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THE FIRST EXPERIENCE OF USING ANTI-VEGF THERAPY PRIOR TO CATARACT SURGERY IN PATIENTS WITH DIABETIC MACULAR EDEMA

https://doi.org/10.21516/2072-0076-2018-11-3-55-61

Abstract

Purpose: assess the effectiveness of anti-VEGF therapy given prior to cataract phacoemulsification in preventing the progression of diabetic macular edema. Material and methods. The retrospective study included 15 patients (15 eyes) with type 2 diabetes who underwent cataract surgery. Group 1 included 8 patients who received anti-VEGF therapy before surgical treatment. The last injection of aflibercept was performed no earlier than 2 weeks before the surgery, regardless of central retinal thickness (CRT) increase. Group 2 included 7 patients who did not receive anti-VEGF therapy before surgery. All patients received standard presurgical preparation. The changes in visual acuity and CRT were assessed on days 5 and 14 after cataract extraction. Results. On day 5, the mean increase of visual acuity was 0.34 ± 0.05 in Group 1 and 0.275 ± 0.07 in Group 2. The mean CRT decrease was 47 μm in group 1, while group 2 showed a mean CRT increase of 135 μm. On day 14, the visual acuity was 0.49 ± 0.1 higher than the initial value in group 1, whilst in group 2 it was 0.21 ± 0.07 lower than on day 5. The mean CRT decrease was 80 μm in group 1, while group 2 revealed a 165 μm increase of CRT. Conclusion. Anti-VEGF therapy prior to cataract surgery of patients with diabetic macular edema should become mandatory if CRT has increased, regardless of visual acuity, since visual acuity measurement is impossible due to cloudy lens environments. The use of aflibercept in patients with clinically insignificant diabetic macular edema 1 month before the planned cataract surgery ensures a positive result of visual acuity increase and improvement of anatomical parameters. For citation: Malysheva N.A. The first experience of using anti-VEGF therapy prior to cataract surgery in patients with diabetic macular edema. Russian ophthalmological journal. 2018; 11 (3): 55-61 (In Russian). doi: 10.21516/2072-0076-2018-11-3-55-61

About the Author

N. A. Malysheva
Academy-VIP Center for Diagnostics and Treatment, Nizhny Novgorod, Russia
Russian Federation


References

1. Moss S.E., Кlein R., Кlein B. The 14-year incidence of visual loss in a diabetic population. Ophthalmology. 1998; 105(6): 998-1003. doi: 10.1016/S0161-6420(98)96025-0

2. Ando R., Noda K., Namba S., et al. Aqueous humour levels of placental growth factor in diabetic retinopathy. Acta Ophthalmol. 2014(92):e245-246. doi: 10.1111/aos.12251

3. Miyamoto N., de Kozak Y., Jeanny J.C., et al. Placental growth factor-1 and epithelial haemato-retinal barrier breakdown: potential implication in the pathogenesis of diabetic retinopathy. Diabetologia. 2007(50): 461-70. doi: 10.1007/s00125-006-0539-2

4. Bry M., Kivelä R., Leppänen V.M. Vascular endothelial growth factor-B in physiology and disease. Physiol Rev. 2014 Jul;94(3):779-94. doi: 10.1152/physrev.00028.2013

5. Meyer-Schwickerath G.R.E., Schott K. Diabetic Retinopathy and Photocoagulation. Am. J. Ophthalmol. 1968; 66(4):597-603. https://doi.org/10.1016/0002-9394(68)91279-8

6. Aiello L. M., Beetham W. P., Balodlmos M. C., Chazan, B.I., Bradley, R.F. Ruby laser photocoagulation in treatment of diabetic proliferating retinopathy. Preliminary report. Goldberg M.F., Fine S. L., eds. Symposium on the treatment of diabetic retinopathy. US Government printing office. Washington; 1968: 437-65

7. Riaskoff S. Light Coagulation Treatment of Diabetic Retinopathy in the Eye Hospital Rotterdam. Ophthalmologica. 1972; 165:548-550. doi:10.1159/000308560

8. ETDRS Research Group. Photocoagulation for Diabetic Macular Edema. Early Treatment Diabetic Retinopathy Study Report Number 1. Arch Ophthalmic. 1985; 103:1796-806. doi:10.1001/archopht.1985.01050120030015

9. Roider J., Brinkmann R., Wirbelauer C., Laqua H., Birngruber R. Subthreshold (retinal pigment epithelium) photocoagulation in macular diseases: a pilot study. Br. J. Ophthalmol. 2000; 84(1):40-7. http://dx.doi.org/10.1136/bjo.84.1.40

10. Качалина Г.Ф., Павлова Е.С. Субпороговая аргоновая коагуляция сетчатки в лечении очаговой диабетической макулопатии. Офтальмохирургия. 2004; (3):43-6.

11. Gao X., Xing D. Molecular mechanisms of cell proliferation induced by low power laser irradiation. J. Biomed. Sci. 2009; 16:4. doi:10.1186/1423-0127-16-4

12. Roider J., Michaud N.A., Flotte T.J., Birngruber R. Response of the retinal pigment epithelium to selective photocoagulation. Arch. Ophthalmol. 1992; 110(12):1786-92. doi:10.1001/archopht.1992.01080240126045

13. Korobelnik J.F., Do D.V., Schmidt-Erfurth U., et al. Intravitreal Aflibercept for diabetic macular edema. Ophthalmology. 2014; 121:2247-54. doi: 10.1016/j.ophtha.2014.05.006

14. Fauser S., Muether P.S. Clinical correlation to differences in ranibizumab and aflibercept vascular endothelial growth factor suppression times. Br. J. Ophthalmol. 2016 Nov;100(11):1494-1498. doi: 10.1136/bjophthalmol-2015-308264.

15. Papadopoulos N., Martin J., Ruan Q., et al. Binding and neutralization of vascular endothelial growth factor (VEGF) and related ligands by VEGF Trap, ranibizumab and bevacizumab. Angiogenesis. 2012; 15(2):171-85. doi: 10.1007/s10456-011-9249-6

16. Heier J.S., Korobelnik J.F., Brown D.M., et al. Intravitreal aflibercept for diabetic macular edema: 148-week results from the VISTA and VIVID studies. Ophthalmology. 2016; 123(11): 2376-85. doi: 10.1016/j.ophtha.2016.07.032

17. Ziemssen F., Schlottman PG., Lim J.I., et al. Initiation of intravitreal aflibercept injection treatment in patients with diabetic macular edema: a review of VIVID DME and VISTA DME data. Int. J. Retina Vitreous. 2016 Jul 11; 2:16. doi: 10.1186/s40942-016-0041-z

18. Белоусова Н.Ю. Экссудативно-воспалительная реакция глаза в хирургии катаракты: современный взгляд на проблему. Современные технологии в медицине. 2011; 3: 134-41.

19. Pollak A., Leiba H., Bukelman A., Oliver M. Cystoid macular oedema following cataract extraction in patients with diabetes. Br. J. Ophthalmol. 1992; 76(4): 221-4.

20. Henricsson M., Heijl A., Janzon L. Diabetic retinopathy before and after cataract surgery. Br. J. Ophthalmol. 1996; 80(9): 789-93.

21. Kim S.J., Equi R., Brssler N.M. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophtalmology. 2007; 114(5): 881-9. doi:10.1016/j.ophtha.2006.08.053

22. Eriksson U., Alm A., Bjarnhall G., et al. Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls. Graefes Arch Clin Exp Ophthalmol. 2011;249(3):349-59. doi: 10.1007/s00417-010-1484-9

23. Diabetic Retinopathy Clinical Research Network Authors/Writing Committee; Baker C.W., Almukhtar T., Bressler N.M., et al. Macular edema after cataract surgery in eyes without preoperative central-involved diabetic macular edema. JAMA Ophthalmol. 2013;131(7):870-9. doi: 10.1001/jamaophthalmol.2013.2313

24. Laura H.P., Jan S.A.G., Frank J.H.M., Bjorn W. Prevention of CME after cataract surgery. Cataract & Refractive surgery. Today Europe. 2013; 7: 53-5.

25. Балаболкин М.И., Клебанова Е.М., Креминская В.М. Лечение сахарного диабета и его осложнений. Москва: Медицина; 2005.

26. Дедов И.И., Шестакова М.В. Сахарный диабет. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 5-е изд. Приложение к журналу Сахарный диабет. 2011; 3.

27. Mathys K.C., Cohen K.L. Impact of nepafenac 0.1% on macular thickness and postoperative visual acuity after cataract surgery in patients at low risk for cystoid macular oedema. Eye (Lond). 2010 Jan;24(1):90-6. doi: 10.1038/eye.2009.10

28. American Academy of Ophthalmology. Cataract and Anterior Segment Panel. Cataract in the Adult Eye. San Francisco: American Academy of Ophthalmology; 2011.

29. Chae J.B., Joe S.G., Yang S.J., et al. Effect of combined cataract surgery and ranibizumab injection in postoperative macular edema in nonproliferative diabetic retinopathy. Retina. 2014; 34(1):149-56. doi:10.1097/IAE.0b013e3182979b9e

30. Fine J., Fichman R., Grabow. Clear corneal cataract surgery and topical anesthesia. Thorofare: Slack Inc., 1993.


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For citations:


Malysheva N.A. THE FIRST EXPERIENCE OF USING ANTI-VEGF THERAPY PRIOR TO CATARACT SURGERY IN PATIENTS WITH DIABETIC MACULAR EDEMA. Russian Ophthalmological Journal. 2018;11(3):55-61. (In Russ.) https://doi.org/10.21516/2072-0076-2018-11-3-55-61

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ISSN 2072-0076 (Print)
ISSN 2587-5760 (Online)