Purpose
To evaluate early changes in retrobulbar blood flow following intravitreal injection of anti‐vascular endothelial growth factor (VEGF) agents.
Methods
Ten patients affected by neovascular ...age‐related macular degeneration in 1 eye were enrolled. Five eyes received intravitreal bevacizumab (1.25mg/0.05mL) and 5 eyes aflibercept (2mg/0.05mL). Retrobulbar blood flow was examined by color doppler ultrasonography (Aplio 500, Toshiba Medical System, Tokyo, Japan). Peak systolic velocity (PSV) and resistivity index (RI) was measured from ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) in both injected and uninjected sound eyes, before and 21 days after treatment.
Results
Before and after intravitreal bevacizumab mean retrobulbar blood flow parameters significantly change in PCA: PSV 15.24±3.96 cm/sec vs 12.90±2.63 cm/sec (p=0.0012), RI 0.74±0.02 vs 0.77±0.07 (p=0.009) and in CRA: PSV 14.16±1.8 cm/sec vs 12.29±1.54 cm/sec (p=0.005), RI 0.77±0.03 vs 0.79±0.03 (p=0.029). In the sound fellow eyes, significant changes resulted in PCA: PSV 17.26±3.45 cm/sec vs 13.63±3.3 cm/sec (p=0.003), RI 0.74±0.05 vs 0.79±0.03 (p=0.026). Before and after intravitreal aflibercept measured data significantly change in PCA: PSV 12.8±3.09 cm/sec vs 7.20±0.62 cm/sec (p=0.023), RI 0.68±0.03 vs 0.77±0.03 (p=0.007) and in CRA: PSV 14.28±1.2 cm/sec vs 11.04±0.77 cm/sec (p=0.037), RI 0.73±0.03 vs 0.78±0.05 (p=0.022). In the sound fellow eyes, significant changes resulted in PCA: PSV 12.44±2.89 cm/sec vs 9.18±1.42 cm/sec (p=0.044), RI 0.69±0.05 vs 0.75±0.02 (p=0.028).
Conclusions
Intravitreal injections of bevacizumab and aflibercept significantly reduce ocular hemodynamic parameters both in treated and in untreated eyes. These evidences suggest a possible systemic effect.
“For export only” anti-inflammatory and lightening creams are medicinal products sold in African countries for their skin whitening action. In the last years, Rapid Alerts from European Medicinal ...Regulatory Agencies evidenced the presence of a large number of illegal and counterfeit anti-inflammatory products advertised for their whitening action on black skin in the European market.
These drugs, containing glucocorticoids, are illegally sold in Europe in unauthorized ethno-cosmetics-shops and mainly bought by immigrants.
This paper reports a new RP-LC method for the rapid simultaneous screening of six different active ingredients in anti-inflammatory and whitening products (creams, ointment and suspension): betamethasone dipropionate, dexamethasone, fluocinonide, fluocinolone acetonide, clobetasol propionate, methyl-prednisolone acetate. The method was developed and validated in view of its possible application in quality control laboratories, mainly those appointed to the control of illegal/counterfeit medicinal products. The associated measurement uncertainty was calculated from validation data. The method was then applied to the analysis of whitening products obtained from the Italian illegal market.
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