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Publisher: BMC (Biomed Central)   (Total: 310 journals)

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Showing 1 - 200 of 310 Journals sorted alphabetically
Acta Neuropathologica Communications     Open Access   (Followers: 1, SJR: 2.683, CiteScore: 5)
Acta Veterinaria Scandinavica     Open Access   (Followers: 1, SJR: 0.655, CiteScore: 1)
Addiction Science & Clinical Practice     Open Access   (Followers: 8, SJR: 1.224, CiteScore: 3)
Advances in Rheumatology     Open Access   (Followers: 1)
Advances in Simulation     Open Access   (Followers: 5)
Agriculture & Food Security     Open Access   (Followers: 16, SJR: 0.575, CiteScore: 2)
AIDS Research and Therapy     Open Access   (Followers: 14, SJR: 1.08, CiteScore: 2)
Algorithms for Molecular Biology     Open Access   (Followers: 4, SJR: 1.333, CiteScore: 2)
Allergy, Asthma and Clinical Immunology     Open Access   (Followers: 26, SJR: 0.732, CiteScore: 2)
Alzheimer's Research & Therapy     Open Access   (Followers: 3, SJR: 2.449, CiteScore: 6)
Animal Biotelemetry     Open Access   (Followers: 1, SJR: 1.067, CiteScore: 2)
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 12, SJR: 1.104, CiteScore: 3)
Annals of General Psychiatry     Open Access   (Followers: 26, SJR: 0.784, CiteScore: 2)
Annals of Occupational and Environmental Medicine     Open Access   (Followers: 13, SJR: 0.452, CiteScore: 1)
Annals of Surgical Innovation and Research     Open Access   (Followers: 3, SJR: 0.328, CiteScore: 1)
Antimicrobial Resistance and Infection Control     Open Access   (Followers: 7, SJR: 1.573, CiteScore: 3)
Applied Cancer Research     Open Access   (Followers: 3)
Archives of Physiotherapy     Open Access   (Followers: 12)
Archives of Public Health     Open Access   (Followers: 12, SJR: 1.244, CiteScore: 3)
Arthritis Research & Therapy     Open Access   (Followers: 15, SJR: 2.154, CiteScore: 4)
Asia Pacific Family Medicine     Open Access   (Followers: 1, SJR: 0.538, CiteScore: 1)
Asthma Research and Practice     Open Access   (Followers: 1)
Basic and Clinical Andrology     Open Access   (SJR: 0.564, CiteScore: 2)
Behavioral and Brain Functions     Open Access   (Followers: 3, SJR: 0.986, CiteScore: 3)
Big Data Analytics     Open Access   (Followers: 30)
BioData Mining     Open Access   (Followers: 5, SJR: 0.982, CiteScore: 2)
Bioelectronic Medicine     Open Access   (Followers: 1)
Biological Procedures Online     Open Access   (SJR: 1.352, CiteScore: 4)
Biological Research     Open Access   (Followers: 1, SJR: 0.654, CiteScore: 2)
Biology Direct     Open Access   (Followers: 9, SJR: 1.694, CiteScore: 3)
Biology of Mood & Anxiety Disorders     Open Access   (Followers: 5)
Biology of Sex Differences     Open Access   (Followers: 2, SJR: 1.902, CiteScore: 4)
Biomarker Research     Open Access   (Followers: 3)
Biomaterials Research     Open Access   (Followers: 6, SJR: 0.735, CiteScore: 3)
Biomedical Dermatology     Open Access  
BioMedical Engineering OnLine     Open Access   (Followers: 8, SJR: 0.542, CiteScore: 2)
BioPsychoSocial Medicine     Open Access   (Followers: 8, SJR: 0.416, CiteScore: 1)
Biotechnology for Biofuels     Open Access   (Followers: 9, SJR: 1.899, CiteScore: 6)
BMC Anesthesiology     Open Access   (Followers: 17, SJR: 0.807, CiteScore: 2)
BMC Biochemistry     Open Access   (Followers: 16, SJR: 0.708, CiteScore: 2)
BMC Bioinformatics     Open Access   (Followers: 179, SJR: 1.479, CiteScore: 2)
BMC Biology     Open Access   (Followers: 64, SJR: 3.842, CiteScore: 5)
BMC Biomedical Engineering     Open Access  
BMC Biophysics     Open Access   (Followers: 3, SJR: 0.682, CiteScore: 2)
BMC Biotechnology     Open Access   (Followers: 16, SJR: 1.012, CiteScore: 3)
BMC Cancer     Open Access   (Followers: 32, SJR: 1.464, CiteScore: 3)
BMC Cardiovascular Disorders     Open Access   (Followers: 22, SJR: 0.909, CiteScore: 2)
BMC Chemical Engineering     Open Access  
BMC Clinical Pathology     Open Access   (Followers: 8, SJR: 1.141, CiteScore: 3)
BMC Complementary and Alternative Medicine     Open Access   (Followers: 18, SJR: 0.858, CiteScore: 3)
BMC Dermatology     Open Access   (Followers: 13, SJR: 0.796, CiteScore: 2)
BMC Developmental Biology     Open Access   (Followers: 13, SJR: 1.43, CiteScore: 2)
BMC Ear, Nose and Throat Disorders     Open Access   (Followers: 1, SJR: 0.653, CiteScore: 2)
BMC Ecology     Open Access   (Followers: 24, SJR: 1.076, CiteScore: 2)
BMC Emergency Medicine     Open Access   (Followers: 18, SJR: 0.572, CiteScore: 1)
BMC Endocrine Disorders     Open Access   (Followers: 8, SJR: 0.965, CiteScore: 2)
BMC Energy     Open Access  
BMC Evolutionary Biology     Open Access   (Followers: 71, SJR: 1.656, CiteScore: 3)
BMC Family Practice     Open Access   (Followers: 13, SJR: 1.137, CiteScore: 2)
BMC Gastroenterology     Open Access   (Followers: 16, SJR: 1.231, CiteScore: 3)
BMC Genetics     Open Access   (Followers: 31, SJR: 1.16, CiteScore: 3)
BMC Genomics     Open Access   (Followers: 90, SJR: 2.11, CiteScore: 4)
BMC Geriatrics     Open Access   (Followers: 14, SJR: 1.257, CiteScore: 3)
BMC Health Services Research     Open Access   (Followers: 18, SJR: 1.151, CiteScore: 2)
BMC Hematology     Open Access   (Followers: 6, SJR: 0.545, CiteScore: 1)
BMC Immunology     Open Access   (Followers: 11, SJR: 0.993, CiteScore: 3)
BMC Infectious Diseases     Open Access   (Followers: 18, SJR: 1.576, CiteScore: 3)
BMC Intl. Health and Human Rights     Open Access   (Followers: 6, SJR: 1.006, CiteScore: 2)
BMC Medical Education     Open Access   (Followers: 48, SJR: 0.765, CiteScore: 2)
BMC Medical Ethics     Open Access   (Followers: 21, SJR: 1.016, CiteScore: 2)
BMC Medical Genetics     Open Access   (Followers: 8, SJR: 1.109, CiteScore: 2)
BMC Medical Genomics     Open Access   (Followers: 5, SJR: 1.688, CiteScore: 3)
BMC Medical Imaging     Open Access   (Followers: 9, SJR: 0.536, CiteScore: 2)
BMC Medical Informatics and Decision Making     Open Access   (Followers: 25, SJR: 0.812, CiteScore: 2)
BMC Medical Physics     Open Access   (Followers: 8)
BMC Medical Research Methodology     Open Access   (Followers: 9, SJR: 2.221, CiteScore: 3)
BMC Medicine     Open Access   (Followers: 13, SJR: 4.219, CiteScore: 7)
BMC Microbiology     Open Access   (Followers: 15, SJR: 1.242, CiteScore: 3)
BMC Molecular and Cell Biology     Open Access   (Followers: 47, SJR: 1.277, CiteScore: 3)
BMC Molecular Biology     Open Access   (Followers: 184, SJR: 1.216, CiteScore: 2)
BMC Musculoskeletal Disorders     Open Access   (Followers: 24, SJR: 0.951, CiteScore: 2)
BMC Nephrology     Open Access   (Followers: 8, SJR: 1.098, CiteScore: 3)
BMC Neurology     Open Access   (Followers: 22, SJR: 1.006, CiteScore: 2)
BMC Neuroscience     Open Access   (Followers: 17, SJR: 1.12, CiteScore: 2)
BMC Nursing     Open Access   (Followers: 26, SJR: 0.766, CiteScore: 2)
BMC Nutrition     Open Access   (Followers: 10)
BMC Obesity     Open Access   (Followers: 7)
BMC Ophthalmology     Open Access   (Followers: 16, SJR: 0.921, CiteScore: 2)
BMC Oral Health     Open Access   (Followers: 7, SJR: 0.867, CiteScore: 2)
BMC Palliative Care     Open Access   (Followers: 33, SJR: 1.105, CiteScore: 2)
BMC Pediatrics     Open Access   (Followers: 17, SJR: 1.278, CiteScore: 2)
BMC Pharmacology     Open Access   (Followers: 2)
BMC Pharmacology & Toxicology     Open Access   (Followers: 6, SJR: 0.785, CiteScore: 2)
BMC Physiology     Open Access   (Followers: 4, SJR: 0.936, CiteScore: 2)
BMC Plant Biology     Open Access   (Followers: 15, SJR: 1.887, CiteScore: 4)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22, SJR: 1.427, CiteScore: 3)
BMC Proceedings     Full-text available via subscription   (Followers: 1, SJR: 0.302, CiteScore: 1)
BMC Psychiatry     Open Access   (Followers: 35, SJR: 1.346, CiteScore: 3)
BMC Psychology     Open Access   (Followers: 19, SJR: 0.817, CiteScore: 2)
BMC Public Health     Open Access   (Followers: 191, SJR: 1.337, CiteScore: 3)
BMC Pulmonary Medicine     Open Access   (Followers: 4, SJR: 1.373, CiteScore: 3)
BMC Research Notes     Open Access   (Followers: 4, SJR: 0.691, CiteScore: 2)
BMC Rheumatology     Open Access   (Followers: 2)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 34, SJR: 0.926, CiteScore: 2)
BMC Structural Biology     Open Access   (Followers: 8, SJR: 1.024, CiteScore: 2)
BMC Surgery     Open Access   (Followers: 10, SJR: 0.693, CiteScore: 2)
BMC Systems Biology     Open Access   (Followers: 12, SJR: 1.109, CiteScore: 2)
BMC Urology     Open Access   (Followers: 15, SJR: 0.853, CiteScore: 2)
BMC Veterinary Research     Open Access   (Followers: 19, SJR: 0.934, CiteScore: 2)
BMC Women's Health     Open Access   (Followers: 13, SJR: 0.931, CiteScore: 2)
BMC Zoology     Open Access   (Followers: 1)
BMJ Evidence-Based Medicine     Hybrid Journal  
Borderline Personality Disorder and Emotion Dysregulation     Open Access   (Followers: 10)
Breast Cancer Research     Open Access   (Followers: 19, SJR: 3.026, CiteScore: 6)
Burns & Trauma     Open Access   (Followers: 13)
Cancer & Metabolism     Open Access   (Followers: 7)
Cancer Cell Intl.     Open Access   (Followers: 6, SJR: 1.13, CiteScore: 3)
Cancer Communications     Open Access  
Cancer Convergence     Open Access   (Followers: 1)
Cancer Imaging     Open Access   (Followers: 3, SJR: 1.012, CiteScore: 3)
Cancer Nanotechnology     Open Access   (Followers: 2, SJR: 1.168, CiteScore: 4)
Cancers of the Head & Neck     Open Access   (Followers: 2)
Canine Genetics and Epidemiology     Open Access   (Followers: 1)
Carbon Balance and Management     Open Access   (Followers: 5, SJR: 0.977, CiteScore: 2)
Cardio-Oncology     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10, SJR: 2.157, CiteScore: 5)
Cardiovascular Ultrasound     Open Access   (Followers: 5, SJR: 0.812, CiteScore: 2)
Cell Communication and Signaling     Open Access   (Followers: 2, SJR: 2.211, CiteScore: 4)
Cell Division     Open Access   (Followers: 1, SJR: 2.445, CiteScore: 4)
Cellular & Molecular Biology Letters     Hybrid Journal   (Followers: 3)
Cerebellum & Ataxias     Open Access   (Followers: 1)
Chemistry Central J.     Open Access   (Followers: 4, SJR: 0.607, CiteScore: 3)
Child and Adolescent Psychiatry and Mental Health     Open Access   (Followers: 27, SJR: 0.901, CiteScore: 2)
Chinese Medicine     Open Access   (Followers: 2, SJR: 0.57, CiteScore: 2)
Chinese Neurosurgical J.     Open Access  
Chiropractic & Manual Therapies     Open Access   (Followers: 5, SJR: 0.599, CiteScore: 2)
Cilia     Open Access   (SJR: 0.732, CiteScore: 1)
Clinical and Molecular Allergy     Open Access   (Followers: 5, SJR: 0.933, CiteScore: 3)
Clinical and Translational Allergy     Open Access   (Followers: 2, SJR: 1.425, CiteScore: 4)
Clinical Diabetes and Endocrinology     Open Access   (Followers: 22)
Clinical Epigenetics     Open Access   (Followers: 11, SJR: 2.435, CiteScore: 5)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Sarcoma Research     Open Access  
Conflict and Health     Open Access   (Followers: 7, SJR: 1.851, CiteScore: 3)
Contraception and Reproductive Medicine     Open Access   (Followers: 1)
COPD Research and Practice     Open Access   (Followers: 1, SJR: 0.755, CiteScore: 2)
Cost Effectiveness and Resource Allocation     Open Access   (Followers: 5, SJR: 0.888, CiteScore: 2)
Critical Care     Open Access   (Followers: 66, SJR: 2.48, CiteScore: 5)
Current Opinion in Molecular Therapeutics     Full-text available via subscription   (Followers: 13)
Diabetology & Metabolic Syndrome     Open Access   (Followers: 7, SJR: 0.943, CiteScore: 2)
Diagnostic and Prognostic Research     Open Access  
Diagnostic Pathology     Open Access   (Followers: 13, SJR: 0.818, CiteScore: 2)
Disaster and Military Medicine     Open Access   (Followers: 4)
Emerging Themes in Epidemiology     Open Access   (Followers: 13, SJR: 1.003, CiteScore: 2)
Energy, Sustainability and Society     Open Access   (Followers: 16, SJR: 0.607, CiteScore: 2)
Environmental Health     Open Access   (Followers: 13, SJR: 1.662, CiteScore: 4)
Environmental Health and Preventive Medicine     Open Access   (Followers: 4, SJR: 0.5, CiteScore: 1)
Epigenetics & Chromatin     Open Access   (Followers: 8, SJR: 3.767, CiteScore: 5)
European J. of Medical Research     Open Access   (Followers: 1, SJR: 0.55, CiteScore: 1)
European Review of Aging and Physical Activity     Open Access   (Followers: 11, SJR: 1.308, CiteScore: 4)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 8, SJR: 0.98, CiteScore: 3)
Experimental Hematology & Oncology     Open Access   (Followers: 4, SJR: 0.842, CiteScore: 2)
ExRNA     Open Access  
Eye and Vision     Open Access   (Followers: 1)
Fertility Research and Practice     Open Access   (Followers: 2)
Fibrogenesis & Tissue Repair     Open Access   (SJR: 1.531, CiteScore: 4)
Fisheries and Aquatic Sciences     Open Access   (Followers: 2, SJR: 0.199, CiteScore: 0)
Flavour     Open Access   (Followers: 3)
Fluids and Barriers of the CNS     Open Access   (Followers: 2, SJR: 2.054, CiteScore: 5)
Frontiers in Zoology     Open Access   (Followers: 8, SJR: 1.597, CiteScore: 3)
Genes and Environment     Open Access   (Followers: 1, SJR: 0.516, CiteScore: 1)
Genetics Selection Evolution     Open Access   (Followers: 7, SJR: 1.745, CiteScore: 4)
Genome Biology     Open Access   (Followers: 35)
Genome Medicine     Open Access   (Followers: 6, SJR: 4.537, CiteScore: 7)
Global Health Research and Policy     Open Access   (Followers: 4)
Globalization and Health     Open Access   (Followers: 7, SJR: 1.262, CiteScore: 2)
Gut Pathogens     Full-text available via subscription   (Followers: 5, SJR: 1.066, CiteScore: 3)
Gynecologic Oncology Research and Practice     Open Access   (Followers: 1)
Harm Reduction J.     Open Access   (SJR: 1.445, CiteScore: 3)
Head & Face Medicine     Open Access   (Followers: 1, SJR: 0.62, CiteScore: 2)
Health and Quality of Life Outcomes     Open Access   (Followers: 15, SJR: 1.069, CiteScore: 3)
Health Research Policy and Systems     Open Access   (Followers: 15, SJR: 1.11, CiteScore: 2)
Hereditary Cancer in Clinical Practice     Open Access   (SJR: 0.848, CiteScore: 2)
Hereditas     Open Access   (Followers: 1, SJR: 0.278, CiteScore: 1)
Human Genomics     Open Access   (Followers: 3, SJR: 1.501, CiteScore: 3)
Human Resources for Health     Open Access   (Followers: 11, SJR: 1.301, CiteScore: 2)
Immunity & Ageing     Open Access   (Followers: 10, SJR: 1.218, CiteScore: 3)
Implementation Science     Open Access   (Followers: 18, SJR: 2.443, CiteScore: 4)
Infectious Agents and Cancer     Open Access   (SJR: 0.855, CiteScore: 2)
Infectious Diseases of Poverty     Open Access   (Followers: 1, SJR: 1.212, CiteScore: 3)
Inflammation and Regeneration     Open Access   (Followers: 2)
Intl. Breastfeeding J.     Open Access   (Followers: 25, SJR: 0.913, CiteScore: 3)
Intl. J. for Equity in Health     Open Access   (Followers: 7, SJR: 1.04, CiteScore: 2)
Intl. J. of Behavioral Nutrition and Physical Activity     Open Access   (Followers: 28, SJR: 2.626, CiteScore: 6)
Intl. J. of Health Geographics     Open Access   (Followers: 7, SJR: 1.385, CiteScore: 3)
Intl. J. of Mental Health Systems     Open Access   (Followers: 7, SJR: 0.721, CiteScore: 2)
Intl. J. of Pediatric Endocrinology     Open Access   (Followers: 10)
Intl. J. of Retina and Vitreous     Open Access   (Followers: 2)
Investigative Genetics     Open Access   (Followers: 1, SJR: 1.809, CiteScore: 3)
Irish Veterinary J.     Open Access   (Followers: 4, SJR: 0.657, CiteScore: 1)

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International Journal of Retina and Vitreous
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2056-9920
Published by BMC (Biomed Central) Homepage  [310 journals]
  • Resistive index of central retinal artery is a bioimaging biomarker for
           severity of diabetic retinopathy

    • Abstract: Background The present study was undertaken to assess the resistive index (RI) of central retinal artery (CRA) as a bioimaging biomarker for the severity of diabetic retinopathy (DR), for the first time. Methods Eighty-one consecutive patients of type 2 diabetes mellitus between the ages of 40 and 70 years were included in a tertiary care center-based cross sectional study. Severity of retinopathy was assessed according to Early Treatment Diabetic Retinopathy Study (ETDRS) classification: diabetes mellitus with no retinopathy (No DR) (n = 26); non-proliferative diabetic retinopathy (NPDR) (n = 29); and proliferative diabetic retinopathy (PDR) (n = 26). Twenty-six healthy controls of similar age were also included. Resistive index of CRA was studied using color Doppler and gray scale sonography. Central subfield thickness (CST), cube average thickness (CAT), retinal photoreceptor ellipsoid zone (EZ) disruption, and retinal nerve fiber layer (RNFL) thickness were evaluated using spectral domain optical coherence tomography. Sensitivity and specificity were assessed by receiver operating characteristic (ROC) curve. Results Mean RI of CRA for the study groups revealed significant increase with severity of diabetic retinopathy (F = 10.24, P < 0.001). The ROC curve analysis showed diagnostic accuracy of RI of CRA (area under curve = 0.841–0.999; sensitivity = 76–100%, specificity = 95.45–100%, P < 0.001) in discriminating controls and patients. Univariate regression analysis revealed significant association between the study groups and RI of CRA (P < 0.001). RI of CRA correlated positively with CST (r = 0.37), CAT (r = 0.45), EZ disruption (r = 0.43) and negatively with RNFL thickness (r = − 0.35) (P < 0.001). Conclusions Resistive index of CRA is a reliable bioimaging biomarker for the severity of DR.
      PubDate: 2019-11-12
  • Serum vitamin D is a biomolecular biomarker for proliferative diabetic

    • Abstract: Background Vitamin D is a multi-functional fat-soluble metabolite essential for a vast number of physiological processes. Non-classical functions are gaining attention because of the close association of vitamin D deficiency with diabetes, and its complications. The present study was undertaken to evaluate the role of vitamin D as a biomarker for proliferative diabetic retinopathy. Methods A tertiary care center based cross-sectional study was undertaken. Seventy-two consecutive cases of type 2 diabetes mellitus were included. Diagnosis of diabetes mellitus was made using American Diabetes Association guidelines. Study subjects included: diabetes mellitus with no retinopathy (No DR) (n = 24); non-proliferative diabetic retinopathy (n = 24); and proliferative diabetic retinopathy (n = 24) and healthy controls (n = 24). All of the study subjects underwent complete ophthalmological evaluation. Best Corrected Visual Acuity (BCVA) was measured on the logarithm of the minimum angle of resolution (logMAR) scale. Serum 25-OH Vitamin D assay was done using chemiluminescent microparticle immunoassay technology. Diagnostic accuracy of vitamin D was assessed using receiver operating characteristics curve analysis and area under curve (AUC) was determined for the first time. Results ANOVA revealed a significant decrease in serum vitamin D levels with severity of diabetic retinopathy (F = 8.95, p < 0.001). LogMAR BCVA was found to increase significantly with the severity of DR (F = 112.64, p < 0.001). On AUC analysis, a cut off value of 18.6 ng/mL for Vitamin D was found to be significantly associated with proliferative diabetic retinopathy [sensitivity = 86.36% (95% CI 65.1–96.9); specificity = 81.82% (95% CI 59.7–94.7); AUC = 0.91 (excellent); and Z value = 8.17]. Conclusions Serum vitamin D levels of ≤ 18.6 ng/mL serve as sensitive and specific indicator for proliferative disease, among patients of DR.
      PubDate: 2019-11-05
  • The effect of image quality on the reliability of OCT angiography
           measurements in patients with diabetes

    • Abstract: Background This study aimed to determine the relationship between image quality and measurement repeatability of optical coherence tomography angiography (OCTA) parameters in patients with non-proliferative diabetic retinopathy. Methods A total of 100 eyes of 50 patients were included in the study. Three OCTA images were obtained consecutively during one session of imaging in all patients using the RTVue AngioVue OCTA device. We applied the signal strength index (SSI) provided by the RTVue system to define scan quality. Superficial vessel density (VD) in the central 3 × 3 mm macular and in the perifoveal region, as well as foveal avascular zone (FAZ) area were evaluated by the AngioAnalytics software for each scan from three consecutive measurements, whereby measurement repeatability of the OCTA parameters were calculated. The effect of SSI value on OCTA parameters, as well as on measurement errors was assessed. Results Values of SSI ranged from 30 to 85 with an overall mean of 61.79 ± 10.38. Mean SSI values showed significant positive correlation with the mean retinal capillary vessel density values, but not with non-flow area. Repeatability of OCTA parameters was generally improved with higher SSI values. We calculated a mean correction factor of 0.22% (95% CI 0.20–0.24 µm; p < 0.001) for VD at the 3 × 3 mm macular scan, 0.23% (95% CI 0.21–0.26%; p < 0.001) for perifoveal VD and − 0.001 mm2 (95% CI − 0.001 to 0.002; p = 0.001) for the non-flow area for each unit increase in SSI for the comparison of images with different SSI values. Conclusions The influence of image quality on OCTA metrics should be considered for image comparisons during follow-up to avoid misinterpretation of small changes in OCTA parameters in patients with diabetes.
      PubDate: 2019-11-04
  • In vitro differentiation of cGMP-grade retinal pigmented epithelium from
           human embryonic stem cells

    • Abstract: Background The World Health Organization (WHO) estimates that the number of individuals who lose their vision due to retinal degeneration is expected to reach 6 million annually in 2020. The retinal degenerative diseases affect the macula, which is responsible for central and detailed vision. Most macular degeneration, i.e., age-related macular degeneration (AMD) develops in the elderly; however, certain hereditary diseases, such as the Stargardt disease, also affect young people. This degeneration begins with loss of retinal pigmented epithelium (RPE) due to formation of drusen (atrophic) or abnormal vessels (exudative). In wet AMD, numerous drugs are available to successful treat the disease; however, no proven therapy currently is available to treat dry AMD or Stargardt. Since its discovery, human embryonic stem cells (hESCs) have been considered a valuable therapeutic tool. Some evidence has shown that transplantation of RPEs differentiated from hESCs cells can result in recovery of both RPE and photoreceptors and prevent visual loss. Methods The human embryonic WA-09 stem cell lineage was cultured under current Good Manufacturing Practices (cGMP) conditions using serum-free media and supplements. The colonies were isolated manually and allowed to spontaneously differentiate into RPE cells. Results This simple and effective protocol required minimal manipulation and yielded more than 10e8 RPE cells by the end of the differentiation and enrichment processes, with cells exhibiting a cobblestone morphology and displaying cellular markers and a gene expression profile typical of mature RPE cells. Moreover, the differentiated cells displayed phagocytic activity and only a small percentage of the total cells remained positive for the Octamer-binding transcriptions factor 4 (OCT-4) pluripotency cell marker. Conclusions These results showed that functional RPE cells can be produced efficiently and suggested the possibility of scaling-up to aim at therapeutic protocols for retinal diseases associated with RPE degeneration.
      PubDate: 2019-10-21
  • Inverted internal limiting membrane-flap technique for large macular hole:
           a microperimetric study

    • Abstract: Background Inverted Internal Limiting Membrane (ILM)-flap technique would seem to lead to higher closure rate and better visual acuity than traditional procedure with ILM peeling for the treatment of large macular hole (LMH). Visual acuity recovery does not reveal many other functional changes related to surgical approach. Our purpose was to evaluate macular function and morphology over a 1-year follow-up after inverted ILM-flap technique for LMH by using microperimetry in order to predict visual prognosis. Methods This study was a prospective unrandomized single-center study. 23 eyes of 22 patients with idiopathic LMH, with a minimum diameter ranging from 400 to 1000 μm, were included. All patients underwent vitrectomy with inverted ILM-flap technique and gas tamponade. We analyzed macular hole closure rate and functional outcomes including best-corrected visual acuity (BCVA), macular sensitivity (MS) at central 12° and central macular sensitivity (CMS) at central 4°, and fixation behavior as bivariate contour ellipse area (BCEA, degrees2) at 68%, 95%, and 99% of fixation points measured by microperimeter, over a follow-up of 12 months. Results The macular hole closure rate was 98%. The BCVA improved from 20/230 (Logmar, 1.06 ± 0.34) to 20/59 (logMar, 0.47 ± 0.45) at last follow-up (p < 0.001). Retinal sensitivity and BCEA significantly improved (MS, p = 0.001; CMS, p < 0.0001; BCEA: 68%, p < 0.01; 95%, p < 0.01; 99%, p = 0.001). Multiple stepwise regression analysis showed the final BCVA was significantly associated with macular hole size (β = 0.002, p = 0.03), preoperative MS (β = − 0.06, p = 0.001) and BCEA at 95% and 99% of fixation points (β = − 0.12, p = 0.01; β = 0.06, p = 0.01). Conclusions Inverted ILM-flap technique for LMH results in good morphologic and functional outcomes. Macular hole size and microperimetric parameters as preoperative MS and BCEA have a predictive role on post-surgical visual acuity.
      PubDate: 2019-10-18
  • Choroidal granuloma caused by Mycobacterium Fortuitum

    • Abstract: Background To report a case of a chronic steroid user male patient who developed local abscesses caused by M. fortuitum and concomitant asymptomatic choroidal granuloma. Case presentation A 37-year-old african-american male with history of use of anabolic drugs and intramuscular mineral oil injections in the upper and lower limbs for 15 years for muscular hypertrophy. He developed intramuscular abscesses with systemic infection, sub-retinal lesions in both eyes and alterations in cerebrospinal fluid suggestive of mycobacteria. Considering these findings, empirical treatment for tuberculosis was started, without success. After several negative cultures of the material drained from the abscesses, finally one of the cultures isolated the agent Mycobacterium Fortuitum. Proper treatment for atypical mycobacteria was initiated with clinical and laboratory improvement. After 6 months the sub-retinal lesions regressed. Conclusions A typical choroidal granuloma caused by M. Fortuitum is a rare presentation of the infection and our report showed a good outcome with proper treatment.
      PubDate: 2019-10-14
  • Diffuse uveitis and chorioretinal changes after yellow fever vaccination:
           a re-emerging epidemic

    • Abstract: Background With increasing incidence of yellow fever, mass campaign vaccinations are underway and little ophthalmological alterations have been reported in literature, specially regarding non-combined vaccines. Case presentation We report the case of a patient with no previous ocular or systemic diseases whom received a single dose of yellow fever vaccination and developed haematological, hepatic and renal alterations progressing with a later onset bilateral asymmetric diffuse uveitis. Ophthalmological findings included fine keratic precipitates scattered throughout the cornea and mild vitritis. Multimodal evaluation showed subtle puntiform choriocapillaris changes with decreased vascular density associated. The patient had a good visual outcome after mild oral prednisone dose, but the image findings have not presented remission. Conclusions Clinicians should be aware of clinical and subclinical ocular manifestations such as subtle puntiform choriocapillaris changes as possible vaccine-related adverse events with potential to impact vision.
      PubDate: 2019-10-07
  • Serum vascular endothelial growth factor is a biomolecular biomarker of
           severity of diabetic retinopathy

    • Abstract: Background Elevated serum vascular endothelial growth factor (VEGF) levels are associated with diabetic retinopathy (DR). Serum VEGF levels correlate with vitreous levels. Neuroretinal changes occur even before the appearance of vascular signs in DR. Role of VEGF as a biomarker for DR has not been assessed. Serum VEGF as a biomarker for severity of DR, was evaluated for the first time. Methods Consecutive cases of type 2 diabetes mellitus [without DR, (no DR, n = 38); non-proliferative DR, (NPDR, n = 38); proliferative DR, (PDR, n = 40)] and healthy controls (n = 40) were included. Serum VEGF was measured using enzyme linked immunosorbent assay. Accuracy of VEGF as a biomarker for severity of retinopathy was measured using the area under the receiver operator characteristic (ROC) curve. Results Serum VEGF levels in controls, No DR, NPDR and PDR groups showed significant incremental trend from 138.96 ± 63.37 pg/ml (controls) to 457.18 ± 165.69 pg/ml (PDR) (F = 48.47; p < 0.001). Serum VEGF levels were observed to be significantly elevated even before DR had set in clinically. ROC for serum VEGF levels was significant in discriminating between the cases and the controls and had good accuracy in discerning between subjects with and without retinopathy. The area under curve (AUC ± SE) for discrimination was significant: (a) cases and controls (n = 156): AUC = 0.858 ± 0.029, p < 0.001; (b) DR (NPDR + PDR) and No DR (n = 116): AUC = 0.791 ± 0.044, p < 0.001; and (c) NPDR and PDR (n = 78): AUC = 0.761 ± 0.056, p < 0.001, with over 90% projected sensitivity and specificity at various cut off values. Conclusion Serum VEGF level is a simple, effective laboratory investigative test in predicting the onset of DR in eyes showing no evidence of DR and serves as a reliable biomolecular biomarker for severity of DR.
      PubDate: 2019-10-01
  • In vivo and in vitro toxicity evaluation of liposome-encapsulated

    • Abstract: Background To evaluate the in vivo and in vitro toxicity of a new formulation of liposome-encapsulated sirolimus (LES). Methods In vitro experiments were done using ARPE-19 and HRP cells. An MTT assay was used to determine cell metabolic activity and a TUNEL assay for detecting DNA fragmentation. In vivo experiments were conducted on New Zealand albino rabbits that received intravitreal injections of empty liposomes (EL) or different concentrations of LES. Histopathological and immunohistochemical analyses were performed on the rabbit’s eyes following injection. Results Eighteen eyes of nine rabbits were used. MTT assay cell viability was 95.04% in group 1 (12.5 µL/mL LES). 92.95% in group 2 (25 µL/mL LES), 91.59% in group 3 (50 µL/mL LES), 98.09% in group 4 (12.5 µL/mL EL), 95.20% on group 5 (50 µL/mL EL), 98.53% in group 6 (50 µL/mL EL), and 2.84% on group 8 (50 µL/mL DMSO). There was no statistically significant difference among groups 1 to 7 in cell viability (p = 1.0), but the comparison of all groups with group 8 was significant (p < 0.0001). The TUNEL assay comparing two groups was not statistically significant from groups 1 to 7 (p = 1.0). The difference between groups 1 to 7 and group 8 (p < 0.0001) was significant. Histopathological changes were not found in any group. No activation of Müller cells was detected. Conclusion A novel formulation of LES delivered intravitreally did not cause in vitro toxicity, as evaluated by MTT and TUNEL assays, nor in vivo toxicity as evaluated by histopathology and immunohistochemistry in rabbit eyes.
      PubDate: 2019-09-24
  • Prevalence of silicone oil droplets in eyes treated with intravitreal

    • Abstract: Objective To assess the number of eyes with silicone oil in the vitreous after intravitreal injection. Methods This cross-sectional, comparative study was divided into 2 groups: (1) treatment—eyes subjected to antiangiogenic therapy; (2) control—no history of intravitreal injection. Subjects were assessed regarding age, gender, clinical diagnosis, lens status, visual acuity and number of previous intravitreal injections. All eyes underwent a meticulous slit-lamp and ultrasound examination for the identification of silicone oil. ImageJ software was used to quantify the index of silicone oil (IOS) by ultrasonography. Results Sixty-seven eyes (30 controls, 37 treated) were included. Slit-lamp examination found silicone oil droplets in 25 out of 37 (67.57%) treated eyes and in none of the control group. Ultrasonography identified silicone oil in 28 out of 37 (75.68%) treated eyes and in 1 out of 30 (3.33%) controls. An observed agreement of 85.07% and a Cohen’s Kappa coefficient of 69.10% (p < 0.0001) between ultrasonography and biomicroscopy were found. Wilcoxon test showed a statistically significant difference (p = 0.0006) in IOS between controls (0.41 ± 0.43%) and treated eyes (2.69 ± 2.55%). Spearman’s correlation test (0.61; p < 0.0001) showed that the greater the number of injections, the higher the IOS. Conclusions Silicone oil droplets were found in the majority of the eyes previously treated with antiangiogenic intravitreal injection. The greater the number of injections, the higher the likelihood of finding silicone oil. An improvement in the technique of injection and better-quality syringes post-injection silicone oil droplets.
      PubDate: 2019-09-11
  • Neovessel as first manifestation of relapse of associated multifocal
           choroiditis and MEWDS

    • Abstract: Purpose To report a case of multifocal choroiditis (MC) that has relapsed as choroidal neovascularization in the contralateral eye followed by a mixed aspect of multiple evanescent white dot syndrome (MEWDS) and MC. Methods Retrospective case report and literature review. The clinical findings were documented by fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography (OCT-A). Results The authors describe the case of a 39-year-old woman with prior ocular history of presumed MEWDS in her left eye, which developed into MC 7 years later in the same eye and 11 years later in the right eye, starting as choroidal neovascularization and developing into MEWDS. OCT-A showed neovessel in a supposedly active MC area outside the macular region in right and left eyes. OCT showed increased choroidal thickness in both eyes and a choroidal neovascularization in the right eye, treated using anti- VEGF therapy. Conclusion This case corroborates the proximity of some inflammatory diseases such as MC and MEWDS. OCT-A has opened new horizons for the better understanding of some retinal diseases by providing more thorough and promising morphological analyses using enhanced tools.
      PubDate: 2019-09-10
  • Short-term eplerenone for treatment of chronic central serous
           chorioretinopathy; a prospective study

    • Abstract: Background Increased mineralocorticoid activity is one of the plausible causes of chronic central serous chorioretinopathy (CSCR) and mineralocorticoid inhibitors such as eplerenone have been investigated as its potential therapy. This study investigates the short-term safety and efficacy of oral eplerenone in patients with chronic CSCR. Patients and methods Prospective study of 13 eyes of 13 patients with the diagnosis of chronic CSCR. All patients received eplerenone 50 mg/day for 4 weeks. Enhanced depth imaging optical coherence tomography (OCT) was obtained. Best corrected visual acuity (BCVA), and OCT parameters including sub retinal fluid (SRF), choroidal thickness (CT) and central macular thickness (CMT), were measured manually. Results The mean SRF height decreased slightly at 1-month follow-up as compared to baseline, but the change was not statistically significant (94.18 ± 17.53 vs. 113.15 ± 18.69; p = 0.08). Subfoveal CT and CMT was significantly reduced as compared to baseline (6.6% [p = 0.002] and 7.05% [p = 0.04], respectively). The BCVA did not change significantly (20/28 vs. 20/30 [p = 0.16]). Conclusion This study suggests that oral eplerenone may be used as a safe and potentially effective treatment in chronic CSCR, however there are minimal short-term effects on subretinal fluid or visual acuity therefore therapeutic trials longer than one month are necessary to test its benefits. Trial registration identification number: NCT01822561. Registered 3/25/13,
      PubDate: 2019-09-09
  • Microperimetry and OCT angiography evaluation of patients with ischemic
           diabetic macular edema treated with monthly intravitreal bevacizumab: a
           pilot study

    • Abstract: Background Functional and anatomical evaluation of patients with ischemic diabetic macular edema after monthly injections of Bevacizumab. Methods Five eyes from five patients with diabetic macular edema associated with macular ischemia in fluorescein angiography (FA), received 6 monthly intravitreal injections of Bevacizumab. All subjects underwent SD-OCT, FA, OCT angiography (OCTA) and microperimetry at baseline and after 6 months follow-up. Primary outcome measures were improvement of best corrected visual acuity (BCVA), microperimetry and assessment of macular perfusion (foveal avascular zone size and capillary loss). Results Five patients completed the follow-up. BCVA improved from 20/180 to 20/74 (p = 0.01) and macular sensitivity improved from 11.66 to 16.26 dB (p < 0.007). We also observed that areas of ischemia on OCTA represented areas of lower macular sensitivity on microperimetry. No changes in macular perfusion status were noted. Conclusions Monthly intravitreal Bevacizumab in patients with ischemic diabetic macular edema improved BCVA and macular sensitivity without compromise of perfusion in the macula. Capillary dropout areas in OCTA correlated with lower retinal sensitivity on microperimetry.
      PubDate: 2019-09-03
  • Vascularized drusen: a cross-sectional study

    • Abstract: Background To investigate whether neovascularization may arise and be detectable in drusen, as reported in histopathologic studies, by OCTA prior to developing exudation and to assess its prevalence in a cohort of patients with intermediate AMD. Methods Retrospective cross-sectional study of 128 patients with intermediate AMD recruited as part of a separate ongoing clinical trial conducted at multiple large tertiary referral retina clinics. One hundred and twenty-eight consecutive patients with exudative AMD in one eye and intermediate non-exudative AMD in the fellow eye were enrolled and analyzed between September 2015 and March 2017. Results SD-OCTA identified vascularization within drusen in 7 of 128 eyes, for a prevalence of 5.5%. A total of 12 instances of vascularized drusen were noted. Out of the 12 vascularized drusen noted, 7 were located in the parafoveal region or subfoveal region and 5 was in the extrafoveal region. 9 of 12 instances of vascularized drusen exhibited a uniform sub-RPE hyperreflectivity, whilst 3 of 12 exhibited more heterogenous reflectivity. In all 12 instances, FA images failed to identify the neovascular nature of vascularized drusen. Conclusions Our results demonstrate the utility of SD-OCTA for the diagnosis of vascularized drusen in patients with intermediate non-exudative AMD. Longitudinal studies are needed to delineate the evolution and conversion risk of these lesions over time, which can be of substantial clinical relevance.
      PubDate: 2019-08-20
  • The use of anterior segment optical coherence tomography (ASOCT) in
           demonstrating recurrence of vitreoretinal lymphoma (VRL) in the anterior

    • Abstract: Background Primary vitreoretinal lymphoma (VRL) is a rare disease with 30–380 new cases in the United States per year. Its insidious process and spread to the central nervous system (CNS) leads to a mean 5-year survival rate from 41.4 to 71%. Medical treatment of VRL has been summarized extensively in the literature and involves intraocular rituximab and methotrexate as first line agents in unilateral VRL, with systemic chemotherapy to be considered in bilateral or CNS-involving disease. In addition, therapeutic “debulking” vitrectomy has been reported in the literature, with some limited success. Despite this, recurrence rate is high and should always be suspected in the setting of new inflammation. Anterior segment optical coherence tomography (ASOCT) has not been previously used to image VRL recurrence in the anterior vitreous. Case presentation A 63-year-old man, with VRL was found to have cells and debris in the anterior vitreous, 10 months after his first vitrectomy, intravitreal rituximab and methotrexate. Since the patient was phakic at the time of initial vitrectomy, the anterior vitreous had not been removed. ASOCT confirmed the findings. Subsequent surgery removed the lens and debris. Both the patient’s vision and ASOCT improved. Conclusions We suggest that ASOCT of the anterior segment is a useful diagnostic tool to monitor for recurrence of VRL. In biopsy-proven VRL, phakic patients who undergo therapeutic vitrectomy, should also be considered for lens extraction and anterior vitrectomy to limit recurrences.
      PubDate: 2019-08-20
  • The retinal foveal avascular zone as a systemic biomarker to evaluate
           inflammatory bowel disease control

    • Abstract: Background Inflammatory bowel disease (IBD) is a systemic inflammatory disease and is classified as Crohn’s disease (CD) or ulcerative colitis (UC) depending on the extent of gastrointestinal tract involvement. IBD can be associated with extraintestinal findings, such as fever, weight loss, arthralgia, and mucocutaneous lesions, as well as hepatic, renal and ophthalmological involvement. Clinical parameters and colonoscopy are used to establish the criteria for controlled or non-controlled disease and subsequent definition of treatment. Our objective in the present study was to compare the area of the foveal avascular zone (FAZ) in patients with a diagnosis of IBD during remission and active disease. Methods 144 eyes of 72 patients with IBD were evaluated via a complete ophthalmological exam. Fundus photography and optical coherence tomography/angiography (OCT/OCTA) were performed with a Topcon Triton. The macula and posterior pole were evaluated by binocular indirect ophthalmoscopy and fundus biomicroscopy. The area of the FAZ was determined via manual delimitation of superficial retinal vascular layers from OCTA with software. To establish disease activity, we considered the Mayo Score, fecal calprotectin levels, colonoscopy results and clinical parameters. All retinal parameters were evaluated in a blinded manner. Means were compared between groups using the Mann–Whitney test. Results The participants had a mean age of 42.26 years and included 28 males (38.88%) and 44 females (61.11%). Among the participants, 37 had a diagnosis of CD (51.38%), and 35 had a diagnosis of UC (48.61%). Twenty-five patients (34.72%) had active disease, and 47 (65.27%) were in remission. The area of the FAZ did not differ significantly between the CD and UC groups (p = 0.91 for the right eye and p = 0.76 for the left eye) but did differ significantly between the remission and active disease groups (p = 0.01 for the right eye and p = 0.02 for the left eye). Discussion Our study is the first to evaluate the area of the FAZ in patients with IBD via swept-source OCTA. The area of the FAZ did not differ significantly in either eye between the CD and UC groups. However, patients classified as having active disease according to clinical parameters and colonoscopy presented a significant decrease in the area of the FAZ compared with patients in remission. The area of the FAZ is an ophthalmological parameter that can be obtained non-invasively and is increased in ischemic diseases such as diabetic retinopathy. The FAZ may decrease due to vascular engorgement or increased systemic inflammation. This parameter can be used to help determine whether a patient is in remission or active IBD, thus potentially reducing the need for invasive exams during disease follow-up.
      PubDate: 2019-08-06
  • Primary outcomes of the VIDI study: phase 2, double-masked, randomized,
           active-controlled study of ASP8232 for diabetic macular edema

    • Abstract: Background ASP8232 is a potent and specific small molecule vascular adhesion protein-1 (VAP-1) inhibitor. This study evaluated the effect of ASP8232 on excess retinal thickness when given alone or in combination with ranibizumab in patients with center-involved diabetic macular edema (CI-DME). Methods This was a phase 2a, placebo and sham-injection controlled, double-masked, randomized, parallel-group clinical trial. Participants were patients with CI-DME and central subfield thickness (CST) ≥ 375 µm in the study eye as assessed by spectral domain optical coherence tomography. Eligible patients were randomized to (1) daily oral ASP8232 40 mg monotherapy; (2) combination therapy of daily oral ASP8232 40 mg and monthly intravitreal ranibizumab 0.3 mg; or (3) monthly intravitreal ranibizumab 0.3 mg monotherapy. The treatment period was 12 weeks. CST and best corrected visual acuity (BCVA) were assessed at baseline and at Weeks 2, 4, 8, 12, 16 and 24. The primary outcome was the mean percent change from baseline in excess CST at Week 12. Secondary outcomes were BCVA, safety and tolerability, and pharmacokinetic and pharmacodynamic characteristics of ASP8232. Results After 12 weeks, the mean (95% confidence interval) percent change in excess CST was 11.4% (− 15.0%, 37.8%) in the ASP8232 group, − 61.7% (− 86.1%, − 37.2%) in the ASP8232/ranibizumab group, and − 75.3% (− 94.8%, − 55.8%) in the ranibizumab group. The change from baseline in the two ranibizumab arms was statistically significant (P < 0.001) as was the difference between the ranibizumab groups and the ASP8232 group (P < 0.001). Mean (SD) increase in BCVA score from baseline was 3.1 (7.3) in the ASP8232 group, 5.2 (7.1) in the ASP8232/ranibizumab group, and 8.2 (9.5) in the ranibizumab group. The increase from baseline in BCVA score was statistically and clinically significant in the ranibizumab group compared with the ASP8232 group (P = 0.015). ASP8232 resulted in near complete inhibition of plasma VAP-1 activity whilst ranibizumab had no effect. Conclusions Near complete inhibition of plasma VAP-1 activity with ASP8232 had no effect on CST in patients with CI-DME. Furthermore, combination therapy did not provide additional benefit to treatment with ranibizumab alone, which significantly reduced CST and improved BCVA. Trial registration; NCT02302079. Registered on November 26, 2014
      PubDate: 2019-08-01
  • Observational study of intraocular lens tilt in sutureless intrascleral
           fixation versus standard transscleral suture fixation determined by
           ultrasound biomicroscopy

    • Abstract: Background The position of the intraocular lens (IOL) is a major factor that affects the final visual acuity after cataract surgery. However, no prospective study has compared the IOL positions associated with the sutureless intrascleral technique and the standard transscleral suturing technique. The current study compared the IOL positions in the two techniques using ultrasound biomicroscopy (UBM) in vivo. Methods Twenty-one eyes of 21 patients were included in this observational study conducted between February and May 2015. Eleven patients underwent the sutureless intrascleral technique, and 10 patients underwent transscleral fixation with suturing. Ophthalmologic examination and UBM were performed in all patients. Optic tilt was measured in relation to the iris plane. The haptic location was defined. Mann–Whitney test and multiple linear regression were used to analyze the vertical and horizontal gradients. Significant differences were considered when p ≤ 0.05. Results The most common indication for scleral fixation was a complication during phacoemulsification (81.81% in the sutureless group and 60% in the suture group). The mean vertical and horizontal tilts were, respectively, 0.24 ± 0.21 and 0.25 ± 0.19 mm in the sutureless group and 0.14 ± 0.17 and 0.23 ± 0.16 mm in the suture group. No significant differences were seen in the vertical tilt and horizontal tilt (p = 0.888 and p = 0.148, respectively) between the groups. Gender (p = 0.835), age (p = 0.888), follow-up time (p = 0.915), and surgical duration (p = 0.094) were not associated with optic tilt. Of the 22 haptics in the sutureless group, 21 (95.45%) were in the intrascleral tunnel; of the 20 haptics in the suture group, 13 (65%) were posterior to the ciliary body, four (20%) anterior to the ciliary body, and three (15%) in the ciliary sulcus. Conclusion This study showed that there are no significant differences in the IOL positions between the two techniques.
      PubDate: 2019-07-29
  • Prospective evaluation of intravitreal bevacizumab for ischemic central
           retinal vein occlusion

    • Abstract: Background Although previous studies have evaluated the effect of anti-VEGF therapies for central retinal vein occlusion (CRVO) patients, the majority of previous studies have excluded or included a very small number of patients with ischemic CRVO (iCRVO). The aim of our study is to examine the effects of bevacizumab on macular edema secondary to ischemic central retinal vein occlusion, as well as the effects on central choroidal thickness and best-corrected visual acuity. Methods In this prospective, interventional case series, iCRVO was defined by the presence of ≥ 10 or more disc diameter areas of retinal nonperfusion by fluorescein angiography (FA) and by the presence of a b/a ratio less than 1.5 by full-field electroretinogram (ffERG). Nine eyes with iCRVO received monthly bevacizumab 0.5 mg injections at baseline and months 1 to 5 for a maximum of six injections. Main outcome measures were visual acuity (Snellen), central foveal thickness, and central choroidal thickness as measured by Spectral-Domain Optical Coherence Tomography (SD-OCT) at baseline and at 6 month following initial intravitreal bevacizumab injection. Pairwise t-tests and the Wilcoxon signed-rank test were conducted to compare the outcome measures. Results After intravitreal administration of bevacizumab, there was a significant reduction of central foveal thickness from 858 ± 311 μm at baseline to 243 ± 106 μm at the 6-month follow-up, as well as a significant reduction of central choroidal thickness from 282 ± 38 μm at baseline to 227 ± 56 μm at the 6-month follow-up (p = 0.0006, p = 0.0003 respectively). The visual acuity worsened from a median of 1.3 to 1.7 (p = 0.02). Conclusion In patients with iCRVO, intravitreal bevacizumab led to a reduction of central macular edema and central choroidal thickness, but a worsening of visual acuity. Intravitreal bevacizumab reduces macular edema but is not able to overcome the poor prognosis of iCRVO.
      PubDate: 2019-07-26
  • Diabetic macular edema treated with intravitreal aflibercept injection
           after treatment with other anti-VEGF agents (SWAP-TWO study): 6-month
           interim analysis

    • Abstract: Background Diabetic macular edema (DME) is an important cause of vision loss and despite the anatomical and functional improvement achieved with treatment, there are reports of persistent DME regardless of continuous anti-VEGF therapy. The purpose of this study is to examine the effect of patients with DME previously treated with other anti-VEGF agents who are transitioned to intravitreal aflibercept (IAI) on a fixed dosing regimen. Methods This prospective study included 20 patients presenting with DME with a history of previous anti-VEGF treatment with ranibizumab or bevacizumab. Patients received a 2 mg (0.05 mL) IAI every 4 weeks until no evidence of fluid by optical coherence tomography (OCT) followed by a fixed dosing schedule of 2 mg IAI once every 8 weeks through 24 months. There was a pre-planned interim analysis of the mean absolute change from baseline central foveal thickness at month 6 as measured by OCT. Secondary outcomes included mean change from baseline in ETDRS visual acuity and anatomic parameters. Optical Coherence tomography angiography (OCTA) capillary perfusion density (CPD) after transitioning to IAI therapy were also reported. Results Average central subfield thickness on OCT at baseline was 419.7 ± 92.0 and improved to 303.8 ± 73.1 at 6-months (p < 0.001). At 6 months after IAI treatment, BCVA increased + 1.5 letters from baseline (p = 0.38). OCTA CPD analysis revealed significant increase from baseline in the foveal avascular zone in non-proliferative diabetic retinopathy group (p = 0.02). Conclusions Patients with prior anti-VEGF therapy who were transitioned to IAI therapy revealed significant anatomic improvements through 6 months. Trial registration Treatment of Diabetic Macular Edema With Aflibercept in Subjects Previously Treated With Ranibizumab or Bevacizumab (SwapTwo), Trial registration number: NCT02559180. Date of registration: September 24, 2015.
      PubDate: 2019-07-23
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