Navigation Links
Cancer treatment controls macular edema related to diabetes and to cataract surgery

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
American Academy of Ophthalmology

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:
(Date:11/25/2015)... ... 2015 , ... The McHenry County law firm of Botto Gilbert Lancaster, ... Francisco J. Botto and Alex C. Wimmer. Attorneys Botto and Wimmer represented the claimant ... (2d) 130884WC. , According to court documents, Adcock testified that on May 10, 2010 ...
(Date:11/25/2015)... ... ... SCOTTSDALE, AZ) - Today, Dr. Todd C. Hobgood ... non-surgical treatments, announced the expansion of his private practice capabilities with the grand ... trained and nationally recognized for his natural approach, Dr. Todd Hobgood serves the ...
(Date:11/25/2015)... ... November 25, 2015 , ... In an ongoing Clinical Study conducted ... in Chicago, IL, UV Angel is evaluating the efficacy of its product and its ... units (totaling 30 beds) from May 2014 through October 2015 at a 360-bed, acute-care, ...
(Date:11/25/2015)... ... November 25, 2015 , ... ... scholarships for people struggling with eating disorders as a result of the $20,000 ... annual event, held at Fox Run Golf Club in Eureka, will help individuals ...
(Date:11/25/2015)... Davie, Florida (PRWEB) , ... November 25, 2015 ... ... PharmaTech LLC has announced that it has undertaken significant expansion of its current ... Florida. The investment is part of PharmaTech’s strategy to increase its manufacturing capacity ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... BOULDER, Colo. , Nov. 24, 2015 /PRNewswire/ ... announced that its Chief Executive Officer, Ron ... Annual Healthcare Conference in New York.  The public ... a webcast on the Array BioPharma website.Event:Piper Jaffray ... OfficerDate:  , Wednesday, December 2, 2015Time:1:30 p.m. Eastern ...
(Date:11/24/2015)... New York , 24. November 2015 ... des Avery Breathing Pacemaker Systems, ist erfreut, ... als Clinical Consultant bekannt geben zu können. ...   --> Foto ... Stockholm (Schweden). Von 1984-1986 war ...
(Date:11/24/2015)... 24, 2015 Avery Biomedical Devices (ABD), manufacturer ... announce the appointment of Anders Jonzon , MD; ... Dr. Jonzon is a Physiologist ... Hospital, Uppsala University, Uppsala and Children,s Hospital, Karolinska, ... a fellow at the Cardiovascular Institute (UCSF). His research ...
Breaking Medicine Technology: