Anat Loewenstein

Tel Aviv Sourasky Medical Center, Tell Afif, Tel Aviv, Israel

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Publications (233)560.96 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the effect of pupil dilation on biometric measurements and intraocular lens power calculation using the IOLMaster (Carl Zeiss Meditec, Jena, Germany). Prospective observational case series. In this prospective study, two consecutive optical biometry measurements, before and after pupil dilation, were performed using the IOLMaster on 318 eyes, in 214 patients, at the cataract pre-surgery clinic. The parameters compared were axial length (AL), corneal power (mean K), cylinder and the corresponding intraocular lens (IOL) power which was calculated using the SRK/T formula. This study found no statistically significant difference in pre- and post-dilation measurements in AL (0.005, P = 0.476), K (0.001, P = 0.933) or calculated IOL power (0.011, P = 0.609). A statistically significant difference was shown in cylinder measurements pre- and post-dilation (0.102, P < 0.001). This study demonstrates there is no clinically significant effect of pupil dilation on the IOLMaster measurements of axial length, corneal power and corresponding theoretical IOL power calculated using the SRK/T formula. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of ophthalmology. 01/2015;
  • Elad Moisseiev, Anat Loewenstein
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    ABSTRACT: Purpose: To describe a new method for training residents in ophthalmology in performing laser retinopexy around retinal breaks, and its practicality. Methods: The simulator consists of a model eye that can be adjusted to fit any laser instrument, with a retinal break created in it. The retinal breaks are made of paper strips and can simulate tears and holes. The simulator is used with a three-mirror lens and real laser instrument. Results: The simulator creates conditions simulating near-real laser retinopexy and has been used successfully in training 3 novice residents who have never performed this procedure before. Conclusions: This simulator is simple, reusable and inexpensive. We believe it may be a valuable instructional tool in training residents in performing laser retinopexy, shorten their learning curve and improve their efficiency it in. © 2014 S. Karger AG, Basel.
    Ophthalmologica 11/2014; · 1.87 Impact Factor
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    ABSTRACT: Ranibizumab (Lucentis(R)) is a Fab-antibody fragment developed from Bevacizumab, a full-length anti-VEGF antibody. Both compounds are used for treating age-related macular degeneration (AMD). The influence of bevacizumab and ranibizumab on genes involved in signal transduction and cell signaling downstream of VEGF were compared in order to detect possible differences in their mode of action, which are not related to their Fab-antibody fragments.
    BMC Research Notes 09/2014; 7(1):617.
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    ABSTRACT: Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of off-label substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients.
    British Journal of Ophthalmology 09/2014; 98(9):1144-1167. · 2.81 Impact Factor
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    ABSTRACT: The purpose of this four year retrospective study was to compare the anatomical and functional outcomes of complicated retinal detachment (RD) surgery by pars plana vitrectomy (PPV) with and without retinotomy. The main outcome measures were primary anatomical success (defined as retinal re-attachment at the final follow-up after a single operation, with or without silicone in situ), final anatomical success, final best-corrected visual acuity (BCVA) and postoperative complications. Baseline characteristics did not differ between the groups, although there was a borderline significant trend for the retinotomy group to be associated with worse pre-surgical ocular pathology. With a mean follow-up of 18 (±7.8) months, primary anatomical success was achieved in 76.7% (33 of 43) of the retinotomy group eyes vs. 67.8% (40 of 59) of the eyes in the group without retinotomy. Final anatomical success rates for the retinotomy group and no retinotomy group were 100 and 93.2% respectively. The final BCVA was 1.57 LogMAR with retinotomy and 1.38 without retinotomy, an improvement in both groups. The incidence of postoperative complications was similar in the two groups, while the frequency of macular holes was higher in the retinotomy group. A similar degree of improvement in BCVA following both surgeries indicates their similar efficacy and justifies their performance even in complicated eyes in order to improve the patients' quality of life. With neither approach superior to the other, the choice of method should be left to the surgeon.
    Albrecht von Graæes Archiv für Ophthalmologie 08/2014; · 2.33 Impact Factor
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    ABSTRACT: Purpose: To report the long-term outcome of an intravitreal dexamethasone drug delivery system (DEX-DDS) injection for noninfectious uveitic macular edema. Methods: This was a retrospective study of 8 eyes (7 patients). Results: The mean follow-up time was 17.3 months. Macular edema resolved in all eyes at 3.9 weeks (range 1-6.9) postinjection. The central point thickness improved from 612 ± 143 to 250 ± 55 µm (p < 0.05). The mean best corrected visual acuity improved by 0.25 logMAR (p < 0.05) at 3.9 weeks (range 1-6.9) postinjection. In 5 eyes, macular edema did not recur after a mean follow-up of 14.5 months. In 3 eyes, macular edema relapsed after 4.7 months (range 3.6-6.3) and resolved again following further injections. Two eyes developed intraocular pressure elevation, which was well controlled with topical treatment. Conclusions: Intravitreal DEX-DDS injections resulted in resolution of macular edema and visual acuity improvement. Some eyes required repeated injections, but most eyes achieved long-term resolution. No significant complications were noticed. © 2014 S. Karger AG, Basel.
    Ophthalmologica 07/2014; 232(2). · 1.87 Impact Factor
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    ABSTRACT: PurposeThe purpose was to evaluate the pain associated with intravitreal Ozurdex injections, and to compare it with that associated with intravitreal bevacizumab injections.Methods The study included 57 eyes of 57 patients who received an intravitreal Ozurdex injection at our institution. Pain was measured by the visual analog scale (VAS). Additional parameters recorded included age, sex, indication for the injection, number of previous Ozurdex injections in the study eye, presence of diabetes mellitus, and lens status. Data were compared with a 2 : 1 sex- and age-matched control group of 114 patients who received intravitreal bevacizumab injections.ResultsIndications for injection included diabetic macular edema (40.4%) and macular edema secondary to central and branch retinal vein occlusion (28% and 31.6%, respectively). Pain scores on the VAS ranged from 0 to 90, with a mean of 20.8±20.3. There was no significant difference in pain between Ozurdex and bevacizumab injections. Pseudophakia was correlated with increased pain in Ozurdex injections.Conclusions This is the first series evaluating the pain associated with intravitreal Ozurdex injections. Despite a larger needle gauge and tunneled injection technique, intravitreal injection of Ozurdex is not associated with increased pain compared with bevacizumab. This finding may be a potential advantage for Ozurdex, and may serve to improve patient compliance with future long-term treatment protocols.Eye advance online publication, 13 June 2014; doi:10.1038/eye.2014.129.
    Eye (London, England) 06/2014; · 1.97 Impact Factor
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    ABSTRACT: Purpose: To examine the effect of an intravitreal dexamethasone drug delivery system (DEX-DDS) in the treatment of persistent cystoid macular edema (CME) of different etiologies. Methods: Thirty-seven eyes with persistent CME were treated with DEX-DDS and analyzed for changes in best-corrected visual acuity (BCVA) and optical coherence tomography. Eyes were categorized into three groups: diabetic macular edema (DME, n = 14), vein occlusion (n = 15) and uveitis (n = 7). Results: The mean follow-up was 22 ± 6.9 weeks. BCVA improved from 0.62 ± 0.38 to 0.35 ± 0.29 logMAR (p < 0.0001). Central macular thickness decreased by 184 ± 246 µm from baseline (p < 0.0001). In eyes where CME resolved and recurred, the average CME-free period was 11 weeks. The uveitis group showed faster CME resolution (2 weeks) and a longer CME-free period (20 weeks). Similar efficacy was shown for repeat DEX-DDS injections. The safety profile was good. Conclusion: DEX-DDS is beneficial in the treatment of persistent CME. In cases of uveitis, CME resolution is rapid, resulting in the longest effect duration, when compared with other CME etiologies. © 2014 S. Karger AG, Basel.
    Ophthalmologica 06/2014; 232(2). · 1.87 Impact Factor
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    ABSTRACT: To evaluate the onset and duration of improvement in best-corrected visual acuity (BCVA) in eyes treated with dexamethasone intravitreal implant 0.7 mg (DEX implant) for macular edema after branch or central retinal vein occlusion. Post hoc analysis of data from 2 previously reported multicenter, 6-month, randomized sham-controlled clinical trials. Patients received a single DEX implant (n = 427) or sham procedure (n = 426) in the study eye. The primary endpoint was the percentage of eyes with ≥15-letter improvement in BCVA from baseline at postimplant Day 7. The baseline mean BCVA was 20/80. At Day 7, 10.3% of DEX implant-treated eyes versus 4.0% of sham-treated eyes (P < 0.001) had ≥15-letter improvement in the BCVA, and 27.2% of DEX implant-treated eyes versus 10.6% of sham-treated eyes had ≥10-letter improvement (P < 0.001). The mean improvement at Day 7 was 5.3 letters (branch retinal vein occlusion, 5.1; and central retinal vein occlusion, 5.8) with DEX implant and 1.6 letters (branch retinal vein occlusion, 2.3; and central retinal vein occlusion, 0.1) with sham (P < 0.001). The mean time from initial observation of ≥15-letter BCVA gain to the last observation of ≥15-letter BCVA gain was 70 days. Dexamethasone intravitreal implant treatment led to improvement in BCVA compared with sham procedure as early as postimplant Day 7. The duration of ≥3-line improvement was typically 2 to 3 months.
    Retina (Philadelphia, Pa.) 05/2014; · 2.93 Impact Factor
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    ABSTRACT: Purpose To report the long-term outcomes of triamcinolone acetonide–assisted anterior vitrectomy during complicated cataract surgery with vitreous loss. Setting Tel Aviv Medical Center, Tel Aviv, Israel. Design Case series. Methods Consecutive patients who had triamcinolone acetonide–assisted anterior vitrectomy for complicated cataract surgery with vitreous loss between January 2010 and January 2012 were studied. The main outcome measures were the results of the ocular examination and spectral-domain optical coherence tomography of the macula at the last follow-up visit 12 months or more postoperatively. The ocular examination included corrected distance visual acuity (CDVA), intraocular pressure (IOP), and anterior segment and fundus biomicroscopy. Results The study included 15 patients (15 eyes) with a mean age of 71 years (range 50 to 92 years). The mean follow-up was 21 months (range 12 to 29 months). At the last follow-up, the mean CDVA was statistically significantly better than preoperatively (0.24 logMAR ± 0.31 [SD] versus 0.89 ± 0.81 logMAR) (P=.0033); all patients had improved CDVA over the preoperative values. Except for 1 patient with a macular scar, all the patients had a CDVA between 20/40 and 20/20. At last follow-up, 1 patient required 2 IOP-lowering medications that had been used preoperatively as well. The mean IOP was 15.3 ± 2.4 mm Hg. There were no cases of residual vitreous strands in the anterior chamber, inflammatory reactions, triamcinolone acetonide crystals, retinal breaks, retinal detachment, or pseudophakic cystoid macular edema. Conclusion Triamcinolone acetonide-assisted anterior vitrectomy during complicated cataract surgery with vitreous loss was safe and effective. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
    Journal of Cataract and Refractive Surgery 05/2014; 40(5):722–727. · 2.75 Impact Factor
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    ABSTRACT: Purpose: Subthreshold laser treatment of diabetic macular edema (DME) may have less deleterious effects on the photoreceptors than regular continuous wave laser. This study aimed to assess whether subthreshold laser causes a long-term damage to the retinal structures, as demonstrated by spectral-domain optical coherence tomography (SD-OCT), and to evaluate the change in the axial diameter of retinal diabetic microaneurysms following treatment. Methods: A retrospective study of eyes that were diagnosed with non-foveal involving DME and underwent subthreshold laser treatment with the Lumenis Novus SRT system. SD-OCT scans of treated retinal areas, performed prior to treatment and approximately 4 months following treatment, were assessed for changes in the continuity of the photoreceptor (PR) layer, the thickness of the PR-retinal pigment epithelium layer, the retinal thickness at the treatment sites, and the diameter of the microaneurysms. Results: Thirty-one microaneurysms were included in this study. Following treatment, the continuity of the ellipsoid zone of the inner segments of the photoreceptors was confirmed in all but two cases. The thickness of the photoreceptor-retinal pigment epithelium layers was 72.32 ± 7.36 µm and 70.97 ± 7.27 µm prior to and following treatment, respectively (p=0.061). The retinal thickness at the treatment sites decreased from 398.65 ± 57.89 µm to 372.74 ± 60.4 µm (p<0.001). The mean measured diameter of the microaneurysms was 87.32 ± 27.45 µm and 6.68 ± 26.12 µm, respectively (p<0.001). Conclusions: In this study, subthreshold laser treatment for diabetic macular edema has been shown to be safe, as demonstrated by SD-OCT.
    Investigative ophthalmology & visual science 04/2014; · 3.43 Impact Factor
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    ABSTRACT: Background/Aims: Bevacizumab (Avastin), an anti-vascular endothelial growth factor drug, has been successfully used in recent years to treat ocular pathologies, mostly by intravitreal administration. The aim of this study was to investigate the safety and efficacy of topically applied bevacizumab for the treatment of neovascular glaucoma (NVG). Methods: Patients with NVG were treated with topical bevacizumab (25 mg/ml) 4 times daily during 2 weeks. The following parameters were evaluated at baseline and on days 3, 7 and 14: visual acuity, slit-lamp examination, intraocular pressure (IOP), heart rate and systemic blood pressure. Iris neovascularization was documented using slit-lamp color photos at baseline and on day 14. Results: Eight eyes of 8 patients with NVG were evaluated. After the 2-week treatment, mean IOP was lowered from 34.9 mm Hg (SD 12.8) at baseline to 28.8 mm Hg (SD 9.9) on day 14, representing a mean reduction of 6.1 mm Hg (17.5%). Three patients had clinical regression of their iris neovascularization. Ocular adverse events were transient and included mild upper eyelid swelling, mild exacerbation of superficial punctate keratitis and mild corneal epithelial bullae in an already edematous cornea. There were no serious systemic adverse events. Conclusions: Topical application of bevacizumab may lower IOP and result in regression of neovascularization in patients with NVG. © 2014 S. Karger AG, Basel.
    Pharmacology 02/2014; 93(3-4):108-112. · 1.58 Impact Factor
  • Shani Golan, Anat Loewenstein
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    ABSTRACT: Abstract Objective or Purpose: Macular edema (ME) is secondary to various disease processes. It is most commonly seen following venous occlusive disease, diabetic retinopathy, posterior segment inflammatory disease, and vitreomacular traction syndromes. Treatment varies, depending upon the underlying etiology, and has led to varying degrees of success. Advances in vitreoretinal surgical techniques over the years have expanded the list of indications for vitreoretinal surgical treatment. The purpose of this review is to outline the current use of vitreoretinal surgery and highlight the ever-growing indications for surgery in macular edema. Design: This is a comprehensive review, using Medline, of all literature published on vitreoretinal surgery for macular edema secondary to various conditions. Results: Over 450 abstracts were reviewed, and the articles pertinent to our discussion were selected. The search words were "macular edema" and "pars plana vitrectomy" or "surgery." Conclusions: The pathology of the vitreous body is associated with ME in several different conditions, and vitreoretinal surgical techniques can be effective in the management of ME in the majority of them. The ever-expanding new surgical techniques, as well as the new pharmacologic agents used during surgery, show great promise for the future.
    Seminars in ophthalmology 01/2014; · 1.09 Impact Factor
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    Shani Golan, Michaella Goldstein, Anat Loewenstein
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    ABSTRACT: The 12th Euretina Congress Milan, Italy, 6–9 September 2012 The congress provided a chance for retina specialists all over the world to listen and learn from international world-leading experts in retina sharing their experience and knowledge. Main sessions, free paper presentation sessions, instructional courses and wetlabs took place throughout the 4-day meeting. In addition, joint symposia with both ESCRS and WCPOS added an exciting dimension to the program.
    Expert Review of Ophthalmology 01/2014; 8(1).
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    ABSTRACT: To report on the efficacy of macular and optic nerve spectral-domain optical coherence tomography (SD-OCT) in differentiating between long-standing central retinal artery occlusion (CRAO) and nonarteritic anterior ischemic optic neuropathy (NAION). SD-OCT scans of the macula and optic nerve in 24 patients with unilateral optic atrophy secondary to CRAO (12 patients) and NAION (12 patients) were compared both qualitatively and quantitatively for differentiating features. In patients with long-standing CRAO, there was a significantly greater (P < .001) thinning of the macula relative to the fellow uninvolved eye (-59.7 ± 31.8 μm) compared to patients with longstanding NAION (-19.9 ± 8.4 μm) even though both conditions caused a similar (P = .726) degree of peripapillary retinal nerve fiber layer loss (-42.4 ± 18.5 μm and -44.1 ± 12.4 μm, respectively). SD-OCT macular scans can be used as an adjunctive tool for differentiating between longstanding CRAO and NAION. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:38-44.].
    Ophthalmic surgery, lasers & imaging retina. 01/2014; 45(1):38-44.
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    ABSTRACT: Diabetic macular edema (DME) is a highly prevalent cause of vision loss and has a remarkable impact on public health, and on the quality of life of diabetic patients. Even though laser photocoagulation has been the standard of care for decades, a substantial group of patients are unresponsive and fail to improve after laser treatment. Recently, new pharmacological approaches based on the use of intravitreal drugs, such as corticosteroids and anti-vascular endothelial growth factor, have revolutionized the treatment of DME. The use of intravitreal drugs is supported by the improvement in visual acuity reported by several clinical trials and can limit the potentially destructive effects of the laser treatment. Encouraging results also emerged from studies evaluating the use of a combination therapy, or the association of intravitreal drugs and laser treatment. This review aims at providing a brief synopsis of the main investigations regarding the current pharmacological approach to DME. © 2013 S. Karger AG, Basel.
    Ophthalmic Research 12/2013; 51(2):88-95. · 1.56 Impact Factor
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    ABSTRACT: Purpose: Previous reports have demonstrated that the serum levels of vascular endothelial growth factor (VEGF) are reduced after intravitreal injections of bevacizumab. This study aimed to determine the serum levels of ischemia-modified albumin (IMA), a marker of ischemia, and VEGF following intravitreal injections of bevacizumab. Methods: This was a prospective study. Blood samples were drawn prior to injection and at 1, 7, and 30 days after injection. Results: A total of 11 patients participated in this study. Mean serum IMA levels were lower than baseline during follow-up, with statistically significant differences compared to baseline levels at day 1 and day 30 (preinjection: 49.82 ± 15.28 ng/mL; 44.57 ± 12.01 ng/mL, p = 0.007, and 43.71 ± 13.82 ng/mL, p = 0.001, respectively). Mean serum VEGF levels were lower than baseline throughout the follow-up period (from 307.45 ± 273.45 pg/mL at baseline to 159.55 ± 120.68 pg/mL at day 30). Mean serum VEGF levels were significantly lower compared to baseline levels at day 1 and day 7 (147.09 ± 106.08 pg/mL, p = 0.014; 72.91 ± 50 pg/mL, p = 0.011, respectively). Conclusions: In this study, mean serum IMA and VEGF levels were lower following intravitreal bevacizumab injections.
    European journal of ophthalmology 12/2013; · 1.06 Impact Factor
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    ABSTRACT: Background/Aims: Bevacizumab (Avastin), an anti-vascular endothelial growth factor drug, has been successfully used in the recent years to treat ocular pathologies, mostly by intravitreal administration. The aim of the current study was to assess the off-label topical use of high-dose bevacizumab for the treatment of corneal neovascularization. Methods: Seventeen eyes of 17 patients with corneal neovascularization secondary to various pathologies were included. The patients were treated with topical bevacizumab (25 mg/ml) 4 times daily for 2 weeks. The following parameters were evaluated at baseline and on days 3, 7 and 14: visual acuity, slit-lamp examination, intraocular pressure, heart rate and blood pressure. Color photos were obtained at baseline and on day 14. Results: Eleven eyes (65%) demonstrated regression of corneal neovascularization and/or clearing of corneal opacification. Adverse ocular events were mild and transient, and included eyelid swelling/chalazion and superficial punctate keratitis. Conclusion: Treatment with high-dose topical bevacizumab (25 mg/ml) was effective for corneal neovascularization in nearly two thirds of the eyes treated. Adverse ocular side effects were mild and transient. © 2013 S. Karger AG, Basel.
    Pharmacology 12/2013; 92(5-6):310-314. · 1.58 Impact Factor
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    ABSTRACT: Topical bevacizumab is a potential treatment modality for corneal neovascularization, and several recent studies have demonstrated its efficacy. No previous study of the pharmacokinetics of topical bevacizumab has been performed in human eyes. The purpose of this study is to investigate the pharmacokinetics of topical administration of bevacizumab in human eyes, and also to compare the pharmacokinetics of intravitreal bevacizumab injections with previously reported data. Twenty-two (22 eyes) were included in this study, and divided into four groups: eight patients received topical bevacizumab and aqueous samples were obtained 1 hour later during cataract extraction surgery (group 1), eight patients received topical bevacizumab and vitreous samples were obtained 1 day later during pars-plana vitrectomy (PPV) (group 2), three patients received intravitreal bevacizumab and vitreous samples were obtained during PPV (group 3). Vitreous samples from three patients who received no bevacizumab served as controls (group 4). All samples underwent enzyme-linked immunosorbent assay to detect bevacizumab. No bevacizumab was detected in the aqueous or vitreous of any topically treated eyes. The mean vitreal half-life for intravitreally injected bevacizumab was 4.9 days in four non-vitrectomized eyes and 0.66 days in one previously vitrectomized eye. Topically administered bevacizumab does not penetrate the cornea into the anterior chamber and vitreous cavity, indicating that topical use for treating corneal neovascularization has minimal risk of intraocular penetration and adverse events related to intraocular vascular endothelial growth factor inhibition. The half-life following intravitreal bevacizumab injection measured in this study is comparable to that of previous reports, and includes the first demonstration of a significantly reduced half-life following intravitreal injection in a previously vitrectomized eye.
    Albrecht von Graæes Archiv für Ophthalmologie 10/2013; · 1.93 Impact Factor
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    ABSTRACT: Abstract Purpose/Aim of the study: To study changes in retinal blood flow velocity in patients with early and neovascular age-related macular degeneration (AMD). We used the Retinal Function Imager (RFI, Optical Imaging Ltd., Rehovot, Israel), a noninvasive diagnostic approach for measuring blood flow velocity. Materials and Methods: Sixty eyes of 43 AMD patients and 53 eyes of 35 healthy individuals over the age of 50 were recruited for this study. All patients were scanned by the RFI with analysis of blood flow velocity of secondary and tertiary branches of arteries and veins. Differences among groups were assessed by mixed linear models. Results: The average velocity in AMD patients was significantly lower compared to controls in arteries (3.6 ± 1.4 versus 4.3 ± 1.0 mm/sec, p = 0.009) but not in veins (2.6 ± 0.9 versus 3.1 ± 0.6 mm/sec, p = 0.08). When comparing the velocity between low- and high-grade AMD eyes, venous velocity was slower in the high grade AMD eyes only in the "narrow" group of vessels. Conclusions: Decreased blood flow velocity in retinal arteries in patients with AMD was found. Despite the fact that AMD is essentially a choroidal disease, retinal vessels show a functional abnormality, which may suggest that the vascular abnormality in this disease is more generalized.
    Current eye research 10/2013; · 1.51 Impact Factor

Publication Stats

3k Citations
560.96 Total Impact Points


  • 1991–2014
    • Tel Aviv Sourasky Medical Center
      • Department of Ophthalmology
      Tell Afif, Tel Aviv, Israel
  • 1990–2014
    • Tel Aviv University
      • Department of Ophthalmology
      Tell Afif, Tel Aviv, Israel
  • 2013
    • Centre Hospitalier Intercommunal Creteil
      Créteil, Île-de-France, France
  • 2010–2012
    • Wills Eye Institute
      Philadelphia, Pennsylvania, United States
    • Meir Medical Center
      Kafr Saba, Central District, Israel
    • University of California, Irvine
      • Department of Ophthalmology
      Irvine, CA, United States
  • 2011
    • Sheba Medical Center
      Gan, Tel Aviv, Israel
  • 1993–2008
    • Technion - Israel Institute of Technology
      • Ruth and Bruce Rappaport Faculty of Medicine
      Haifa, Haifa District, Israel
  • 2003
    • Hadassah Medical Center
      • Department of Ophthalmology
      Jerusalem, Jerusalem District, Israel
  • 1997–2000
    • Johns Hopkins Medicine
      • Wilmer Eye Institute
      Baltimore, MD, United States