The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Travis C Porco - One of the best experts on this subject based on the ideXlab platform.
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incidence of presumed silicone oil droplets in the vitreous cavity after Intravitreal bevacizumab injection with insulin syringes
JAMA Ophthalmology, 2017Co-Authors: Rahul N Khurana, Louis K Chang, Travis C PorcoAbstract:Importance Intravitreal bevacizumab is a frequently used antivascular endothelial growth factor medication in the United States, but its off-label use is associated with risks associated with the compounding preparation. Objective To determine the incidence of presumed silicone oil droplets after Intravitreal bevacizumab was prepared in insulin syringes by a compounding pharmacy. Design, Setting, and Participants A retrospective review was conducted of 60 patients who experienced Intravitreal silicone oil droplets in the eye after Intravitreal bevacizumab injections from a single specialist practice from October 1, 2015, to November 30, 2016. Bevacizumab, 1.25 mg/0.05 mL, was delivered in insulin syringes with a 31-gauge needle. Main Outcomes and Measures Small, round clear spheres in vitreous on dilated biomicroscopic retinal examination. Results Over a 14-month period involving 6632 Intravitreal bevacizumab injections, 60 cases (35 [58%] women) of Intravitreal silicone droplets were identified. Mean [SD] age of the patients was 80 [12] years; the population comprised 48 white, 9 Asian, and 3 Hispanic patients. The incidence of silicone oil droplet injections was 0.03% (1 of 3230) from October 2015 to April 2016 and 1.7% (59 of 3402) from May to November 2016 (Fisher exact test, P P Conclusions and Relevance An increase in Intravitreal silicone oil associated with bevacizumab prepared with insulin syringes was documented. Priming the syringe before injection was associated with a lower frequency of this complication. These findings suggest that physicians should counsel their patients on the risk of floaters with Intravitreal bevacizumab preloaded in insulin syringes.
Shunji Kusaka - One of the best experts on this subject based on the ideXlab platform.
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serum concentrations of bevacizumab avastin and vascular endothelial growth factor in infants with retinopathy of prematurity
American Journal of Ophthalmology, 2012Co-Authors: Tatsuhiko Sato, Noriyuki Kuno, Kazuko Wada, Hitomi Arahori, Kenji Imoto, Chiharu Iwahashishima, Shunji KusakaAbstract:Purpose To determine the serum concentrations of bevacizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received Intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after Intravitreal bevacizumab. Design Case series. Methods Eleven infants (4 girls and 7 boys) with ROP were studied. They received 0.25 mg or 0.5 mg of Intravitreal bevacizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP. Serum samples were collected before and 1 day, 1 week, and 2 weeks after the Intravitreal bevacizumab. The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined. Results The serum concentration of bevacizumab before and 1 day, 1week, and 2 weeks after a total of 0.5 mg of Intravitreal bevacizumab was 0 ng/mL, 195 ± 324 ng/mL, 946 ± 680 ng/mL, and 1214 ± 351 ng/mL, respectively. The serum bevacizumab level before and 1 day and 1 week after a total 1.0 mg of Intravitreal bevacizumab was 0 ng/mL, 248 ± 174 ng/mL, and 548 ± 89 ng/mL, respectively. The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a total of 0.5 mg Intravitreal bevacizumab was 1628 ± 929 pg/mL, 427 ± 140 pg/mL, 246 ± 110 pg/mL, and 269 ± 157 pg/mL, respectively. There was a significant negative correlation ( r = −0.575, P = .0125) between the serum concentration of bevacizumab and VEGF when a total of 0.25 mg or 0.5 mg of bevacizumab was injected. Conclusions These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after Intravitreal bevacizumab in ROP patients.
Philip J Rosenfeld - One of the best experts on this subject based on the ideXlab platform.
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predicted biological activity of Intravitreal vegf trap
British Journal of Ophthalmology, 2008Co-Authors: Michael W Stewart, Philip J RosenfeldAbstract:Aim: To compare the Intravitreal binding activity of VEGF Trap with that of ranibizumab against vascular endothelial growth factor (VEGF) using a time-dependent and dose-dependent mathematical model. Methods: Intravitreal half-lives and relative equimolar VEGF-binding activities of VEGF Trap and ranibizumab were incorporated into a first-order decay model. Time-dependent VEGF Trap activities (relative to ranibizumab) for different initial doses (0.5, 1.15, 2 and 4 mg) were calculated and plotted. Results: Seventy-nine days after a single VEGF Trap (1.15 mg) injection, the Intravitreal VEGF-binding activity would be comparable to ranibizumab at 30 days. After injection of 0.5, 2 and 4 mg VEGF Trap, the Intravitreal VEGF-binding activities (comparable to ranibizumab at 30 days) would occur at 73, 83 and 87 days, respectively Conclusion: On the basis of this mathematical model, VEGF Trap maintains significant Intravitreal VEGF-binding activity for 10–12 weeks after a single injection.
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the international Intravitreal bevacizumab safety survey using the internet to assess drug safety worldwide
British Journal of Ophthalmology, 2006Co-Authors: A E Fung, Philip J Rosenfeld, Elias ReichelAbstract:Aim: Off-label Intravitreal injections of bevacizumab (Avastin) have been given for the treatment of neovascular and exudative ocular diseases since May 2005. Since then, the use of Intravitreal bevacizumab has spread worldwide, but the drug-related adverse events associated with its use have been reported only in a few retrospective reviews. The International Intravitreal Bevacizumab Safety Survey was initiated to gather timely information regarding adverse events from doctors around the world via the internet. Methods: An internet-based survey was designed to identify adverse events associated with Intravitreal bevacizumab treatment. The survey web address was disseminated to the international vitreoretinal community via email. Rates of adverse events were calculated from participant responses. Results: 70 centres from 12 countries reported on 7113 injections given to 5228 patients. Doctor-reported adverse events included corneal abrasion, lens injury, endophthalmitis, retinal detachment, inflammation or uveitis, cataract progression, acute vision loss, central retinal artery occlusion, subretinal haemorrhage, retinal pigment epithelium tears, blood pressure elevation, transient ischaemic attack, cerebrovascular accident and death. None of the adverse event rates exceeded 0.21%. Conclusion: Intravitreal bevacizumab is being used globally for ocular diseases. Self-reporting of adverse events after Intravitreal bevacizumab injections did not show an increased rate of potential drug-related ocular or systemic events. These short-term results suggest that Intravitreal bevacizumab seems to be safe.
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short term safety and efficacy of Intravitreal bevacizumab avastin for neovascular age related macular degeneration
Retina-the Journal of Retinal and Vitreous Diseases, 2006Co-Authors: Ryan M Rich, Harry W. Flynn, Philip J Rosenfeld, Carmen A Puliafito, Sander R Dubovy, Janet L Davis, Serafin Gonzalez, William J Feuer, Richard C Lin, Geeta A LalwaniAbstract:PURPOSE To evaluate the safety and efficacy of Intravitreal bevacizumab (Avastin, Genentech Inc.) for the treatment of neovascular age-related macular degeneration (ARMD). METHODS A retrospective review was performed on consented patients with neovascular ARMD receiving Intravitreal bevacizumab therapy. All patients received Intravitreal bevacizumab at baseline with additional monthly injections given at the discretion of the treating physician. At each visit, a routine Snellen visual acuity assessment was performed followed by an ophthalmic examination and optical coherence tomography (OCT) imaging. RESULTS Fifty-three eyes of 50 patients received an Intravitreal bevacizumab injection between May and August 2005. Including the month 3 visit, the average number of injections was 2.3 out of a maximum of 4 injections. No serious drug-related ocular or systemic adverse events were identified. Improvements in visual acuity and central retinal thickness measurements were evident by week 1 and continued through month 3. At month 3, the mean visual acuity improved from 20/160 to 20/125 (P < 0.001) and the mean central retinal thickness decreased by 99.6 microm (P < 0.001). CONCLUSION Off-label Intravitreal bevacizumab therapy for neovascular ARMD was well tolerated over 3 months with improvements in visual acuity and OCT central retinal thickness measurements. While the long-term safety and efficacy of Intravitreal bevacizumab remain unknown, these short-term results suggest that Intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD.
Rahul N Khurana - One of the best experts on this subject based on the ideXlab platform.
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incidence of presumed silicone oil droplets in the vitreous cavity after Intravitreal bevacizumab injection with insulin syringes
JAMA Ophthalmology, 2017Co-Authors: Rahul N Khurana, Louis K Chang, Travis C PorcoAbstract:Importance Intravitreal bevacizumab is a frequently used antivascular endothelial growth factor medication in the United States, but its off-label use is associated with risks associated with the compounding preparation. Objective To determine the incidence of presumed silicone oil droplets after Intravitreal bevacizumab was prepared in insulin syringes by a compounding pharmacy. Design, Setting, and Participants A retrospective review was conducted of 60 patients who experienced Intravitreal silicone oil droplets in the eye after Intravitreal bevacizumab injections from a single specialist practice from October 1, 2015, to November 30, 2016. Bevacizumab, 1.25 mg/0.05 mL, was delivered in insulin syringes with a 31-gauge needle. Main Outcomes and Measures Small, round clear spheres in vitreous on dilated biomicroscopic retinal examination. Results Over a 14-month period involving 6632 Intravitreal bevacizumab injections, 60 cases (35 [58%] women) of Intravitreal silicone droplets were identified. Mean [SD] age of the patients was 80 [12] years; the population comprised 48 white, 9 Asian, and 3 Hispanic patients. The incidence of silicone oil droplet injections was 0.03% (1 of 3230) from October 2015 to April 2016 and 1.7% (59 of 3402) from May to November 2016 (Fisher exact test, P P Conclusions and Relevance An increase in Intravitreal silicone oil associated with bevacizumab prepared with insulin syringes was documented. Priming the syringe before injection was associated with a lower frequency of this complication. These findings suggest that physicians should counsel their patients on the risk of floaters with Intravitreal bevacizumab preloaded in insulin syringes.
Andrew N Antoszyk - One of the best experts on this subject based on the ideXlab platform.
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score study report 7 incidence of Intravitreal silicone oil droplets associated with staked on vs luer cone syringe design
American Journal of Ophthalmology, 2009Co-Authors: Ingrid U. Scott, Neal L Oden, Paul C Vanveldhuisen, Michael S Ip, Barbara A Blodi, Andrew N AntoszykAbstract:Purpose To evaluate the incidence of Intravitreal silicone oil (SO) droplets associated with Intravitreal injections using a staked-on vs luer cone syringe design in the SCORE (Standard Care vs COrticosteroid in REtinal Vein Occlusion) Study. Design Prospective, randomized, phase III clinical trial. Methods The incidence of Intravitreal SO was compared among participants exposed to the staked-on syringe design, the luer cone syringe design, or both of the syringe designs in the SCORE Study, which evaluated Intravitreal triamcinolone acetonide injection(s) for vision loss secondary to macular edema associated with central or branch retinal vein occlusion. Injections were given at baseline and 4-month intervals, based on treatment assignment and study-defined retreatment criteria. Because Intravitreal SO was observed following injections in some participants, investigators were instructed, on September 22, 2006, to look for Intravitreal SO at all study visits. On November 1, 2007, the luer cone syringe design replaced the staked-on syringe design. Results A total of 464 participants received a total of 1,205 injections between November 4, 2004 and February 28, 2009. Intravitreal SO was noted in 141 of 319 participants (44%) exposed only to staked-on syringes, 11 of 87 (13%) exposed to both syringe designs, and 0 of 58 exposed only to luer cone syringes ( P Conclusion In the SCORE Study, luer cone syringe design is associated with a lower frequency of Intravitreal SO droplet occurrence compared with the staked-on syringe design, likely attributable to increased residual space in the needle hub with the luer cone design.
