13.3 Medical Retina – Age-Related Macular Degeneration (AMD)
13.4 Medical Retina - Diabetes
13.5 Medical Retina – Retinal Vein Occlusion (RVO)
13.6 Vitreoretinal Surgery
13.11 Ocular Oncology
Kaiser, P.K. 2006. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: 5-year results of two randomized clinical trials with an open-label extension: TAP report no. 8. Graefes Arch Clin Exp Ophthalmol 244(9) 1132-1142
2001. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization--verteporfin in photodynamic therapy report 2. Am J Ophthalmol 131(5) 541-560.
Brown, D.M., Michels, M., Kaiser, P.K. et al. 2009. Ranibizumab versus Verteporfin Photodynamic Therapy for Neovascular Age-Related Macular Degeneration: Two-Year Results of the ANCHOR Study. Ophthalmology 116(1) 57-65.e55.
Kaiser, P.K., Brown, D.M., Zhang, K. et al. 2007. Ranibizumab for Predominantly Classic Neovascular Age-related Macular Degeneration: Subgroup Analysis of First-year ANCHOR Results. American Journal of Ophthalmology 144(6) 850-857.e854.
Boyer, D.S., Antoszyk, A.N., Awh, C.C. et al. 2007. Subgroup Analysis of the MARINA Study of Ranibizumab in Neovascular Age-Related Macular Degeneration. Ophthalmology 114(2) 246-252.
Chang, T.S., Bressler, N.M., Fine, J.T. et al. 2007. Improved Vision-Related Function After Ranibizumab Treatment of Neovascular Age-Related Macular Degeneration: Results of a Randomized Clinical Trial. Archives of Ophthalmology 125(11) 1460-1469.
PRN ranibizumab treatment satisfactory cf monthly
3 induction IVR doses, then monthly f/u & PRN dosing based on OCT
Reduces number of injections from 12 to 5 per year, while maintaining VA
Lalwani, G.A., Rosenfeld, P.J., Fung, A.E. et al. 2009. A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study. Am J Ophthalmol 148(1) 43-58.e41.
Abraham, P., Yue, H. and Wilson, L. 2010. Randomized, double-masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER study year 2. Am J Ophthalmol 150(3) 315-324.e311.
No difference in rate of endophthalmitis and arterial thromboembolic events in 0.5 vs 0.3mg IVR group or frequency of injection use. Increased risk of stroke if prior history of stroke
Boyer, D.S., Heier, J.S., Brown, D.M. et al. 2009. A Phase IIIb study to evaluate the safety of ranibizumab in subjects with neovascular age-related macular degeneration. Ophthalmology 116(9) 1731-1739.
Larsen, M., Schmidt-Erfurth, U., Lanzetta, P. et al. 2012. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month MONT BLANC study results. Ophthalmology 119(5) 992-1000
Kaiser, P.K., Boyer, D.S., Cruess, A.F. et al. 2012. Verteporfin plus ranibizumab for choroidal neovascularization in age-related macular degeneration: twelve-month results of the DENALI study. Ophthalmology 119(5) 1001-1010.
Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, Jaffe GJ. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011 May 19;364(20):1897-908. doi: 10.1056/NEJMoa1102673. Epub 2011 Apr 28. PMID: 21526923; PMCID: PMC3157322.
Progression of AMD 5 years:
AREDS formulation: Beta-carotene, Vitamin C, Vitamin E, Zinc, Copper
25% risk reduction for development advanced AMD for categories 3 & 4
Group, A.-R.E.D.S.R. 2001. A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E, Beta Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss: AREDS Report No. 8. Archives of Ophthalmology 119(10) 1417-1436.
AREDS2 formulation: Lutein, Zeaxanthin, Vitamin C, Vitamin E, Zinc, Copper
Adding Omega 3 or lutein + zeaxanthin to AREDS → no additional benefit
Beta-carotene for smokers = more lung Ca
Replace AREDS beta-carotene with lutein + zeaxanthin → slightly better than AREDS alone
If deficient diet, lutein and zeaxanthin were more effective Reduced dose of Zinc → no change
Group*, T.A.-R.E.D.S.R. 2013. Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial. JAMA 309(19) 2005-2015.
Wolf, S., Balciuniene, V.J., Laganovska, G. et al. 2014. RADIANCE: a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia. Ophthalmology 121(3) 682-692.e682.
Koh, A., Lai, T.Y.Y., Takahashi, K. et al. 2017. Efficacy and Safety of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial. JAMA Ophthalmol 135(11) 1206-1213.
Lee, W.K., Iida, T., Ogura, Y. et al. 2018. Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy in the PLANET Study: A Randomized Clinical Trial. JAMA Ophthalmology 136(7) 786-793
Ohji, M., Takahashi, K., Okada, A.A. et al. 2020. Efficacy and Safety of Intravitreal Aflibercept Treat-and-Extend Regimens in Exudative Age-Related Macular Degeneration: 52- and 96-Week Findings from ALTAIR : A Randomized Controlled Trial. Adv Ther 37(3) 1173-1187.
Dugel, P.U., Koh, A., Ogura, Y. et al. 2020. HAWK and HARRIER: Phase 3, Multicenter, Randomized, Double-Masked Trials of Brolucizumab for Neovascular Age-Related Macular Degeneration. Ophthalmology 127(1) 72-84.
All rights reserved. No part of this publication which includes all images and diagrams may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the authors, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.
Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.