Terapia anty-VEGF w cukrzycowym obrzęku plamki

• Authors: Katarzyna Mozolewska-Piotrowska

Title variants

EN

Anti-VEGF treatment in diabetic macular edema

• Languages of publication: PL

Abstracts

PL

Obrzęk plamki jest najczęstszą przyczyną znacznego pogorszenia widzenia u pacjentów z cukrzycą. Jednym z głównych czynników odpowiedzialnych za gromadzenie się płynu w obszarze plamkowym i powstawanie obrzęku jest wewnątrzgałkowy wzrost stężenia śródbłonkowego czynnika wzrostu naczyniowego (VEGF, vascular endothelial growth factor). Wyniki licznych badań potwierdzają lepsze efekty terapii anty-VEGF ranibizumabem, bewacyzumabem lub afliberceptem (zarówno w monoterapii, jak i terapii łączonej) w porównaniu z dotychczas stosowaną laseroterapią w zakresie poprawy ostrości wzroku u pacjentów z pogorszeniem widzenia w przebiegu cukrzycowego obrzęku plamki. Praca przedstawia możliwości leczenia inhibitorami anty-VEGF w zależności od czasu trwania i postaci obrzęku, wyjściowej ostrości wzroku oraz wcześniej stosowanych metod leczenia, w celu osiągnięcia najlepszego efektu terapii u danego pacjenta.

EN

Macular edema is the leading cause of considerable visual impairment in diabetic patients. Elevated levels of vascular endothelial growth factor (VEGF) in the vitreous humour play a key role in accumulation of fluid and in formation of diabetic macular edema. According to the results of multiple studies, anti-VEGF therapy with ranibizumab, bevacizumab or aflibercept proved to be more effective in improving vision in patients with decreased visual acuity due to diabetic macular edema (both in mono- and combined therapy) than laser photocoagulation. The paper presents different treatment options of anti- VEGF therapy depending on various forms of macular edema, visual acuity and previously undergone treatments to achieve the best functional results in an individual patient.

Keywords

EN

aflibercept; cukrzyca; cukrzycowy obrzęk plamki; inhibitory VEGF; laseroterapia; ranibizumab; terapia anty-VEGF; terapia skojarzona

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OphthaTherapy
• Year: 2015
• Volume: 2
• Issue: 3
• Pages: 205-210

Contributors

author

Katarzyna Mozolewska-Piotrowska

• Katedra i Klinika Okulistyki, Pomorski Uniwersytet Medyczny w Szczecinie

References

• 1. Klein R, Knudtson MD, Lee KE, et al. The Wisconsin epidemiologic study of diabetic retinopathy XXIII: the twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology 2009; 116(3): 497-503.
• 2. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. British Medical Journal 1998; 317: 703-713.
• 3. Arend O, Remky A, Elsner AE, et al. Quantification of cystoid changes in diabetic maculopathy. Invest Ophthalmol Vis Sci 1995; 36(3): 608-613.
• 4. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: early treatment diabetic retinopathy study report number 1. Archives of Ophthalmology 1985; 103(12): 1796-1806.
• 5. Nguyen QD, Tatlipinar S, Shah SM, et al. Vascular endothelial growth factor is a critical stimulus for diabetic macular oedema. Am J Ophthalmol 2006; 142: 961-969.
• 6. Aiello LP, Avery RL, Arrigg PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994; 331: 1480-1487.
• 7. Funatsu H, Yamashita H, Sakata K, et al. Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema. Ophthalmology 2005; 112: 806-816.
• 8. Massin P, Bandello F, Garweg JG, et al. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE study): a 12-month randomized, controlled, double masked, multiceter phase II study. Diabetes Care 2010; 33: 2399-2405.
• 9. Mitchell P, Bandello F, Schmidt-Erfurth U, et al. The RESTORE Study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology 2011; 118: 615-625.
• 10. Brown DM, Nguyen QD, Marcus DM, et al.; RIDE and RISE Research Group. Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. Ophthalmology 2013; 120: 2013-2022.
• 11. Campochiaro PA, Wykoff CC, Shapiro H, et al. Neutralization of vascular endothelial growth factor slows progression of retinal nonperfusion in patients with diabetic macular edema. Ophthalmology 2014; 121: 1783-1789.
• 12. Do DV, Schmidt-Erfurth U, Gonzalez VH, et al. The DA VINCI Study: phase II primary results of VEGF Trap-Eye in patients with diabetic macular edema. Ophthalmology 2011; 118(9): 1819-1826.
• 13. Korobelnik JF, Do DV, Schmidt-Erfurth U, et al. Intravitreal aflibercept for diabetic macular edema. Ophthalmology 2014; 121: 2247-2254.
• 14. Arevalo JF, Fromow-Guerra J, Quiriz-Mercado H, et al.; The Pan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow up. Ophthalmology 2007; 114: 743-750.
• 15. Michaelides M, Kaines A, Hamilton RD, et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT Study) 12-month data: report 2. Ophthalmology 2010; 117: 1107-1118.
• 16. Wells JA, Glassman AR, Jampol LM, et al.; Diabetic Retinopathy Clinical Research Network. Aflibercept, bevacizumab or ranibizumab for diabetic macular edema. N Engl J Med 2015; 372: 1193-1203.
• 17. Bandello F, De Benedetto U, Knutsson KA, et al. Ranibizumab in the treatment of patients with visual impairment due to diabetic macular edema. Clin Ophthalmol 2011; 5: 1303-1308.
• 18. Elman MJ, Bressler NM, Qin H, et al.; Diabetic Retinopathy Clinical Research Network. Expanded 2 year follow-up of ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology 2011; 118: 609-614.
• 19. Nguyen QD, Shah SM, Khwaja AA, et al. Two year outcomes of the ranibizumab for edema of the macula in diabetes (READ-2) study. Ophthalmology 2007; 114: 1860-1867.
• 20. Googe J, Brucker AJ, Bressler NM, et al. Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina 2011; 31: 1009-1027.
• 21. Sohn HJ, Han DH, Kim TI, et al. Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema. Am J Ophthalmol 2011; 152: 686-694.
• 22. Soheilian M, Ramezani A, Obudi A, et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology 2009; 116: 1142-1150.
• 23. Synek S, Vojnikovic B. Intravitreal bevacizumab with or without triamcinolone for refractory diabetic macular edema. Coll Antropol 2010; 34(2): 99-103.
• 24. Cunha-Vaz J, Ashton P, Lezzi R, et al. Sustained delivery fluocinolone acetonide vitreous implants: long term benefit in patients with chronic diabetic macular edema. Ophthalmology 2014; 121: 1892-1903.
• 25. Stewart MW. Corticosteroid use for diabetic macular edema: old fad or a new trend? Curr Diab Rep 2012; 12: 364-375.

• Document Type: article