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Waterkotte T, He X, Wanasathop A, Li SK, Park YC. Long-Term Antibody Release Polycaprolactone Capsule and the Release Kinetics in Natural and Accelerated Degradation. ACS Biomater Sci Eng 2022; 8:4428-4438. [PMID: 36170673 DOI: 10.1021/acsbiomaterials.2c00808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although therapy using monoclonal antibodies (mAbs) has been steadily successful over the last 20 years, the means of delivery of mAbs has not been optimized, especially for long-term delivery. Frequent injections or infusions have been the current standard of care. In this study, we have developed a long-term antibody biodegradable implant using a porous polycaprolactone (PCL) capsule. It released bevacizumab (Bev) slowly for 8 months to date. The Bev release kinetics fit a drug release model with experimental data of the diffusion coefficient and partition coefficient through the polymer capsule. Since screening drug release profiles for the long term (>6 months) is time consuming, an accelerated degradation method was used after validating the characteristics of the PCL capsule in natural and accelerated degradation conditions. The correlation of the time period between natural and accelerated degradation was determined. Overall, the study suggests that mAbs can be released from a porous PCL capsule without an effect of the polymer degradation over a long period (∼6 months) and the long-term release kinetics can be determined by the accelerated degradation within 14 days.
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Affiliation(s)
- Thomas Waterkotte
- Department of Chemical & Environmental Engineering, University of Cincinnati, 2901 Woodside Dr., Cincinnati, Ohio 45221, United States
| | - Xingyu He
- Department of Chemical & Environmental Engineering, University of Cincinnati, 2901 Woodside Dr., Cincinnati, Ohio 45221, United States
| | - Apipa Wanasathop
- College of Pharmacy, University of Cincinnati, 3255 Eden Ave, Cincinnati, Ohio 45229, United States
| | - S Kevin Li
- College of Pharmacy, University of Cincinnati, 3255 Eden Ave, Cincinnati, Ohio 45229, United States
| | - Yoonjee C Park
- Department of Chemical & Environmental Engineering, University of Cincinnati, 2901 Woodside Dr., Cincinnati, Ohio 45221, United States
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2
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Ochinciuc R, Ochinciuc U, Baltă G, Al Barri L, Pac C, Adrian T, Baltă F, Burcea M. High-resolution images in macular disorders. Rom J Ophthalmol 2021; 65:204-211. [PMID: 34179590 PMCID: PMC8207868 DOI: 10.22336/rjo.2021.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: This study analyzed and compared the results of adaptive optics (AO) and fundus autofluorescence (FAF) in various maculopathies. Methods: The study included four different types of maculopathy: central serous chorioretinopathy (CSC), retinitis pigmentosa (RP), Stargardt disease (STGD) and phototoxic retinopathy. In all four cases, cone mosaic and cone density were obtained using AO fundus camera. Further, the high-resolution images were compared with the FAF and optical coherence tomography (OCT) results. Results: In CSC, FAF and AO, changes could be shown in the macula even two years after the subretinal fluid resorption, as opposed to a normal OCT. The improvement of FAF and cone mosaic appearance was concomitant with the visual acuity growth. Several cone mosaic phenotypes were observed in RP and STGD. In RP, the cone density was 24.240 cones /mm2 in the center, and decreased to 8.163 cones/ mm2 in the parafoveal area. In STGD, the cone density was lower in the center, 9.219 cones/ mm2, and higher at the periphery, 12.594 cones/ mm2. In the case of phototoxic retinopathy, AO and OCT were more effective than FAF in highlighting the photoreceptor and retinal pigment epithelium lesions. Conclusions: FAF and AO are very useful tools in macular pathologies examination. FAF can offer a true picture of the metabolic changes in the macula, while AO allows the view of changes up to the cellular level. Abbreviations: STGD = Stargardt disease, CSC = central serous chorioretinopathy, RP = retinitis pigmentosa, AO = adaptive optics, FAF = fundus autofluorescence
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Affiliation(s)
- Radu Ochinciuc
- Department of Ophthalmology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Uliana Ochinciuc
- Department of Ophthalmology, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania
| | - George Baltă
- Emergency Eye Hospital and Clinic, Bucharest, Romania
| | - Leila Al Barri
- Department of Ophthalmology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Cristina Pac
- Department of Ophthalmology, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Teodoru Adrian
- Department of Ophthalmology, Faculty of Medicine, "Lucian Blaga" University of Sibiu, Romania
| | - Florian Baltă
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Marian Burcea
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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3
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Femtosecond-LASIK outcomes using the VisuMax ®-MEL ® 80 platform for hyperopia and hyperopic astigmatism refractive surgery. Exp Ther Med 2021; 21:288. [PMID: 33603895 PMCID: PMC7851669 DOI: 10.3892/etm.2021.9719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/11/2020] [Indexed: 12/03/2022] Open
Abstract
The present study evaluated the efficacy, the safety and the predictability of the Femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) procedure for hyperopia and hyperopic astigmatism. We retrospectively analyzed the postoperative 12-month evolution of 593 eyes with hyperopia and hyperopic astigmatism that underwent Femto-LASIK treatment. The procedure was predictable and effective. No eye lost 2 lines of corrected distance visual acuity (CDVA), demonstrating a safety profile of the procedure. Nine percent of the eyes gained at least one line of CDVA. The accuracy of the spherical equivalent after 12 months was 74% within ±1.0 diopter (D) of emmetropia. The refractive outcomes were stable during the follow-up period. There were no significant complications during the procedure. Femto-LASIK using the VisuMax®-MEL® 80 platform was demonstrated to be a suitable option to correct selected cases of hyperopia and hyperopic astigmatism. A longer follow-up period is required to better assess the refractive results and to detect any further regression.
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4
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Branisteanu DC, Branisteanu DE, Feraru CI, Branisteanu CI, Moraru A, Zemba M, Balta F. Influence of unilateral intravitreal bevacizumab injection on the incidence of symptomatic choroidal neovascularization in the fellow eye in patients with neovascular age-related macular degeneration (Review). Exp Ther Med 2020; 20:182. [PMID: 33101472 PMCID: PMC7579776 DOI: 10.3892/etm.2020.9312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022] Open
Abstract
Neovascular age-related macular degeneration (neovascular ARMD) represents only 10% of ARMD cases but is responsible, if untreated, for quick and severe central vision loss due to major macular changes. The presence of choroidal neovascularization (CNV) in one eye is associated with an approximately 10% risk of CNV development in the fellow eye each year. Intravitreal anti-VEGF therapy has quickly evolved as the standard treatment in neovascular ARMD in the last decade due to significant anatomical and functional improvements, especially in the early stages. In many reports an improvement in the untreated fellow eye was mentioned and systemic exposure was soon confirmed for all anti-VEGF agents after unilateral intravitreal injection. In particular, bevacizumab intravitreal injection is followed by a consistent reduction of serum VEGF levels and the drug was shown to have the longest serum half-life raising important debates about its safety. Once bevacizumab was detected in the fellow eye of an animal model after unilateral injection, the possible influence on fellow eye conversion rate into neovascular ARMD was questioned. Although comparative studies have not found statistically significant differences between drugs regarding the incidence of symptomatic CNV in the fellow eye during treatment, we observed, on a retrospective 36-month evaluation, a reduced incidence of symptomatic CNV in the fellow eye that might be explained by the consistent systemic exposure of bevacizumab.
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Affiliation(s)
- Daniel Constantin Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
- ‘Retina Center’ Eye Clinic, 700126 Iasi, Romania
| | - Daciana Elena Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Crenguta Ioana Feraru
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
- ‘Retina Center’ Eye Clinic, 700126 Iasi, Romania
| | | | - Andreea Moraru
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihail Zemba
- Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Florian Balta
- Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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5
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Ochinciuc R, Balta F, Branisteanu DC, Burcea M, Zemba M, Ochinciuc U, Barac R. Subretinal alteplase injections in massive subretinal hemorrhage due to age-related macular degeneration: A case report series. Exp Ther Med 2020; 20:208. [PMID: 33123237 PMCID: PMC7588788 DOI: 10.3892/etm.2020.9338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
This report describes a series of cases with massive subretinal hemorrhage (SRH) due to age-related macular degeneration (AMD) treated by subretinal alteplase injections. In all cases, the surgical technique consisted in 25-gauge pars plana vitrectomy (PPV) and alteplase injection under the retina using a 38-gauge cannula. After the fluid-gas exchange, bevacizumab injection was performed in all patients. Three cases of SRH in which this technique was used, as well as their evolution at one week and one month postoperatively are described. Visual acuity was hand motion in all three cases at presentation. After surgery, a significant anatomical and functional improvement was noted in all cases. One month postoperatively, none of the patients had blood under the macula, and visual acuities significantly improved to 0.8, 0.2 and 0.16 (decimal fraction). A consistent reduction of central retinal thickness was observed on optical coherence tomography (OCT) from the first week postoperatively. No intra and postoperative complications were noted. Subretinal alteplase injection proved as a viable solution in these severe SRH with early presentation. There was no need to change the systemic anticoagulant and antiaggregant therapy. Bevacizumab intravitreal injection at the end of surgery has an important role in preventing further bleeding.
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Affiliation(s)
- Radu Ochinciuc
- Department of Ophthalmology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Florian Balta
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Marian Burcea
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihail Zemba
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Uliana Ochinciuc
- Department of Ophthalmology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Ramona Barac
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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6
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Moraru AD, Costin D, Moraru RL, Branisteanu DC. Outcomes of simultaneous vs. sequential pars plana vitrectomy and cataract surgery. Exp Ther Med 2020; 20:183. [PMID: 33101473 PMCID: PMC7579769 DOI: 10.3892/etm.2020.9313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
The coexistence of cataract and vitreoretinal diseases is common in clinical practice. The technological achievements of the last decade in both types of surgeries, allow simultaneous interventions on lens and retina. This retrospective study assessed the morphofunctional results obtained after performing simultaneous surgeries in a series of 87 patients presenting with both pathologies. The cases were retrospectively reviewed from their clinical records from 2017 to 2019. The patients were divided into two groups: group 1 comprising 41 cases underwent the combined procedure and group 2 comprising 46 patients underwent vitrectomy, followed by cataract surgery after 3-10 months. The functional and anatomical outcomes and the complications were assessed pre- and post-operatively. The statistical analysis was carried out by MaxStat software. The final best corrected visual acuity (BCVA), in group 1 was <0.1 in 4.88% of the cases, 0.1 to 0.3 in 17.07%, 0.3 to 0.5 in 51.22% and >0.5 in 26.83% eyes. In group 2, the final BCVA, after both surgeries were completed was <0.1 in 8.7% cases, 0.1 to 0.3 in 30.43%, 41.3% were 0.3 to 0.5 and 19.57% were >0.5. During the cataract surgery, the most common intraoperative complication was miosis, followed by posterior capsule rupture. Postoperative, 12.2% cases from group 1 developed an immediate inflammatory reaction in the anterior chamber, and 17.07% presented with posterior capsular opacification (PCO). Simultaneous surgery is safe and effective in obtaining a good morphological and functional result and offers the advantage of a clear eye media that allows a safer vitrectomy and thus a quicker rehabilitation of the patient. The analysis of the risks and benefits of each procedure should be taken into account and the cases selected individually for either simultaneous or sequential surgery in order to obtain the best outcomes.
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Affiliation(s)
- Andreea Dana Moraru
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Department of Ophthalmology, 'N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Dănuț Costin
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,Department of Ophthalmology, 'N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Radu Lucian Moraru
- Department of Otorhinolaryngology, 'Transmed Expert' Medical Center, 700011 Iași; 4'Retina Center' Eye Clinic, 700126 Iași, Romania
| | - Daniel Constantin Branisteanu
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.,'Retina Center' Eye Clinic, 700126 Iași, Romania
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7
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Moraru AD, Costin D, Moraru RL, Costuleanu M, Brănișteanu DC. Current diagnosis and management strategies in pachychoroid spectrum of diseases (Review). Exp Ther Med 2020; 20:3528-3535. [PMID: 32905090 PMCID: PMC7464929 DOI: 10.3892/etm.2020.9094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 12/25/2022] Open
Abstract
This review presents a systematic analysis of the literature regarding the pachychoroid disease spectrum nomenclature, diagnosis criteria and therapeutic options. Pachychoroid related diseases are a new concept, introduced into the ophthalmological nomenclature in 2013 and evolving both as concept and as classification since then. The six disorders included in this phenotype have some common characteristics (thick choroid, pachyvessels, attenuation of the choriocapillaris), but also show individual features. The classification of the pachychoroid spectrum was revised many times, with the recent addition of the focal choroidal excavation (FCE) and peripapillary pachychoroid syndrome (PPS). As the terminology is developing, so is the number of case reports and case series from the initial report in 2013 to 57 reports in 2019. This review takes into account both the current literature and the clinical experience of the authors, emphasizing the understanding of the pathogenesis and aiming to update the therapeutic options available.
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Affiliation(s)
- Andreea Dana Moraru
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,Department of Ophthalmology, 'Prof. N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Dănuț Costin
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,Department of Ophthalmology, 'Prof. N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Radu Lucian Moraru
- Department of Otorhinolaryngology, 'Transmed Expert' Medical Center, 700011 Iaşi, Romania
| | - Marcel Costuleanu
- Department of Physiopathology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Daniel Constantin Brănișteanu
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,'Retina Center' Eye Clinic, 700126 Iași, Romania
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8
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Moraru AD, Costin D, Moraru RL, Branisteanu DC. Artificial intelligence and deep learning in ophthalmology - present and future (Review). Exp Ther Med 2020; 20:3469-3473. [PMID: 32905155 PMCID: PMC7465350 DOI: 10.3892/etm.2020.9118] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/30/2020] [Indexed: 02/06/2023] Open
Abstract
Since its introduction in 1959, artificial intelligence technology has evolved rapidly and helped benefit research, industries and medicine. Deep learning, as a process of artificial intelligence (AI) is used in ophthalmology for data analysis, segmentation, automated diagnosis and possible outcome predictions. The association of deep learning and optical coherence tomography (OCT) technologies has proven reliable for the detection of retinal diseases and improving the diagnostic performance of the eye's posterior segment diseases. This review explored the possibility of implementing and using AI in establishing the diagnosis of retinal disorders. The benefits and limitations of AI in the field of retinal disease medical management were investigated by analyzing the most recent literature data. Furthermore, the future trends of AI involvement in ophthalmology were analyzed, as AI will be part of the decision-making regarding the scientific investigation, diagnosis and therapeutic management.
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Affiliation(s)
- Andreea Dana Moraru
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,Department of Ophthalmology, 'N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Danut Costin
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,Department of Ophthalmology, 'N. Oblu' Clinical Hospital, 700309 Iași, Romania
| | - Radu Lucian Moraru
- Department of Otorhinolaryngology, Transmed Expert, 700011 Iaşi; 4'Retina Center' Eye Clinic, 700126 Iaşi, Romania
| | - Daniel Constantin Branisteanu
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iaşi, Romania.,'Retina Center' Eye Clinic, 700126 Iași, Romania
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9
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Tăbăcaru B, Stanca S, Mocanu V, Zemba M, Stanca HT, Munteanu M. Intraoperative flap-related complications in FemtoLASIK surgeries performed with Visumax ® femtosecond laser: A ten-year Romanian experience. Exp Ther Med 2020; 20:2529-2535. [PMID: 32765745 PMCID: PMC7401922 DOI: 10.3892/etm.2020.8907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
Incidence and clinical results of intraoperative flap and interface-related complications were investigated after Femtosecond-LASIK surgery, where flap creation was performed with VisuMax® femtosecond laser. A retrospective 10-year cohort study was conducted including all eyes treated for all refractive errors by Femtosecond-LASIK technique. All the flaps were made by the same refractive surgeon with the VisuMax® (Carl Zeiss Meditec) femtosecond laser. We report the intraoperative flap and interface-related complications in these eyes, also describing their management. The study included 4,032 eyes. Flap and interface-related complications were: opaque bubble layer (OBL) 21.18%, suction loss 1.29%, difficult docking 0.69%, difficult dissection of the flap 0.59%, bleeding from limbal blood vessels 0.35%, de-epithelialization of the flap 0.12%, and interface debris 0.025%. These situations were appropriately addressed, with favorable outcomes. Flap creation is an important step in LASIK surgery. The predictability and safety have improved since the flap incision is assisted by a femtosecond laser, but complications of the flap and interface can still occur during the flap creation. Refractive surgeons should be aware and properly manage any unusual situation.
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Affiliation(s)
- Bogdana Tăbăcaru
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Simona Stanca
- Department of Pediatrics, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Valeria Mocanu
- Department of Ophthalmology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mihail Zemba
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Horia Tudor Stanca
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Mălăescu M, Stanca HT, Tăbăcaru B, Stănilă A, Stanca S, Danielescu C. Accuracy of five intraocular lens formulas in eyes with trifocal lens implant. Exp Ther Med 2020; 20:2536-2543. [PMID: 32765746 PMCID: PMC7401767 DOI: 10.3892/etm.2020.8891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/22/2020] [Indexed: 11/14/2022] Open
Abstract
Accuracy of intraocular lens (IOL) calculation formulas SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II were compared in prediction of postoperative refraction for multifocal and implants using a single optical biometry device. The authors included 88 refractive lens exchange and cataract surgeries, with AcrySof IQ PanOptix implant (Alcon Laboratories, Inc.). All eyes were divided into three groups based on axial length (AL), group 1: <22 mm (14 eyes), group 2: 22-24.5 mm (68 eyes) and group 3: >24.5 mm (6 eyes). The refractive prediction error (RPE) and mean absolute error (MAE) were calculated for 5 different formulas: SRK/T, Hoffer Q, Holladay 1, Haigis and Barrett Universal II. For eyes with the AL between 22 mm and 24.5 mm the greatest percentage of eyes with RPEs within ±0.25 D was 32.4% for Haigis formula, followed by Barrett Universal II, Hoffer Q and Holladay 1 with 29.4%. The percentage of eyes with RPEs within ±0.50 D was 100% only for Barrett Universal II and Holladay 1, 94.1% for SRK/T and 91.2% for Haigis and Hoffer Q. The first and third group with AL <22 and >24.5 mm were too small to have statistical significance due to the reluctancy to use multifocal IOLs on extreme ALs. ANOVA test showed no statistical difference (P=0.166) between the RPEs measured for each formula in this cohort. This study showed no statistical difference between formulas for this trifocal lens implant. There was a tendency for the RPE to be within ±0.25 D for most of the eyes with the Haigis formula, and within ±0.50 D for all the eyes with the Barrett Universal II formula in the group with the AL between 22 and 24.5 mm.
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Affiliation(s)
- Monica Mălăescu
- Department of Ophthalmology, Faculty of Medicine, 'Lucian Blaga' University, 550159 Sibiu, Romania
| | - Horia T Stanca
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdana Tăbăcaru
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adriana Stănilă
- Department of Ophthalmology, Faculty of Medicine, 'Lucian Blaga' University, 550159 Sibiu, Romania
| | - Simona Stanca
- Department of Pediatrics, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ciprian Danielescu
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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11
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Bro T, Derebecka M, Jørstad ØK, Grzybowski A. Off-label use of bevacizumab for wet age-related macular degeneration in Europe. Graefes Arch Clin Exp Ophthalmol 2019; 258:503-511. [PMID: 31889214 DOI: 10.1007/s00417-019-04569-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To analyse current off-label use of bevacizumab for wet age-related macular degeneration (AMD) in Europe. METHODS The study was conducted as a combined survey and literature review. It included the 22 most populous countries in Europe. In each country, ophthalmologists with particular knowledge about off-label treatment responded to a questionnaire. RESULTS Answers were obtained from twenty European countries. The off-label use of bevacizumab for wet AMD greatly differed between nations; the bevacizumab proportion varied from non-existent (0%) to very high (97%). There were also large disparities within single countries (e.g. 0-80%), which were attributable to differences in regional decision-making. Both governmental institutions and national ophthalmological societies expressed highly diverging opinions on the use of off-label treatment. Intravitreal administration of bevacizumab had been a matter of legal dispute in several countries. The question about responsibility for off-label therapy mainly remained unanswered. CONCLUSIONS There was a highly varying utilization of bevacizumab between European countries. Despite an intention of a consistent approach to medical regulations, Europe has not yet reached a professional or political consensus on the ophthalmic off-label use of bevacizumab.
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Affiliation(s)
- Tomas Bro
- Futurum, the Academy for Health and Care in Region Jönköping, Jönköping, Sweden. .,Ögonmottagningen, Höglandssjukhuset, 575 81, Eksjö, Sweden.
| | | | - Øystein Kalsnes Jørstad
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Andrzej Grzybowski
- University of Warmia and Mazury, Olsztyn, Poland.,Institute for Research in Ophthalmology, Poznan, Poland
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12
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Boda D, Caruntu C. Highlights of the 3rd conference of the Romanian Association of Immuno-Dermatology and the 37th conference of the Romanian Society of Immunology held in Bucharest between September 19 and 22, 2019. Exp Ther Med 2019; 18:4953-4955. [PMID: 31798716 PMCID: PMC6880389 DOI: 10.3892/etm.2019.8174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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