Macular Degeneration: Kovacević D

Kovacević D, Caljkusić-Mance T, Misljenović T, Mikulicić M, Alpeza-Dunato Z. · Department of Ophthalmology, University Hospital Rijeka, Rijeka, Croatia. · Coll Antropol. · Pubmed #19137998 No free full text.

Abstract: The aim of this study is to report short-term effect of the treatment of "wet" ARMD (age-related macular degeneration) with intravitreal bevacizumab (Avastin). Prospective study included 36 patients (36 eyes) with "wet' form of ARMD. All patients were over 60 year old (22 female, 14 male). Changes of macula included minimally classic CNV (choroidal neovascularisation) (24), occult subfoveal CNV (10) and first stage of cicatrial CNV (2). Bevacizumab 1.25 mg was administered intravitreally through pars plana using a 27-gauge needle. Patients had no previous eye treatment. Ophthalmic exam before and after the treatment included: Snellen VA (visual acuity) and examination including measurement of IOP (intraocular pressure), FA (fluorescein angiography) and interview with patients. After 4-6 weeks 28 (78%) patients had significant improvement of VA. Median VA improved from 0.083 to 0.200 (p<0.01). Eight patients (22%) had no significant improvement in VA but three of them reported to see more light. FA showed complete resolution of macular edema in 6 patients (17%), partially resolved in 23 patients (64%) and no change in 7 patients (19%). No systemic side-effect was found. Short-term results suggest that intravitreally administered bevacizumab is well tolerated treatment for ARMD with very high number of patients showing improvement in VA.

Kovacević D, Misljenović T, Njirić S, Mikulicić M, Vojniković B. · Department of Ophthalmology, University Hospital Rijeka, Rijeka, Croatia. · Coll Antropol. · Pubmed #19140270 No free full text.

Abstract: The pathogenesis of age-related maculopathy (ARM), the most common cause of visual loss after the age of 60 years, involves a variety of hereditary and environmental factors. When the cataractous lens is removed and replaced by clear intraocular lens, a significant increase in ocular transmittance of optical radiation occurs. The aim of this study was to assess whether cataract surgery in older persons may increase the risk for development of ARM. This is a retrospective study. Medical records of 307 patients, aged 43 to 96 years, (163 male and 144 female) were randomly evaluated. They had undergone cataract extraction (phacoemulsification or extracapsular lens extraction) with clear intraocular lens implantation from January 2001 to December 2005 at the Department of Ophthalmology, University Hospital Rijeka. Patients were examined two weeks after surgery and followed up for at least two years. Based on the exclusion criteria, only patients without any sign of AMD at the first postoperative check up were included. A total of 80 patients (26%) showed development of ARM at the last check up, which was at least 2 years after surgery. Our results indicate that pseudophakia is a risk factor for development of ARM.

Vojniković B, Kovacević D, Njirić S, Coklo M. · Eye Polyclinic Dr. B. Vojniković, Rijeka, Croatia. · Coll Antropol. · Pubmed #18756880 No free full text.

Abstract: In the north Croatian Adriatic area in the period of seven years (from January 2001 to September 2007) 475 patients (39 to 80 years of age) with dry form of age related macular degeneration (AMD) were diagnosed. Complete ophthalmologic examination with special reference to visual field testing (Perimetric analysis) was performed. Peripheral visual field defects were found in 85% of patients. Elderly patients with more advanced forms of macular degeneration had more peripheral visual field defects. In 400 patients corticosteroid therapy (5 mg Prednisolonacetate, anterior H-inject, Winthorp) was administered via parabulbar injections every day/five days. Control group consisted of 75 patients treated with regular polyvitamine therapy (Lutein, Beta Karoten, Vitamin E). Patients treated with corticosteroids had peripheral visual field improvements from 10 to 25 degrees and central field improvements from 5 to 20%. In the control group treated with vitamins, central visual field showed improvements from 0.5 to 1% in 43 patients but without peripheral visual field improvements after 6 months.