[Show abstract][Hide abstract] ABSTRACT: As the intravitreal injection of therapeutic medication plays an increasingly large role in ophthalmology, its implementation continues to be modified and refined. Variations in injection technique are discussed, and the authors combine their clinical and research experience with a review of the literature to propose a recommended intravitreal injection protocol.
Seminars in ophthalmology 05/2011; 26(3):104-13. DOI:10.3109/08820538.2010.541318 · 1.20 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To compare intravitreal bevacizumab (IVB) injection versus macular photocoagulation (MPC) or a combination of intravitreal bevacizumab and intravitreal triamcinolone acetonide (IVB/IVTA) injection in improving visual acuity (VA) of patients with primary diabetic macular oedema (DMO).
The following databases were searched: Medline (1950 - December week 3, 2009), The Cochrane Library (Issue 4, 2009), EMBASE (up to 24 December 2009), and the TRIP database (up to 23 December 2009), using no language or other limits. Randomized controlled trials were included that consisted of patients with primary DMO (not with refractory DMO), those comparing IVB injection with MPC or IVB/IVTA injection, those reporting VA outcomes, and those having a minimum follow-up of 6 weeks.
In the four randomized clinical trials comparing IVB injection with MPC, IVB injection demonstrated significantly greater improvement in VA at 6 weeks, but not at 12 weeks. In the three randomized clinical trials comparing IVB injection with IVB/IVTA, IVB injection demonstrated greater improvement in VA at 6 weeks but the benefit was again no longer significant at 12 weeks. No adjunctive effect of IVTA was demonstrated.
Intravitreal bevacizumab injection is effective in improving VA in patients with primary DMO for 6 weeks, but the benefits are no longer present 12 weeks following the injection.
[Show abstract][Hide abstract] ABSTRACT: This systematic review assesses the effectiveness of intravitreal bevacizumab (IVB) versus a comparison group in the treatment of branch retinal vein occlusion (BRVO)-associated macular edema, and explores its effects on visual acuity (VA) and central macular thickness (CMT).
The authors searched the following databases: Medline (1950-October week 3, 2011), The Cochrane Library (Issue 10, 2011), EMBASE (up to 24 October 2011), and the TRIP Database (up to 24 October 2011), using no language or other limits. Trials that were included consisted of patients with BRVO-associated macular edema, those comparing a 1.25 mg IVB injection with a comparison group, those reporting both VA and CMT outcomes, and those having a minimum follow-up of 4 weeks.
In the four trials comparing IVB with a comparison group, IVB was effective in improving VA and CMT values in the long-term (12 weeks) in patients with BRVO-associated macular edema. Furthermore, statistically significant improvements in VA in the short-term (4 weeks) could also be seen.
Clinicians should use this review as an indicator that IVB is effective in improving VA and CMT values in the long-term in patients with BRVO-associated macular edema. It is important to note, however, that statistically significant improvements in VA in the short term could be seen. This review's main aim was to serve as an evidence base for potentially using other modalities, such as IVB, which seems to be reserved for certain cases.
Albrecht von Graæes Archiv für Ophthalmologie 04/2012; 250(6):787-93. DOI:10.1007/s00417-012-2016-6 · 2.33 Impact Factor
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