Navigation Links
Cancer treatment controls macular edema related to diabetes and to cataract surgery
Date:7/31/2009

SAN FRANCISCO, CA---This month's Ophthalmology, the journal of the American Academy of Ophthalmology, reports on use of bevacizumab (Avastin), to benefit diabetic patients with macular edema as well as people who develop cystoid macular edema after cataract surgery. Bevacizumab is also used to treat some cancers. Another study describes methods that could make cataract surgery safer for diabetic retinopathy (DR) patients. DR is the major threat to vision in working-age people, a problem that will only intensify if cases triple by 2050 as predicted.

New Treatment Succeeds after Laser Fails in Diabetic Patients; Treatment also Controls Cystoid Macular Edema after Cataract Surgery

DR damages the light-sensitive retina at the back of the eye, the area that transmits images to the optic nerve. In type 2 diabetes patients, retinopathy vision loss most often results from macular edema (DME), swelling and thickening of the macula in the retina's center. Laser treatment is usually able to reduce vision loss, but widespread, diffuse DME (DDME) is often resistant to laser and other standard treatments.

Treating DMME with bevacizumab (Avastin), an anti-vascular endothelial growth factor (anti-VEGF) medication that inhibits abnormal blood vessels, was studied in115 patients (139 eyes) by the Pan-American Collaborative Retina Study Group, led by J. Fernando Arevalo, MD, of the Caracas Central Ophthalmologic Clinic, Venezuela. Within one month of the initial intravitreal bevacizumab (IVB) injections, improvement could be detected. By the end of the 24 month follow-up period vision had improved in 51.8 percent of eyes, and 97.1 percent of eyes were either stable or improved. No serious adverse effects occurred.

The Pan-American Collaborative Retina Study Group also reviewed the use of bevacizumab in patients with post-cataract surgery cystoid macular edema (CME) who had not responded to standard treatment. Twenty to 30 percent of all cataract surgery patients develop CME, in which the macula swells as fluid-filled cysts form. Usually the condition resolves without treatment and causes no permanent vision loss, but in a small percentage of patients vision remains worse than 20/40 and treatment is needed. Standard treatments include steroids, non-steroidal anti-inflammatories (NSAIDs), other medications, or surgery.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one IVB injection and followed for 12 months between 2005 and 2007. At the study's outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2 percent) improved and the rest remained stable (27.8 percent). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

"Large, randomized controlled clinical trials are needed to confirm IVB's efficacy and safety in treating these conditions," Dr. Arevalo said. "The results for DMME are very promising and suggest that combining anti-VEGF treatment with laser therapy may prove useful." He added, "Also, once further study is completed, unresolved CME post-cataract surgery should be considered for inclusion as an indication for use of IVB." "

Extra Precautions Needed with Cataract Surgery for DR Patients

Before 1996, retinopathy often developed or progressed rapidly in diabetic patients following cataract surgery. In the past decade the less-invasive phacoemulsification method has reduced cataract surgery complications in general, but the impact on diabetic retinopathy has been unclear. A clinic-based cohort study (2004 to 2006) led by Jie Jin Wang, MMed, PhD, at the Centre for Vision Research, University of Sydney, Australia, followed 169 diabetic patients aged 65 years and older for 12 months post-cataract surgery. Forty-five of these patients had surgery in just one eye.

Overall, DR developed or progressed in about one-third of operated eyes compared with about one-fifth of non-operated eyes. In the 45 patients for whom fellow eye comparisons were made, DR progressed in 35.6 percent of operated eyes versus 20 percent of non-operated eyes. Research on older cataract surgery methods had reported DR progression in 37 to 38 percent of eyes within 12 to 18 months of surgery; phacoemulsification is somewhat less likely to stimulate DR progression, the new study suggests. Dr. Wang cautions that patients who need cataract surgery may simply be at greater risk for DR progression, because both conditions are related to poor control of diabetes. Cataract may be a marker for greater DR severity or increased risk of progression.

"Although our results should not argue against cataract surgery in older people with diabetes, clinicians need to recognize the DR risk, treat active DR preoperativelyfor example, use laser treatment to control macular edemaand closely monitor diabetes and DR after cataract surgery," Dr. Wang said.


'/>"/>

Contact: Mary Wade
mwade@aao.org
415-561-8534
American Academy of Ophthalmology
Source:Eurekalert

Related medicine news :

1. Lung Cancer Alliance Launches Online Early Interventions Resource Center
2. Virus May Affect Survival in Head and Neck Cancer
3. Cancer Survivors Face Tough Road Long After Treatment Ends
4. Texas on Top of Cancer Research: Dallas Regional Chamber Hosts Forum on New $3 Billion Fund
5. Brain Scan May Help Predict Cancer Drug Response
6. Living Green Marketplace Announces the Cancer Care Wellness Box to Bring Comfort to Cancer Patients During Medical Treatment
7. Ritas Squeezes Pediatric Cancer with $451,000 Donation
8. Chinese women join global breast cancer trial
9. AstraZeneca Submits New Drug Applications for ZACTIMA(TM) in Second-Line Advanced Non-Small Cell Lung Cancer
10. National Cancer Coalition Announces Angel Grant Recipients
11. JNCI news brief: Antibody linked to chemotherapy drug inhibits ovarian cancer in lab
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/28/2016)... ... ... a year and a half of planning the Multiple Pathways of Recovery Conference , ... Recovery Conference was held May 2 -4, 2016 at the Mystic Marriott Hotel & ... explore the many pathways individuals use to get into and sustain their recovery. Pathways ...
(Date:5/27/2016)... ... 2016 , ... More than a third of American adults are considered obese, ... has received increased attention in recent years, as an article published May ... loss, most people are familiar with the basic requirements of maintaining a healthy diet ...
(Date:5/27/2016)... ... May 27, 2016 , ... Two director-level employees of Horizon Blue ... Women and Industry (TWIN) 2016 honorees. The award recognizes businesswomen who excel in ... Geri Boone, Director of the MLTSS (Managed Long-Term Services and Supports) Program at Horizon ...
(Date:5/27/2016)... ... ... An influential resource amongst nurses and professionals in the health care world, ... of topics detailing why we appreciate nurses in so many different ways. From exclusive ... being in a major recession to one of the hottest growing professions in any ...
(Date:5/27/2016)... ... May 27, 2016 , ... This campaign aims to ... which we as a society can control and change. , As nearly 795,000 Americans ... 40 seconds within the United States. Plus, with an estimated 129,000 of these people ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... , May 25, 2016  Granger Diagnostics today ... test for wounds and infections. This test ensures ... and select viruses. The test requires only a ... David G. Bostwick , MD, ... to facilitate wound healing: "We are excited to ...
(Date:5/25/2016)... 2016 ReportsnReports.com adds "Chronic ... that provides an overview on therapeutic pipeline of ... stages, therapeutics assessment by drug target, mechanism of ... type, along with latest updates, and featured news ... involved in the therapeutic development for Chronic Cough ...
(Date:5/24/2016)...   , Study met ... and superiority in , Excellent plus ... of the ascending colon   , ... B.V. today announced new positive data from the phase III MORA ... standard 2 litre PEG with ascorbate. The study met both primary ...
Breaking Medicine Technology: