Provider: - Institution: - Data provided by Europeana Collections- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain ...Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Uvod:Degeneracija makule u svezi s dobi (AMD) je najčešći uzrok gubitka vida u ljudi
starijih od 50 godina u zemljama razvijenog ...svijeta, od čega najveći udio morbiditeta pripada
neovaskularnom obliku bolesti. Aktualne metode liječenja, inhibitori djelovanje čimbenika
rasta vaskularnog endotela (antiVEGF) te fotodinamska terapija verteporfinom (PDT),
ograničenog su funkcionalnog učinka te zahtijevaju dugotrajnu primjenu.
Cilj:Utvrditi bi li kombinacija liječenja intravitrealno primjenjenog bevacizumaba
(antiVEGF) i PDT-a povećala učinkovitost liječenja u odnosu na monoterapiju
bevacizumabom uz poboljšanje najbolje korigirane vidne oštrine (BCVA) i/ili manji broj
intravitrealnih reaplikacija uz produženje perioda remisije.
Ispitanici i metode: U studiju je uključeno 210 pacijenata sa neovaskularnom AMD praćenih
tijekom 2006-2009.g. Početna BCVA mjerena je u logMAR (logaritam minimalne kutne
rezolucije) jedinicama, a središnja fovealna debljina (CFT) mjerena je optičkom koherentnom
tomografijom (OCT). Pacijenti su uzorkovani u 2 jednake skupine:105 pacijenata u skupinu
(KOMB) liječenu inicijalnom kombinacijom PDT-a i intravitrealno primjenjenog
bevacizumaba (1,25mg/0,05ml), te 105 pacijenata (BEV) inicijalno liječenih samo
intravitrealno primjenjenim bevacizumabom (1,25mg/0,05ml). Tijekom perioda praćenja
svakih 6 tjedana u ukupnom trajanju od 3 godine, određivani su BCVA i CFT te je dodatno
intravitrealno primjenjivan bevacizumab u obje skupine počevši od 12. tjedna nakon inicijalne
terapije i to u slučaju aktivnosti bolesti ili recidiva. Dobiveni BCVA i CFT nakon 1., 2. i 3.
godine praćenja uspoređivani su sa početnim vrijednostima unutar svoje skupine pojedinačno
te između skupina KOMB i BEV. Uspoređen je također broj primjenjenih intravitrealnih
aplikacija bevacizumaba na navedenim kontrolnim periodima praćenja između obje skupine. Rezultati:101 pacijent u KOMB skupini i 100 pacijenata u BEV skupini kompletiralo je
period praćenja od 1 godine, 91 pacijent (KOMB i BEV) tijekom 2 godine i 82 pacijenta
(KOMB) i 80 pacijenata (BEV) tijekom 3 godine. Početne vrijednosti BCVA i CFT između
skupina nisu se statistički razlikovale. Nakon 3 godine praćenja u obje skupine pacijenata
došlo je do značajnog poboljšanja (p<0,01) BCVA u odnosu na početnu vrijednost: za 0,132
logMAR (KOMB) i 0,116 logMAR (BEV) tijekom 1. godine; za 0,092 logMAR (KOMB) i
0,096 logMAR (BEV) tijekom 2. godine; za 0,091 logMAR (KOMB) i 0,106 logMAR
(BEV) tijekom 3.godine. Također je došlo do značajnog smanjenja CFT (<0,01) za 55
mikrona (KOMB) i 50 mikrona (BEV) tijekom 1. godine; za 57 mikrona (KOMB) i 53
mikrona (BEV) tijekom 2. godine; za 52 mikrona (KOMB) i 60 mikrona (BEV) tijekom
3.godine. U međusobnoj usporedbi tijekom korespondentnih intervala praćenja tijekom1.,2. i
3. godine ovo poboljšanje nije dovelo do značajne razlike u BCVA niti u CFT između KOMB
i BEV skupina. Tijekom 1. godine u KOMB skupini primjenjeno je prosječno 3,36 injekcija, a
u BEV skupini 4,26 injekcija što je statistički značajno manje (p<0,0001). Tijekom prve dvije
godine broj primjenjenih injekcija u KOMB skupini bio je 6,68, a u BEV skupini 7,19
(p=0,035). Tijekom tri godine praćenja u KOMB skupini primjenjeno je 9,95 injekcija, a u
BEV skupini 10,4 što nije bilo statističko značajno manje (p=0,143). Tijekom perioda
praćenja zabilježeno je 5 puknuća retinalnog pigmentnog epitela u BEV skupini, 10 odvajanja
stražnje staklovine (PVD) u KOMB, a 12 PVD-a u BEV skupini.
Zaključak: Kombinirano liječenje neovaskularne AMD postiglo je jednako učinkovite
rezultate u poboljšanju BCVA i CFT, uz značajno manji broj intravitrealnih aplikacija
bevacizumaba tijekom prve dvije godine praćenja i jednako dobar sigurnosni profil liječenja.- Introduction: Age-Related Macular Degeneration is a leading cause of severe visual loss in
population over 50 in Western countries with neovascular subtype accounting for the most of
severe cases. Available treatment modalities including Vascular Endothelial Growth Factor
inhibitors (antiVEGF) and verteporfin photodynamic therapy (PDT) are of limited efficiency
and require prolonged treatment.
Aim: To investigate whether PDT combined with intravitreal bevacizumab (antiVEGF)
would result in increased treatment efficiency in comparison to bevacizumab monotherapy in
terms of better best corrected visual acuity (BCVA) and/or reduced need for intravitreal
bevacizumab injections.
Participants and methods: 210 patients included in the study were followed-up from 2006-
2009. Baseline BCVA was measured in logMAR units (logarithm of minimal angle
resolution), and central foveal thickness (CFT) was determined by optical coherence
tomography (OCT). Patients were randomly assigned to 2 equal groups: at baseline 105
patients in combination group (KOMB) received a single session of PDT combined with
intravitreal bevacizumab (1,25mg/0,05ml), while 105 patients (BEV) received only
intravitreal bevacizumab (1,25mg/0,05ml). During 3 year follow-up period at 6 week intervals
BCVA and CFT were checked and patients retreated with intravitreal bevacizumab starting
from the week 12 post initial therapy, in case of persistent leakage or leakage reoccurrence.
The BCVA and CFT results obtained at 1, 2 and 3 year intervals were compared to baseline
values within groups and between groups at the corresponding follow-up intervals. Number of
required intravitreal injections was also compared between groups at the corresponding
follow-up intervals. Results:101 patients in KOMB group and 100 patients in BEV group completed the 1 year
follow-up, 91 patients in (KOMB and BEV) completed 2 year follow-up, and 82 patients
(KOMB) and 80 patients (BEV) completed 3 year follow-up. There was no statistical
difference in BCVA and CFT at baseline between groups. At 3 year follow-up a significant
improvement in BCVA (p<0,01) compared to baseline was observed within both groups:
0,132 logMAR (KOMB) and 0,116 logMAR (BEV) increase at 1 year; 0,092 logMAR
(KOMB) and 0,096 logMAR (BEV) increase at 2 years; 0,091 logMAR (KOMB) and 0,106
logMAR (BEV) increase at 3 years. A significant decrease in CFT was also observed within
both groups (<0,01): 55 microns (KOMB) and 50 microns (BEV) decrease at 1 year; 57
microns (KOMB) and 53 microns (BEV) at 2 years; 52 microns (KOMB) and 60 microns
(BEV) at 3 years. These improvements did not result in statistically significant difference in
BCVA and CFT between groups at corresponding follow-up intervals at 1, 2 and 3 years.
During first year a total of 3,36 injections was given in KOMB group which was significantly
less (p<0,0001) when compared to total number of 4,26 injections given in BEV group.
During first 2 years a total number injections given in KOMB group was 6,68 and in BEV
group 7,19 (p=0,035). During the 3 year period 9,95 injections were given in KOMB group
while 10,4 injections were given in BEV group (p=0,143). 5 retinal pigments epithelium rips
were noted in BEV group, 10 posterior vitreous detachments were observed in KOMB and 12
in BEV groups.
Conclusion: PDT combined with intravitreal bevacizumab has resulted in non-inferior visual
treatment outcome to bevacizumab monotherapy with significantly smaller number of
required intravitreal injections during first 2 years of treatment. Safety profile was comparable
between groups.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain ...Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain ...Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain ...Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain ...Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Cilj istraživanja: S obzirom da su vaskularizacija i vezivna proliferacija ključni faktori nastanka komplikacija u pacijenata koji ...su zadobili perforativnu ozljedu oka i u pacijenata sa dijabetičnom retinopatijom, cilj ovog istraživanja bio je utvrditi postoji li povišenje VEGF‐a (odgovornog u stimuliranju angiogeneze) kod navedenih bolesti.
Ispitanici i metode: U ispitivanje je bilo uključeno 56 pacijenata. Prvu grupu ispitanika činili su pacijenti sa proliferativnom dijabetičnom retinopatijom (n=36); od toga 20 pacijenata sa dijabetes melitusom tipa I i 16 pacijenata sa dijabetes melitusom tipa II. Njima je za vrijeme operativnog zahvata vitrektomije uziman uzorak staklovine u kome je određivana količina VEGF‐a i njegovih receptora (VEGFR1 i VEGFR2).
Drugu grupu ispitanika činili su pacijenti sa perforativnom ozljedom oka kojima je za vrijeme operacije obrade rane uzimana očna vodica u kojoj je određivana količina VEGF‐a.
Uzeti humani materijal analiziran je komercijalnim ELISA testom, a rezultati su međusobno uspoređeni i statistički obrađeni.
Rezultati: U staklovinama pacijenata sa PDR‐om i dijabetes melitusom tipa I pronađeno je značajno više VEGF‐a (432,23 pg/ml) nego u grupi pacijenata sa PDR‐om i dijabetes melitusom tipa II(147,53 pg/ml) i kontrolnoj skupini (63,26 pg/ml). U staklovinama pacijenata sa PDR‐om i dijabetes melitusom tipa I osim samog VEGF‐a pronađeno je značajno više VEGFR1 (1460,41 pg/ml) nego u pacijenata sa PDR‐om i dijabetes melitusom tipa II (641,39 pg/ml). U staklovinama pacijenata sa PDR‐om i dijabetes melitusom tipa I pronađeno je značajno više VEGFR2 (1054,64 pg/ml) nego u pacijenata sa PDR‐om i dijabetesom melitusom tipa II (448,49 pg/ml). U očnim vodicama pacijenata sa perforativnom ozljedom i izraženim znakovima upale pronađena je značajno veća količina VEGF‐a (887,77 pg/ml) nego u pacijenata bez znakova upale (27,92 pg/ml). U očnim vodicama pacijenata sa perforativnom ozljedom i ranom većom od 2 mm pronađena je veća količina VEGF‐a (760,06 pg/ml) nego u pacijenata sa ranom manjom od 2 mm (219,48 pg/ml), iako razlika nije bila statistički značajna. U očnim vodicama pacijenata sa perforativnom ozljedom i ozlijeđenim samo prednjim segmentom nije pronađena značajno veća količina VEGF‐a (552,13 pg/ml) nego u pacijenata u kojih su ozlijeđena oba segmenta (518,52 pg/ml). U očnim vodicama pacijenata sa perforativnom ozljedom i dolaznom vidnom oštrinom manjom od 0,1 nije pronađena značajno veća količina VEGF‐a (549,96 pg/ml) nego u pacijenata sa dolaznom vidnom oštrinom većom od 0,1 (525,44 pg/ml). U očnim vodicama pacijenata sa perforativnom ozljedom gdje je od ozljede do obrade rane proteklo više od 4 sata pronađena je značajno veća količina VEGF‐a (948,27 pg/ml) nago u pacijenata gdje je proteklo od ozljede do obrade rane manje od 4 sata (212,92 pg/ml). U očnim vodicama pacijenata sa perforativnom ozljedom i intrabulbarnim stranim tijelom pronađena je veća količina VEGF‐a (671,26 pg/ml) nego u pacijenata bez intrabulbarnog stranog tijela (161,52 pg/ml), iako razlika nije bila statistički značajna.
Zaključak: Dobiveni rezultati ukazuju da primjena anti‐VEGF terapije ima smisla u dijabetičara sa PDR‐om i to više u pacijenata sa dijabetes melitusom tipa I,a osobito u onih sa neovaskularnim glaukomom. U pacijenata sa perforativnom ozljedom koji imaju izražene znakove upale, ranu veću od 2 mm, te intrabulbarno strano tijelo i u kojih je od ozljede do obrade rane prošlo više od 4 sata tkđ. ima smisla primijeniti anti‐VEGF terapiju.- Objectives: It is known that vascularisation and proliferation have a main role in complications in patients with open globe eye injury and in patients with prolipherative diabetic retinopathy. We studied the roles of VEGF and its receptors in the development of vascularisation and proliferation in patients with PDR and open globe eye injury. We determined the quantity of VEGF and its receptors in the ocular fluids in patients with open globe eye injury and in patients with PDR in DM I and DM II.
Patients and Methods: The study included 56 patients from the Department of Ophthalmology, University Hospital Rijeka from January 2006 to January 2008. The first group consists of 36 patients with PDR (20 patients with DM I and 16 patients with DM II). During the surgery the sample of vitreous was taken out to obtain the VEGF, VEGFR1 and VEGFR2 levels. The second group consists of 20 patients with open globe eye injury in which were aqueous humor taken out, during surgery to obtain VEGF levels. VEGF levels in ocular fluid were assayed by ELISA.
Results: The mean VEGF levels in the vitreous were significantly higher in diabetics with PDR and diabetes melitus I (432,23 pg/ml) than in diabetics with PDR and diabetes melitus II (147,53 pg/ml) and in control group (63,26 pg/ml). The mean VEGFR1 levels in the vitreous were significantly higher in diabetics with PDR and diabetes melitus I (1460,41 pg/ml) than in diabetics with PDR and diabetes melitus II (641,39 pg/ml). The mean VEGFR2 levels in the vitreous were significantly higher in diabetics with PDR and diabetes melitus I (1054,64 pg/ml) than in diabetics with PDR and diabetes melitus II (448,49 pg/ml). In the aqueous humor VEGF levels were significantly higher in patients with open globe eye injury and uveitis (887,77 pg/ml) than in patients without uveitis (27,92 pg/ml). In the aqueous humor VEGF levels were higher but not significantly in patients with open globe eye injury and wound bigger than 2 mm (760,06 pg/ml) than in patients with open globe eye injury and wound less than 2 mm (219,48 pg/ml). In the aqueous humor in patients with open globe eye injury and injured anterior segment was not found a significant bigger quantity of VEGF(518,52 pg/ml) than in patients with injured both segments (552,13 pg/ml) In the aqueous humor in patients with open globe eye injury and incoming vission less than 0,1 was not found a significantly higher quantity of VEGF (549,96 pg/ml) than in patients with incoming vission more than 0,1 (525,44 pg/ml)
In the aqueous humor VEGF levels were significantly higher in patients with open globe eye injury where from injury to surgery passed more than 4 hours (948,27 pg/ml) than in patients where from injury to surgery passed less than 4 hours (212,92 pg/ml).
In the aqueous humor VEGF levels were higher, but not significantly in patients with open globe eye injury and intrabulbar foreign body (671,26 pg/ml) than in patients with open globe eye injury without intrabulbar foreign body (161,52 pg/ml).
Conclusion: Findings suggest that anti VEGF therapy has apllication in diabetics with PDR in DM I specially in patients with neovascular glaucoma and in patients with open globe eye injury with uveitis, intrabulbar foreign body, in patients with wound larger than 2 mm and in patients where from injury to surgery passed more than 4 hours.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Nije poznato***- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal ...Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- Nije poznato***- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal ...Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
