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Approach to Retinal Vascular Disease
Published in Anita Prasad, Laser Techniques in Ophthalmology, 2022
Treatment options for retinal vascular diseases include: Laser treatment alone.Anti-VEGF alone.IV steroid injections or implants alone.Laser + anti-VEGF combination therapy.Laser + steroid combination therapyLaser + anti-VEGF + steroid combination therapyLaser + surgery – vitrectomy, clearance of vitreous haemorrhage, ERM peel.Newer laser treatment – multi spot, subthreshold.
Angiogenesis in Hematological Malignancies
Published in Gertjan J. L. Kaspers, Bertrand Coiffier, Michael C. Heinrich, Elihu Estey, Innovative Leukemia and Lymphoma Therapy, 2019
Alida C. Weidenaar, Hendrik J. M. de Jonge, Arja ter Elst, Evelina S. J. M. de Bont
In conclusion, controversial data are published on the topic of ALL cells and angiogenic factors; a better understanding of the complex interaction is needed. Currently, it is not clear what the potential role of therapeutic (i.e., anti-VEGF) interventions in ALL will be.
Pegaptanib sodium therapy
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Lawrence J Singerman, Mithlesh C Sharma, Joan H Hornik
In studies of systemically administered anti-VEGF drugs used at much higher doses to treat cancer, potential systemic adverse effects have included hypertension, proteinuria, and peripheral thromboembolic events.8,9 None of these complications occurred with greater frequency in patients who received pegaptanib sodium; the rates of systemic events were the same in both the treatment and the sham groups.9
Long term outcomes following anti-VEGF therapy for diabetic macular edema
Published in Expert Review of Ophthalmology, 2022
Christopher M. Maatouk, Resya Sastry, Rishi P. Singh
In summary, this review of 21 studies of the long-term outcomes of anti-VEGF treatment for DME found that anti-VEGF treatment produces long-term VA and CRT benefits. Anti-VEGF agents provide longer periods of improved vision than laser or sham with fewer adverse effects and may be more cost-effective than laser treatments for individuals with center-involving DME causing vision loss. However, this review highlights a concern with anti-VEGF treatment, in that patients in real-world settings may not perform as well as their counterparts participating in clinical trials. Emphasis should be placed on the development of more efficient anti-VEGF agents and delivery methods which reduce the number of follow-up visits and treatments that patients require. In conjunction, further exploration of imaging biomarkers for treatment responses and outcomes may lead to more effective monitoring and assist with guiding treatment strategies.
The patients’ view: age-related macular degeneration and its effects – a meta-synthesis
Published in Disability and Rehabilitation, 2022
Anne Thier, Christine Holmberg
Serious side effects from anti-VEGF injections, e.g., eye infections, were not mentioned by patients. Bloodshot and watering eyes, pain, general discomfort and visual distortions were the most reported side effects. With familiarity with the injection procedure, participants developed strategies for the relief of slight side effects: almost all participants needed some rest after the injection, and many would sleep while waiting for the discomfort and visual disturbances to resolve [6,22,29]. The reasons for terminating the therapy, as reported by patients, were: unsuccessful treatment, increasing age, too much effort to organise someone to accompany them to the treatment centre, too much exertion, transportation costs, bad general health, dread of the injection, the burden on relatives or carers, the costs of the treatment, and lack of confidence in the doctor [34]. If treatment was no longer an option for patients, this often felt like a major loss and was not easy to accept [18].
A 5-Year Analysis of Physician-Industry Interactions, Physician Gender, and Anti-VEGF Use in US Ophthalmologists
Published in Seminars in Ophthalmology, 2021
Arjun Watane, Meghana Kalavar, Marissa Patel, Nicolas Yannuzzi, Elizabeth A. Vanner, Ajay E. Kuriyan, Jayanth Sridhar
The choice of anti-VEGF injections has serious implications in healthcare spending in the United States, as these anti-VEGF agents vary greatly in pricing. At approximately $50 per dose, Bevacizumab is significantly less expensive and more cost-effective than the alternatives, which are priced between $1200 and $2000 depending on the drug, dose, and purpose.10,11 Between 2008 and 2015, the use of bevacizumab in patients undergoing treatment for AMD was estimated to save $17.3 billion in Medicare costs.12 Despite this, total spending by Medicare on aflibercept and ranibizumab rose from $2.4 billion in 2013 to $3.5 billion in 2017, which accounted for 14% of the total Medicare spending.13 Therefore, the choice between brand and off-label anti-VEGF medications may be of economic significance, and potential factors associated with this choice should be explored.