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Bilgic A, Kodjikian L, de Ribot FM, Spitzer MS, Vasavada V, Gonzalez-Cortes JH, Sudhalkar A, Chakraborty S, Mathis T. Real-world experience with brolucizumab in neovascular age-related macular degeneration over 2 years: the REBA extension study. Graefes Arch Clin Exp Ophthalmol 2024; 262:1161-1167. [PMID: 38063874 DOI: 10.1007/s00417-023-06329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/05/2023] [Accepted: 11/23/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND To determine long-term efficacy and safety of intravitreal brolucizumab therapy for neovascular age-related macular degeneration (nAMD) in the real-world setting. METHODS Retrospective, observational, multicentric study and an extension of the REBA study (Real-world Experience with Brolucizumab in nAMD) to 24 months. The study entailed follow-up of 91 consecutive eyes (67 patients) with nAMD who received brolucizumab therapy and completed 24 months of follow-up. Both treatment-naïve and switch therapy patients were included. All relevant data were collected. The primary outcome measure was changed in best-corrected visual acuity (BCVA) over time. Secondary outcome measures included change in central subfield thickness (CST) and complications. RESULTS The mean (SD) baseline BCVA was 48.4 (3.5) letters and 36.2 (7.1) letters in treatment-naïve group and switch therapy group, respectively. BCVA gain was + 9.2 (3.7) letters (p = 0.01) and + 7.7 (3.4) letters (p = 0.011), respectively. The change in mean (SD) CST has shown a significant decrease in retinal thickness in treatment-naïve group (from 432.5 (68.4) to 283.0 (51.3) µm; p = 0.018) and in switch therapy group (from 452.5 (40.5) to 271.0 (43.4) µm; p = 0.011) group. One switch patient developed vascular occlusion and another a macular hole after the fifth brolucizumab injection as reported in the primary study. Both patients recovered uneventfully. Three patients demonstrated reversible intraocular inflammation between months 10 and 24. CONCLUSION Patients showed a significant anatomical and functional response to brolucizumab therapy in the real world, regardless of prior treatment status, until the end of the follow-up period. Overall, 5 significant untoward events were noted.
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Affiliation(s)
- Alper Bilgic
- Alphavision Augenarztpraxis, 27568, Bremerhaven, Germany.
- MS Sudhalkar Medical Research Foundation, Baroda, 390001, India.
| | - Laurent Kodjikian
- Service d'Ophtalmologie, Centre Hospitalier Universitaire de La Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69004, Lyon, France
- UMR-CNRS 5510, MATEIS, INSA, Université Lyon 1, Villeurbane, 69100, Lyon, France
| | | | - Martin S Spitzer
- Department of Ophthalmology, University of Hamburg, 20246, Hamburg, Germany
| | | | - Jesus Hernan Gonzalez-Cortes
- Ophthalmology Department, School of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, 64460, Monterrey, Mexico
| | - Aditya Sudhalkar
- Alphavision Augenarztpraxis, 27568, Bremerhaven, Germany.
- MS Sudhalkar Medical Research Foundation, Baroda, 390001, India.
| | | | - Thibaud Mathis
- Service d'Ophtalmologie, Centre Hospitalier Universitaire de La Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69004, Lyon, France
- UMR-CNRS 5510, MATEIS, INSA, Université Lyon 1, Villeurbane, 69100, Lyon, France
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Treviño-Herrera AB, Gonzalez-Cortes JH, Gonzalez-Cantu JE, Garza-Chavarria JA, Martinez-Pacheco VA, Bilgic A. Suprachoroidal silicone oil as an intraoperative complication during Pars Plana Vitrectomy: A case report. Int J Surg Case Rep 2023; 108:108441. [PMID: 37393679 PMCID: PMC10382846 DOI: 10.1016/j.ijscr.2023.108441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Complications related to silicone oil tamponade are frequent. There are reports of events related to silicone oil (SO) injection during Pars Plana Vitrectomy (PPV). This case presents the unexpected injection of SO in the suprachoroidal space. The proper management of this complication along with the preventive measures are discussed. CASE PRESENTATION A 38-year-old male presented with a one-week history of decreased vision in his right eye (OD). His visual acuity was hand motion (HM). A late-onset retinal detachment recurrence with proliferative vitreoretinopathy (PVR) in his OD was diagnosed. Cataract surgery and PPV were scheduled. During PPV, a choroidal detachment (CD) secondary to the suprachoroidal injection of silicone oil (SO) was noted. Suprachoroidal SO was identified timely and was managed with external drainage through a posterior sclerotomy. CLINICAL DISCUSSION Suprachoroidal silicone oil injection is a potential complication during PPV. For the management of this complication, the drainage of the silicone oil from the suprachoroidal space through a posterior sclerotomy may be considered as an option. This complication may be avoided by periodically checking the correct position of the infusion cannula during the PPV, by injecting the SO into the vitreous cavity under direct visualization and by using automated injection systems. CONCLUSION Suprachoroidal silicone oil injection is an intraoperative complication that might be avoided by cross-checking the correct position of the infusion cannula and by injecting SO under direct visualization.
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Affiliation(s)
- Alan Baltazar Treviño-Herrera
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico
| | - Jesus Hernan Gonzalez-Cortes
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico; Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico.
| | - Jesus Emiliano Gonzalez-Cantu
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico
| | - Javier Alan Garza-Chavarria
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
| | | | - Alper Bilgic
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
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Gonzalez-Cortes JH, Bilgic A, De Los Santos Polanco J, Treviño-Herrera AB, Sudhalkar A, Gonzalez-Cantu JE, Mohamed-Hamsho J. Spontaneous closure of an idiopathic macular hole after epiretinal membrane development. Am J Ophthalmol Case Rep 2022; 29:101767. [PMID: 36507466 PMCID: PMC9731824 DOI: 10.1016/j.ajoc.2022.101767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/23/2022] [Accepted: 11/28/2022] [Indexed: 12/09/2022] Open
Abstract
Purpose To report non-operative closure of an idiopathic full thickness macular hole (FTMH) spontaneous secondary to the development of a macular epiretinal membrane (ERM). Observations A 68-year-old woman, with no relevant medical history, and a 6-month history of decreased visual acuity in her right eye was diagnosed to have an idiopathic FTMH. The patient refused surgery and the FTMH was followed-up for seven years. The spectral domain optical coherent tomography follow-up showed the evolution of the FTMH and its spontaneous closure after development of an ERM. In the presence of an ERM with vitreo-papillary detachment, it is possible that the centripetal forces involved helped bring together the edges of the macular hole resulting in a possible spontaneous closure. Additionally and separately, the presence of an ERM may act as scaffolding for Muller cell migration and consequent macular hole closure. Conclusions and importance Development of an ERM was followed by non-operative FTMH closure in this specific case. It is important to note, that this is an extraordinary situation in which the patient had a favorable anatomical evolution despite having rejected conventional surgical intervention. Studies aimed at determining the mechanisms and situations in which these cases occur could provide answers that help us make more appropriate decisions. To our knowledge, the present case is the first in the literature to report a spontaneous closure of a FTMH secondary to the appearance and progression of a previously non-existent ERM.
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Affiliation(s)
- Jesus Hernan Gonzalez-Cortes
- Department of Ophthalmology, Autonomous University of Nuevo Leon (UANL), University Hospital and Faculty of Medicine, Monterrey, Nuevo Leon, Mexico,Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
| | - Alper Bilgic
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico,Alpha Vision Augenarzt Praxis, Bremerhaven, Germany,Corresponding author. Alpha Vision Augenarzt Praxis, Buergermeister-Smidt Str. 162, 27568, Bremerhaven, Germany.
| | - Jefther De Los Santos Polanco
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
| | - Alan Baltazar Treviño-Herrera
- Department of Ophthalmology, Autonomous University of Nuevo Leon (UANL), University Hospital and Faculty of Medicine, Monterrey, Nuevo Leon, Mexico
| | - Aditya Sudhalkar
- Alpha Vision Augenarzt Praxis, Bremerhaven, Germany,MS Sudhalkar Medical Research Foundation, Baroda, India
| | - Jesus Emiliano Gonzalez-Cantu
- Department of Ophthalmology, Autonomous University of Nuevo Leon (UANL), University Hospital and Faculty of Medicine, Monterrey, Nuevo Leon, Mexico
| | - Jesus Mohamed-Hamsho
- Department of Ophthalmology, Autonomous University of Nuevo Leon (UANL), University Hospital and Faculty of Medicine, Monterrey, Nuevo Leon, Mexico
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Gonzalez-Cortes JH, Bages-Rousselon Y, Gonzalez-Cantu JE, Mohamed-Hamsho J. Minimally Invasive Surgery for the Removal of Posterior Intraocular Foreign Bodies. J Ophthalmic Vis Res 2017; 12:236-240. [PMID: 28540021 PMCID: PMC5423383 DOI: 10.4103/jovr.jovr_109_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This is a prospective clinical assay that included six patients who were diagnosed with penetrating corneal injury, traumatic cataract, and posterior segment intraocular foreign body (IOFB). Following anterior segment repair and extraction of traumatic cataract by clear cornea phacoemulsification, a standard 25-gauge transconjunctival pars plana vitrectomy was performed to find and release the IOFB. With active suction using a 25-gauge silicone tipped cannula, the foreign body was retrieved and safely placed in the anterior chamber. After stabilization of the anterior chamber with viscoelastic injection, IOFB extraction through the main phaco incision was easily performed, followed by placement of an intraocular lens. Of the six patients, 66.6% showed a significant improvement of visual acuity. No complications associated directly with the surgical procedure occurred. Our surgical technique is a safe alternative for handling and removing a posterior IOFB. There was no need for a scleral incision.
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Affiliation(s)
| | - Yunuen Bages-Rousselon
- Department of Ophthalmology, Hospital Dr. Jose Eleuterio Gonzalez, Autonomous University of Nuevo Leon, Mexico
| | | | - Jesus Mohamed-Hamsho
- Department of Ophthalmology, Hospital Dr. Jose Eleuterio Gonzalez, Autonomous University of Nuevo Leon, Mexico
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