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Groselli S, Bechstein L, Gabka K, Ulbig M. [Anti-VEGF (anti-vascular endothelial growth factor) treatment for central vein occlusion during breastfeeding]. DIE OPHTHALMOLOGIE 2023; 120:751-754. [PMID: 35925357 DOI: 10.1007/s00347-022-01694-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Affiliation(s)
- S Groselli
- Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland.
| | - L Bechstein
- Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland
| | - K Gabka
- Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland
| | - M Ulbig
- Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland
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Zehden JA, Mortensen XM, Reddy A, Zhang AY. Systemic and Ocular Adverse Events with Intravitreal Anti-VEGF Therapy Used in the Treatment of Diabetic Retinopathy: a Review. Curr Diab Rep 2022; 22:525-536. [PMID: 36053385 DOI: 10.1007/s11892-022-01491-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Intravitreal anti-vascular endothelial growth factor (VEGF) agents are used routinely in the management of neovascular conditions including proliferative diabetic retinopathy and diabetic macular edema. While the efficacy of anti-VEGF agents has been well-validated, their ocular and systemic adverse events should always be considered and discussed with patients. The aim of this review is to discuss the most recent literature reports regarding the various ocular and systemic adverse events associated with intravitreal anti-VEGF treatment in diabetic retinopathy. RECENT FINDINGS The most frequently reported adverse ocular events include subconjunctival hemorrhage, vitreous hemorrhage, increased intraocular pressure, uveitis, endophthalmitis, ocular surface disease, and traumatic cataract. Subconjunctival hemorrhage and vitreous hemorrhage are the most common ocular adverse events reported with intravitreal anti-VEGF treatment. The most serious (though rare) ocular adverse events include endophthalmitis and rhegmatogenous retinal detachment. A consensus regarding the association of systemic adverse events (such as myocardial infarction, stroke, and death) with intravitreal anti-VEGF treatments has not been established. Intravitreal anti-VEGF therapy is used in the treatment of diabetic retinopathy, macular degeneration, and other diseases. These agents are associated with a variety of ocular and systemic adverse events that ophthalmologists should always consider.
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Affiliation(s)
- Jason A Zehden
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA
| | - Xavier M Mortensen
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA
| | - Ashvini Reddy
- Athena Eye Institute, San Antonio, TX, USA
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Alice Yang Zhang
- Department of Ophthalmology, University of North Carolina at Chapel Hill, 2226 Nelson Hwy Suite 200, Chapel Hill, NC, 27517, USA.
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Anderson PO. Treating Glaucoma and Neovascular Eye Diseases While Breastfeeding. Breastfeed Med 2022; 17:3-5. [PMID: 34881990 DOI: 10.1089/bfm.2021.0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Philip O Anderson
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California, USA
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Shao Z, Li S, Yu X, Wang J, Liu H, Zhang Y, Huang C, Zhou F, Li J. Intravitreal Conbercept for Idiopathic Choroidal Neovascularization in Nursing Women. Breastfeed Med 2021; 16:915-918. [PMID: 34213377 DOI: 10.1089/bfm.2021.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: To report the clinical course and vascular endothelial growth factor (VEGF) levels in breast milk among three nursing women diagnosed with idiopathic choroidal neovascularization (CNV) before and after intravitreal injection of conbercept. Methods: This was an observational case series. The main outcomes and measures included best-corrected visual acuity (BCVA), anatomical features using optical coherence tomography, and breast milk concentrations of VEGF before and after the intravitreal injection of conbercept. Results: BCVA was increased, and no ocular or systemic safety problems were observed in any of the three patients during the follow-up period. An enzyme-linked immunosorbent assay was used to measure VEGF concentrations in the breast milk samples. Samples were collected 1 day before and 1, 7, and 30 days after the first intravitreal injection of conbercept. After conbercept injection, VEGF levels in breast milk were slightly decreased and did not change significantly in the following week; levels recovered fully by 30 days post-treatment. Conclusions: Intravitreal injection of conbercept shows favorable effectiveness and safety in the treatment of idiopathic CNV in nursing women and does not result in a significant reduction in VEGF in human breast milk.
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Affiliation(s)
- Zheyi Shao
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shanshan Li
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuechen Yu
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiawei Wang
- Department of Ophthalmology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Heng Liu
- NHC Key Laboratory of Otorhinolaryngology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ying Zhang
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chao Huang
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fang Zhou
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianqiao Li
- Department of Ophthalmology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Central Retinal Vein Occlusion with Severe Macular Edema in Early Pregnancy. Retin Cases Brief Rep 2020; 16:547-549. [PMID: 33017380 DOI: 10.1097/icb.0000000000001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the clinical course and treatment outcomes of a patient with central retinal vein occlusion (CRVO) with severe macular edema in early pregnancy. METHODS Interventional case report. RESULTS A 39-year-old woman with gestational diabetes mellitus and a 15-pack year smoking history presented at 7 weeks gestation with decreased vision due to CRVO with marked macular edema. One month later visual acuity had decreased to 20/400 and macular edema had worsened to a central subfield thickness of 1432 µm. She was treated with a single intravitreal dexamethasone implant at 16 weeks gestation. She responded well with visual acuity improving to 20/40+ and complete resolution of macular edema. At 33 weeks gestation the cystoid macular edema recurred but the patient refused treatment. The cystoid macular edema spontaneously resolved 3 weeks postpartum but recurred 3 months later with visual acuity worsening to 20/50. This macular edema resolved completely after a single 1.25 mg bevacizumab injection. She required no further treatment and 23 months later her macula was dry with visual acuity of 20/25. Her baby was healthy. CONCLUSIONS Although pregnancy appears to aggravate CRVO-associated macular edema, the visual loss may be reversible. Intravitreal steroid appears to be effective during pregnancy with no apparent systemic or fetal complications. Young patients with RVO and center-involving macular edema may stabilize with minimal treatment.
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