Intravitreal Ranibizumab Injections Research Articles

Baseline Diabetic Retinopathy Severity and Time to Diabetic Macular Edema Resolution with Ranibizumab Treatment: A Meta-Analysis

Having a better understanding of how long diabetic macular edema (DME) takes to resolve in patients with diabetic retinopathy (DR) after treatment with ranibizumab, and the factors affecting this outcome, would be of benefit to physicians and patients alike. The objective of this analysis was to evaluate the time to first DME resolution and the impact of baseline DR severity on this outcome in patients treated with ranibizumab in phase III clinical trials. Meta-analysis of data from the phase III trials, RIDE (NCT00473382) and RISE (NCT00473330), and DR Clinical Research Network protocols I (NCT00444600), S (NCT01489189), and T (NCT01627249). Patients with DME (central subfield thickness [CST] > 250 μm) and DR with Diabetic Retinopathy Severity Scale (DRSS) score between 35 and85. Intravitreal injection of ranibizumab. The time to first DME resolution (defined as CST ≤ 250 μm) within 24 months was evaluated overall and by baseline DR severity category per the DRSS (35 of 43 [mild or moderate nonproliferative DR], 47-53 [moderately severe or severe nonproliferative DR], 60 [mild proliferative DR], and 61-85 [moderately severe to severe proliferative DR]). There were 777 patients included in the meta-analysis. The overall mean (95% confidence interval) time to first DME resolution, adjusted for baseline CST, was 6.0 (5.6-6.4) months. The mean (95% CI) time to first DME resolution was 7.1 (6.2-7.9), 5.9 (5.2-6.6), 6.0 (4.8-7.2), and 4.5 (3.5-5.5) months for the 35 of 43, 47 to 53, 60, and 61 to 85 baseline DRSS categories, respectively (overall P= 0.002). By month 24, the proportion of eyes with DME resolution was 74.9% (221 of 295), 77.5% (299 of 386), 69.4% (109 of 157), and 78.7% (148 of 188) for the 35 of 43, 47 to 53, 60, and 61 to 85 baseline DRSS categories, respectively (overall P= 0.17). This meta-analysis of data from patients treated with ranibizumab showed that DME resolution was faster in patients with more severe DR at baseline. However, by month 24, a similar proportion of patients achieved DME resolution, regardless of baseline DR severity. These findings may guide treatment decisions and inform patient expectations in clinical practice. Proprietary or commercial disclosure may be found after the references.

ROLE OF INTRAVITREAL RANIBIZUMAB IN TREATING THE DIABETES MELLITUS TYPE-2 PATIENTS WITH SUBFOVEAL CHOROIDAL THICKNESS AND DIMINISHED VISUAL ACUITY

Objective: This study was conducted with the objective to measure the Subfoveal Choroid thickness and correlate it with the diminished visual acuity in patients with Diabetes Mellitus Type 2, who develop macular edema and to study the effect of Intravitreal injections of Ranibizumab during follow up. Methods: A cross sectional, interventional study conducted in 52 patients with uncontrolled Diabetes Mellitus Type-2 with macular edema by measuring the Subfoveal Choroid thickness with the help of manual caliper function present in the Heidelberg Spectralis OCT program. Patients with SFCT less than 450 microns were included. The SFCT and the corresponding visual acuity were measured before and after Intravitreal Ranibizumab injections 1.25mg (0.05mL) at monthly intervals for 3 months and correlated with age, gender, and choroid thickness. Results: Out of 52 patients there were 31 (59.61%) females and 21 (40.38%) males. 50% of the patients were aged between 50 and 60 years and 50% patients were aged between 60 and 70 years. The patients responding to the Intravitreal injections in terms of best-corrected visual acuity (BCVA) between the reinjection and post-injection were found to be statistically important (p=0.001). The subfoveal Choroidal thickness (SFCT) variations, before and after injections were found to be statistically significant at the end of 3 months (p<0.05). Conclusions: Injection Ranibizumab was found to have a significant role in the reduction of average SFCT and in addition clear evidence of improved BCVA.

Bilateral Branch Retinal Vein Occlusion after mRNA-SARS-CoV-2 Booster Dose Vaccination

We report a case of a patient with a bilateral branch retinal vein occlusion (BRVO) 24 h after a booster vaccination with the mRNA-1237 vaccine. Fluorescein angiography, performed at three weeks follow-up, showed vascular leakage and blockage, corresponding to hemorrhage areas associated with ischemic areas in the macula and along the arcades involved in the occlusion. The patient was scheduled for urgent injections of intravitreal ranibizumab and laser photocoagulation of the ischemic areas. To the best of our knowledge, this is the first case described of concomitant bilateral RVO after COVID-19 vaccination. The rapid onset of the side effects in a patient with multiple risk factors for thrombotic events suggests that vulnerable microvascular conditions require detailed investigations before administration of a COVID-19 vaccine.

Optic nerve head perfusion changes in eyes with proliferative diabetic retinopathy treated with intravitreal ranibizumab or photocoagulation: a randomized controlled trial.

Proliferative diabetic retinopathy (PDR) is a serious sight-threatening disease, and half of the patients with high-risk PDR can develop legal blindness within 5 years, if left untreated. This study was aimed at comparing panretinal photocoagulation (PRP) and intravitreal ranibizumab injections in terms of radial peripapillary capillary (RPC) density on optical coherence tomography angiography (OCTA) in patients with treatment-naive PDR. This open-label, prospective, randomized clinical trial included 50 patients with treatment-naive PDR with optic disc neovascularization and randomized them into two groups: group 1, with patients undergoing two sessions of PRP 2 weeks apart, and group 2, with patients received three intravitreal ranibizumab injections (0.5 mg) 1 month apart for 3 consecutive months. Patients underwent a full ophthalmological examination, including best-corrected distance visual acuity (BCDVA) measurement in the logarithm of minimal angle of resolution (logMAR) notation and OCTA before intervention and monthly after the last laser session or the first intravitreal ranibizumab injection for 3 months of follow-up. Visual field (VF) was tested at the beginning and end of 3 months. Forty-two (84%) eyes completed the 3-month follow-up, including 22 eyes in the PRP group (88%) and 20 (80%) eyes in the ranibizumab group. The two groups were comparable in terms of demographic characteristics, diabetes duration, baseline BCDVA, glycated hemoglobin level, OCTA parameters, VF indices, and intraocular pressure (all P > 0.05). The RPC density change from baseline to the 3-month follow-up was significantly lower in the PRP group than in the ranibizumab group (mean difference in RPC density change: - 3.61%; 95% confidence interval: - 5.57% to - 1.60%; P = 0.001). The median (interquartile range) logMAR change from baseline to the 3-month follow-up (0.0 [0.2]) was significantly higher in the PRP group than in the ranibizumab group (- 0.15 [0.3]; P < 0.05). The median changes in central foveal thickness from baseline to the 3-month follow-up differed significantly between the two groups (P = 0.001). In eyes with PDR and neovascularization of the disc RPC density on OCTA increased in the ranibizumab group and decreased in the PRP group. Visual acuity gain was higher in the ranibizumab group than in the PRP group. Future multicenter trials addressing our limitations are required to verify the findings of this study.

Changes in Serum Concentrations of Vascular Endothelial Growth Factors-A and B after Intravitreal Injection of Ranibizumab and Conbercept for Retinopathy of Prematurity

Introduction: The aim of this study was to compare the changes in serum concentrations of vascular endothelial growth factor (VEGF)-A and B after intravitreal injection of ranibizumab (IVR) or conbercept (IVC) for retinopathy of prematurity (ROP). Methods: In this prospective study, infants with type 1 ROP in both eyes were recruited in our hospital from September 2021 to February 2022, randomly assigned to the ranibizumab and conbercept groups and administered IVR or IVC (0.25 mg/0.025 mL). Blood samples were collected before the operation and 1 and 4 weeks after the operation to measure the concentrations of serum VEGF-A and B. Results: A total of 20 ROP infants were randomly assigned to the ranibizumab (n = 10) and conbercept groups (n = 10). In the ranibizumab group, the serum VEGF-A concentrations before operation and 1 and 4 weeks after the operation were 73.55 ± 40.78, 11.47 ± 7.00, and 75.36 ± 30.87 pg/mL, respectively (p < 0.01). Least Significant Difference (LSD) pairwise comparison did not show any significant difference in the groups between 4 weeks postoperatively and preoperatively (p > 0.05). In the conbercept group, the serum VEGF-A concentrations before operation and 1 and 4 weeks after the operation were 86.69 ± 55.06, 14.68 ± 10.11, and 43.55 ± 57.92 pg/mL, respectively (p < 0.01). LSD comparison showed significant differences between 1 week and 4 weeks postoperatively and preoperatively (p < 0.05), but no significant differences were observed between 1 and 4 weeks postoperatively (p > 0.05). Regarding serum VEGF-B concentrations before the operation and 1 and 4 weeks after the operation, no significant differences were detected in the ranibizumab group (p > 0.05), but significant differences were observed in the conbercept group (7.26 ± 2.34, 3.09 ± 2.41, and 4.55 ± 3.37 ng/mL, respectively; p < 0.01). LSD showed significant differences between 1 or 4 weeks postoperatively and preoperatively (p < 0.05), but no significant difference was detected between 1 and 4 weeks postoperatively (p > 0.05). Conclusions: Serum VEGF-A levels in infants with ROP were suppressed after IVR or IVC but returned to preoperative levels at 4 weeks after IVR and remained lower than the preoperative levels at 4 weeks after IVC. Serum VEGF-B was not affected by IVR but was suppressed by IVC for 4 weeks.

Short-term effects of intravitreal anti-vascular endothelial growth factor agents on body weight and multiple systems after treatment for retinopathy of prematurity.

This study's goal was to assess the short-term effect on body weight and multiple systems following intravitreal injections of ranibizumab and aflibercept for retinopathy of prematurity (ROP). We retrospectively assessed infants with ROP who received intravitreal anti-vascular endothelial growth factor agents (VEGF) treatment at our hospital. They were classified into 2 groups based on the drugs administered: the intravitreal ranibizumab (IVR) group and the intravitreal aflibercept (IVA) group. The body weight (BW) gains for the pre-treatment week, the 1st week after treatment, and the 2nd week after treatment were compared for each group. Additionally, other parameters such as blood pressure, heart rate, oxygen concentration, volume of milk and output of urine at four time points were also measured. We used repeated measurement analysis of variance analyzed these data. In total, 95 preterm infants were recruited, including 51 cases in the IVR group and 44 cases in the IVA group. The BW gain for the 1st week after treatment was significantly lower than the pre-treatment week in each group (P < 0.05), while there was no decrease in weekly BW gain in the 2nd week after treatment compared with that pre-treatment week. Based on the comparison between groups, the BW gain in the IVR group was significantly higher than in the IVA group in the second post-treatment week. Repeated measurement analysis of variance showed that there were no significant differences in blood pressure, heart rate, oxygen concentration, volume of milk and output of urine in both groups over time. IVR and IVA could have a short-term inhibitive effect on body weight gain in infants after treatment for ROP, whereas there is no significant impact on other systems.

Effects of Intravitreal Ranibizumab Injection to Treat Macular Edema due to Central Retinal Vein Occlusion on Choroidal Findings and Functional-Morphological Parameters

Introduction: Little research has examined the effects of anti-vascular endothelial growth factor therapy on subfoveal choroidal thickness (SCT), choroidal blood flow, aqueous flare, and humor levels of growth and inflammatory factors in patients with macular edema due to central retinal vein occlusion (CRVO). Methods: In 58 patients with macular edema due to CRVO treated by intravitreal ranibizumab injection (IRI), we retrospectively assessed best-corrected visual acuity (BCVA, assessed as the logarithm of the minimum angle of resolution [logMAR]), 8 aqueous factors (by suspension array), mean blur rate (MBR; estimated by laser speckle flowgraphy as a measure of choroidal blood flow), aqueous flare (with a laser flare meter), and SCT and central macular thickness (CMT; by optical coherence tomography). Results: After 4 weeks, IRI resulted in a significant improvement in BCVA and CMT and a significant reduction in SCT, choroidal MBR, and aqueous flare. SCT was significantly positively correlated with placental growth factor and significantly negatively correlated with platelet-derived growth factor-AA, and change in SCT was significantly negatively correlated with change in BCVA (logMAR). Aqueous flare was significantly negatively correlated with SCT. Conclusion: Growth and inflammatory factors may be associated with SCT, and changes in SCT may be associated with changes in BCVA after IRI to treat macular edema due to CRVO.

Efficacy of Combining Intravitreal Injections of Ranibizumab with Micropulse Diode Laser versus Intravitreal Injections of Ranibizumab Alone in Diabetic Macular Edema

Efficacy of Combining Intravitreal Injections of Ranibizumab with Micropulse Diode Laser versus Intravitreal Injections of Ranibizumab Alone in Diabetic Macular Edema

Subfoveal choroidal thickness before and after intravitreal Ranibizumab injection in patients with choroidal neovascularization

Background: Ranibizumab is anti-vascular endothelial growth factor (anti-VEGF) agent made for intraocular use, like smaller antibody fragment that can penetrate retina. Intravitreal ranibizumab therapy has been accepted as a predominant treatment for CNV in recent years.

Effect of Intravitreal Injection of Ranibizumab on Diabetic Macular Oedema at a Tertiary Centre in West Bengal: A Prospective Study

Introduction: Diabetic Retinopathy (DR) is one among the many causes of visual loss in people all over the world. Diabetic Macular Oedema (DME) is the most common among vision threatening complications of DR, with a major impact on quality of life of the patient. The intravitreal ranibizumab injection (anti Vascular Endothelial Growth Factor (VEGF), which prevents neovascularisation, is given monthly with approved dose of 0.3/0.5 mg with or without laser in the option of choice for all cases of central involving macular oedema. Aim: To find out the effectiveness of injection ranibizumab on patients with DME and to provide the better line of treatment for DME patients. Materials and Methods: This prospective study with quasiexperimental design constituted all the Type I and II Diabetic patients attending Out Patient Department (OPD) in College of Medicine and JNM Hospital, West Bengal, India from December 2019 to January 2021. Spectral Domain Optical Coherence Tomography (SD-OCT) images were obtained and used to diagnose macular oedema. Intravitreal injection ranibizumab (0.5 mg) was given as a standard treatment protocol with a dose interval of one month to all the DME patients. Foveal Thickness (FT) and Visual Acuity (VA) were evaluated before and after one month of injection. The t-test was used to compare the mean value of Central Macular Thickness (CMT) before and after intervention, p&lt;0.05 was considered for statistical significance. Results: In the current study, (n=105), mean age of the population was 55.1 years and gender distribution being: females- 54 (51.4%) and males- 51 (48.6%). Mean duration of diabetes was 10.7 years. CMT value significantly decreased from mean of 416.0095 to 383.8667 after injection. The mean LogMAR value significantly decreased from 1.0350 to 0.8625 after injection. Positive correlation was found between LogMAR after treatment with CMT (r-0.857; p-value &lt;0.0001). Conclusion: Single dose of 0.5mg of intravitreal injection of ranibizumab is effective in decreasing the CMT and improving VA in patients with DME.

Effect of Intravitreal Injection of Ranibizumab (Lucentis) on Corneal Biomechanics

Effect of Intravitreal Injection of Ranibizumab (Lucentis) on Corneal Biomechanics

Release of ranibizumab using a porous poly(dimethylsiloxane) capsule suppressed laser-induced choroidal neovascularization via the transscleral route

The administration of anti-vascular endothelial growth factor drugs in the posterior eye segment with sustained release through less invasive methods is a challenge in the treatment of age-related macular disease. We developed a flexible capsule device using porous poly(dimethylsiloxane) (PDMS) that was able to release ranibizumab. The porous PDMS sheet was fabricated by salt-leaching of a micro-sectioned PDMS sheet containing salt microparticles. Observation with scanning electron microscopy revealed that the pore densities could be adjusted by the concentration of salt. The in vitro release study showed that the release rate of fluorescein isothiocyanate-tagged albumin could be adjusted based on the pore density of the porous PDMS sheet. Ranibizumab could be released in a sustained-release manner for 16 weeks. The device was implanted on the sclera; its efficacy in terms of the suppression of laser-induced choroidal neovascularization (CNV) in rats was compared with that of monthly intravitreal injections of ranibizumab. At 8 and 18 weeks after implantation, the CNV area was significantly reduced in rats that received the ranibizumab-releasing device compared with those that received the placebo device. However, although monthly intravitreal injections of ranibizumab reduced CNV for 8 weeks, this reduction was not sustained for 18 weeks. In conclusion, we demonstrated a novel controlled-release device using a porous PDMS sheet that could suppress CNV via a less invasive transscleral route versus intravitreal injections. This device may also reduce the occurrence of side effects associated with frequent intravitreal injections.Graphical

Short-term impact of glycaemic control and intravitreal ranibizumab treatment on serum cytokine levels and diabetic macular edema in patients with unregulated blood glucose

Objective: To evaluate the short-term effect of glycaemic control and intravitreal ranibizumab treatment on diabetic macular edema (DME) and to assess the correlation between HbA1c and certain serum cytokines. Design: A prospective study of 43 participants with HbA1c levels exceeding 53 mmol/mol (7%) and with DME, as detected by spectral domain optical coherence tomography (SDOCT). Subjects: Participants were grouped according to their initial best corrected distance visual acuity (BCVA). Group 1 was treated with three monthly doses of intravitreal ranibizumab (0.5 mg) injections, and Group 2 was followed without treatment. Methods: Serum cytokine levels, including interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1(MCP-1), and vascular endothelial growth factor (VEGF) were analysed at the beginning and at the end of 3 months, using enzyme-linked immunosorbent assays (ELISA). Results: A significant decrease in macular thicknesses (except for one quadrant) was observed in Group. Changes in serum cytokine levels were not correlated with HbA1c decrease. Serum VEGF level was significantly increased in Group 1, despite the intravitreal treatment. Conclusion: Short-term glycaemic control alone had limited value in the treatment of DME. The therapeutic effect of intravitreal treatment on DME supports the role of the local cytokine milieu in the pathophysiology.

Serum and vitreous vascular endothelial growth factor levels in diabetic retinopathy.

To research whether serum vascular endothelial growth factor (VEGF) levels could be used to evaluate diabetic retinopathy (DR) progression and to compare vitreous VEGF levels after injections of intravitreal bevacizumab (IVB), ranibizumab (IVR), and triamcinolone acetonide (IVTA) in proliferative diabetic retinopathy (PDR). We enrolled a total of 91 eyes of 89 subjects (70 eyes of 68 diabetics and 21 eyes of 21 non-diabetic controls). The diabetic subjects were divided into three groups as PDR (n = 28), non-proliferative diabetic retinopathy (n = 20), and no-DR (n = 20). Eyes with PDR (n = 31) were injected with IVB (n = 7), IVR (n = 10), or IVTA (n = 6) 3days before vitrectomy, and eight eyes did not receive an injection. Serum and vitreous samples were collected before vitrectomy and analyzed using ELISA. We found the severity of retinopathy was not correlated with serum VEGF levels (P = .919, ρ = -0.011). Compared with the controls, vitreous VEGF was higher in the PDR (P < .001), whereas serum VEGF did not differ (P = .99). The controls had lower vitreous VEGF than the IVB, IVR, and no-injection subgroups (P = .01, P < .001, and P = .04, respectively). Vitreous VEGF was similar among the injected and no-injection subgroups (P = .17). Serum VEGF levels may not directly reflect retinopathy progression. Neither IVB, IVR nor IVTA could eliminate vitreous VEGF levels within 3days before vitrectomy.

Assessment of mouse VEGF neutralization by ranibizumab and aflibercept.

To assess the interaction between ranibizumab, aflibercept, and mouse vascular endothelial growth factor (VEGF), both in vivo and in vitro. In vivo, the effect of intravitreal injection of ranibizumab and aflibercept on oxygen induced retinopathy (OIR) and the effect of multiple intraperitoneal injections of ranibizumab and aflibercept on neonatal mice were assessed. In vitro, the interaction of mouse VEGF-A with aflibercept or ranibizumab as the primary antibody was analyzed by Western blot. In both experiments using intravitreal injections in OIR mice and multiple intraperitoneal injections in neonatal mice, anti-VEGF effects were observed with aflibercept, but not with ranibizumab. Western blot analysis showed immunoreactive bands for mouse VEGF-A in the aflibercept-probed blot, but not in the ranibizumab-probed blot. Aflibercept but not ranibizumab interacts with mouse VEGF, both in vivo and in vitro. When conducting experiments using anti-VEGF drugs in mice, aflibercept is suitable, but ranibizumab is not.

Comparison between intravitreal ranibizumab injection and posterior subtenon triamcinolone acetonide injection at time of cataract surgery for prevention of progression of diabetic macular edema

BackgroundThe goal of this work is to assess progression of diabetic macular edema (DME) following intravitreal ranibizumab injection compared to subtenon triamcinolone acetonide injection at cataract operation.MethodsRetrospective analysis of 73 eyes of 65 participant with DME, with central macular thickness (CMT) ≥ 300 μm. The included eyes were separated into three groups; phacoemulsification with intravitreal Ranibizumab injection group, phacoemulsification with subtenon Triamcinolone acetonide injection group and phacoemulsification only group. Main measures involved best corrected visual acuity (BCVA) one week, one month and three months post-operative. The CMT was compared preoperative and postoperative (one and three months).ResultsAfter 1 month of operation, there was a statistical substantial distinction in the median of CMT between ranibizumab & control group (p < 0.001), between subtenon TA & control group (p < 0.001) and in ranibizumab and subtenon TA group (p = 0.023). After 3 months, the variance between ranibizumab & control group was considerable (p < 0.0001) and the variance between subtenon TA & control group was considerable (p = 0.030).ConclusionsCombined phacoemulsification with intravitreal injections of ranibizumab or subtenon triamcinolone acetonide may prevent further progression in CMT in individuals with DME following cataract operation.

Atypical venous vasculitis as a complication of venous thrombosis

AbstractPurpose: To asses the importance of multimodality imaging in successive examinations of patients with retinal branch vein occlusion in order to evaluate possible unexpected complications.Methods: We present a descriptive study (case report). We have performed a multimodal imaging study of a patient with an inferior temporal branch vein thrombosis. The best corrected visual acuity (BCVA) is taken in a patient who received 5 intravitreal injections of Ranibizumab. Posteriorly the patient presented with a decrease in visual acuity and the angiographic study showed a venous vasculitis involving the inferior temporal branch retinal vein, resembling frosted branch angiitis. Optical coherence tomography (OCT) showed inflammatory cystic macular edema with neurosensory detachment. To perform angiography and OCT, we use the Heidelberg Spectralis.Results: Serial evaluation with OCT allowed the observation of a cystic macular edema with neurosensory detachment that was treated with intravitreal Dexamethasone implantation achieving a BCVA of 0.3 to a BCVA of 0.7 after 2 months. Angiography showed a perivenular infiltration that reminded us of frosted branch angiitis. General laboratory tests and serology for cytomegalovirus and Epstein–Barr virus were requested, and the patient was referred to the internal medicine department to rule out systemic diseases.Conclusions: Serial multimodality imaging is very useful in the follow‐up of patients with venous occlusions. It allows us to observe atypical complications such as vasculitis found in the context of a patient who suffered a venous branch occlusion. Vasculitis can be found in the context of an ocular disease or associated with diseases such as Bechet's disease, Sarcoidosis, Multiple Sclerosis, Lupus, Polyarteritis nodosa, Sjogren's disease, Relapsing polychondritis, Antiphospholipid antibodies, Syphilis, Whipple's disease, Cytomegalovirus infection, leukaemia or lymphomas. Despite the growing popularity of OCT, we cannot ignore the importance of fluorescein angiography for the follow‐up of these cases.

Comparison of efficacy and safety of intravitreal ranibizumab and conbercept before vitrectomy in Chinese proliferative diabetic retinopathy patients: a prospective randomized controlled trial

BackgroundTo compare the efficacy and safety of preoperative intravitreal injections of ranibizumab and conbercept in Chinese proliferative diabetic retinopathy (PDR) patients.MethodsThis prospective randomized controlled trial enrolled 90 eyes of 80 patients with PDR. Forty-four eyes of 40 patients that received intravitreal ranibizumab (IVR) injections (0.5 mg/0.05 mL) before vitreous surgeries were assigned to the IVR group. Forty-six eyes of 40 patients that received intravitreal conbercept (IVC) injections (0.5 mg/0.05 mL) before vitreous surgeries were assigned to the IVC group. Intraoperative and postoperative indices were assessed for further comparison between the two groups.ResultsThere were no statistically significant differences in all surgery indices, including intraoperative indices (surgery time, P = 0.225; intraoperative bleeding, P = 0.808; endodiathermy use, P = 0.693; incidence of iatrogenic retinal breaks, P = 0.740; relaxing retinotomy, P = 0.682; retinal reattachment, P = 0.682 and silicone oil tamponade, P = 0.814) and postoperative indices (postoperative vitreous hemorrhage (VH), P = 0.808; neovascular glaucoma (NVG), P = 0.964; recurrent retinal detachment, P = 0.531; postoperative fibrovascular proliferation progression, P = 0.682 and reoperation, P = 0.955) between the two groups. There were no statistically significant differences in best-corrected visual acuity (BCVA) at each follow-up visit (P = 0.939, 0.669, 0.741 and 0.717, respectively) or in central retinal thickness (CRT) (P = 0.976, 0.699, 0.551 and 0.686, respectively). As for safety profile, both groups had no ocular or system adverse events during the observation period.ConclusionsIVR and IVC as a pretreatment of vitrectomy had similar efficacy and safety profile for Chinese PDR patients.Trial registration: Registered at ClinicalTrials.gov (NCT05414149).

Comparison of intravitreal injection of ranibizumab versus bevacizumab for treatment of type 1 and aggressive retinopathy of prematurity in rural Egypt. A randomized clinical trial

ObjectiveThe objective of this study is to evaluate the efficacy of intravitreal ranibizumab (IVR) monotherapy compared with intravitreal bevacizumab (IVB) monotherapy for treatment of type 1 and aggressive retinopathy of...

Spontaneous resolution of treatment‐resistant foveal capillary macroaneurysms in retinal diseases

AbstractPurpose: Capillary macroaneurysms (CMAs), may be observed in many retinal diseases causing chronic macular edema. A targeted photocoagulation can be efficient to close extrafoveal CMAs. However, treatment of foveal CMAs can be challenging. We report 2 cases of foveal CMAs with chronic edema resistant to intravitreal injections (IVI), which spontaneously resolved after discontinuation of treatment.Methods: Patients with foveal aneurysms greater than 150 μm in diameter, related to retinal diseases and treatment‐resistant were evaluated with ophthalmologic examination and multimodal imaging.Results: Case 1: a 74‐year old female with retinal branch vein occlusion complicated with chronic macular edema was referred for treatment. Foveal macroaneurysm was detected on indocyanine green angiography (ICGA) and was resistant to ranibizumab followed by aflibercept monthly IVI. Six months after stopping treatment, macular edema spontaneously resolved with occlusion of the CMA.Case 2: a 82‐year old patient was treated for a chronic diabetic macular edema on his left eye. He received regular IVI of ranibizumab, aflibercept and dexamethasone implant without improvement. A retrofoveal CMA was noted on ICGA. After 4 months without IVI, the central macular thickness and the vision improved spontaneously.Conclusions: Chronic macular edema related to foveal CMAs is usually resistant to anti‐VEGF and steroid intravitreal injections. In some cases, spontaneous resolution of the macroaneurysm can occur when treatment is stopped.