with sham injection, m aintained their visual acuity or gained acuity (33 percent vs. 23 percent; P=0.0 03). As early as six weeks after beginning therapy with the study drug, and at a ll subsequent points, the mean visual acuity among patients receiving 0.3 mg of pegaptanib was better than in those receiving sham injections (P < 0.002). Among the adverse events that occurred, endophthalmitis (in 1.3 percent of patients), traumatic injury to the lens (in 0.7 percent), and retinal detachment (in 0.6 p ercent) were the most serious and required vigilance. These events were associat ed with a severe loss of visual acuity in 0.1 percent of patients. CONCLUSIONS: Pegaptanib appears to be an effective therapy for neovascular age-related macul ar degeneration. Its long-term safety is not known.展开更多
Purpose:To report two cases of retinal pigment epithelium(RPE)tears following intravitreal pegaptanib injections for occult choroidal neovascularization.Design:Noncomparative case series.Methods:The charts of two pati...Purpose:To report two cases of retinal pigment epithelium(RPE)tears following intravitreal pegaptanib injections for occult choroidal neovascularization.Design:Noncomparative case series.Methods:The charts of two patients with pigment epithelial tears after receiving intravitreal pegaptanib were reviewed.Approval from the institutional review board and informed consent were obtained before chart review.Fundus photos,intravenous fluorescein angiograms,and optical coherence tomography(OCT)were obtained before and after therapy confirmed the diagnosis.Results:Two patients had turbid pigment epithelial detachments(PEDs)and occult choroidal neovascular membranes(CNVMs)treated with intravitreal pegaptanib.Both patients developed RPE tears weeks following one intravitreal pegaptanib injection.Conclusions:This report describes the development of RPE tears after intravitreal pegaptanib injection.Caution should be taken in cases of turbid pigment epithelial detachments in the monocular patient when treatment with intravitreal pegaptanib is entertained.Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this devastating visual complication.展开更多
publication. Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed. Results Anti-VEGF agents have manifested great...publication. Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed. Results Anti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization, though some of them are still used as off-label drugs. Intravitrea~ injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications, and intimate monitoring in both adult and pediatric population are warranted. Future directions should be focused on carrying out more well-designed large-scale controlled trials, promoting sustained duration of action, developing safer and more efficient generation of anti-VEGF agents. Conclusions Anti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases. However, more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.展开更多
文摘AIM: To compare the efficacies of subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium injections for the inhibition of corneal neovascularization in an experimental rat model. METHODS: Sixteen corneas of 16 rats were chemically cauterized and randomized into four groups: bevacizumab group that treated with 0.05mL/1.25mg bevacizumab, ranibizumab group that treated with 0.05mL/0.5mg ranibizumab, pegaptanib group that treated with 0.05mL/0.15mg pegaptanib sodium, and control group that treated with 0.05mL saline solution. Digital photographs of the corneas were taken and analyzed using an image analysis software program. All corneas were excised and examined histologically on the 15 th day. RESULTS: Each treatment group had significantly less neovascularized corneal areas and fewer blood vessels than the control group (all P 【0.05). In addition, bevacizumab group had significantly less neovascu-larized corneal areas and fewer blood vessels than ranibizumab and pegaptanib groups (both P 【0.05). However, there was no significant difference between the ranibizumab and pegaptanib groups regarding percentage of neovascularized corneal areas and number of blood vessels (both P 】0.05). CONCLUSION: Subconjunctival bevacizumab, ranibiz-umab, and pegaptanib sodium were effective with no corneal epitheliopathy for inhibiting corneal neovascularization after corneal burn in rats .Bevacizumab was more effective than ranibizumab and pegaptanib sodium.
文摘BACKGROUND: Pegaptanib, an anti-vascular endothelial growth factor therapy, w as evaluated in the treatment of neovascular age-related macular degeneration. METHODS: We conducted two concurrent, prospective, randomized, double-blind, mu lticenter, dose-ranging, controlled clinical trials using broad entry criteria. Intravitreous injection into one eye per patient of pegaptanib (at a dose of 0. 3 mg, 1.0 mg, or 3.0 mg) or sham injections were administered every 6 weeks over a period of 48 weeks. The primary end point was the proportion of patients who had lost fewer than 15 letters of visual acuity at 54 weeks. RESULTS: In the com bined analysis of the primary end point (for a total of 1186 patients), efficacy was demonstrated, without a dose-response relationship, for all three doses of pegaptanib (P< 0.001 for the comparison of 0.3 mg with sham injection;P < 0.001 for the comparison of 1.0 mg with sham injection; and P=0.03 for the comparison of 3.0 mg with sham injection). In the group given pegaptanib at 0.3 mg, 70 per cent of patients lost fewer than 15 letters of visual acuity, as compared with 5 5 percent among the controls (P < 0.001). The risk of severe loss of visual acui ty (loss of 30 letters or more)-was reduced from 22 percent in the sham-inject ion group to 10 percent in the group receiving 0.3 mg of pegaptanib (P < 0.001). More patients receiving pegaptanib (0.3 mg), as compared with sham injection, m aintained their visual acuity or gained acuity (33 percent vs. 23 percent; P=0.0 03). As early as six weeks after beginning therapy with the study drug, and at a ll subsequent points, the mean visual acuity among patients receiving 0.3 mg of pegaptanib was better than in those receiving sham injections (P < 0.002). Among the adverse events that occurred, endophthalmitis (in 1.3 percent of patients), traumatic injury to the lens (in 0.7 percent), and retinal detachment (in 0.6 p ercent) were the most serious and required vigilance. These events were associat ed with a severe loss of visual acuity in 0.1 percent of patients. CONCLUSIONS: Pegaptanib appears to be an effective therapy for neovascular age-related macul ar degeneration. Its long-term safety is not known.
文摘Purpose:To report two cases of retinal pigment epithelium(RPE)tears following intravitreal pegaptanib injections for occult choroidal neovascularization.Design:Noncomparative case series.Methods:The charts of two patients with pigment epithelial tears after receiving intravitreal pegaptanib were reviewed.Approval from the institutional review board and informed consent were obtained before chart review.Fundus photos,intravenous fluorescein angiograms,and optical coherence tomography(OCT)were obtained before and after therapy confirmed the diagnosis.Results:Two patients had turbid pigment epithelial detachments(PEDs)and occult choroidal neovascular membranes(CNVMs)treated with intravitreal pegaptanib.Both patients developed RPE tears weeks following one intravitreal pegaptanib injection.Conclusions:This report describes the development of RPE tears after intravitreal pegaptanib injection.Caution should be taken in cases of turbid pigment epithelial detachments in the monocular patient when treatment with intravitreal pegaptanib is entertained.Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this devastating visual complication.
基金This work was supported by grants from the Key Chmc Medicine Research Program, the Ministry of Health, China （No. 201302015）, the National Science and Technology Research Program, the Ministry of Science and Technology, China （No. 2012BAI08B01）, the National Natural Science Foundation of China （Nos. 81170817, 81200658）, and the Scientific Research Program, Science and Technology Commission of Shanghai Municipality, Shanghai （Nos. 13441900900, 13430720400, 134119a8800, 13430710500）.
文摘publication. Study selection Clinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed. Results Anti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization, though some of them are still used as off-label drugs. Intravitrea~ injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications, and intimate monitoring in both adult and pediatric population are warranted. Future directions should be focused on carrying out more well-designed large-scale controlled trials, promoting sustained duration of action, developing safer and more efficient generation of anti-VEGF agents. Conclusions Anti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases. However, more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.
